Treatment of varicose veins

Varicose veins (varicose veins) are a very common vascular disease that has been known to people since ancient times.It is mentioned in the papyri of ancient Egypt;A mummy was even unearthed with signs of varicose veins on its legs.Information on pathology can be found in Hippocrates, Galen and Avicenna.Modern doctors also often encounter varicose veins in patients and are looking for effective treatment methods.

The term “varicose veins” is of Latin origin, the word “varix” is translated as “expansion”.For this reason the disease was also called “varicose veins”.In this disease, the peripheral veins increase in volume, become long, tortuous, deformed and nodular.Blood stagnates in the lower parts of the leg because the valves function worse and the walls become weaker.Vascular damage is most often observed in the legs, as the vessels are under the greatest strain, you have to pump large amounts of blood and overcome gravity.

Varicose veins are diagnosed in approximately 17-25% of people.In young people, both boys and girls are equally affected.In mature and elderly women, this pathology occurs two to three times more often than in men of the same age.This is due to constant hormonal changes in the female body that occur throughout life.

How are the veins in the legs arranged?

The legs have two groups of venous vessels: superficial and deep or deep.The first are located in the subcutaneous tissue, that is, on the surface of the leg.The latter lie deeper, in the thickness of the muscles, next to the arteries and tendons.The deep and superficial vessels are connected by perforating or perforating veins.Its wall is made up of collagen and elastin fibers with weak and few smooth muscles.

The vein wall has a three-layer structure:

• At the tip is the adventitia, which consists of loose connective fibers and smooth muscle cells elongated along the walls and is surrounded by small capillaries and nerves that are responsible for the trophism of the vessel.
• In the middle is the media, consisting of circular smooth muscle fibers.
• The intima lies inside.The base of the intima is the endothelium;Between its cells there are longitudinal fibers of smooth muscle.  The inner shell is folded, the thickenings lie opposite each other and resemble swallows' nests or patch pockets.They are called valves and are responsible for the correct direction of blood flow.

Venous valves direct blood from the peripheral parts to the heart and from the superficial to the deep veins.They prevent backflow and increase venous pressure.In addition to the valves, smooth muscles, tendons and leg muscles are also involved in maintaining normal tone.When one of the layers (usually the middle and inner layers) is damaged, the veins lose their tone and expand, forming varicose veins.

There are several superficial veins:

1. The great saphenous vein is located on the inside of the leg;its walls are equipped with several valves;Blood from the anterior surface of the thigh is collected into this vein by a series of smaller vessels.
2. The small saphenous vein is located on the outside of the leg and is equipped with valves.It collects blood from the veins in the front and back of the leg.

The communication between the large and small veins takes place via connecting vessels.

The deep veins are the posterior and anterior tibial veins, the popliteal vein and the femoral vein.  Varicose veins develop in them in advanced stages if the disease is not treated for a long time.

Why do varicose veins occur and who is at risk of developing them?

It's currently difficult to say why people get varicose veins.Only a number of risk factors have been identified, due to which the valves weaken and the elasticity and tone of the walls of the superficial and perforating veins decrease.

Here are the factors that lead to the development of the disease:

