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 amount of fluid in the vessels, which gradually stretch, lose elasticity and firmness.Varicose veins are characterized by the formation of voluminous 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, incurable purulent ulcers are formed on the skin, which are very difficult to heal due to the irreversible necrotic processes that progress in them.In order for the treatment of varicose veins on the legs to be effective and help prevent recurrence, it is necessary to first find out the causes.
Causes of varicose veins on the legs
The tendency to develop such a serious 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 nutrition.If the diet is dominated by fatty, heavy food rich in animal fat, the risk of developing varicose veins of the lower extremities increases significantly.
- Heavy physical activity.Certain types of work, for example, cook, waiter, surgeon, office worker, hairdresser, create conditions for a gradual increase in pressure in the veins.With regular stress, blood vessels and valves become deformed;due to the constant high pressure, the walls of the veins become thinner, they become brittle and varicose veins develop.
- Wearing uncomfortable high-heeled shoes.Such shoes reduce the amplitude of muscle contraction and compress blood vessels, which in turn contributes to impaired blood flow and the appearance of varicose veins.
- Sedentary lifestyle.In the absence of at least minimal muscle load, blood begins to stagnate in the venous bed, because the vein walls do not contract on their own.Gradually, the blood vessels stretch, the function of the valves is disturbed and varicose thickenings and knots are formed.
- Excess weight.The more extra pounds a person has, the greater the load on the lower limbs, and therefore on the blood vessels.In addition, obese people move very little and generally eat poorly, which doubles the chances of getting varicose veins in the legs.
- Pregnancy.As the fetus grows, the volume of blood in the future mother's body increases, which puts 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, encouraging the development of varicose veins.In most cases, varicose veins during pregnancy are reversible, so after giving birth, the woman can completely get rid of the problem.
- Old age.As the body ages, the walls of the veins, as well as the valves, stop performing their functions completely, becoming weak.Elasticity and firmness are lost, which causes blood vessels to stretch.
The mechanism of the development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- In the initial phase, in the presence of a hereditary predisposition and provoking exogenous and endogenous factors, venous blood slows down.The long-term process of stagnation causes the development of inflammatory processes in the walls and valves of the vein.
- When the valves are incompetent and the vein walls 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 overstrain and deformation of the blood vessel walls.
- Further stagnation of blood and progression of the inflammatory process contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected veins is impaired.Varicose veins cause stagnation of blood in the vessels, which leads to local toxic lesions, as well as an increase in pressure.In advanced stages, blood vessels are no longer able to withstand excess pressure, resulting in ruptures that lead to profuse bleeding.
Symptoms
The disease is insidious in that it is practically asymptomatic in its earliest stages.The first sign that indicates the development of varicose veins is fatigue in the legs, which patients often ignore and do not become a reason to seek advice from a specialist.However, as the pathology progresses, fatigue in the legs is felt more and more often, especially in the evening hours, after a working day.Other symptoms of vascular diseases:
- Pain, tightness.Such signs begin to appear from the second stage, when the pathological process begins to progress.The pain usually occurs in the evening after a working day, and disappears in the morning.If a person ignores the discomfort and there is no treatment, the pain syndrome becomes chronic and worries constantly.
- Swollen veins and vascular network.At first, the affected veins are stronger than usual, but later they begin to protrude, protrude, forming nodes.The vascular network is most often localized on the thighs and legs.
- Cramps.A characteristic sign of varicose veins, the cause of which is blood stagnation in the veins.Stagnant processes lead to increased pressure in the vessels, due to which the muscles begin to contract spontaneously.
In addition, vascular disease is accompanied by pronounced external changes.With the development of ischemia, patients complain of constant itching.Excessive stretching and thinning of 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 pigmented spots;
- hair loss.
If the patient develops trophic ulcers, accompanied by blackening of the extremities, this indicates the progression of irreversible necrotic processes.
Complications of varicose veins of the legs
If varicose veins of the lower extremities are not treated, serious complications develop as the disease progresses, such as:
- Venous thrombosis.Along with this complication, pathological processes affect the deep veins.The pathology is accompanied by clogging of a vessel with a blood clot - a thrombus.The main cause of venous thrombosis is the slowing down of blood flow in the lower extremities.
- Pulmonary embolism.A condition when a blood clot that has separated from the vessel wall, along with the blood flow, 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 breathing and circulation disorders.
- Thrombophlebitis.It is characterized by inflammation of the superficial vessel walls, followed by the formation of a blood clot.The disease is manifested by hyperemia, swelling along the inflamed and blocked vein, and pain of varying intensity.Acute thrombophlebitis is accompanied by fever and chills, which complete the above symptoms.
- Trophic 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 progression of the inflammatory process contribute to compaction 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 left untreated, the complication spreads rapidly and leads to a worsening of the patient's condition.
- Bleeding from varicose veins.A dangerous complication that develops against the background of rupture of varicose nodes.
Bleeding can occur due to mechanical injury, because 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 must make an appointment with a phlebologist 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 on the limbs are revealed.To confirm the diagnosis, an additional examination is indicated, including the following procedures:
- Doppler ultrasound;
- ultrasound duplex angioscanning;
- radionuclide and radiopaque phleboscintigraphy;
- phlebomanometry;
- plethysmography;
- photoplethysmography.
Treatment of varicose veins on the legs
If the disease is diagnosed in the earliest stages, when there are no serious complications, conservative therapy is prescribed, the main goals of which are:
- eliminate stagnant processes;
- normalize the pressure in the veins;
- restore blood circulation;
- eliminate pathological symptoms.
Medicines of the following groups are used for these purposes:
- Venotonics 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.
- Nonsteroidal anti-inflammatory drugs.They have a pronounced anti-inflammatory effect and relieve pain.
- Antiaggregation agents.It reduces the risk of thrombosis and improves tissue trophism.
If drug treatment is ineffective and the disease progresses, the doctor discusses with the patient the possibility of surgical treatment.Surgical methods for treating varicose veins include:
- Sclerotherapy.Introduction of a sclerosing drug into the lumen of the affected vein, which glues the vessel, causing it to retract itself, being replaced by connective tissue.
- Laser coagulation.Indicated in cases where the diameter of the affected veins does not exceed 10 mm.Laser rays create the effect of sclerosis in the vessel, due to which it recedes on its own.
- Phlebectomy.Surgical intervention during which the surgeon cuts out the deformed areas of the blood vessels, performing all the necessary manipulations through microscopic punctures on the skin.
Contraindications
For varicose veins on the legs, all actions that contribute to the development of stagnation in the veins of the lower extremities are contraindicated:
- long stay in static positions;
- heavy physical activity, lifting heavy weights;
- sitting with legs up or crossed;
- wearing tight, uncomfortable shoes.
It is also necessary to get rid of bad habits such as smoking and alcohol abuse.Tobacco smoke and alcohol negatively affect the health of the entire organism, making the veins fragile, thin and inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
The cost of treating varicose veins of the lower extremities
The cost of treating varicose veins on the legs is influenced by the following factors:
- the stage at which the disease was diagnosed;
- related complications;
- individually selected method of therapy - conservative or surgical;
- the need for additional therapeutic techniques, such as physiotherapy.