Varicose veins of the lower extremities are a chronic systemic pathology that develops against the background of dysfunction of the valves that control blood flow.
This leads to the accumulation of an excessive volume of fluid in the vessels, which gradually stretch, losing elasticity and strength.Varicose veins are characterized by the formation of bulky nodes under the skin of the legs, but this is not the only symptom of the disease.Patients complain of pain and heaviness in the legs, burning and itching, dryness and irritation of the skin.In advanced cases, non-healing purulent ulcers form on the skin, which are very difficult to cure due to irreversible necrotic processes that develop in them.In order for the treatment of varicose veins in the legs to be effective and to help prevent recurrence, it is necessary to first discover its causes.
Causes of varicose veins in the legs
The tendency to develop such a severe vascular disease is often hereditary, and in most cases this pathology is inherited by women.Therefore, if there are cases of varicose veins in your family, girls and women will be at risk.
Other common causes of the disease:
- Poor diet.If the diet is dominated by fatty, heavy foods rich in animal fats, the risk of varicose veins of the lower extremities increases significantly.
- Heavy physical activity.Certain types of work, for example, a cook, a waiter, a surgeon, an office worker, a hairdresser, create conditions for a gradual increase in pressure in the veins.With regular pressure, blood vessels and valves are deformed.due to the continuous high pressure, the walls of the veins become thinner, they become fragile and varicose veins develop.
- Wearing uncomfortable high heels.Such shoes reduce the range of muscle contraction and compress blood vessels, which in turn contributes to impaired blood flow and the development of varicose veins.
- Sedentary lifestyle.In the absence of at least a minimal load on the muscles, blood begins to pool in the venous bed, since the walls of the veins do not contract on their own.Gradually, the vessels are stretched, the function of the valves is disturbed and varicose thickening and knots are formed.
- Excess weight.The more excess weight a person has, the greater the load on the lower extremities and, consequently, on the blood vessels.In addition, obese people move little and mostly eat poorly, doubling the chances of developing varicose veins.
- Pregnancy.As the fetus grows, the volume of blood in the expectant mother's body increases, which creates additional stress on the veins.In addition, the growing uterus and fetus compress the pelvic vessels, which prevents normal venous outflow.During pregnancy, the hormone progesterone is produced in excess, which relaxes the walls of blood vessels, promoting the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after childbirth a woman can completely get rid of the problem.
- Age.As the body ages, the walls of the veins, as well as the valves, cease to fully perform their functions, they become weak.Elasticity and strength are lost, causing the vessels to stretch.
The mechanism of development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- At the initial stage, in the presence of hereditary predisposition and provocation of exogenous and endogenous factors, a slowing of venous blood flow occurs.A long-term process of stagnation causes the development of inflammatory processes in the walls and valves of the vein.
- When the valves are inadequate and the walls of the venous vessels are weak, blood begins to flow through the veins in both directions.This leads to an increase in intravenous pressure, which in turn leads to excessive stretching and deformation of the vessel walls.
- Further stagnation of blood and the progression of the inflammatory process contributes to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins weakens.Varicose veins cause stagnation of blood in the vessels, which leads to local toxic damage, as well as an increase in pressure.In advanced stages, the vessels can no longer withstand the excessive pressure, resulting in ruptures, leading to heavy bleeding.
Symptoms
The disease is insidious in that in the early stages it is practically asymptomatic.The first sign that indicates the development of varicose veins is fatigue in the legs, which is often ignored by patients and there is no reason to seek advice from a specialist.However, as the pathology progresses, fatigue in the legs is felt more often, especially in the evening, after a working day.Other symptoms of vascular disease:
- Pain, feeling of compression.Such signs begin to appear from the second stage, when the pathological process begins to develop.The pain occurs mostly in the evening after a day's work and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and worries him constantly.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to swell, swell, forming nodes.The vascular network is most often found in the thighs and legs.
- Cramps.A characteristic sign of varicose veins, the cause of which is the stagnation of blood in the veins.Stagnant processes lead to increased pressure in the vessels, as a result of which the muscles begin to contract spontaneously.
In addition, vascular disease is accompanied by intense external changes.With the development of ischemia, patients complain of constant itching.The excessive stretching and thinning of the veins leads to the formation of hematomas and bruises.In advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- peeling;
- formation of dark colored spots.
