Treatment of varicose veins

Varicose veins (varicose veins) are a very common vascular disease that people have known about since ancient times.It is mentioned in the Ancient Egyptian papyri;A mummy was even excavated with manifestations of varicose veins in its legs.They find information about pathology in Hippocrates, Galen and Avicenna.Modern doctors also often find varicose veins in their patients and look for effective treatment methods.

The term "varicose veins" is of Latin origin, the word "varix" translates as "expansion."That is why the disease began to be called “Varices”.With this disease, peripheral veins increase in volume, become long, tortuous, deformed and knotted.Blood pools in the lower leg because the valves begin to malfunction and the walls become weak.Most often, vascular damage is observed in the legs, since there is an increased load on the vessels, it is necessary to pump large volumes of blood and overcome the force of gravity.

Varicose veins are diagnosed in approximately 17% to 25% of people.Among young people, both boys and girls are equally affected.In mature and elderly women, this pathology occurs 2-3 times more frequently than in men of the same age.This is due to the 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 are located 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 venous wall has a three-layer structure:

• At the top is the adventitia, which is composed of loose connective fibers, elongated smooth muscle cells along the walls, surrounded by small capillaries and nerves responsible for vessel trophism.
• In the middle is the media, which consists of circular smooth muscle fibers.
• The intimacy is found inside.The basis of the intima is the endothelium;Between its cells there are longitudinal fibers of smooth muscles.  The inner layer is folded, the thickenings are opposite each other and resemble swallow nests or patch pockets.They are called valves and are responsible for the correct direction of blood flow.

Venous valves direct blood from peripheral parts to the heart, as well as from superficial to deep veins.They prevent reverse flow and increase venous pressure.In addition to the valves, the smooth muscles, tendons and muscles of the leg participate in maintaining normal tone.When any of the layers (usually the middle and inner layers) are damaged, the veins lose their tone and expand, and varicose veins appear.

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 femoral surface is collected into this vein through a series of smaller vessels.
2. The small saphenous vein is located on the outside of the leg, is equipped with valves, and collects blood from veins in the front and back of the leg.

Communication between large and small veins occurs through connected vessels.

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

Why do varicose veins appear and who is at risk of getting sick?

It's hard to say why people get varicose veins right now.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.

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

• Inheritance.The structure of the walls of blood vessels is genetically determined;With some changes in the genes, they become weaker and the valves do not close properly.As a result, with the slightest increase in pressure in the veins, a reverse outflow of blood occurs, the vessels overflow and expand.
• Hormonal changes in the woman's body.  This situation is typical for pregnant women or the second half of the cycle, when the amount of progesterone increases and the level of estrogen decreases.As a result, blood rheology changes (coagulation 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 flow throughout the body.Excess subcutaneous fat in the abdomen causes increased pressure in the abdominal cavity and compression of the main veins.This causes stagnation of blood in the vessels of the legs and, in addition, the appearance of 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 doses of alcohol, dehydration occurs, the blood thickens, clots form, blocking small blood vessels and causing congestion.
• Static occupational loads, such as lifting heavy loads, working standing or sitting.In such a situation, muscle tone decreases, blood worsens from the lower extremities to the heart, stagnation occurs, and the veins in the legs dilate because of this.  
• Congenital blood coagulation pathologies.Hypercoagulation, in which too many factors responsible for the formation of clots occur in the blood, causes thrombosis and prevents the movement of blood through the vessels.
• Wrong diet.A diet deficient in several vitamins (C, E, PP) and plant fiber causes alterations in the structure of the endothelium and other structural elements of the vascular walls.
• Tight underwear.When wearing tight underwear, some veins become pinched, which obstructs blood flow from the lower half of the body.
• Frequent constipation.People suffering from this problem have to constantly push, this increases the pressure inside the abdomen and, as a result, the outflow of blood becomes difficult.
• High heel.Excessive strain on the calf muscles and insufficient contraction causes blood to stagnate in the veins.
• Warm climate.In summer, with the heat, the body becomes dehydrated.If you do not compensate for the problem by drinking enough fluid, the risk of blood clots forming in the vessels will increase.
• Heart and kidney pathologies.These can be congenital or acquired heart defects, kidney failure.
• Excess doses of medications that affect coagulation.In this case, the blood vessels can become clogged with blood clots.
• Operation.The risk of thrombosis in this case increases due to blood loss and compression of the veins during the intervention.

