Varicose veins

signs of varicose veins

At least half of adults have some type of problem with enlarged veins. This common condition is a familiar problem for many people. Women are at least twice as likely to develop varicose veins as men. Between both sexes, it affects between 25% and 60% of adults, depending on age.

Dilated veins do not always look like convex bluish strands; Sometimes varicose veins appear as a fine vascular meshwork that runs just beneath the surface of the skin. It almost always affects the legs and feet. Visible, swollen, tortuous veins, sometimes surrounded by patches of congested capillaries, resembling spider webs or spider veins, are superficial varicose veins. Although they are often painful and disfiguring, in most cases they are harmless. When inflammation develops, these veins become dense to the touch and can impede blood circulation to such an extent that ankle swelling, itching, and pain occur in the affected limb.

In addition to the superficial venous network, the legs have an internal or deep venous network. In rare cases, the deep veins in the legs are also affected by varicose veins. These deep varicose veins are usually not visible, but they can cause swelling or pain throughout the leg and, more dangerously, can be a site for blood clots to form.

To help oxygenated blood circulate from the lungs to all parts of the body, arteries have a thick muscular lining. For the reverse flow of blood through the venous system, the surrounding muscles are used, the muscular layer in the venous wall is thin and weak, but the veins are equipped with internal valves that allow blood to pass in only one direction: towards the heart. , valves are necessary to prevent the reverse flow of blood.

In the case of varicose veins, the valves do not work properly, causing blood to pool in the vein and making it difficult for the muscles to push the blood "up. "Instead of flowing from one valve to another, blood continues to pool in the vein, increasing venous pressure and further damaging the valves, causing the vein to bulge and become tortuous. Because superficial veins have less muscular support than deep veins, they are more likely to have varicose veins.

What contributes to the development of varicose veins?

Any condition that involves excessive tension and pressure on the legs or abdomen can cause varicose veins. The most common factors that cause intra-abdominal pressure are pregnancy, obesity, and work that requires standing for long periods of time or lifting heavy objects. Chronic constipation, prostate adenoma that requires straining when defecating and urinating, and in rare cases, tumors can also cause varicose veins. A sedentary lifestyle contributes to the development of varicose veins, since muscles that do not work do not pump blood well.

The chance of having varicose veins increases with age as the muscles and veins weaken. Previous trauma to the leg can damage venous valves and contribute to the development of varicose veins. Genetics also plays a role, so if other family members have varicose veins, you are more likely to have them too. Contrary to popular belief, sitting cross-legged does not cause varicose veins, although it may aggravate an existing condition.

Can varicose veins be prevented?

Although genetics influence the risk of developing varicose veins, there are things you can do to prevent them:

  • Exercise regularly because staying in good physical shape is the best way to keep leg muscles toned, improve blood circulation and control weight. It is believed that among all types of fitness, swimming and water aerobics have the greatest preventive effect;  
  • Healthy weight support; If you are overweight or even obese, losing weight will reduce the risk of developing varicose veins, since a normal weight prevents excess pressure on the veins in your legs;
  • Avoid tight clothing. Tight clothing can restrict blood flow in the thighs, groin, and legs;
  • Avoid frequent and prolonged use of high-heeled shoes, as they can impede blood circulation. Shoes with completely flat soles are also undesirable; It is better to choose shoes with low, stable heels or elastic soles, as they are better for blood circulation and also improve the tone of the calf muscles.
  • Motion! You should avoid sitting or standing for a long time to stimulate blood circulation. If your daily routine requires you to be on your feet a lot, consider wearing a daily support shirt. Stretch your legs and exercise as often as possible to improve 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, not your back.  This will reduce the pressure of the uterus on the veins in the pelvic area and even improve 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 socks, stockings or special pantyhose.

Spider veins and varicose veins

As we age, many of us find bluish stars with lumps under the skin or swollen cords extending down our thighs and calves. These deformed blood vessels occur in 60% of adults after age 50.  

What are spider veins?

Spider veins are small, tortuous blood vessels that show through the skin. They can be red, purple, or blue in color and appear most often on the legs or face.  

What are varicose veins?

These are larger blood vessels that have lost their elasticity, have swollen and have acquired a tortuous path due to changes in the venous wall. These veins appear bluish and raised above the surface of the skin. Varicose veins can appear anywhere, but most often develop in 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 to the heart. The vessels are surrounded by muscles that contract and help pump blood to the heart. Normally, healthy venous valves prevent backflow of blood. However, problems with the valves, muscles, or blood pressure can cause blood to pool inside the vein. When blood pools in a vein, pressure increases and the vein wall weakens. As a result, the vein becomes bulging and tortuous. As a result, depending on the caliber of the blood vessel and the degree of swelling, a network of spider veins or varicose veins forms.

Who is at risk for varicose veins?

Spider veins or varicose veins of large veins can appear in anyone, but women are susceptible to this problem twice as often as men. This problem is also familiar to those who have jobs that require them to be on their feet constantly, such as nurses, hairdressers, professors and professors. Other factors that trigger the development of varicose veins include aging, obesity, pregnancy, a leg injury or surgery, and a family history of varicose veins.

What symptoms are accompanied by varicose veins?