• Inheritance.The structure of blood vessel walls is genetically determined;With some changes in the genes, they become weaker and the valves no longer close well.As a result, even the slightest increase in pressure in the veins causes a reverse outflow of blood, the vessels overflow and expand.
• Hormonal changes in women's bodies.  This situation is typical for pregnant women or for the second half of the cycle, when the amount of progesterone increases and estrogen levels decrease.As a result, the rheology of the blood changes (the ability to clot increases), vascular tone decreases, elastin and collagen fibers are destroyed and the risk of blood clots increases.
• Obesity.Overweight people move little, which slows blood circulation in the body.Excess subcutaneous fat on the abdomen leads to increased pressure in the abdominal cavity and compression of the main veins.This leads to blood congestion in the leg vessels and subsequently to varicose veins.
• Diabetes mellitus.Sugar, the level of which increases in this disease, damages the vascular endothelium, which increases the risk of blood clots.
• Alcoholism.When drinking large amounts of alcohol, dehydration occurs, the blood thickens, and blood clots form, blocking small blood vessels and causing constipation.
• Static occupational stress, such asB. Lifting heavy loads, working while standing or sitting.In such a situation, muscle tone decreases, blood flow from the lower extremities to the heart worsens, stagnation occurs and, as a result, the veins in the legs expand.  
• Congenital pathologies of blood coagulation.Hypercoagulation, in which too many factors responsible for the formation of blood clots are produced, leads to thrombosis and obstructs blood flow through the vessels.
• Wrong diet.A diet deficient in a number of vitamins (C, E, PP) and plant fiber leads to disruptions in the structure of the endothelium and other structural elements of the vascular walls.
• Tight underwear.When wearing tight underwear, some veins become pinched, resulting in obstruction of blood flow from the lower half of the body.
• Frequent constipation.People who suffer from this problem have to constantly push, which increases the pressure in the abdominal cavity, making it difficult for blood to drain.
• High heel.Overuse of the calf muscles and inadequate contraction cause blood to stagnate in the veins.
• Hot climate.In summer, the heat causes the body to become dehydrated.If you do not correct the problem by drinking enough fluids, the risk of blood clots in the vessels increases.
• Pathologies of the heart and kidneys.These can be congenital or acquired heart defects or kidney failure.
• Overdose of medications that affect clotting.In this case, the blood vessels may become blocked by blood clots.
• Operation.In this case, the risk of thrombosis increases due to blood loss and vein compression during the procedure.

How can varicose veins be complicated?

• Thrombosis due to blood stasis.
• Vascular thromboembolism as a result of blood clot detachment.
• Thrombophlebitis or inflammation of the vein wall.
• PE (pulmonary embolism).In this case, blood flow in the pulmonary circulation is severely disrupted, which leads to death.Small blood clots can lodge in the small pulmonary arteries and cause a heart attack or pulmonary edema.  
• Trophic ulcers, eczema on the skin of the legs due to tissue malnutrition.When blood circulation is poor, little oxygen and nutrients reach the tissue, which impairs regeneration or leads to massive cell necrosis.
• Edema syndrome.Due to impaired blood outflow and stagnation, fluid enters the intercellular space through the walls of blood vessels.The swelling is soft in consistency, elastic and occurs most often near the affected vein, regardless of the time of day.  
• Dermatitis.The inflammatory process in the skin occurs due to impaired blood circulation and tissue nutrition. 
• Hyperpigmentation, cyanosis of the affected skin areas.
• Solidification of the subcutaneous fatty tissue due to swelling and bleeding.

How to diagnose varicose veins

• The condition of the valves is examined using functional tests (application of a tourniquet).They are named after the authors - Troyanov-Trendelenburg, Pratt, Sheinis, Delbe-Perthes, etc. For the Troyanov-Trendelenburg test, you need to lay the patient horizontally and then offer to raise the leg 450.In this position, the doctor strokes the extremity from the foot upward to drain the superficial veins.The next step is to apply a tourniquet to the upper half of the thigh, after which the patient stands up from the couch.Healthy veins in the legs should fill after 15 seconds.  
• Duplex ultrasound examination of veins (ultrasound angioscanning) provides the most information and allows visualization of the vessels and blood flow through them.
• Dopplerography is a method for assessing blood circulation through vessels.
• Phlebography, or X-ray examination with contrast material, which helps examine the internal structure of the vessel.
• Phleboscintigraphy is a technique in which radioactive substances are used and further examined using a special device to distribute them.

To examine the superficial veins, they are examined and palpated.The first three methods are used as additional examinations.The last two methods are necessary to examine the condition of the deep or deep veins.

