Modern healthcare faces many different challenges, but despite the rapid advances in medicine, there are diseases that continue to affect millions of people. Varicose veins of the lower limbs ICD 10 - I83 is just such a problem that practically cannot be resolved in time.
Distribution in numbers
The disease is widespread in various developed countries, such as the USA, France, Belgium, Germany, etc. The number of patients with this diagnosis is almost a quarter of the population of each country.
Half of all patients are over 55 years old, but the other part are able-bodied workers, most often employed in production. As each CVD disease progresses, complications form, patients lose their jobs due to disability, so the problem becomes not only medical, but also economic and social. The appearance of varicose veins can be related to the age of the patient. In people over 70, varicose veins of the lower extremities are more common than in people before retirement age.
In four out of a hundred patients over the age of 80, varicose veins take on a form aggravated by concomitant pathologies, in the form of trophic ulcers, various dermatitis or eczema. Also, at this age, other diseases of the cardiovascular and bronchopulmonary systems appear, which excludes the possibility of surgical intervention.
important!At the first symptoms of the disease, it is better to consult a doctor; the younger the patient's age, the lower the risks if surgical treatment is required.
Origin of the disease
Despite the fact that the disease progresses gradually, there are still etiological factors for the development of varicose veins.
So what are the causes of varicose veins:
- heredity;
- endocrinological reasons;
- mechanical factor;
- infection;
- intoxication;
- nonspecific inflammatory process;
- factors contributing to venous hypertension.
Complaints and symptoms
Oddly enough, visible disorders appear at the very beginning of the disease, which are often overlooked. Perceiving the defects of the small vessels as an insignificant external disorder that "will disappear by itself", patients provoke the development of the disease.
Additional symptoms develop progressively:
- feeling tired/heaviness in the legs;
- swelling in the leg area;
- night cramps;
- tingling, numbness, "pins and needles" sensation;
- pain in the area of varicose veins.
The diagnosis of varicose veins is an important condition at any stage of the disease
The disease at each stage requires diagnosis, it is the diagnosis that suggests which treatment option is most acceptable for the patient. Clinical and instrumental diagnostic methods are used in tandem. Depending on the course of the disease, all methods or only a part of them can be used.
Clinical Research Methods - Review and Discussion
Clinical methods are used not only for varicose veins, but also for any other disease:
- History taking. The anamnesis includes all the basic data about his life (age, heredity, bad habits, type of main work).
- Definition of Complaints. Complaints may indicate how advanced the varicose veins are by the time of examination. The duration of the disease becomes an important condition. When did the first symptoms of foot disease appear?
- inspection.During the examination, the doctor should pay attention not only to the blood vessels, but also to the condition of the skin in order to rule out the presence of complications and concomitant pathologies. It is also important to determine the degree of damage, the temperature at the site of varicose veins, as well as the tension and elasticity of the vessel.
A phlebologist is the first doctor who should see your feet.
Instrumental research methods are a prerequisite
To prescribe treatment, one examination will not be enough. Varicose veins of the lower extremities require mandatory instrumental diagnostics. With instrumental research methods, foci of varicose lesions, length of the damaged vessel, insufficiency of venous valves, speed of blood flow, etc. are determined.
This:
Ultrasound. A standard B-mode examination gives a complete picture of the anatomical structure and location of the vessel, as well as those adjacent to it. Ultrasound also reveals pathologies of the venous wall.Doppler ultrasound. The study determines the speed of blood flow, thereby identifying the pathologies of the valves in the vessel.X-ray contrast venography . A more complex type of diagnosis using X-rays. The procedure is rarely used due to the possible occurrence of complications.Computed tomography venography . It is performed in the same way as X-ray contrast, with the introduction of a contrast substance into the lumen of the vessel. A CT image, unlike an X-ray, is three-dimensional.MRI. The method is justified and informative and is carried out without the administration of contrast or other drugs. However, this method remains expensive, so it is used extremely rarely.
Note!In patients with an allergy to iodine, contrast agents cannot be administered, in which case an MRI may be necessary.
Diagnosis according to the classification
Like other diseases, varicose veins are divided into classes, taking into account many factors:
| External manifestations |
|
| Cause of the disease |
|
| Anatomical location of veins |
|
| Mechanism of the disease |
|
The most common reason for contact with specialists is the 2nd degree of varicose veins of the lower extremities, when the external manifestations of the disease become significant. Perhaps, if the disease does not manifest itself externally, then the discovery of varicose veins will occur at later stages.
