Modern medicine varicose veins of lower limbs

Modern healthcare faces many different challenges, but despite rapid advances in medicine, there are still some diseases that continue to affect millions of people. Varicose vein disease ICD 10-I83 is one such problem that is virtually impossible to resolve over time.

Prevalence (number)

The disease has spread widely in developed countries such as the United States, France, Belgium, and Germany, and the number of confirmed patients accounts for almost a quarter of each country's population.Half of all patients are over 55 years old, but another proportion are able-bodied workers, often employed in manufacturing. As any VD disease progresses, complications develop, patients lose their jobs due to disability, so the problem is not only a medical one, but also an economic and social one. The occurrence of varicose veins is related to the age of the patient. Varicose veins in the lower limbs are more common in people over 70 than in people before retirement age.In four out of one hundred patients over 80 years of age, varicose veins were aggravated by concomitant pathologies such as trophic ulcers, various dermatitis, or eczema. Also at this age, other diseases of the cardiovascular and bronchopulmonary systems occur, precluding the possibility of surgical intervention.

important!It is best to consult a doctor as soon as symptoms of the disease appear; the younger the patient, the lower the risk of needing surgery.

origin of disease

Although the disease progresses gradually, there are still etiological factors that contribute to the development of varicose veins.So, what are the causes of varicose veins:

• genetics;
• Endocrine causes;
• mechanical factors;
• Infect;
• poisoning;
• nonspecific inflammatory processes;
• Factors leading to venous hypertension.

Complaints and Symptoms

Oddly enough, in the early stages of the disease, obvious disease is present but often goes unnoticed. The disease develops as the patient mistakes the small blood vessel defect for a minor external condition that will "go away on its own. "More symptoms gradually appear:

• Fatigue/heavy feeling in the legs;
• swelling of the feet;
• Night cramps;
• Numbness, tingling, "tingling" feeling;
• Pain in the area of varicose veins.

Diagnosis of varicose veins is important at any stage of the disease

Disease at any stage requires a diagnosis; the diagnosis indicates which treatment options are best for the patient. Both clinical and instrumental diagnostic methods are used. Depending on the course of the disease, all or only some of these methods may be used.

Clinical examination methods—examination and interview

The clinical approach is applicable not only to varicose veins, but also to any other disease:

1. Medical history collection. The medical record includes all the basic facts about his life (age, genetics, bad habits, main type of work).
2. Definition of complaint. Complaints may indicate how advanced the varicose veins are on examination. The duration of the disease becomes an important condition. When did the first symptoms of leg disease appear?
3. examine.During the examination, the doctor must pay attention not only to blood vessels, but also to the condition of the skin to rule out the presence of complications and accompanying lesions. It is also important to determine the extent of the injury, the temperature of the varicose vein site, and the tone and elasticity of the blood vessels.

A phlebologist is the first doctor who should see your feet.

Instrumental testing methods are a prerequisite

In order to develop a treatment plan, one examination is not enough. Varicose veins of the lower limbs require mandatory instrument diagnosis. In the instrumental research method, the focus of varicose lesions, the length of damaged blood vessels, venous valve insufficiency, blood flow velocity, etc. are determined.this:

1. ultrasound.Standard B-mode studies provide a complete picture of the anatomy and location of blood vessels and their adjacent vessels. Ultrasound can also reveal lesions in vein walls.
2. Doppler ultrasound.This study determines the blood flow velocity and thus the pathological condition of the blood vessel valves.
3. X-ray contrast venography. X-rays are used for more complex diagnosis. This procedure is rarely used due to possible complications.
4. computed tomography venography. It is performed in the same manner as X-ray imaging, with contrast agent introduced into the lumen of the blood vessel. Unlike X-rays, CT images are three-dimensional.
5. MRI.The method is rational and informative, and can be performed without the use of contrast media or other medications. However, this method is still expensive and therefore rarely used.

notes!Contrast media cannot be used in patients with iodine allergy, in which case MRI may be required.

Diagnosis by category

Like other diseases, varicose veins are divided into several categories, taking into account many factors:

external performance	telangiectasia; Varicose veins; edema; Hyperpigmentation; The ulcer is in the healing stage; The ulcer is in the active stage.
disease cause	congenital; The cause is unknown; Acquired (injury, etc. ).
anatomical location of veins	shallow; deep; Distinguish varicose vein perforations individually.
Pathogenesis	thrown into nearby ships; Venous blood flow is blocked.