Treatment of varicose veins

Conservative treatment options

• Drug therapy does not cure varicose veins, but with the help of drugs, valve function, vascular trophism and blood circulation are partially improved and the risk of thrombosis is reduced.Venotonics are used for this purpose.They can be prescribed for any type of varicose veins.For thrombophlebitis, ointments containing nonsteroidal anti-inflammatory drugs are indicated.Anticoagulants are also used in this situation, which effectively dissolve blood clots.Treatment should be selected by a doctor after a thorough diagnosis and taking into account the patient's characteristics.
• Herbal medicine and additional techniques are of additional value.It is recommended to wear compression socks, do gymnastics, ski, cycle and swim.The "bicycle" exercise in the supine position, flexion and extension of the feet gives good results;it improves blood flow from the extremities.You can do the exercises if there are no complications.  It is also recommended to take a contrast shower in the morning (first water the leg with warm water and then gradually reduce the temperature to cold).  Cool baths with decoctions of oak bark, horse chestnut, chamomile, St. John's wort, rubbing the skin with tincture of white acacia flowers, Kalanchoe leaves and apple cider vinegar help.Leeches help get rid of thrombophlebitis.
• Mode.You need to get out of bed slowly, 5-10 minutes.Your legs should be raised by 10-15⁰ at night;To do this, place a pillow under your heels.You need to walk calmly, it is undesirable to cross your legs while sitting and not to strain yourself.It is recommended that all patients wear compression stockings.
• You need to eat right, include coarse fiber and foods rich in vitamins in your diet.  Citrus fruits, tomatoes, rose hips, black currants, nuts, legumes, liver, onions, eggs and seafood are useful.It is important not to drink alcohol, not to smoke and to drink enough water during the day.If constipation persists, we recommend taking a laxative.

Surgical treatment

Phlebectomy or complete removal of veins

The indication for such a radical operation is varicose veins, which involve a large number of veins.At the same time, complications arise - trophic ulcers that are difficult to treat, thrombophlebitis, persistent swelling of the legs, general symptoms (fatigue, dizziness, fainting).

The operation is contraindicated in ischemic heart disease, severe infections, in very old patients, in the second half of pregnancy, in local inflammation of the legs (erysipelas, pustular rash, eczema).

Only surgery can radically free the patient from varicose veins and restore the function of the valves.If the situation is too severe, untreated and neglected, this method of treatment remains the only one.The disadvantages of the procedure are the need for anesthesia and observation of the patient in the hospital for several days, as well as postoperative trauma with scars.

Laser therapy (endovascular microthermocoagulation)

Treatment of varicose veins with a laser is used when the pathology is associated with diseases of the cardiovascular system (CHI, hypertension), changes in peripheral vessels (phlebitis, thrombophlebitis), diseases of the respiratory system (asthma, chronic bronchitis, pleurisy), pathologies of the gastrointestinal tract (cholecystitis, ulcers, peritonitis), nervous system (chronic injuries, meningitis, encephalitis and their consequences)combined is genitourinary system (inflammation of the kidneys, prostate, pathology of the uterus with appendages), with skin diseases (furunculosis, dermatitis, psoriasis, etc.).

Contraindications to the use of lasers are oncology, decompensated pathology of the kidneys, liver, heart, brain sclerosis and pregnancy.

The main advantages of laser therapy are its effectiveness in eliminating the expansion of superficial veins, speed (duration of manipulation is 15-20 minutes), the need to go to the hospital and low trauma.
Among the disadvantages, the poor accessibility of the technology should be highlighted;Not all clinics have the appropriate equipment.The treatment is expensive and is of little use for severely affected and deep veins.Improper use of the laser can cause thermal burns, and sometimes depigmentation occurs at the sites of exposure.

Radiofrequency coagulation (ablation)

The operation is indicated for extensive lesions of the saphenous veins, trophic ulcers resulting from long-term and untreated varicose veins.

Radiofrequency coagulation is contraindicated in acute thrombophlebitis, limited patient mobility, pregnancy and psychological disorders.

The main advantages of the method are freedom from pain, the absence of injuries and the need for hospitalization.The patients can return to their normal activities the next day.

The disadvantage is the high cost of the procedure.

Sclerotherapy

Indicated for varicose veins of small and large superficial veins (for large vessels, the procedure is carried out under the control of duplex Doppler ultrasound) in the initial stages and without complications.