Note!The term "internal varicose veins of the lower extremities" is used only colloquially, which means varicose veins of the deep veins, which can only be diagnosed by instrumental methods.
To treat or not to treat, that is the question
The gradual progression of the disease sooner or later prompts patients to the idea that treatment is necessary. Often the doctor's task is to convince the patient to start treatment in the initial stages of the disease. The direction of treatment can be different and depends on many factors (age, symptoms, degree of the disease, etc. ).
In this way, treatment can be aimed at:
- improving the quality of life; cosmetic surgical interventions.
- prevention of complications; influence on microcirculation.
- eliminate symptoms; hemodynamically significant treatment.
One way or another, the treatment is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, complexity is important, so you cannot limit yourself to only surgical intervention or only therapeutic and preventive physical training. It is important to follow all the doctor's instructions.
Lifestyle tips
Varicose veins oblige patients to abandon the factors that provoke complications. Sometimes such a measure is necessary, since untreated varicose veins significantly worsen the quality of life.
Do-it-yourself treatment is a futile exercise, but you should pay attention to your lifestyle so that varicose veins do not progress so quickly.
What should be done for varicose veins:
- Women should give up high-heeled shoes;
- Give up bad habits, especially smoking;
- Move, if you have to sit or stand for a long time, try to change your position;
- Avoid tight/fitting clothes and shoes;
- Avoid exposure to high temperatures (sunbaths, hot wax, baths, saunas);
- Control your weight;
- Do not lift heavy objects;
- Take a contrast shower;
- Walk, run, swim more often;
- Keep your feet elevated whenever possible (sleep, rest).
Compression therapy
Regardless of the etiology, patients with varicose veins should wear medical hosiery or apply elastic bandages.
- The use of knitwear is the most comfortable, socks or knee socks made of special material most often do not cause discomfort. The degree of compression of medical hosiery should be recommended by a doctor. The only downside to compression clothing is its cost.
Note!The brands of manufacturers of medical knitwear can be different, so you should choose carefully. Make sure the elastic on your socks or knee socks is not too tight.
- Alternatively, patients often prefer to use short, medium or long elastic bandages. The choice of stretch also depends on the stage of the disease and should be recommended by a doctor. The first few uses may be a bit difficult as you will need to control the tension level of the bandage yourself.
Compression therapy is used daily, wearing underwear or bandages significantly relieves the load on the legs throughout the day.
Physical education and sports as treatment
Varicose veins require movement, so therapeutic and preventive physical education is an important component. Of course, it is better not to perform exercises blindly, but to choose a set of exercises with a specialist. Some medical facilities offer group therapy exercises.
Most often, exercise therapy exercises do not require special training and are available regardless of age; for greater clarity, a set of exercises for exercise therapy:
- Tighten and relax the thigh muscles (10 times);
- Inhale, lift the abdominal wall, exhale, pull the stomach (4 times);
- Bend and straighten your legs at the ankle (10 times);
- Inhaling, raise your arms up through the sides, while exhaling, lower them (4 times);
- Bend and straighten the toes (15 times);
- Raise your arms up as you inhale and lower as you exhale.
Even from this small set of exercises, it is clear that everyone can do them, regardless of age. It is important not to rush and do everything at a slow pace without holding or speeding up your breathing.
Athletes can also perform this set of exercises before the main workout. It is especially important if the patient engages in any sport that is not recommended for varicose veins.
Sport, as an alternative to exercise therapy for varicose veins of the lower extremities, is also suitable, but you should consult a doctor and a personal trainer. Some exercises will have to be excluded from training.
Athletes are sometimes simply forced out of their professional careers, especially in jumping, powerlifting and heavyweight boxing. Those who like to swim, run and walk, in turn, can continue to do so.
Medicines, after a doctor's prescription
The goals of pharmacology in the treatment of varicose veins are different, namely:
- improvement of vein tone;
- microcirculation correction;
- improvement of lymphatic drainage;
- prevention of thrombotic complications;
- suppressing the development of complications.
That is why all medicines must be prescribed by a doctor. It is in this sense that there is a guarantee of a successful resolution of the disease.
Drug treatment is used at different stages: in the preparation of the patient for an upcoming operation, in the postoperative period, as well as in obvious contraindications for operation. The drugs can be systemic or local and are used both in tandem and separately.
