At least half of adults have a problem with enlarged veins. This common condition is a family problem for many people. Women are at least twice as likely to develop varicose veins as men. Depending on age, 25 to 60% of adults are affected in both sexes.
Enlarged veins do not always look like convex bluish strands; Sometimes varicose veins appear as a thin network of vessels that runs just beneath the surface of the skin. The legs and feet are almost always affected. Visibly swollen and tortuous veins - sometimes surrounded by blocked capillary areas that resemble a spider web or spider veins - are superficial varicose veins. Although they are often painful and disfiguring, they are mostly harmless. When inflammation develops, these veins condense when touched and can impede blood circulation to such an extent that swelling of the ankles, itching, and pain in the affected limb occur.
In addition to the superficial venous network, the legs have an internal or deep venous network. In rare cases, the deep veins of the legs are also affected by varicose veins. These deep varicose veins are usually not visible, but can cause swelling or pain throughout the leg and, most dangerously, promote the formation of blood clots.
To help circulate oxygen-rich blood from the lungs to all parts of the body, the arteries have a thick muscular lining. The surrounding muscles are used to return blood through the venous system, the muscle layer on the vein wall is thin and weak, but the veins are equipped with internal valves that only allow blood flow in one direction - to the heart. The valves are needed toto prevent the backflow of blood.
In varicose veins, the valves do not function properly, causing blood to back up in the vein and making it difficult for the muscles to push the blood "up. " Instead of flowing from one valve to the other, the blood continues to pool inof the vein, which increases venous pressure and further impairs the function of the valves, causing the vein to bulge and become tortuous. Because superficial veins provide less muscle support than deep veins, they are more susceptible to varicose veins.
What contributes to the development of varicose veins?
Any condition that involves excessive strain and pressure on the legs or stomach can lead to varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity, and jobs that require long periods of standing or heavy lifting. Chronic constipation, prostate adenoma that requires straining to defecate and urinate, and in rare cases tumors can cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins because dysfunctional muscles do not pump blood well.
As you age, the likelihood of varicose veins increases as muscles and veins weaken. Previous leg trauma can damage the venous valves and contribute to the development of varicose veins. Genetics also play a role. So if other family members have varicose veins, you are more likely to have it too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it can worsen an existing condition.
Can varicose veins be prevented?
Although genetics play a role in your risk of developing varicose veins, there are things you can do to prevent them:
- Regular physical activity is the best way to strengthen leg muscles, improve blood circulation and control weight by staying in good physical shape. Swimming and water aerobics are believed to have the greatest preventive effect of all forms of fitness;
- Healthy Weight Support; If you are overweight or even obese, losing weight reduces your risk of developing varicose veins because normal weight prevents excessive pressure on the leg veins.
- Avoid tight clothing. Tight clothing can reduce blood flow to the thighs, groin, and legs.
- Avoid wearing high-heeled shoes frequently and for long periods of time as they can impair blood circulation. Shoes with completely flat soles are also undesirable; It is better to choose shoes with low and stable heels or elastic soles, as these are better for blood circulation and also improve the tone of the calf muscles.
- Movement! Prolonged sitting or standing should be avoided to stimulate blood circulation. If your daily routine requires you to be on your feet a lot, consider wearing a daily support jersey. Stretch your legs and exercise as often as possible to improve blood circulation and reduce venous pressure.
- Fight against smoking. Research shows that smoking can contribute to the development of varicose veins.
- During pregnancy you should sleep on your left side and not your back. This reduces the pressure of the uterus on the veins in the pelvic area and even improves the blood supply to the fetus;
- If you have risk factors for developing varicose veins, ask your doctor to choose compression stockings for you - these can be special socks, stockings or tights.
Spider veins and varicose veins
As we age, many of us notice bumpy, bluish stars under the skin or swollen tendons extending down our thighs and calves. These deformed blood vessels occur in 60% of adults over the age of 50.
What are spider veins?
Spider veins are small, winding blood vessels that are visible through the skin. They can be red, purple, or blue in color and most commonly appear on the legs or face.
What are varicose veins?
These are larger blood vessels that have lost their elasticity due to changes in the vein wall, become swollen and take on a tortuous shape. Such veins appear bluish and protrude above the surface of the skin. Varicose veins can occur anywhere, but they most commonly appear on the legs, thighs, and feet.
What causes spider veins and varicose veins?
Healthy veins collect blood from the capillary network and transport it from the periphery to the heart through a system of one-way valves. These valves direct blood flow in the desired direction from the superficial veins to the deeper veins and the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent the backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to pool in the vein. When blood collects in a vein, the pressure increases and the vein wall becomes weaker. This causes the vein to bulge and become twisted. This causes a network of spider veins or varicose veins to form, depending on the caliber of the blood vessel and the degree of swelling.
Who is at risk for varicose veins?
Spider veins or varicose veins of large veins can occur in anyone, but women are twice as likely to suffer from this problem as men. This problem is also familiar to those whose jobs require being on their feet constantly, including nurses, hairdressers, lecturers and teachers. Other factors that trigger the development of varicose veins include age, obesity, pregnancy, injury or surgery to the leg, and a family history of varicose veins.
What symptoms are associated with varicose veins?
Spider veins and/or varicose veins are often more than just an unpleasant cosmetic defect. Varicose veins are a condition that can cause unpleasant symptoms and dangerous complications, especially pain or cramps in the legs, heaviness, throbbing, or tingling. Severely inflamed veins feel hard and restrict blood flow, causing itchy and swollen ankles. In addition, trophic changes in the skin and subcutaneous tissue occur over time, such as thickening, pigmentation, and ulceration.