Pregnant women and nursing mothers, allergies to medications, deep vein thrombosis, and infectious and inflammatory skin changes on the legs are not treated with this method.

The main advantages are low price, quick recovery and no need for hospitalization.The procedure leaves no marks and does not cause any injuries.

The disadvantage is the risk of getting the sclerosing drug into a deep vein, reduced effectiveness when it comes into contact with blood and the possibility of using it only in the initial stages.

Is it possible to cure varicose veins at home?

At home, it is allowed to use auxiliary methods for the treatment of varicose veins that relieve the symptoms.They use ointments from the pharmacy or homemade ones, herbal-based baths and lotions, compresses, drink decoctions and infusions to improve blood circulation and relieve swelling.Below you will find some recipes.

Chestnut tincture

Take about 200g of ripened and peeled chestnuts.Pass through a meat grinder or chop with a blender.Fill everything with a liter of vodka, put it in a dark corner and let it rest for a few weeks.To make the product smell good, add a few drops of peppermint oil.In the evening, grease your legs with the tincture to relieve heaviness and itching, strengthen blood vessels and prevent them from becoming brittle.It is also recommended to make a compress from the tincture.If there is no chestnut, it is replaced with nutmeg, the recipe remains the same.Tincture with musk nuts can be used for more than just rubbing sore feet;It is recommended to drink 20 drops daily.After the bottle is empty, a new tincture is made.However, there should be a break of 2 weeks between taking the next portion.

Calendula based ointment

An infusion is made from marigold flowers - pour a tablespoon of boiling water, put on fire, boil for a few minutes, leave in a thermos for 3 hours.Strain the infusion and add to a little fat;Lanolin, petroleum jelly, badger fat are suitable.For smell, it is recommended to add a drop of aromatic oil (rose, bergamot, citrus, sage, lavender, etc.).Rub the ointment morning and evening with gentle movements from the bottom of the leg to the knee until completely absorbed.Thyme, hop cones and nettle are also added to the marigold infusion.

Chamomile oil

Medicinal chamomile flowers are placed in a half-liter jar of a dark shade so that the container is filled to the top.Pour half a liter of any vegetable oil, for example from olive, corn, hemp.  Let stand for a month, shaking or stirring occasionally.The oil infusion is then filtered.For scent, add a few drops of tea tree, mint, lavender and grapefruit aroma oil.Apply chamomile oil to the foot early in the morning and late in the evening while performing a light massage.You can also make night compresses from the infusion.

Wormwood-based compress

Take a pack of kefir or fermented baked milk and 3 tablespoons of dried wormwood.The grass is crushed and mixed with kefir (ryashenka).If the grass is wet, place it on cheesecloth along with a thick liquid.A compress is then placed on the leg, covered on top with wax paper (cellophane wrap is not used) and everything is fixed with several layers of bandage.  Keep your legs elevated and remove the compress after half an hour.It is recommended to carry out the procedure twice a day.Instead of wormwood, you can take hops, chamomile flowers, string, clover, oak or birch leaves, St. John's wort, horsetail, tricolor violet flowers and yarrow.Combinations of different plants have a good effect.To improve the effect of the compress after the procedure, it is recommended to lie down for some time with your legs elevated.All of the herbs listed can be used as an infusion for a foot bath.The water in such a bath should be warm, the duration of the procedure is about 25 minutes.It relieves fatigue, swelling, relieves skin itching and pain.

Traditional recipes for internal use

Various herbal teas improve blood circulation in the veins.The following herbs are used:

• clover
• successively
• Leaves and berries of cranberries, viburnum, strawberries, raspberries
• Coltsfoot
• Marigold
• Japanese sophora
• Melissa
• Schisandra
• Hawthorn

The grass is dried, then chopped up and made into a mixture of different plant species.Then take 3 tablespoons, pour a liter of boiling water, leave in a thermos overnight and drink 1/3 glass before meals.

Varicose veins can be treated well with bee pollen and honey.Pollen should be consumed internally.Honey can also be eaten, but still works well as a compress.It is recommended to add infusions of various herbs to honey.