Phlebosclerosing treatment
Phlebosclerosis also refers to pharmacological treatment methods, but its use is often unjustified, since the positive effect does not apply to all patients. For the most part, the method is used for correction in an aesthetic sense.
It should be noted that the use of this method is fraught with relapses and complications, so the procedure is performed by surgeons who have undergone special training.
Physiotherapy in the treatment of varicose veins
Physiotherapy methods are not the main ones in the treatment of varicose veins, but they are successfully used to alleviate the symptoms of the disease. D'arsonval, electrophoresis, barotherapy, magnetic therapy for varicose veins of the lower extremities are used only under the supervision of a doctor, since any physiotherapy has a number of indications and contraindications.
All physiotherapy procedures are applied not continuously, but in courses of 10-20 days. In most cases, physiotherapy slows down the progression of the disease, but it is not the main method of treatment and certainly cannot be used as monotherapy.
Surgical treatment
Despite the multitude of treatment methods, surgery remains practically the most basic and significant. Vascular surgeons perform successful operations on many patients.
Traumatic venectomies have become a thing of the past with the advent of modern minimally invasive methods. Brunner's approach, Müller's dissection, and mini-phlebectomy with Varadi hooks facilitate the treatment of patients with varicose veins and often proceed within a day.
Of course, there are also contraindications for surgical intervention, the main group being patients over 75 years of age who exhibit tissue trophic disorders, microcirculation disorders and/or lymphatic drainage or excessive lesions of the venous vessels. There are special instructions for performing operations on such patients. Sometimes you have to completely abandon the operation, and sometimes doctors still work through a combined phlebectomy.
Medication treatment
The scheme for the treatment of varicose veins is determined by the doctor. Conservative methods and surgical methods are used for this, it all depends on the stage of development of the disease, as well as the presence of complications.
The simultaneous use of drugs and ointments allows you to relieve the symptoms of the pathology and achieve good results in treatment. Currently, there is a large selection of drugs on the shelves of pharmacies, they are effective in combating pathology in the early stages of development.
Medicinal treatment of varicose veins in the legs is effective.
important!Only a doctor can prescribe drugs, dosage and course of their use.
Sclerotherapy
Sclerotherapy is one of the best methods of treating varicose veins today. Specially applied drugs allow you to destroy the stagnation of the vein inside. After some time, it will begin to stick together and dissolve, and blood circulation will be transferred to healthy veins.
The treatment is carried out in a course that includes up to six sessions for each affected leg. You can notice a positive result no earlier than two weeks. However, patients should be prepared to experience pain and numbness.
Soon the unpleasant symptoms will disappear, the painful veins will disappear. The dosage of the drug is selected taking into account the individual characteristics of the patient.
Complications and side effects are extremely rare. A properly performed procedure gives great chances of recovery.
Echosclerotherapy is the same as sclerotherapy, the difference is the use of an ultrasound scanner. This method is preferable because the movement of the syringe can be monitored and the medicine will be distributed evenly.
Foam sclerotherapy is another type of sclerotherapy. Medicines are applied in the form of microfoam, so the procedure allows you to achieve better results. The thing is that the drug is much closer to the walls of the veins and does not mix with the blood.
Surgical methods of treatment
Surgical treatment of varicose veins is used only if conservative methods do not achieve the desired result. Patients are given local anesthesia and can go home after a few hours.
There are practically no hematomas and no intoxication characteristic of general anesthesia. The obtained result lasts for several years.
Phlebectomy is a type of operation performed in local surgery. Two small incisions are made to remove the affected vein. Sometimes this method can replace sclerotherapy. After only a few weeks, the patient will be able to return to his usual way of life.
Laser treatment is the most gentle treatment method and can only be performed by a qualified specialist. Using an ultrasound scanner, a light guide is inserted into the vein.
The procedure is controlled by special devices. The laser beam causes the plasma to boil, the diseased vein closes and does not participate in blood circulation. The cost of such an intervention is high, so it is not affordable for everyone.
Darsonvalization
With the help of the D'arsonval apparatus, it is possible to normalize blood circulation, as well as to remove congestion in diseased veins. The increased tone gradually decreases, the tone of the veins increases. Patients get relief from pain and itching.
Full circulation of lymph, as well as full blood circulation, allows the tissues to receive adequate nutrition and the amount of oxygen in them increases. Veins narrow or expand, gymnastics can increase their elasticity.
The device moves from bottom to top. Lymph and blood flow from the ankle to the thigh and the congestion stops. To achieve the desired result, you must undergo a full course of treatment, which includes at least twenty procedures.