How can varicose veins become complicated?

• Thrombosis due to blood stagnation.
• Vascular thromboembolism as a result of the dislodgement of a blood clot.
• Thrombophlebitis or inflammation of the venous wall.
• PE (pulmonary embolism).In this case, blood flow in the pulmonary circulation is severely impaired, 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.In case of poor blood circulation, little oxygen and nutrients reach the tissues, which impairs regeneration or causes massive cell necrosis.
• Edema syndrome.As a result of impaired blood flow and stagnation, fluid leaks through the walls of blood vessels into the intercellular space.The swelling is soft, elastic in consistency and appears most frequently near the affected vein, regardless of the time of day.  
• Dermatitis.The inflammatory process in the skin develops due to a violation of blood flow and tissue nutrition. 
• Hyperpigmentation, cyanosis of the affected areas of the skin.
• Consolidation of subcutaneous fat due to swelling and hemorrhage.

How to diagnose varicose veins

• Through functional tests (tourniquet application) the condition of the valves is studied.They are named after the authors: Troyanov-Trendelenburg, Pratt, Sheinis, Delbe-Perthes, etc.For the Trojanov-Trendelenburg test, it is necessary to lie the patient in a horizontal position, and then offer him to raise his leg 450. In this position, the doctor strokes the limb from the foot up to empty 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 table.Healthy leg veins should fill after 15 seconds.  
• Duplex ultrasound scanning of veins (ultrasound angioscanning) provides the most information and allows you to visualize the vessels and blood flow through them.
• Dopplerography is a method of assessing blood circulation through the vessels.
• Phlebography or X-ray examination with contrast, which helps to study the internal structure of the vessel.
• Phleboscintigraphy is a technique that uses radioactive substances and a special device for its distribution will be further studied.

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

Treatment of varicose veins

Conservative treatment options

• Drug therapy does not cure varicose veins, but with the help of drugs, the function of the valves, vascular trophism, blood circulation are partially improved and the risk of thrombosis is reduced.For this purpose, venotonics are used.They can be prescribed for any type of varicose veins.Ointments with non-steroidal anti-inflammatory drugs are indicated for thrombophlebitis.Also in this situation, anticoagulants are used, which effectively resolve blood clots.The treatment must be selected by a doctor, after a thorough diagnosis and taking into account the characteristics of the patient.
• Herbal medicines and additional techniques have auxiliary value.It is advisable to wear compression stockings, do gymnastics, ski, ride a bicycle and swim.The “bicycle” exercise in the supine position, flexion and extension of the feet, gives good results;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 irrigate the leg with warm water, and then gradually reduce the temperature to cold).  Cold 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 eliminate thrombophlebitis.
• Mode.You should get out of bed slowly, 5 to 10 minutes.Legs should be elevated 10 to 15⁰ at night;To do this, place a cushion under your heels.You should walk calmly, it is undesirable to cross your legs when sitting and not overwork yourself.All patients are recommended to wear compression stockings.
• It is necessary to eat right, include coarse fiber and foods rich in vitamins in your menu.  Citrus fruits, tomatoes, rose hips, black currants, walnuts, legumes, liver, onions, eggs and seafood will be useful.It is important not to drink alcohol, not smoke and drink enough water during the day.In case of persistent constipation, it is recommended to drink a laxative.

Surgical treatment

Phlebectomy or complete removal of the veins.

