Varicose veins on the legs: symptoms and treatment

Varicosis is a systemic disease that can affect the vessels in any part of the body. Its essence is the dysfunction of the valves that control the direction of blood flow. Because of this, there is an accumulation of excessive volume of fluid in the veins, under the influence of which the walls stretch and lose their elasticity.

Most often, medical publications focus on the symptoms and treatment of varicose veins on the legs, since this variety of the disease is considered the most common: according to statistics, more than 80% of all cases of varicose veins are precisely on the lower limbs. However, despite this, for most patients, the diagnosis of varicose veins is a surprise, and its detection occurs in the later stages. All this indicates an insufficient awareness of people about the dangers that varicose veins carries.

Features, causes and mechanism of the development of varicose veins

The main feature of varicose veins of the legs is its vastness. Changes are subject to superficial and deeply running veins on a large length. Since there is a fairly large and long load on the feet, the valves in the circulatory system can begin to weaken in childhood. Therefore, the detection of varicose veins on the legs often occurs in young people and girls.

It is the lower extremities that is characterized by such a phenomenon as hidden varicose veins: against the background of pronounced changes in veins and unpleasant symptoms, there are no visible signs of the disease. Therefore, in about a third of all cases, the disease is detected in advanced stages.

To carry out effective treatment of varicose nodes on the legs, the doctor will have to find out the causes of its occurrence. Since even when using radical methods in 80% of patients, relapse of varicose veins occurs, special attention has to be paid to reducing the effect on the processes of factors provoking varicose veins. These include:

• Hereditary predisposition is an actually uncontrolled factor, which, nevertheless, can be restrained by standard preventive measures;
• Physical influences - an increased load on the legs (long standing and sitting, the habit of crossing the legs, excess weight, weight lifting);
• physiological effects - hormonal changes and taking hormonal drugs (most often contraceptives), metabolic disorders, lack of physical activity;
• Pathological causes are chronic diseases of the liver, kidneys, injuries and systematic tug of soft tissues of the lower extremities, tumors, squeezing the veins in the abdominal cavity.

Depending on the location of the veins, doctors distinguish several types of varicose veins on the legs:

1. Surface. It is expressed by the appearance of a bluish or red varicose grid on the legs, which first resembles a web, and then the plexus of fairly thick winding lines.
2. Deep. It is expressed by a defeat that are not visible during external examination of vascular plexus. Pain in the veins of the lower extremities with varicose expansion of this type is more intense, higher risk of complications.
3. Combined when deep and superficial veins are subjected to change.

The establishment of the causes of varicose veins and its elimination are in close relationship. First of all, it is important to exclude factors that have the greatest negative impact on the state of veins.

When diagnosing venous changes, it is important to differentiate them with other diseases. For example, varicose veins under the knee looks the same as Becker cyst, and is accompanied by similar symptoms.

Stages

The appearance of the first signs of varicose veins on the legs occurs at the progressive stages, when the venous valves perform their functions by less than 50%. At the first or zero stage of varicose veins, which is known as a "stage of compensation", there is no discomfort, as well as visible changes. The detection of the initial stage of varicose veins on the legs occurs with a careful examination of the limbs by a phlebologist.

In the second stage of varicose veins, which is known as "subcompensation", the changes are expressed quite well:

• The outlines of large veins are visible under the skin, but they may not protrude above the surface of the skin;
• On the surface of the skin on the hips and under the knees, a pattern of thin varicose grid from blue or red capillaries is clearly visible;
• By evening, the legs become swollen;
• At night, the calf muscles are cramped.

This stage of varicose veins of the lower extremities is distinguished by increasing symptoms, which weakens after rest.

At the final stage of varicose veins, decompensation occurs: the body cannot replenish the needs of tissues in oxygen, and the valves in the veins by 90% lose their functions. The condition of the limbs worsens due to insufficient blood supply. This stage of varicose veins is characterized by a decrease in tissue abilities to regeneration. The abundance of complications worsens the general condition of the patient. Symptoms at the final stage of varicose veins are constantly preserved.

Symptoms

The most common and early symptom of varicose veins is pain in the legs by the end of the working day. It appears with a change in deep and surface vessels, and is a signal of insufficiently good blood supply to the soft tissues. In some cases, pain is the only symptom of varicose veins of the deep veins of the lower extremities. With a change in surface vessels, the appearance of varicose veins on the legs, which often creates only aesthetic inconvenience, signals the development of the disease.

The nature of pain with varicose veins at different stages of the development of the disease may differ:

• At the initial stage, there is a slight discomfort that resembles ordinary fatigue;
• With progression to the second stage, a burning sensation appears in the legs from varicose veins, which is often localized under the knee;
• Pulling pain with varicose veins of the lower extremities is accompanied by 2 and 3 stages of the disease, along with this, a cramps of the calf muscle can occur;
• Acute pain that provoke chromium occurs at the final stages of the disease.

In addition to obvious physical discomfort, the disease is accompanied by external changes. Most of the patients complain that their legs scratch - with varicose veins, this is considered a normal phenomenon that indicates ischemic processes. A thin varicose grid, which practically does not bother in the first stages, over time protrudes stronger, turning into a thick interweaving of thickened vessels. Any physical activity, including coughing, sneezing or long walking, can lead to a rupture of enlarged capillaries, and sometimes veins. Blood is poured under the skin, forming hematomas.

The presence of bruises on the legs with varicose veins indicates a stable progression of the disease, excessive stretching and thinning of the veins.

The appearance of red spots on the legs with varicose veins, peeling of the skin, its thinning and exposure to injuries indicates atrophic processes that are characteristic of the final stages of the disease. The complications are indicated by the redness of the lower leg, which is accompanied by acute pain and lameness. Such a symptom is characteristic of phlebitis and thrombophlebitis. If the patient is blackened by the leg, this indicates a serious blockage of veins and the beginning of necrotic processes.

