Varicose veins of the lower extremities - a persistent and irreversible expansion and elongation of the veins that arise as a result of gross changes in their walls, as well as the lack of the valve apparatus due to a genetic defect.
The predisposition of women is due to a cyclical increase in the elasticity of the vein walls by increasing the concentration of the hormone progesterone .
The primary factors in the emergence of varicose veins is an inherited weakness of the vascular wall.
In addition, of great importance in the pathogenesis is a way of life:
- long work standing or sitting;
- lack of regular physical activity;
- lifting weights;
- the appointment of estrogen drugs.
The risk of varicose veins of the lower limbs increases with age. But more and more patients under 30 years of age.
Symptoms of varicose veins
Most often varicose veins patients concerned about the feeling of heaviness, fullness, heat, itching of the skin, "anxiety" in my legs and the aching, throbbing pain in the calf muscles. A characteristic feature of these signs is their appearance after prolonged standing. Usually, discomfort completely disappear or their intensity is significantly reduced during walking, in lying position, after a night of rest or with the use of medical compression products.
An important feature of the disease are cramping in the calf muscles, which usually occur in night time.
Saphenous vein expand in the form of a crimped blue conglomerates in the Shin and thigh. Unfortunately, it is believed that spider veins are a manifestation of varicose veins. However, this is not an absolute sign of disease and is largely a purely cosmetic problem. Such symptoms could be on skin with varicose veins, but for the most part occur in healthy people.
With the development of varicose veins, develop eating disorders of the skin of the Shin. Initially there are areas of excessive staining, later subcutaneous tissue and the skin are compacted, the latter acquires a characteristic "painted" look. In the center of the painted area of the skin in response to minimal trauma, there is a small white area, which resembles a drop of stearin. This so-called white atrophy of the skin, followed by open trophic ulcer.
Malnutrition of the skin is a sign of chronic venous insufficiency, which also includes a symmetrical swelling in the legs.
An ultrasound scan (color duplex scanning; triplex scanning) - the "gold standard" in the diagnosis of varicose veins of the lower extremities. Ultrasound specialist must inspect the vessels of the legs on both sides. He estimates the diameter, compressibility, characteristics of blood flow and the amount of reflux (reverse blood flow). Evaluation of venous valves performed in the patient lying down, but standing.
Treatment of varicose veins of the lower extremities
The same symptoms can be signs of different diseases, and the disease can occur not textbook. Do not try to be treated yourself — consult your doctor.
Modern treatment of varicose veins include surgery, sclerotherapy, compression therapy and use of various medicines.
Surgical treatment is the only method that can reliably improve the quality of life, reduce risks of complications and the likelihood of relapse. It consists in removing varicose veins. There are 2 types of interventions:
- Thermal ablation - minimally invasive (no incisions) treatment with laser or radio frequency sensor;
- Traditional surgery involves excision of varicose saphenous veins. The technique of such interventions sufficiently developed and allows to obtain good functional and cosmetic result.
The article also provides sclerotherapy as a method of surgical treatment. It complements, and in some cases (initial stages of varicose veins) replaces surgery. The procedure involves injection of a special medication into the varicose vein that glues it inside.
Compression treatment of varicose veins
Elastic bandages: pros and cons
Compression therapy is an essential component of any method of treatment of varicose veins and the most effective method of prevention.
For the implementation of the compression treatment, the most frequently used elastic bandages, which, depending on the degree of stretching is divided into 3 classes:
- short (elongation of the bandage not more than 70 % of the original size);
- average (range of increase in original length when stretched in the range 70-140 %);
- a long (140 % higher) the elongation.
Classes mandatory indicate on the packaging of bandage, and they are essential characteristics for the correct selection of products.
Bandages long-stretch appropriate to use in the immediate postoperative period with the aim of stopping the blood and secure the bandage. To ensure optimal therapeutic compression mode is most suitable bandages short or medium elongation.
When using elastic bandages should adhere to the following rules:
- The bandage is applied, the maximum pre-stretching the foot on themselves, to prevent the formation of folds at the ankle that could damage the skin during movement;
- Always start bandaging from the joints of the toes and take the heel;
- The pressure bandage should be gradually decrease from the ankle to the thigh;
- The roll of bandage unwinds outwards while it is in the vicinity of the skin;
- Modeling of the cylindrical profile of the limb is achieved by putting a foam or latex pillows.
Most patients with varicose veins should use elastic bandage during the day, applying it in the morning before rising from bed and taking off in the evening before the night's rest. For treatment of trophic ulcers can be applied multilayer compression bandages, do not remove for a long time, directly with the affected area of the skin of the drumstick in contact bandages soaked in medicinal substances (zinc-gelatin dressings, etc.).
Despite the high efficiency, compression treatment elastic bandages has obvious disadvantages – the infliction of physical and aesthetic discomfort, in addition to older people are very difficult to bandage themselves, observing all the rules.
The wide popularity of special compression hosiery. He presented the stockings to the lower, middle and upper third of the thigh, and pantyhose (including special tights for pregnant women) of the four compression classes.
This knitwear made of cotton, natural rubber – elastane and synthetic rubber. Products made of natural fibers optimal for sensitive and affected (varicose eczema, dermatitis, trophic disorders) skin. With regard to synthetic fibers, the advantages of a small diameter and a variety of colors, allowing to produce medical hosiery with high aesthetic properties.
Drug therapy of varicose veins
The main objectives of medical therapy are the elimination of subjective symptoms of venous insufficiency and in the prevention and reduction of severity of side effects after surgery.
One of the most commonly prescribed drugs are drugs with active ingredient Diosmin. Usually one week after the start of the reception is positive dynamics are night cramps, pain, feeling of heaviness, and reduces swelling. It is believed that the minimum course duration should be at least 2 months. In severe forms of varicose veins, the drug can be continued for up to six months or more.
Creams and gels
Ease of use and relative cheapness of ointments and gels make them very popular among patients and doctors. A serious drawback of the uncontrolled use of local drugs is the high frequency of skin complications in the form of peeling, dermatitis and eczema caused by the increase in sensitivity upon prolonged use of the same means.
So I do not recommend the use of drugs local action (ointments, gels, creams) as prophylaxis and in the absence of symptoms of chronic venous disease.
Agents based on heparin - one of the most popular drugs. Apply 3-4 times a day. When you start using possible mild skin irritation and peeling phenomenon in the field of application of the drug.
In Russia, widespread physiotherapeutic treatment methods. To combat such symptoms of varicose veins of the lower limbs as pain and cramps in the calf muscles, you can use the method of electrical stimulation of the muscles. Other methods of physical therapy have no evidence of the effectiveness of treatment of this disease.
Prevention of varicose veins
Rational organization of work and rest is necessary for all patients with varicose veins. This category of patients is not recommended the work connected with long stay standing or sitting, lifting heavy loads, high temperature. At work and at home they need periodic rest is raised at an angle of 15-20 degrees feet (during sleep it is recommended to lift the foot end of the bed above the level of the heart), a balanced diet that excludes the consumption of spicy and salty foods as well as alcohol. Should strictly control the body weight because obesity leads to disease progression.
Under conditions of elastic compression of the allowed class mobile sports (skiing, Cycling), but the optimal conditions for venous outflow and muscle training of the lower extremities are provided with swimming.