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

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

Only surgery can radically rid the patient of varicose veins and restore the function of the valves.If the situation is too serious, untreated and neglected, this treatment method is still the only one.The disadvantages of the intervention are the need to administer anesthesia and keep the patient in the hospital for several days for observation, postoperative trauma with scars.

Laser therapy (endovascular microthermocoagulation)

Laser treatment of varicose veins is used if the pathology is combined 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 lesions, meningitis, encephalitis and their consequences), genitourinary system (inflammation of the kidneys, prostate,pathology of the uterus with appendages), with skin diseases (furunculosis, dermatitis, psoriasis, etc.).

Contraindications for the use of laser are oncology, decompensated pathology of the kidneys, liver, heart, cerebral sclerosis, pregnancy.

The main advantages of laser therapy are its effectiveness in eliminating the dilation of superficial veins, speed (the duration of the manipulation is 15 to 20 minutes), the absence of the need to go to the hospital and low trauma.
Among the disadvantages, it is worth highlighting the poor accessibility of the technique;Not all clinics have the appropriate equipment.Treatment is expensive and of little use for deep and severely affected veins.If the laser is used incorrectly, you can suffer a thermal burn, and depigmentation sometimes occurs at the exposure sites.

Radiofrequency coagulation (ablation)

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

Radiofrequency coagulation is contraindicated in acute thrombophlebitis, limited mobility of the patient, pregnancy and mental disorders.

The main advantages of the method are its painlessness, the absence of injuries and the need for a hospital stay.Patients can return to normal activities the next day.

The disadvantage is the high cost of the intervention.

Sclerotherapy

Indicated for varicose veins of small and large superficial veins (in large vessels it is performed under duplex Doppler ultrasound control) in the initial stage and without complications.

Pregnant and lactating mothers, drug allergies, deep vein thrombosis, infectious and inflammatory skin lesions on the legs are not treated with this method.

The main advantages are the low price, quick recovery and the absence of hospitalization.The procedure does not leave marks and does not cause injuries.

The disadvantage is the risk of the sclerosing drug entering a deep vein, reduced effectiveness upon 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 permissible to use auxiliary methods for the treatment of varicose veins, which relieve the symptoms.They use pharmacy or self-prepared ointments, herbal baths and lotions, compresses, drink decoctions and infusions to improve blood flow and relieve swelling.Below are some recipes.

chestnut tincture

Take about 200 g of ripe and peeled chestnuts.Pass through a meat grinder or grind with a blender.Fill everything with a liter of vodka, put it in a dark corner and let it rest for a couple of weeks.To make the product smell good, add a couple of drops of peppermint oil.At night, lubricate your legs with the tincture to eliminate heaviness and itching, strengthen blood vessels and prevent their fragility.It is also recommended to make a compress with the tincture.If there is no chestnut, it is replaced by nutmeg, the recipe remains the same.Tincture with musk nuts can not only be used to rub sore feet;It is recommended to drink 20 drops a day.Once the bottle is finished, a new tincture is made.But there should be a break of 2 weeks between taking the next portion.

Calendula-based ointment

An infusion is made from calendula flowers: pour a tablespoon of boiling water, put on fire, cook for a couple of minutes and leave for 3 hours in a thermos.Strain the infusion and add it to some type of fat;Lanolin, Vaseline and badger grease are suitable.For the scent, it is recommended to add a drop of aromatic oil (rose, bergamot, citrus, sage, lavender, etc.) Rub the ointment in the morning and evening, with gentle movements from the sole of the leg to the knee, until completely absorbed.Thyme, hop cones and nettle are also added to the calendula infusion.

chamomile oil

Medicinal chamomile flowers are placed in a dark-colored half-liter glass jar so that the container is filled to the top.Pour in half a liter of any type of vegetable oil, for example, olive, corn, hemp.  Let it rest for a month, shaking or stirring occasionally.After that, the oil infusion is filtered.For aroma, add a couple of drops of tea tree, peppermint, lavender and grapefruit fragrance oil.Apply chamomile oil to your foot early in the morning and late at night, while performing a light massage at the same time.You can also make night compresses with the infusion.