Complications of varicose veins
Although spider veins and varicose veins affect the appearance of the legs and cause unpleasant symptoms, they rarely pose a serious health risk. However, in some cases, complications can arise that require a visit to the doctor and even hospitalization.
The most common complications of varicose veins are trophic ulcers against the background of long-term venous insufficiency; Such ulcers most often form in the ankle area and heal very poorly. The second common and more dangerous complication of varicose veins is thrombophlebitis - a thickening and inflammation of the vein wall, which in turn can lead to venous thrombosis - a dangerous complication that requires hospitalization and intensive treatment. If thrombosis has developed in the deep venous system, there is a risk of migration of the blood clot, the so-called thromboembolism, and as a result of thrombophlebitis, chronic post-thrombophlebitis disease may develop, which significantly affects the patient's quality of life and performance.
Diagnosis of varicose veins of the lower extremities
Spider veins and varicose veins of the superficial veins are easy to diagnose - a visual examination is sufficient. However, the primary diagnostic complex always includes an ultrasound examination of the deep venous system, since superficially dilated veins may indicate insufficiency of the valves of the deep veins of the lower extremities, which requires a serious treatment approach. During the examination, the doctor always pays attention to the swelling of the ankles, the symmetry of the swelling, if any, the compaction of the venous wall and subcutaneous tissue, changes in skin color, pigmentation, pain and the presence of trophic ulcers.
In most cases, unless they are associated with venous insufficiency, spider veins and varicose veins do not require surgical treatment, but they can be removed for cosmetic reasons. If varicose veins are accompanied by symptoms such as heaviness in the legs, pain, muscle fatigue or cramps, swelling of the ankles, there are treatment recommendations that relieve the symptoms and slow the progression of the disease.
Treatment of varicose veins
Treatment approaches for varicose veins can be conservative and surgical. A phlebologist can make the choice of therapy method based on an examination and examination. The purpose of examining for varicose veins is to determine the stage of the disease and the risk of possible complications. Such an examination includes a thorough examination, ultrasound examination of the veins of the lower extremities and, in some cases, laboratory tests.
Who treats varicose veins?
A phlebologist treats diseases of the veins of the lower extremities. A phlebologist is a doctor with a surgical specialization based on training first in general surgery and then in cardiovascular surgery. Phlebology is a branch of vascular surgery that deals with the research and treatment of diseases and malformations of the venous system. A phlebologic surgeon must be familiar with a wide range of techniques for treating venous disease.
Conservative treatment of varicose veins
Conservative therapy for varicose veins is aimed at slowing down their development and preventing complications. Usually it consists of recommendations on lifestyle changes (weight loss, proper physical activity, elimination of static loads that contribute to the progression of the disease), the selection of compression stockings, the prescription of drugs that strengthen the walls of the venous vessels, and the prescription of aPhysiotherapy course.
Compression jersey – support socks, stockings and tights
The easiest way to prevent varicose veins from progressing is to wear support stockings. Also called compression socks, they improve blood circulation and relieve pain and discomfort in the legs. They are available in pharmacies and medical supply stores. Such stockings are particularly necessary during pregnancy and on long flights.
Lifestyle change can also help prevent the rapid development of varicose veins. First of all, you need to normalize your weight and incorporate physical activity such as walking or swimming into your life. Rule out frequent wearing of high heels, static loads and a sedentary lifestyle.
Drug treatment – There are many medications, both in the form of gels and creams and in the form of tablets, that have a venotonic effect and affect the progression of varicose veins and slow down their development. However, their effect can only be effective in combination with other preventive measures.
Physiotherapy – For varicose veins, both in the early stages and in advanced forms of the disease, pressotherapy is most often used – physiotherapy with compression – sequential compression of the veins with special circular pads, with the pressure spreading from the feet to the hips, improves blood circulation, stimulates the vascular wall and normalizes the function of the venous valves. This treatment is prescribed 2-4 times a year in courses of 10-12 procedures. It is also recommended to carry out treatment after sessions of sclerotherapy and laser therapy for varicose veins. Such physiotherapy can be carried out either independently or in combination with special electrical stimulation of the leg muscles, with the expectation that the therapeutic effect will reinforce each other.
Other situations in which physiotherapy gives good results are trophic changes in the skin caused by advanced stages of varicose veins. In these cases, laser therapy, magnetic therapy, phono- and electrophoresis (→ and other methods) can be prescribed that it is 100% contraindicated to carry out physiotherapy for varicose veins, which is accompanied by thrombosis or thrombophlebitis. Therefore, before carrying out physiotherapeutic procedures, you shouldundergo an ultrasound scan of the veins of the lower extremities.
Surgical and minimally invasive treatment of varicose veins and their complications
Patients, most of whom are women and girls, because varicose veins most often affect the beautiful half of humanity, come to the phlebologist because of the external side of the disease - they are bothered by unsightly spots and cords on their legs. Treatment of varicose veins in this situation usually involves eliminating cosmetic defects. For this purpose, minimally invasive methods of treating varicose veins are used - sclerotherapy and endovenous laser coagulation (EVLC).
The term "minimally invasive" in relation to medical procedures means "little traumatic" and "gentle". In fact, such treatment is carried out on an outpatient basis, causes minimal pain, comparable to a normal injection, and allows excellent results. In this treatment, the inner wallof the vein is destroyed with a drug (sclerosing agent) or a laser, which leads to adhesions of the vessel lumen and the disappearance of the cosmetic defect.
The decision about the treatment method is made by the doctor based on the examination and examination. For complicated varicose veins, surgical treatment is used and is carried out in hospital.