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One in two people suffers from varicose veins. Some people don't even suspect they are sick. Others, the majority of them, wait until the last minute to see a doctor, preferring to treat themselves with a variety of gels and creams whose ads promise "forever healthy veins. "At the same time, many people are simply unaware that today’s medicine has made huge advances in treating this disease and offers several minimally invasive and painless methods.

Varicose veins

There is a view that "varicose veins of the lower limbs" are diagnosed only in people "over 40 years old. "The truth is, no one is immune to this disease. The main cause of varicose veins in the lower limbs is when a person remains in one position (standing or sitting) for a long time, and blood accumulates in the veins during prolonged static load. The modern world is structured in such a way that most in-demand professions place demands on us: all office workers sit in front of computers all day, while salespeople, hairdressers, teachers, or surgeons are forced to spend theirTime to "stand up" during the workday.Risk groups also include:

• Pregnant women (varicose veins in women’s lower limbs are intermittent and return to normal after delivery);
• People engaged in heavy physical labor and lifting weights;
• People interested in strength training;
• Everyone who is overweight.

Phlebologists have a joke: "Anyone who lives will see his varicose veins, unless of course he dies of some other disease! " Cynical? But there is some truth to every joke. 90% of the world's population today suffers from this disease.

What symptoms of varicose veins in the lower extremities should alert a patient and indicate that it’s time to see a doctor? Not everything is simple here. Generally, the disease develops gradually, and many people don't notice problems with their veins at all, attributing everything to fatigue or age-related changes. Let's take the infamous "spider veins" as an example - damage to the small (reticular) blood vessels of the venous system.Modern phlebology does not consider reticular varicose veins of the lower extremities alone. Rather, it is a cosmetic defect that occurs in women due to hormonal imbalances and does not necessarily lead to varicose veins. The main symptoms of varicose veins in the lower limbs include swelling, a feeling of heaviness in the legs after get off work, and sometimes cramps.

Today, lower extremity venous ultrasonography is the most informative method for diagnosing varicose veins. When should you do it? If at the end of the day your legs feel "full of lead" and visibly swollen. By the way, it is now considered the gold standard for a phlebologist to personally perform an ultrasound examination to determine the severity of the disease and decide on the further treatment strategy for the patient.

Stages of varicose veins in lower limbs

According to the CEAP international classification used in phlebology, the development of deep varicose veins of the lower extremities is divided into 6 stages.

• Stage zero.There were no noticeable changes other than leg discomfort at the end of the day.
• The first stage.A single network of small veins can be seen through the skin.
• second stage.The dilation of the saphenous vein is clearly visible through the skin of the leg.
• The third phase.A feeling of heaviness in the legs is accompanied by swelling and the appearance of venous "lumps" above the surface of the skin.
• The fourth stage.In the area above the dilated deep veins, the skin begins to itch persistently, and over time, the skin turns dark brown.
• The fifth stage.An indicator of advanced disease: trophic ulcers appear where damaged veins have been scratched and take a long time to heal.
• Stage Six.Trophic ulcers no longer heal, ooze, and become continuously infected.

Depending on the extent of varicose veins in the lower extremities, doctors choose one or another treatment strategy.

Varicose vein surgery

It is worth clearly understanding that the treatment of varicose veins of the lower limbs does not always involve surgical intervention. Patients often search the Internet for answers to the following question: "How to treat reticular varicose veins of the lower limbs? " Although such a diagnosis simply does not exist in Western terminology, this is exactly the situation in which surgery can be performed without surgery.In the initial stages of varicose veins, it is enough to adjust your lifestyle and take rutin drugs, which strengthen the walls of blood vessels. Only a doctor can prescribe its dosage and duration of use.Fundamental treatments for varicose veins in the lower extremities include phlebectomy, laser surgery, and various mechanochemical methods*. Let's take a closer look at them.

• standard phlebectomyThis is a surgical removal of fragments of damaged veins under general or spinal anesthesia. It can be performed in various ways (according to Babcock, according to Varady et al. ), the choice of which is decided by the doctor based on the severity of the lesion and the diameter of the damaged vein. In any case, modern phlebology considers this treatment method as an extreme measure, used when other methods cannot be used for various reasons.
• intravenous laser coagulationIt belongs to the category of modern thermal ablation treatment methods. An electric current is applied to the affected vein, causing a blood clot to form. Over time, the clot is replaced by connective tissue and the problem vein disappears. The advantage of this method is that it is painless. The surgery is performed under local anesthesia; upon completion, the patient gets up and goes home.
• radiofrequency ablationThis is another method of laser treatment for varicose veins in the lower limbs. The operating principle is similar to intravenous laser coagulation, except that in this case the role of the electrode is played by a light guide, through which the pathologically altered vein is exposed to radiofrequency radiation. This surgery is also performed using local anesthesia and has a short recovery period.
• ultrasonic sclerotherapyToday, this mechanochemical approach is considered more innovative than laser therapy because it uses chemical rather than physical agents. A sclerosing agent, a special medicinal substance that "glues" the veins together, is injected into the vein cavity. The procedure is painless for the patient and is performed in an outpatient setting. Most effective for superficial varicose veins. However, it is not included in the basic compulsory medical insurance coverage.