The most common reason for contacting a specialist is grade 2 varicose veins of the lower limbs, when the external manifestations of the disease become apparent. Perhaps, if the disease does not manifest externally, then the detection of varicose veins will occur at a later stage.

notes!The concept "varicose veins in the lower extremities" is used colloquially only to mean deep varicose veins that can only be diagnosed by instrumental methods.

To treat or not to treat, that is the question

Sooner or later, the gradual progression of the disease prompts the patient to realize the need for treatment. Usually, the task of the doctor is to convince the patient to start treatment at the initial stage of the disease. Treatment directions may vary and depend on many factors (age, symptoms, extent of disease, etc. ).Therefore, the goals of treatment can be:

• Improve quality of life; cosmetic surgical intervention.
• Prevention of complications; impact on microcirculation.
• Eliminate symptoms; hemodynamically significant treatment.

In any case, the treatment method is always chosen by a specialist (phlebologist, vascular surgeon). In the treatment of varicose veins, complexity is important, so you cannot limit yourself to surgical intervention, or to therapeutic and preventive physical exercises. It is very important to follow all your doctor's instructions.

Lifestyle Tips

Varicose veins force patients to abandon the factors that cause complications. Sometimes such measures are necessary because untreated varicose veins can significantly affect quality of life.Self-treatment is useless, however, you should pay attention to your lifestyle to prevent varicose veins from progressing so quickly.What to do for varicose veins:

• Women need to give up their high heels;
• Quit bad habits, especially smoking;
• Move around, and if you have to sit or stand for long periods of time, try changing your posture;
• Avoid tight/tight-fitting clothing and shoes;
• Avoid exposure to high temperatures (tanning, hot wax, bathing, sauna);
• Weight control;
• Do not lift heavy objects;
• Take a contrast shower;
• Walk, run, and swim more;
• Keep your legs elevated as much as possible (sleeping, resting).

compression therapy

Regardless of the cause, people with varicose veins should wear medical knitwear or use an elastic bandage.

1. It is most convenient to use knitwear; stockings or knee-high socks made of special materials usually do not cause inconvenience. The compression level of medical socks should be recommended by your doctor. The only downside to compression garments is the price.

   notes!Medical knitwear manufacturers may have different brands, so you need to choose carefully. Make sure the elastic on your knee socks or stockings isn't too tight.

2. As an alternative, patients often prefer short, medium or long elastic bandages. The choice of dilation also depends on the stage of the disease and should be recommended by a doctor. It may be a little difficult the first few times you use it, as you need to control the tension level of the bandage yourself.

Compression therapy is used daily and wearing underwear or bandages can greatly reduce the strain on your legs throughout the day.

Physical Education and Exercise as Therapy

Varicose veins require exercise, so physical education for treatment and prevention is an important component. Of course, it is better not to perform exercises blindly, but to choose a set of exercises with an expert. Some medical facilities offer group exercise therapy sessions.In most cases, exercise therapy exercises require no special training and can be performed regardless of age; for clarity, there are a group of exercise therapy exercises:

• Tighten and relax thigh muscles (10 times);
• Inhale, lift the abdominal wall, exhale, contract the abdomen (4 times);
• Bend and straighten legs at ankles (10 reps);
• Inhale, raise your arms upward from both sides, and when exhale, lower them (4 times);
• Bend and straighten toes (15 reps);
• Raise your arms as you inhale and lower your arms as you exhale.

Even from this small set of exercises, you can see that anyone can do them, regardless of age. It's important to take your time and do everything slowly, without holding or speeding up your breathing.Athletes can also perform this set of exercises before the main training session. This is especially important if the patient participates in any exercise that is inappropriate for varicose veins.Exercise is also suitable as an alternative to exercise therapy for varicose veins in the lower limbs, but consultation with a doctor and personal trainer is required. Some exercises must be excluded from training.Athletes are sometimes forced to give up their careers, especially in jumping, weightlifting and heavyweight boxing. Those who enjoy swimming, running and walking can continue to do so.

Medications, after being prescribed by a doctor

The pharmacological goals for treating varicose veins are different, namely:

• Improve venous tone;
• Correct microcirculation;
• Improve lymphatic drainage;
• Prevent thrombotic complications;
• Inhibit the development of complications.