Often, spider veins and/or varicose veins are not just an unpleasant cosmetic defect. Varicose veins are a disease that can cause unpleasant symptoms and dangerous complications, in particular pain or cramps in the legs, a feeling of heaviness, throbbing or tingling. Severely swollen veins become hard to the touch and reduce circulation, causing itching and swelling in the ankles. Additionally, over time, trophic changes develop in the skin and subcutaneous tissue, such as thickening, pigmentation, and ulceration.

Complications of varicose veins.

Although spider veins and varicose veins spoil the appearance of the legs and cause uncomfortable symptoms, they rarely pose a serious threat to health. However, in some cases complications may develop that require a visit to the doctor and even hospitalization.

The most common complications of varicose veins are trophic ulcers against the background of prolonged venous insufficiency; These ulcers most often form in the ankle area and heal very poorly.  The second common and most dangerous complication of varicose veins is thrombophlebitis (thickening and inflammation of the venous wall, which in turn can lead to venous thrombosis), a dangerous complication that requires hospitalization and intensive treatment. If a thrombosis has developed in the deep venous system, there is a danger that the blood clot will migrate, the so-called thromboembolism, and as a result of thrombophlebitis, a chronic post-thrombophlebitis disease may develop, which significantly affects the patient's quality of life. . life and performance.  

Diagnosis of varicose veins of the lower extremities.

Spider veins and superficial vein varicose veins are easy to diagnose; a visual examination is enough. However, the primary diagnostic complex always includes an ultrasound examination of the deep venous system, since superficial 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 present, the compaction of the venous wall and subcutaneous tissue, changes in skin color, pigmentation, pain and the presence of trophic ulcers.

Most cases of spider veins and varicose veins, unless accompanied by venous insufficiency, do not require surgical treatment, but can be removed for cosmetic purposes.  If varicose veins are accompanied by discomfort such as heaviness in the legs, pain, muscle fatigue or cramps, swelling of the ankles, there are treatment recommendations that will reduce symptoms and slow down the progression of the disease.   

Treatment of varicose veins

Therapeutic approaches for varicose veins can be conservative and surgical. The choice of the therapy method can be made by a phlebologist based on examination and examination. The goal of varicose vein examination is to determine the stage of the disease and the risk of developing possible complications. Such an examination, which includes a comprehensive 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 specialty, which is based on training first in general surgery and then in cardiovascular surgery.  Phlebology is a branch of vascular surgery that deals with the study and treatment of diseases and malformations of the venous system.  A phlebologist surgeon must master a wide range of techniques used in the treatment of venous diseases.

Conservative treatment of varicose veins.

Conservative therapy for varicose veins is aimed at slowing down their development and preventing complications. It usually consists of recommendations for lifestyle changes (weight loss, adequate physical activity, elimination of static loads that contribute to the progression of the disease), selection of compression stockings, prescription of medications that tone the wallsof venous vessels and prescription of a course of physiotherapy.

Compression jersey: socks, tights and support tights

The simplest way to prevent the progression of varicose veins is to wear support stockings. Also called compression stockings, they improve blood circulation and relieve pain and discomfort in the legs. They can be found in pharmacies and specialty medical supply stores. These stockings are especially necessary during pregnancy and during long flights.

Lifestyle change It can also help prevent the rapid development of varicose veins. First of all, it is necessary to normalize your weight and introduce physical activity into your life, such as walking or swimming; exclude frequent wearing of high heels, static loads and a sedentary lifestyle.

Pharmacological treatment – There are many drugs, both in the form of gels and creams and in the form of tablets, that have a venotonic effect and affect the speed of progression of varicose veins, slowing down their development. However, its action 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 - a course of physiotherapy using compression - sequential compression of the veins with specialized circular pads, the pressure of which extends fromthe feet to the hips, improving blood flow, stimulating the vascular wall and normalizing the functioning of the venous valves. This treatment is prescribed 2 to 4 times a year in courses of 10 to 12 procedures. It is also recommended to do it after sclerotherapy and laser therapy sessions for varicose veins. This physiotherapy can be performed independently or in combination with specialized electrical stimulation of the leg muscles, with the expectation of mutually enhancing the therapeutic effect.

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, magnetotherapy, phonotherapy and electrophoresis (→ and other methods) may be prescribed. What is 100% contraindicated for physiotherapy of varicose veins is concomitant thrombosis or thrombophlebitis, therefore, before undergoing a course of physiotherapy procedures, you shouldundergo ultrasound examination 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 fair half of humanity, come to the phlebologist because of the external side of the disease: they are bothered by unsightly spots and cords on the veins. legs. Treatment of varicose veins in this situation usually consists of eliminating cosmetic defects. To do this, minimally invasive methods are used to treat varicose veins: sclerotherapy and endovenous laser coagulation (EVLC).

The term "minimally invasive" in relation to medical procedures means "low traumatic" and "gentle. "  In fact, such treatment is carried out on an outpatient basis, causes minimal pain, comparable to that of a normal injection, and allows excellent results to be achieved. This treatment consists of destroying the inner wall of the vein with a drug (sclerosant) or laser, which causes the lumen of the vessel to stick together and the cosmetic defect to disappear.  

In each case, the decision on the treatment method is made by the doctor based on the examination and examination. In cases of complicated varicose veins, surgical treatment is used, which is performed in a hospital setting.