Modern healthcare faces many different challenges, but despite rapid advances in medicine, there are diseases that continue to affect millions of people. Varicose disease of the lower extremities ICD 10 - I83 is a problem that practically cannot be solved over time.
Prevalence in numbers
The disease has become widespread in several developed countries, such as the United States, 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 healthy workers, most often employed in the manufacturing industry. As any venous disease progresses, complications form, patients lose their jobs due to disability, so the problem is not only medical, but also economic and social. The appearance of varicose veins can be correlated with the patient's age. In people over 70 years of age, varicose veins of the lower extremities are more common than in people before retirement age.
In four out of every hundred patients over 80 years of age, varicose veins acquire 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 arise, thus excluding the possibility of surgical intervention.
Important!At the first symptoms of the disease, it is better to consult a doctor; The younger the patient, the lower the risks if surgical treatment is necessary.
Origins of the disease
Although the disease progresses gradually, there are still etiological factors for the development of varicose veins.
So what are the causes of varicose veins?
- inheritance;
- endocrinological reasons;
- mechanical factor;
- infection;
- poisoning;
- nonspecific inflammatory process;
- Factors that contribute to venous hypertension.
Complaints and symptoms.
Interestingly, at the beginning of the disease visible disorders appear that are often ignored. Mistaking small vessel defects for a minor external disorder that will "go away on its own, " patients provoke the development of the disease.
Other symptoms develop progressively:
- feeling of fatigue/heaviness in the legs;
- swelling in the foot area;
- night cramps;
- numbness, tingling, "pins and needles" sensation;
- pain in the area of varicose veins.
Diagnosis of varicose veins is an important condition at any stage of the disease.
Disease at any stage requires diagnosis, it is the diagnosis that suggests which treatment option is most acceptable to the patient. Clinical and instrumental diagnostic methods are used together. Depending on the course of the disease, all methods or only part of them can be used.
Methods of clinical examination: examination and conversation.
Clinical methods are used not only for varicose veins, but also for any other diseases:
- story take. The anamnesis includes all the basic data of your life (age, heredity, bad habits, type of main job).
- Definition of complaints. Complaints may indicate how much the varicose veins have progressed at the time of examination. The duration of the disease becomes an important condition. When did the first symptoms of leg disease appear?
- Inspection.During the examination, the doctor must pay attention not only to the blood vessels, but also to the condition of the skin, to exclude 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 examination methods are a prerequisite.
To prescribe a treatment, an examination will not be enough. Varicose veins of the lower extremities require mandatory instrumental diagnosis. During instrumental research methods, the foci of varicose lesions, the length of the damaged vessel, the insufficiency of venous valves, the speed of blood flow, etc. are determined.
This:
- Ultrasound.A standard B-mode study provides 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, thus identifying pathologies of the vessel valves.
- X-ray contrast venography. A more complex type of diagnosis using X-ray. The procedure is rarely used due to the possible occurrence of complications.
- CT venography. It is performed in the same way as radiological contrast, with the introduction of a contrast agent into the lumen of the vessel. A CT image, unlike an x-ray, is three-dimensional.
- magnetic resonance.The method is justified and informative and is performed without the administration of contrast or other medications. However, this method is still expensive, so it is used very rarely.
Note!Contrast agents cannot be administered in patients allergic to iodine, in which case an MRI may be necessary.
Diagnosis according to classification.
Like other diseases, varicose veins are divided into classes, taking into account many factors:
| External manifestations |
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| Cause of the disease |
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| Anatomical location of the veins. |
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| Mechanism of the disease. |
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The most common reason for contacting specialists is grade 2 varicose veins of the lower extremities, when the external manifestations of the disease become significant. Perhaps, if the disease did not manifest itself externally, the detection of varicose veins would occur at later stages.
Note!The concept of "internal varicose veins of the lower extremities" is used only colloquially, referring to 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 leads 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 may be different and depends on many factors (age, symptoms, degree of the disease, etc. ).
Thus, the treatment can be aimed at:
- Improve Life Quality; Aesthetic surgical interventions.
- prevent complications; Impact on microcirculation.
- elimination of symptoms; Hemodynamically significant treatment.
One way or another, treatment is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, complexity is important, so you cannot limit yourself only to surgical intervention, nor only to therapeutic and preventive physical training. It is important to follow all doctor's instructions.
Lifestyle tips
Varicose veins force patients to abandon factors that cause complications. Sometimes this measure is necessary, since untreated varicose veins greatly affect the quality of life.
DIY treatment is a futile exercise, however, you must pay attention to your lifestyle so that varicose veins do not progress so quickly.
What should be done with varicose veins:
- Women should abandon high-heeled shoes;
- Give up bad habits, in particular smoking;
- Move around, if you have to sit or stand for a long time, try changing positions;
- Avoid tight/tight clothing and shoes;
- Avoid exposure to high temperatures (sunbathing, hot wax, baths, saunas);
- Control your weight;
- Do not lift heavy objects;
- Take a contrast shower;
- Walk, run, swim more often;
- Keep your legs elevated whenever possible (sleeping, resting).