This is why all medications must be prescribed by a doctor. It is in this case that there is a guarantee of successful resolution of the disease.Medical therapy is used at different stages: when preparing the patient for upcoming surgery, during the postoperative period and in cases of obvious contraindications to surgery. These drugs can be systemic or local, used in tandem or alone.

venous sclerotherapy

Phenosclerosis also refers to pharmacological treatments, however, their use is often irrational, since the positive effects do not apply to all patients. Most often, this method is used for correction in an aesthetic sense.It should be noted that the use of this method is fraught with recurrences and complications, so the operation is performed by specially trained surgeons.

Physical therapy to treat varicose veins

Physical therapy methods are not the mainstay of treatment for varicose veins, but they have been successfully used to relieve symptoms of the disease. D'arsonval, electrophoresis, pneumatic therapy, magnetic therapy for the treatment of varicose veins of the lower limbs can only be used under the supervision of a doctor, since any physical therapy has many indications and contraindications.All physical therapy procedures are not performed continuously, but in a course of 10-20 days. In most cases, physical therapy can slow the progression of the disease but is not the primary treatment and certainly not used as a monotherapy.

Surgical treatment

Although there are many treatments, surgery actually remains the most basic and important. Vascular surgeons have performed successful surgeries on many patients.With the advent of modern minimally invasive methods, traumatic phlebectomies are a thing of the past. The Brunner method, Müller dissection, and miniphlebectomy using a Varadi hook are all helpful in the treatment of patients with varicose veins and usually last within a day.Of course, surgical intervention also has contraindications. The main group is patients over 75 years old who have tissue dystrophy, microcirculation and/or lymphatic drainage disorders, or excessive venous vascular disease. There are special instructions for performing surgery in these patients. Sometimes you have to forego surgery altogether, and sometimes doctors still perform surgery with a combined phlebectomy.

medical treatement

Treatment options for varicose veins are determined by your doctor. For this purpose, both conservative and surgical methods are used, it all depends on the stage of development of the disease and the presence of complications.The simultaneous use of medications and ointments can relieve pathological symptoms and achieve good therapeutic results. Currently, there is a large selection of medications on pharmacy shelves; they are effective against pathologies in their early stages of development. Medications are effective in treating varicose veins in the legs.

important!Only a doctor can prescribe the medication, dosage and course of use.

Sclerotherapy

Sclerotherapy is one of the best treatments for varicose veins today. Special medications allow you to break up the stagnation of internal veins. After a while, it will start to stick together and dissolve, and blood circulation will be diverted to healthy veins.Treatment is performed in one session, consisting of up to six sessions per painful leg. You can expect to see a positive result within two weeks. However, patients should be prepared to experience pain and stinging.Soon the unpleasant symptoms will disappear and the diseased veins will disappear. The choice of drug dosage should take into account the individual characteristics of the patient.Complications and side effects are extremely rare. Properly performed surgery has a high chance of recovery.Echo sclerotherapy is the same as sclerotherapy except that an ultrasound scanner is used. This method is preferred because the movement of the syringe can be monitored and the drug will be evenly distributed.Foam form sclerotherapy is another type of sclerotherapy. The medication is delivered in the form of microfoam, so the procedure can give you better results. The problem is that the drug sits closer to the vein wall and doesn't mix with the blood.

Surgical treatment methods

Surgery is used to treat varicose veins only when conservative methods fail to achieve the desired results. The patient receives local anesthesia and can go home within a few hours.There is virtually no hematoma and none of the intoxicating features of general anesthesia. The results obtained can last for years.Phlebectomy is a procedure performed during local surgery. Two small punctures are made to remove the affected vein. Sometimes this method can be used instead of sclerotherapy. After a few weeks, patients can return to their normal lifestyle.Laser treatment is the gentlest form of treatment and should only be performed by a qualified specialist. Using an ultrasound scanner, a light guide is inserted into the vein.This process is controlled by special devices. The laser beam makes the plasma boil, the diseased veins close, and they do not participate in blood circulation. Such intervention is costly and therefore not acceptable to everyone.

Dalson Verification

With the help of the D'arsonval device, it is possible to normalize blood circulation and decongest diseased veins. The increasing tone gradually decreases and the tone of the veins increases. The patient's pain and itching were relieved.Adequate circulation of lymph fluid and adequate blood circulation can allow tissues to receive sufficient nutrition, and the oxygen content in them will also increase. Veins either narrow or dilate; gymnastics can increase their elasticity. The device moves from bottom to top. Lymph and blood flow from the ankles to the thighs, and congestion ceases. To achieve the desired results, you need to undergo a complete course of treatment, which includes at least twenty procedures.

home remedies

suggestion!Varicose veins can also be effectively treated using home remedies.

