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 excess fluid in vessels that gradually stretch, losing their elasticity and strength. Varicose veins are characterized by the formation of large nodules 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, skin irritation. In advanced cases, non-healing purulent ulcers form on the skin, in which irreversible necrotic processes are increasingly difficult to heal. For the treatment of varicose veins in the legs to be effective and to prevent relapse, it is first necessary to find the causes.
Causes of varicose veins in the legs
The predisposition to such a serious vascular disease is often hereditary and is often inherited by women with this pathology. Therefore, if there is varicose veins in the family, girls and women are at risk.
Other common causes of the disease:
- Malnutrition. If the diet is dominated by fatty, heavy foods saturated with animal fat, the risk of developing varicose veins of the lower extremities increases significantly.
- Heavy physical activity. For example, certain types of work, such as cook, waiter, surgeon, office worker, hairdresser, create conditions for a gradual increase in vascular pressure. With regular loads, the arteries and valves become deformed, the walls of the arteries become thinner, brittle, and varicose veins develop due to the constant high pressure.
- Wear uncomfortable high heels. Such shoes reduce the amplitude of muscle contraction, narrow blood vessels, which contributes to impaired blood flow and the development of varicose veins.
- Passive lifestyle. When there is no minimum load on the muscles, the blood begins to stagnate in the venous bed because the vessel walls do not contract on their own. Gradually, the veins dilate, the valves malfunction, and varicose veins and nodules form.
- Excess weight. The more overweight a person is, the greater the burden on the lower extremities and therefore the arteries. In addition, obese people move very little and eat mostly poorly, which doubles the chances of varicose veins in the legs.
- Pregnancy. As the fetus grows, the volume of blood in the mother's body increases, which puts extra stress on the arteries. In addition, the growing uterus and fetus squeeze the small pelvic vessels, which prevents normal venous flow. During pregnancy, the hormone progesterone is overproduced, which relaxes the walls of blood vessels and promotes the development of varicose veins. In most cases, varicose veins return during pregnancy, so a woman can get rid of the problem completely after giving birth.
- Age. As the body ages, the walls of the arteries, as well as the valves, weaken and cease to function properly. Elasticity and strength are lost, resulting in stretching of the arteries.
The mechanism of development of varicose veins of the lower extremities
Varicose veins of the lower extremities develop according to a complex mechanism:
- In the early stages, when there is a hereditary predisposition and caused by exogenous and endogenous factors, there is a slowing of venous blood flow. Prolonged stagnation leads to the development of inflammatory processes in the walls and valves of the vessel.
- With valve insufficiency and weakening of the walls of the venous vessels, blood begins to flow through the veins in both directions. This leads to an increase in intravenous pressure, which leads to excessive elongation and deformation of the vessel walls.
- Further stagnation of blood and the development of inflammatory processes contribute to the spread of pathology, the development of ischemia and the formation of trophic ulcers.
Gradually, the function of the affected vessels is impaired. Varicose veins cause blood stasis in the arteries, which leads to local toxic lesions and increased blood pressure. In the advanced stages, the vessels can no longer withstand excessive pressure, resulting in fractures, which lead to excessive bleeding.
The disease is insidious in the early stages because it is almost asymptomatic. The first sign of the development of varicose veins - fatigue in the legs, which is often overlooked by patients and is not a reason to seek advice from a specialist. However, as the pathology progresses, fatigue in the legs becomes more pronounced, especially in the evening, after a hard day. Other symptoms of vascular disease:
- Pain, feeling of tightness. Such symptoms begin to appear in the second stage, when the pathological process begins to develop. The pain subsides in the evening after a hard day and disappears in the morning. When a person ignores anxiety and there is no treatment, the pain syndrome becomes chronic and becomes constant anxiety.
- Swollen veins and vascular network. At first, the affected veins are stronger than usual, but then nodules form and swell. Vascular meshu is more localized in the thighs and legs.
- Convulsions. A characteristic symptom of varicose veins caused by blood stasis in the arteries. Stagnant processes cause an increase in pressure in the arteries, as a result of which the muscles begin to contract on their own.
In addition, vascular disease is accompanied by obvious external changes. With the development of ischemia, patients complain of persistent itching. Excessive elongation and thinning of the arteries causes bruising and bruising. In the advanced stages, when atrophic processes develop, the following external symptoms appear:
- red spots on the skin;
- formation of dark pigmented spots;
- absence of hair line.