Treatment of varicose veins in pregnant women

Carrying a baby is accompanied by a hormonal storm and overload in the female body, which often provokes varicose veins.Treatment during this period is conservative with local creams, ointments and gels.

The most effective ointments have a decongestant effect and eliminate feelings of heaviness in the limbs. Apply in a thin layer from bottom to top with gentle massaging movements.The frequency of manipulations is 1-3 times a day.

Folk remedies also help.It is recommended to prepare baths with herbal decoctions (from chamomile, thyme, hop cones, calendula, wormwood, coltsfoot, oak bark, birch leaves, etc.).

You can combat swelling by applying cabbage leaves or raw grated potatoes to your feet.You need to cover the compress with wax paper or regular thick paper, not cellophane, to allow the skin to breathe.The procedure is carried out before bedtime and the lotion is left on overnight.

Doctors also prescribe medications for internal use to pregnant women.There are venotonics that do not negatively affect the development of the fetus and the health of the mother.They are mostly based on plant extracts.

After taking the medication, the tone of the veins increases, the walls become elastic, they no longer stretch as much, the lymphatic flow improves, the liquid part of the blood no longer flows into the intercellular space and the swelling disappears.You cannot take these medications without a doctor's prescription.

Traditional methods of treating varicose veins

There are many folk recipes for infusions, decoctions, lotions and compresses.It is recommended to take a number of remedies internally as well.Below are several ways to treat varicose veins using traditional methods.

Lilac tincture

Take a container with a volume of one and a half liters and pour flowers and lilac leaves into it.Then everything is topped up with vodka or medical alcohol so that the liquid completely covers the grass (to the very edge of the container).Let it steep for a week, shaking occasionally, then filter and rub the tincture onto your feet daily.Rub the skin with gentle massaging movements from fingers to knees.

With the help of the tincture they fight inflammation, swelling, cramps and pain in the legs.

Garlic ointment

Garlic cloves from the whole head are peeled, ground in a meat grinder or pressed through a garlic press.After that, you need to take butter (unsalted) and mix it with crushed garlic in a 1:2 ratio (2 parts butter and 1 part garlic).Apply this mixture to the affected leg, cover with wax paper, bandage, the compress can be kept overnight.

The compress eliminates pain and burning, has antiseptic properties, softens the skin and helps wound healing.

Honey with garlic

You need to take a clove of garlic and 250 ml of honey (preferably linden or buckwheat).Both ingredients are mixed thoroughly and left for a week.Drink one tablespoon three times a day before meals.
The product relieves swelling and fatigue, pain and varicose veins become less noticeable.

Potato juice

Raw potatoes are chopped on a grater or in a blender and the pulp is applied to sore spots.Keep the compress for about half an hour;If desired, you can leave it on all night.To increase efficiency, drink half a glass of potato juice at the same time.The product relieves swelling and discomfort in the leg, eliminates heaviness, reduces fatigue and inflammation.

What effect does wearing compression clothing have on varicose veins?

Compression stockings cannot cure varicose veins.But wearing it slows down the progression of the disease, relieves many of the symptoms it causes and improves well-being.

After putting on compression stockings, the lumen of the saphenous veins narrows, blood and lymph flow better and do not stagnate in the limbs.At the same time, swelling is relieved, spasmodic twitches in the calves disappear, the legs become less tired and there is no feeling of heaviness.

The main compression stockings prescribed for varicose veins are leggings, socks, stockings and long tights.It is recommended to wear the products daily;You must always put them on lying down before getting up in the morning.

There are different degrees of compression of knitwear, they are selected depending on the stage of varicose veins.Only the right underwear has the right therapeutic effect.It's best to get a doctor's prescription, but you can also easily buy stockings or tights with low compression for prevention.

Before purchasing, you need to determine exactly what compression class you need.Find out about the labeling characteristics of your desired company’s products.Reputable companies always use the word “compression” to define the class and specify it in mmHg.If it says “DEN” on the packaging, this product has nothing to do with medical underwear.