The most common method is to use herbs. You can buy it at a pharmacy or pick it up yourself during the summer.

white acacia tree

Prepare alcoholic tinctures from the flowers of the plant. Soak a cotton swab in it and wipe the affected area several times a day.

sage

Gather the fresh herbs and grind them in a mortar. Separate a spoonful of vanilla and mix with an equal amount of sour cream. Apply the resulting mixture to the sore area and cover it with a bandage. After two hours, remove the dressing. Repeat the procedure for five days, take a short break, and then repeat the treatment process again.

longevity flower

Wash the longevity leaves and place on paper towels to dry. Chop the leaves and place in a glass jar. Pour the alcohol over it and cook for 7 days, stirring occasionally. Strain the tincture and lubricate the sore veins for several months.

apple cider vinegar

Dissolve two tablespoons of vinegar in a glass of water and drink it twice a day. It is recommended to apply undiluted apple cider vinegar to the painful area twice daily. After a month, the veins will begin to narrow.

cream

Grate one part of the garlic and add two parts of the butter. Apply pure cream to the painful area, cover it with parchment paper, and cover it with a bandage. Leave the compress on overnight, wash it off in the morning, and wrap your legs with an elastic bandage. Repeat these procedures throughout the month.

garlic

To consolidate the therapeutic effect, garlic can be taken internally. Mix 250 grams of chopped garlic and 350 grams of honey and soak for five days. Take one tablespoon 3 times daily.

tomato

Slice fresh tomatoes, apply to the problem area and cover with a bandage. Leave the compress on for four hours, then remove and wash your feet. The treatment lasts for two weeks, followed by a ten-day break and then repeats.

prevention

It's much easier to prevent disease than to fight it after the fact, which is why prevention is necessary. If you have a genetic predisposition to varicose veins, you need to take extra care of your health.First, you need to give up your bad habits and follow the advice listed above. Your diet should include foods rich in vitamins.

Vitamin E

This vitamin is found in many foods: lettuce, vegetable oils, beans. It is necessary to strengthen the vein walls and increase their elasticity. Vitamin C has exactly the same properties.

copper

Foods rich in copper aid in the synthesis of elastin. This includes seafood. To maintain your weight, you need to give up sugary foods. To prevent varicose veins, the following rules must be observed:

1. It is not recommended to put too much pressure on your legs during the day. People who stand work need to spend several minutes every hour sitting. Ideal: Take a horizontal position, raise your legs above your head and hold for twenty minutes.
2. If you work in a seated position, you'll need to stand up once every hour for a few minutes and stand during that time. Therefore, the speed of blood movement through the veins will increase. Turn your feet in different directions regularly.
3. Lifting heavy objects is not recommended.
4. Massage your feet with cold water every day.
5. Don't go overboard with saunas and baths.

Effective methods of treating varicose veins can achieve good results. Patients can quickly resume their full lives.

How complicated is the condition?

Complications of varicose veins, although they develop gradually, are always difficult to predict. Without medical supervision and treatment, the risk of complications increases many times.

1. Trophic ulcers with ascending and descending varicose veins.They are most commonly located on the lower third of the inner leg, however, they can also be observed on the outer side, although this is rare. The deeper the trophic ulcer, the higher the risk of bleeding.
2. Thrombophlebitis.This can occur with any type of varicose veins; the occurrence of this complication depends directly on the clotting properties of the blood. This complication can be prevented through laboratory monitoring.
3. eczema.Occurs due to violation of tissue trophic properties. Eczema and trophic ulcers can occur together or independently.
4. Bleeding from varicose veins in lower limbs.As mentioned above, this type of complication may occur in the context of a deep trophic ulcer; this type of bleeding is external. As varicose veins progress, internal (subcutaneous) bleeding is observed.

What is important to know about varicose veins

Varicose veins become a test for patients, because the more they ignore it, the more serious the disease manifests itself. The course of varicose veins depends not only on the doctor's instructions, but also on how closely the patient follows them. Varicose veins are a chronic condition, so treatment usually doesn't end even after surgery.It's important to follow your doctor's recommendations, whether it's magnets, medications, or exercise therapy for varicose veins in your legs. This is a complex treatment that can produce positive results and you should not neglect even the smallest point.