Compression therapy
Regardless of the etiology, patients with varicose veins should wear medical knitwear or apply elastic bandages.
- It is most convenient to wear knitwear, stockings or knee-high socks, made of a special material, often do not cause inconvenience. A doctor should recommend the compression level of medical stockings. The only disadvantage of compression garments is their price.
Note!Brands of medical knitwear manufacturers can be different, so choose carefully. Make sure the elastic on your socks or knee-highs is not too tight.
- Alternatively, patients often prefer to use elastic bandages of short, medium or long elasticity. The choice of compliance also depends on the stage of the disease and should be recommended by a doctor. The first few uses may be a little difficult, as you will have to control the level of tension of the bandage yourself.
Compression therapy is used daily, the use of underwear or bandages greatly 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 do the exercises blindly, but to choose a set of exercises with a specialist. Some medical institutions offer group exercise therapy classes.
Most of the time, physical therapy exercises do not require special training and are available regardless of age; for clarity, a set of physiotherapy exercises:
- Tighten and relax your thigh muscles (10 times);
- Inhale, lifting the abdominal wall, exhale, contract the stomach (4 times);
- Bend and straighten your legs at the ankle (10 times);
- Inhaling, raise your arms to the sides, as you exhale, lower them (4 times);
- Bend and straighten your toes (15 times);
- Raise your arms as you inhale and lower them as you exhale.
Even from this small set of exercises it is clear that anyone can do them, regardless of her age. It is important to take your time and do everything at a slow pace, without holding or speeding up your breathing.
Athletes can also perform this series of exercises before the main training. It is especially important if the patient practices any sport that is not recommended for varicose veins.
Sports, as an alternative to exercise treatment for varicose veins of the lower extremities, are also appropriate, but it is necessary to consult a doctor and a personal trainer. Some exercises will have to be excluded from training.
Sometimes athletes are simply forced to abandon their professional careers, especially in jumping, powerlifting, and heavyweight boxing. Those who like to swim, run and walk, in turn, can continue doing so.
Medications, after being prescribed by a doctor.
The objectives of pharmacology in the treatment of varicose veins are different, namely:
- improvement of vein tone;
- correction of microcirculation;
- improvement of lymphatic drainage;
- prevention of thrombotic complications;
- suppression of the development of complications.
That is why all medications must be prescribed by a doctor. It is in this sense that there is a guarantee of successful resolution of the disease.
Drug treatment is used at different stages: in preparing the patient for the upcoming operation, in the postoperative period, as well as in cases of obvious contraindications to surgery. Medications can be systemic or local and used both together and separately.
Phlebosclerosant treatment
Phlebosclerosis also refers to drug treatment methods, however, their 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, therefore the procedure is performed by surgeons who have received special training.
Physiotherapy in the treatment of varicose veins.
Physiotherapeutic methods are not the main ones in the treatment of varicose veins, but they are successfully used to relieve 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 not applied continuously, but in courses of 10 to 20 days. In most cases, physical therapy slows the progression of the disease, but it is not the main treatment method and certainly cannot be used as monotherapy.
Surgical treatment
Despite the numerous therapeutic methods, surgery remains practically the most basic and significant. Vascular surgeons perform successful operations on many patients.
Traumatic venectomies became a thing of the past as modern, minimally invasive methods became available. The Brunner approach, Müller dissection, and mini-phlebectomy with Varadi hooks facilitate the treatment of patients with varicose veins and often last one day.
Of course, there are also contraindications for surgical intervention, the main group are patients over 75 years of age who have trophic tissue disorders, microcirculation and/or lymphatic drainage disorders or excessive lesions of venous vessels. There are special instructions for performing operations on these patients. Sometimes it is necessary to abandon the operation altogether, and sometimes doctors still operate using a combined phlebectomy.
Pharmacotherapy
The treatment regimen for varicose veins is determined by the doctor. For this, conservative methods and surgical methods are used, it all depends on the stage of development of the disease, as well as the presence of complications.
The simultaneous use of medications and ointments allows you to relieve the symptoms of pathology and achieve good results in treatment. Currently, on the shelves of pharmacies there is a large selection of drugs that are effective in combating pathology in its early stages of development.
Pharmacological treatment for varicose veins in the legs is effective.
Important!Only a doctor can prescribe medications, dosage and course of use.
Sclerotherapy
Sclerotherapy is one of the best methods to treat varicose veins today. Specially administered medications allow you to destroy the stagnation of the vein inside. After a while, it will begin to stick 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 sore leg. You can notice a positive result no earlier than two weeks. However, patients should be prepared to experience pain and tingling.
Soon the unpleasant symptoms will disappear, the diseased 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 correctly performed procedure offers high chances of recovery.