Home remedies
advice!Varicose veins can also be effectively treated with home remedies.
The most common methods are the use of medicinal herbs. You can buy them at the pharmacy or collect them yourself in the summer.
White acacia
An alcoholic tincture is prepared on the basis of the flowers of the plant. Soak cotton pads with it and wipe the affected areas several times a day.
Wormwood
Gather fresh herbs and grind them in a mortar. Separate a spoonful of herbs and mix them with the same amount of sour cream. Apply the resulting mixture to the affected areas and apply a bandage on top. After two hours, remove the compress. Repeat the manipulations for five days, take a short break and then repeat the course of treatment again.
Kalanchoe
Wash the kalanchoe leaves, place on a paper towel and allow to dry. Chop the leaves and place them in a glass jar. Pour alcohol on top and let it brew for seven days, stirring occasionally. Strain the tincture and rub the diseased veins for several months in a row.
Apple vinegar
Dissolve two tablespoons of vinegar in a glass of water and drink twice a day. It is recommended to rub undiluted apple cider vinegar on the affected areas twice a day. After a month, the veins will begin to diminish.
cream
Grind part of the garlic, add two parts of butter. In its pure form, apply the resulting cream to the sore spots, cover with baking paper on top and apply a bandage. Leave the compress all night, in the morning wash and wrap your feet with an elastic bandage. Repeat the procedures throughout the month.
Garlic
To consolidate the results of the treatment, you can take garlic internally. Mix 250 grams of chopped garlic and 350 grams of honey, let it brew for five days. Take one spoonful three times a day.
tomatoes
Cut a fresh tomato into slices, apply to the problem area and wrap with a bandage. Keep the compress for four hours, then remove it and wash your feet. The duration of the treatment course is two weeks, after which a ten-day break is taken and repeated.
Prevention
It is much easier to prevent a disease than to fight it later, which is why prevention is necessary. If you have a hereditary predisposition to the development of varicose veins, you should pay more attention to your health.
First of all, you need to give up bad habits and follow the recommendations listed above. Your diet should include foods rich in vitamins.
Vitamin E
The vitamin is contained in many foods: lettuce, vegetable oil, legumes. It is necessary to strengthen the walls of the veins, as well as to increase their elasticity. Vitamin C has exactly the same property.
Med
Elastin synthesis is supported by foods rich in copper. Seafood is included here. To maintain your body weight, you need to give up sugary foods.
To prevent the appearance of varicose veins, you must follow the following rules:
- It is not recommended to put a lot of stress on your legs during the day. People who work in a standing position should spend a few minutes per hour in a sitting position. Ideal: take a horizontal position, raise your legs above your head and hold for twenty minutes.
- If you work in a sitting position, you should get up for a few minutes once an hour and spend that time standing. In this way, the speed of blood movement through the veins will increase. Periodically rotate your legs in different directions.
- Lifting heavy objects is not recommended.
- Massage your feet daily with a stream of cool water.
- Do not overdo it with visits to saunas and baths.
Effective methods of treating varicose veins can achieve good results. Patients quickly return to a full life.
How is the disease complicated?
Complications of varicose veins are always unpredictable, although they develop gradually. Without medical supervision and therapeutic treatment, the risk of developing complications becomes many times greater.
Trophic ulcers with ascending and descending varicose veins. Most often, they are located in the lower third of the leg on the inside, but they can also be observed on the outside, although this manifestation occurs quite rarely. The deeper the trophic ulcer, the higher the risk of bleeding.thrombophlebitis. It can appear with any type of varicose veins, the appearance of such a complication directly depends on the coagulation properties of the blood. This complication can be prevented by laboratory monitoring.Eczema. It occurs due to a violation of tissue trophism. Eczema and trophic ulcers can appear both together and separately.Bleeding from varicose veins of the lower extremities. This type of complication can appear against the background of deep trophic ulcers, as described above; such bleeding will be external. Internal (subcutaneous) bleeding is observed with prolonged varicose veins.
What is important to know about varicose veins
Varicose veins become a test for patients, because the more they ignore it, the more aggressive the disease will behave. The course of varicose veins depends not only on the doctor's instructions, but also on how strictly the patient follows them. Varicose veins are a chronic disease, so even after surgery, the treatment often does not end.
What the doctor advises should be done and followed, be it a varicose vein magnet, medication or exercise therapy. This is a complex treatment that gives a positive result and you should not neglect even one, the most insignificant point.