If a patient develops trophic ulcers accompanied by darkening of the extremities, it 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:
- Venous thrombosis. With such a complication, pathological processes affect the deep veins. The pathological vessel is accompanied by a blood clot - a thrombus. The main cause of venous thrombosis is a delay in blood flow in the lower extremities.
- Pulmonary embolism. A condition in which a blood clot separated from the vessel wall enters the pulmonary artery with blood flow and closes the lumen. If the blood clot is large, death occurs immediately. Small clots do not cause death, but rather lead to complex respiratory and circulatory disorders.
- Thrombophlebitis. It is characterized by inflammation of the walls of superficial vessels, accompanied by the formation of blood clots. The disease manifests itself with hyperemia, inflammation and swelling along the blocked vein, pain of varying intensity. Acute thrombophlebitis is accompanied by fever and chills, which complement the above symptoms.
- Trophic ulcers. An unavoidable complication of untreated varicose veins of the lower extremities, which develops in the absence of timely treatment. Disruption of tissue nutrition and the progression of the inflammatory process contribute to the compression, thinning, darkening of the subcutaneous tissue, followed by the formation of incurable trophic ulcers.
- Varicose eczema. Manifested by local redness, peeling, unbearable itching of the skin. If left untreated, the complication spreads quickly and worsens the patient's condition.
- Bleeding from varicose veins. A dangerous complication that develops against the background of rupture of varicose veins.
Because the walls of the affected vessels are very fragile and thin, bleeding can occur due to mechanical injury. Therefore, even less friction can cause excessive venous bleeding.
Diagnosis of varicose veins of the lower extremities
When there are symptoms of the development of vascular disease of the lower extremities, it is necessary to consult a phlebologist who will diagnose, treat and prevent such vascular pathology.
During the initial examination, the doctor was able to make an initial diagnosis, during which a dense network of vessels, swollen veins protruding above the surface of the skin and venous nodules in the limbs were found. To confirm the diagnosis, an additional examination is performed, including the following procedures:
- ultrasound dopplerography;
- ultrasound duplex angiochanalization;
- radionuclide and radiopaque phleboscintigraphy;
Treatment of varicose veins of the legs
If the disease is diagnosed at the earliest stages, in the absence of serious complications, the main goals are prescribed conservative therapy:
- eliminate stagnant processes;
- normalize vascular pressure;
- to restore blood circulation;
- eliminate pathological symptoms.
The following groups of drugs are used for this purpose:
- Venotonics and phlebotonics. They help to improve blood vessels, normalize blood circulation and improve lymph flow.
- Anticoagulants. They are used to reduce blood viscosity and prevent clotting.
- Non-steroidal anti-inflammatory. They have a clear anti-inflammatory effect that relieves pain.
- Antiplatelets. Reduce the risk of thrombosis, improve tissue trophism.
If medical treatment is ineffective and the disease persists, the doctor discusses surgical treatment options with the patient. Surgical methods for the treatment of varicose veins include:
- Sclerotherapy. The application of a sclerosant drug that attaches a vein to the lumen of the affected vessel, as a result of which it is absorbed independently and replaced by connective tissue.
- Laser coagulation. It is indicated when the diameter of the affected vessels does not exceed 10 mm. The laser beam creates the effect of sclerosis in the vein, as a result of which it dissolves itself.
- Phlebectomy. The surgeon, who excises the deformed areas of the vessels, performs all the necessary manipulations through microscopic holes in the skin.
With varicose veins in the legs, any movement that contributes to the development of stagnant processes in the veins of the lower extremities is contraindicated:
- prolonged stay in a static position;
- heavy physical activity, lifting too much weight;
- bend or sit cross-legged;
- wear tight, uncomfortable shoes.
You also need to get rid of bad habits, such as smoking and alcohol abuse. Tobacco smoke and alcohol have a negative effect on the health of the whole body, the arteries are brittle, thin, inelastic, which soon leads to the development of varicose veins and other cardiovascular diseases.
The cost of treatment of varicose veins of the lower extremities
The following factors affect the treatment of varicose veins in the legs:
- stage at which the disease is diagnosed;
- accompanying complications;
- individually selected method of therapy - conservative or surgical;
- the need for additional therapeutic methods such as physiotherapy.