- hair loss.
If a patient develops trophic ulcers, accompanied by blackening of the extremities, this indicates the development of irreversible necrotic processes.
Complications of varicose veins of the legs
If there is no treatment for varicose veins of the lower extremities, serious complications develop as the disease progresses, such as:
- Venous thrombosis.With this complication, pathological processes affect the deep veins.The pathology is accompanied by blockage of a vessel with a blood clot - thrombus.The main cause of venous thrombosis is the slowing of blood flow to the lower extremities.
- Pulmonary embolism.A condition in which a blood clot detached from the wall of a vessel, along with the blood circulation, enters the pulmonary artery, blocking its lumen.If the blood clot is large, death occurs instantly.Smaller clots do not lead to death, but cause complex respiratory and circulatory disorders.
- Thrombophlebitis.It is characterized by inflammation of the superficial vessel walls, accompanied by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, pain of various degrees of intensity.Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Alimentary ulcers.An inevitable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment.Violation of tissue nutrition and the progression of the inflammatory process contribute to compression of the subcutaneous tissue, thinning, darkening of the skin, followed by the formation of a non-healing trophic ulcer.
- Varicose Eczema.It manifests itself as local redness of the skin, peeling and unbearable itching.If there is no treatment, the complication spreads quickly and leads to a worsening of the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of the rupture of varicose veins.
Bleeding can occur due to mechanical injury, as the walls of the affected veins are very fragile and thin.Therefore, even slight friction can cause severe venous bleeding.
Diagnosis of varicose veins of the lower extremities
If you have symptoms that indicate the development of varicose veins of the lower extremities, you need to make an appointment with a venologist who will diagnose, treat and prevent such vascular pathology.
The doctor will be able to make a preliminary diagnosis during the initial examination, during which a dense vascular network, swollen veins protruding above the surface of the skin and venous nodes in the extremities are discovered.To confirm the diagnosis, he is referred for additional examination, including the following procedures:
- Doppler ultrasound?
- ultrasound double angiography.
- radionuclides and radiopaque venoscintigraphy.
- venomanometry;
- Demography?
- photoplethysmography.
Treatment of varicose veins of the legs
If the disease is diagnosed in the earliest stages, when there are no serious complications, conservative treatment is prescribed, the main goals of which are:
- elimination of stagnant processes.
- normalization of pressure in the veins.
- restoration of blood circulation;
- eliminate the pathological symptoms.
For these purposes, drugs of the following groups are used:
- Phlebotonics and phlebotonics.It helps improve blood vessel health, normalize blood circulation and improve lymph flow.
- Anticoagulants.It is used to reduce blood viscosity and prevent blood clots.
- Non-steroidal anti-inflammatory drugs.They have a strong anti-inflammatory effect and relieve pain.
- Antiplatelet agents.Reduce the risk of thrombosis and improve tissue trophism.
If medication is ineffective and the disease progresses, the doctor discusses surgical treatment options with the patient.Surgical methods for treating varicose veins include:
- Sclerotherapy.Introduction into the lumen of the affected vein of a hardening drug, which sticks the vessel, causing it to regress on its own, replaced by connective tissue.
- Laser coagulation.It is indicated in cases where the diameter of the affected veins does not exceed 10 mm.The laser rays create a hardening effect on the vessel, causing it to regress on its own.
- Phlebectomy.A surgical procedure in which the surgeon excises deformed areas of blood vessels, carrying out all the necessary manipulations through tiny punctures in the skin.
Contraindications
For varicose veins in the legs, any actions that contribute to the development of stagnation in the vessels of the lower extremities are contraindicated:
- long stays in static positions.
- heavy physical activity, lifting heavy weights.
- sits with legs together or crossed.
- wearing tight, uncomfortable shoes.
It is also necessary to get rid of bad habits such as smoking and alcohol abuse.Cigarette smoke and alcohol negatively affect the health of the entire body, making the veins fragile, thin and inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
Cost of treating varicose veins of the lower extremities
The cost of treatment for varicose veins in the legs is affected by the following factors:
- the stage at which the disease was diagnosed;
- related complications;
- individually selected method of treatment - conservative or surgical.
- the need for additional therapeutic techniques, such as physiotherapy.