Diagnostics

The ease of diagnosis of varicose veins on the legs is exaggerated, since the vessels do not always come to the surface. To confirm the diagnosis, the doctor has to conduct an external examination and conduct a number of instrumental research:

• duplex scanning or ultrasound on the lower limb - for varicose veins, it is used first to determine the degree of stretching of the vascular walls, the nature of blood flow in them and detecting blood clots;
• radiography of the limbs with contrast - the standard of functional examination for varicose veins of the lower extremities, which allows you to determine the patency of blood vessels;
• MRI is the gold standard of the modern diagnosis of varicose veins in the lower extremities, which allows you to evaluate the functionality of the venous valves, identify foci of ischemia in soft tissues, detect blood clots and other pathological changes that arose against the background of varicose veins.

To clarify the complete picture of the disease, laboratory studies are prescribed: a coagulogram to assess the risk of thrombosis, a general and biochemical blood test.

Features of treatment

The treatment of varicose veins on the legs is engaged in a phlebologist. After determining the degree of pathological changes, the doctor selects the most effective, in his opinion, methods of therapy. Unfortunately, it will not work to get rid of varicose veins on the legs forever, since the disease is systematic, and even modern treatment methods give a long -term but not 100% stable result.

According to statistics, even after using radical methods for treating varicose veins of the lower extremities in 80% of patients, relapse occurs for 5 years.

In the initial stages of varicose veins on the legs, treatment is preferably conservative. Its basis is the use of local and systemic drugs:

• anticoagulants that reduce blood viscosity and improve tissue nutrition;
• anti -saggers that reduce the risk of thrombosis and improve tissue trophic;
• Venotonics to prevent further stretching of veins, reduce inflammatory processes and swelling.

With pronounced discomfort for varicose veins on the legs, NSAIDs are prescribed. Preparations of this group help reduce pain, prevent the development of complications.

What to do if itching for varicose legs does not allow to sleep, do familiar things and makes you nervous? It is worth trying ointments or gels with a cooling effect. They will not affect the veins and will not help to cope with the disease, but will quickly relieve the symptom.

In addition to conservative therapy, doctors often use the methods of complex treatment of varicose veins of the lower extremities, when minimally invasive and surgical operations are used simultaneously with medical effects. Such a scheme is used for intense symptoms and extensive spread of venous nets. What measures to take and what to do if varicose veins on the legs begins to suddenly progress, a phlebologist decides. At the same time, it takes into account all aspects of the development of the disease, the individual characteristics of the body and health problems, which can become contraindications to certain procedures.

What methods are used to eliminate pathological vessels:

1. Laser coagulation. It is used if the varicose veins did not switch to 2 and 3 stages, that is, in the presence of small "stars" on the surface of the skin. The method is painless and effective, but expensive. There is no 100% guarantee of cure, since the elimination of visible vessels occurs, while the causes of the disease are preserved. Apply in the early stages to eliminate cosmetic defects.
2. Sclerotherapy. In thin and medium thicknesses, the vessels are introduced by a sclerosant, which seals the lumen of the veins, excluding it from the blood flow system. The procedure is practically painless and relatively inexpensive, but has a lot of contraindications. It is used at 1. 2 and sometimes 3 stages.
3. Flebectomy is a classic excision of pathological veins through punctures or cuts on the skin. This method eliminates surface varicose veins on the hips and lower legs. After surgery, visible scars remain, but the operation is the only effective one with advanced forms of varicose veins.

Conducting surgical or minimally invasive intervention does not mean complete getting rid of varicose veins. The patient will have to regularly visit a phlebologist, take medications to maintain vein tone and wear compression linen.

Contraindications

Experts attribute to contraindications for varicose veins on the legs any actions that can cause additional stagnation in the vessels of the lower extremities. These include:

• long stay in static poses;
• weight lifting;
• sitting with bending or crossing the legs.

Also, patients should avoid taking alcohol, which helps to increase blood viscosity and weakens the walls of blood vessels. Smoking can negatively affect the course of the disease. Therefore, after making a diagnosis, it is necessary to abandon bad habits.

Complications

Thrombosis and inflammatory processes in the walls of the veins, which were mentioned earlier, is far from the only thing that varicose veins on the legs is dangerous for the patient in terms of complications. Due to circulatory disorders, not only blood vessels, but also soft tissues suffer, therefore, among the consequences of varicose veins on the legs, problems with muscles and skin are mentioned:

• dermatitis, accompanied by itching rashes, ulceration of the skin, itching;
• eczema, accompanied by cracking of the skin;
• necrotic changes in the skin up to the formation of gangrene;
• trophic ulcers;
• muscle atrophy.

Often, with the progression of the disease and excessive stretching of the walls of blood vessels, the patient risks encountering bleeding from varicose veins of the lower extremities. It can be like closed when blood accumulates in the muscles and under the skin and forms hematomas, or open. The second option is fraught with a large amount of blood and the coming of a coma, especially if the patient takes anti -agents and anticoagulants.

This complication of varicose veins of the veins of the lower extremities can lead not only to injury, but also a slight physical effort, for example, cough or sharp movement.

The most dangerous complications of varicose veins of the lower limb are the pulmonary artery thromboembolism and myocardial infarction. They occur due to the breakdown of the blood clot in the femoral artery and its migration according to the blood flow system in coronary and pulmonary vessels. Mortality in such processes is extremely high, so it is important for the patient to always follow the well -being and urgently see a doctor with difficulty breathing and dull chest pain.