Compress based on wormwood.

Take a packet of kefir or fermented baked milk, 3 tablespoons of dried wormwood.The grass is crushed and mixed with kefir (ryazhenka).When the grass is wet, place it on cheesecloth along with a thick liquid.Then a compress is applied to the leg, covered with wax paper on top (cellophane film 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 perform 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 give a good effect.To improve the effect of the compress after the procedure, it is recommended to lie down for a while with your legs raised.All of the herbs listed can be infused and used to prepare a foot bath.The water in such a bath should be warm, the duration of the procedure is about 25 minutes.Relieves fatigue, swelling, reduces itching and pain of the skin.

Traditional recipes for internal use.

Various herbal infusions improve blood flow in the veins well.The following herbs are used:

• clover
• in succession
• Leaves and berries of lingonberries, viburnum, strawberries, raspberries.
• colt's foot
• Calendula
• Japanese sophora
• balm
• Schisandra
• hawthorn

The herb is dried, then crushed and turned into a mixture of different types of plants.Then take 3 tablespoons, pour a liter of boiling water, leave overnight in a thermos and drink 1/3 glass before meals.

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

Treatment of varicose veins in pregnant women.

Having a baby is accompanied by a hormonal storm in the female body and overload, which often causes varicose veins.Treatment during this period is carried out conservatively, using topical creams, ointments and gels.

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

Home 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 grated raw potatoes to your feet.It is necessary to cover the compress with wax or normal thick paper, not cellophane, so that the skin can breathe.The procedure is done before bedtime and the lotion is left overnight.

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

After taking the drugs, the venous tone increases, the walls become elastic, they do not stretch as much, lymph flow improves, the liquid part of the blood stops leaking into the intercellular space, and the swelling disappears.You cannot take these medications without a prescription.

Traditional methods of treating varicose veins.

There are many popular recipes for infusions, decoctions, lotions and compresses.It is recommended to take various remedies even internally.Below are several options for treating varicose veins using traditional methods.

lilac tincture

Take a container with a volume of one and a half liters, pour lilac flowers and leaves into it.Then everything is poured with vodka or medicinal alcohol so that the liquid completely covers the herb (to the edge of the container).Infuse for a week, shaking occasionally, then strain and rub the tincture into your feet every day.Rub the skin with gentle massaging movements, from fingers to knees.

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

garlic ointment

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

The compress eliminates pain and burning sensation, has antiseptic properties, softens the skin and helps heal wounds.

honey with garlic

It is necessary to take a head of garlic and 250 ml of honey (preferably linden or buckwheat).Both ingredients are mixed well 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 crushed on a grater or in a blender, and the pulp is applied to sore spots.Keep the compress on for about half an hour;If you wish, you can leave it on overnight.To increase effectiveness, 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 is the effect of using compression garments for varicose veins?

Compression garments cannot cure varicose veins.But its use slows down 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 extremities.At the same time, the swelling is relieved, convulsive contractions of the calves disappear, the legs get less tired, and there is no feeling of heaviness.

The main types of compression garments prescribed for varicose veins are tights, socks, stockings, and long tights.It is recommended to use the products every day;It is necessary to put them on in the morning, before getting out of bed, always in a lying position.

There are different degrees of compression of knitwear, they are chosen depending on the stage of varicose veins.Only the right underwear will have the right therapeutic effect.It is best to be prescribed by a doctor, but low-compression stockings or pantyhose, for prevention, are easy to purchase yourself.

Before purchasing, you need to determine exactly what kind of compression you need.Find out about the labeling features of your chosen company's products.Reputable companies always use the word "compression" to define the class and define it in mmHg.If "DEN" is written on the package, then this product has nothing to do with medical underwear.