* Please note that the decision to select one or another treatment method is made by the physician based on the individual indications and contraindications for a given patient.

Ointments and gels for varicose veins

Are there any medications that can treat varicose veins in the lower limbs? They apply, but with two serious reservations. First, since the goal of drug treatment in this case is to relieve the symptoms rather than the cause, they should be prescribed only if there are signs of venous insufficiency, which we have discussed above. Second, they are prescribed only by treating physicians.As for the various gels, creams and ointments used to treat varicose veins of the lower limbs, their effect is extremely negligible, for the simple reason that the active substances reach the vein walls in minimal concentrations. Many patients experience relief after applying such medications to problem areas on their legs, which can be explained by the placebo effect. If you use any external products, then you should take into account this important nuance: they are safe to use only when there are no open skin lesions, that is, in stages 1-3 of the disease.

Massage and physical activity to treat varicose veins

A comprehensive treatment plan for varicose veins includes massage and exercise therapy. Do I need to say that both the first and the second must be approved by the attending physician? Light massage of varicose veins in the lower limbs is aimed at improving blood circulation and should be performed by a specialist only in the absence of trophic ulcers.Gymnastics for varicose veins of the lower limbs can prevent the formation of edema and promote the outflow of lymph fluid. Exercises you can do on your own at home include:

• Cycling.Lie on your back and imitate pedaling a bicycle.
• Walk alternately.Stand on your toes first, then your heels.
• "Scissors".While lying on your back, straighten your legs at the knees and swing them across.

When it comes to yoga and stretching for varicose veins, everything is individual. The ability to perform these exercises depends on factors such as the stage of the disease, the presence of concomitant pathology, and the competency of the fitness instructor.

The risk of varicose veins due to being overweight

Nutrition for varicose veins of the lower limbs is a special topic. The doctor's main wish comes down to one thing: weight must be controlled. Excess weight not only "hits" the joints and is harmful to the function of the cardiovascular system, but it can also be a trigger for varicose veins, since any internal pressure can cause the veins to dilate.There is no special diet for varicose veins in the lower limbs, but it is recommended to exclude spicy and salty foods from the daily menu and replace tea and coffee with herbal teas. The diet should be rich in fiber, fresh vegetables and fruits, which contain high amounts of vitamin C. If you want to prolong the health of your blood vessels in the long term, it is best to say goodbye to bad habits such as drinking and nicotine. time.

consequences of varicose veins

The consequences of ignoring varicose veins are always extremely serious. First, trophic ulcers of varicose veins of the lower extremities are an integral part of the end-stage disease. In addition to looking very unsightly, they are also itchy and painful.Second, all patients diagnosed with varicose veins are at risk for thrombophlebitis of the lower extremities, an inflammatory disease of the veins in which blood clots form within the lumen of the veins. To prevent their appearance, acetylsalicylic acid is also prescribed, but for varicose veins of the lower limbs this is already a double-edged sword. For patients taking anticoagulant drugs, doctors will no longer be able to offer laser surgery as a treatment: ablation procedures (the purpose of which is to cause blood clots) will simply be useless when taking acetylsalicylic acid and similar drugs.

When they ask me: "Doctor, is it possible to do nothing if you have varicose veins? ", I answer honestly: "You can live. But you are unlikely to like this life! " First of all, the veinsNutritional changes can lead to ulcers, which are bound to become infected and leak. Secondly, superficial varicose veins can lead to deep vein thrombosis in the lower extremities, which carries the risk of pulmonary embolism and, in some cases, even death.

Can it be prevented?

It is easier to prevent any disease than to waste time and money on treatment. Unfortunately, varicose veins are a chronic condition. No special precautions are 100% guaranteed to protect us once and for all from the possibility of getting sick. Moreover, even with radical treatment, the probability of recurrence is statistically 30%.Does this mean you should give up everything and not limit yourself? of course not. To prevent varicose veins in the lower limbs, doctors strongly recommend adhering to a healthy lifestyle: watch your weight, exercise more, and participate in non-strength activities (such as going to the swimming pool).Regular use of elastic compression is a good way to prevent varicose veins in the lower limbs: a phlebologist will help you choose class 1 or 2 stockings or tights on an individual basis, depending on the severity of the disease.