Echosclerotherapy is the same as sclerotherapy, the difference is in the use of an ultrasound machine. This method is preferable because the movement of the syringe can be controlled and the medication will be distributed evenly.
Foam sclerotherapy is another type of sclerotherapy. The medications are administered in the form of microfoam, so the procedure allows for better results. The fact is that the medicine is much closer to the walls of the veins and does not mix with blood.
Surgical methods of treatment
Surgical treatment of varicose veins is used only if conservative methods do not achieve the desired result. Patients receive local anesthesia and after a couple of hours they can go home.
There are practically no bruises and no intoxication characteristic of general anesthesia. The result obtained lasts several years.
Phlebectomy is a type of operation performed under local surgery. Two small punctures are made to remove the affected vein. Sometimes this method can replace sclerotherapy. After just a couple of weeks, the patient will be able to return to their usual lifestyle.
Laser treatment is the gentlest 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 is closed and does not participate in blood circulation. The price of such 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 eliminate congestion in diseased veins. The increased tone gradually decreases, the tone of the veins increases. Patients get relief from pain and itching.
Complete lymph circulation, as well as complete blood circulation, allows the tissues to receive adequate nutrition and increases the amount of oxygen in them. The veins narrow or dilate; Gymnastics can increase your 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 complete treatment, which includes at least twenty procedures.
Home remedies
Advice!Varicose veins can also be treated effectively with home remedies.
The most common methods are the use of medicinal herbs. You can buy them at the pharmacy or pick them up yourself in summer.
white acacia
An alcohol tincture is prepared from the flowers of the plant. Soak cotton swabs and wipe affected areas several times a day.
Sagebrush
Pick fresh herbs and grind them in a mortar. Separate a tablespoon of herbs and mix it with the same amount of sour cream. Apply the resulting mixture to sore spots 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 treatment again.
kalanchoe
Wash the Kalanchoe leaves, place them on a paper towel and let them dry. Chop the leaves and place in a glass jar. Pour alcohol on top and let it sit for seven days, stirring occasionally. Strain the tincture and lubricate the sore veins for several months in a row.
Apple vinager
Dissolve two tablespoons of vinegar in a glass of water and drink it twice a day. It is recommended to rub undiluted apple cider vinegar on painful areas twice a day. After a month, the veins will begin to get smaller.
Cream
Grind part of the garlic, add two parts of butter. In its pure form, place the resulting cream on sore spots, cover with parchment paper on top and apply a bandage. Leave the compress on overnight, wash it in the morning and wrap your legs 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 sit for five days. Take one tablespoon three times a day.
Tomatoes
Cut a fresh tomato into slices, apply it to the problem area and wrap it with a bandage. Keep the compress on for four hours, then remove it and wash your feet. The duration of treatment is two weeks, then a ten-day break is taken and repeated.
Prevention
It is much easier to prevent a disease than to combat it afterwards, which is why prevention is necessary. If you have a hereditary predisposition to the development of varicose veins, you should pay increased 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 found in many foods: lettuce, vegetable oil, legumes. It is necessary to strengthen the walls of the veins, as well as increase their elasticity. Vitamin C has exactly the same property.
Copper
Elastin synthesis is favored by foods rich in copper. This includes seafood. To maintain body weight it is necessary to abandon sugary foods.
To prevent varicose veins, you must follow the following rules:
- It is not recommended to put a lot of pressure on your legs during the day. People who work standing need to spend several minutes per hour sitting. Ideal: take a horizontal position, raise your legs above your head and hold for twenty minutes.
- If you work sitting, you should get up for a few minutes once every hour and spend this time standing. Thus, the speed of blood movement through the veins will increase. Periodically turn your feet in different directions.
- Heavy lifting is not recommended.
- Massage your feet daily using a stream of cold water.
- Do not abuse 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 higher.
- Trophic ulcers with ascending and descending varicose veins.They are most frequently located in the lower third of the leg from the inside, however, they can also be observed from the outside, although this manifestation occurs very rarely. The deeper the trophic ulcer, the greater the risk of bleeding.
- Thrombophlebitis.It can occur with any type of varicose veins, the appearance of such a complication directly depends on the clotting properties of the blood. This complication can be prevented through the use of laboratory monitoring.
- Eczema.It occurs due to a violation of tissue trophism. Eczema and trophic ulcers can occur 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 the prolonged course of varicose veins.
What is important to know about varicose veins
Varicose veins become a test for patients, because the more they ignore them, the more aggressive the disease will behave. The course of varicose veins depends not only on the doctor's instructions, but also on the patient's scrupulous compliance with them. Varicose veins are a chronic disease, so even after surgery, treatment often does not end.
You should do and follow what the doctor advises, whether it is a magnet for varicose veins of the lower extremities, medications or exercise therapy. It is a complex treatment that gives a positive result and not a single, even the most insignificant, point should be ignored.