Varicose veins of the lower extremities (varicose veins)

Varicose veins in the legs (varicose veins - common name) - externally visible enlargement of the saphenous veins, which develops as a result of varicose veins or post-thrombotic syndrome and is accompanied by a sharp violation of the venous outflow in the lower extremities.

Modern methods allow to treat varicose veins radically without incisions and pain.

Complaints with varicose veins

Varicose veins in the legs

For many people, varicose veins and spider veins are just a cosmetic problem. In others, varicose veins cause aching pain and discomfort. Sometimes varicose veins lead to more serious problems and complications - thrombophlebitis or the appearance of trophic ulcers. Treatment consists in removing or closing deformed veins, which is the work of a phlebologist.

Varicose veins is a complete degeneration of the venous wall, associated with the weakness of its connective tissue (varicose veins of the lower extremities), or developing with a sharp violation of the venous outflow, due to blockage or overflow of the veins.

Causes of varicose veins of the lower extremities

Varicose veins of the lower extremities

The disease, as the cause of varicose veins of the legs, occurs in 20-40% of the population of the developed countries of the world. For a long time, varicose veins are only a cosmetic defect, but the progression of the disease leads to pain, swelling of the feet and legs, and in advanced stages to darkening of the skin of the legs, inflammatory changes and varicose trophic ulcers.

Hereditary predisposition is the main cause of primary varicose veins, however, the disease develops with excessive stress on the veins. The trigger mechanism for varicose veins of the lower extremities is a sharp physical overstrain, pregnancy and childbirth. In this case, there is a sharp increase in pressure in the veins of the lower extremities and damage to the valve apparatus, which triggers the mechanism for the development of the disease.

Postthrombophlebitic disease

Secondary varicose veins develop after venous thrombosis or as a result of congenital diseases (arteriovenous fistulas, congenital venous dysplasia). Post-thrombotic disease is a complex progressive pathological process in the venous system of the lower extremities. Due to valvular insufficiency or blockage of the deep veins, the saphenous veins dilate as they overflow with blood. Another cause may be congenital or acquired arteriovenous fistulas. Occasionally, congenital obstruction of deep veins occurs, leading to secondary varicose veins (Klippel-Trenaunay syndrome).

Complications of varicose veins

More than 40% of women and 20% of men have swollen dilated varicose veins. In 20% of cases, varicose veins lead to the appearance of a trophic ulcer, more than 25% of patients suffer from thrombophlebitis of varicose veins. These complications often require serious treatment and pose a great threat to health.

Chronic venous insufficiency

Manifestations of chronic venous insufficiency in the lower limb

Obstruction of the venous outflow causes a pathological condition called chronic venous insufficiency. At the very beginning of the disease, the appearance of single nodules of dilated veins can be noted, which do not cause much concern, although they can sometimes ache. Subsequently, there is an increase in the number of varicose veins. The disease slowly but steadily progresses. If the first varicose veins appeared below the knee, then the rate of development of the disease is much higher. If the disease is not stopped, then the third stage of venous insufficiency gradually develops. Edema becomes permanent, a dark color of the skin appears in the ankle area, heaviness in the legs constantly worries, which can persist even after a night's rest. Often develop thrombophlebitis of varicose veins and skin inflammation, eczema and dermatitis. The final stage in the development of varicose veins is the appearance of trophic ulcers.

Thrombophlebitis of varicose veins

Thrombophlebitis on the leg with varicose veins

Thrombophlebitis is the most common complication of varicose veins. Thrombophlebitis is an inflammation of the venous wall, with the formation of blood clots in the lumen of the vein. Thrombophlebitis occurs in superficial and deep veins. With varicose veins, thrombophlebitis occurs in 25% of patients and is usually superficial. The cause of thrombophlebitis in varicose veins is a very slow blood flow, especially in large nodes. Under these conditions, any factors that increase blood clotting (pregnancy, overheating, trauma, sprains, hypothermia and scratches, acute respiratory infections) can cause the formation of a blood clot in the varicose vein and its inflammation. Thrombophlebitis occurs in 25% of patients with varicose veins of the lower extremities. The cause of thrombophlebitis is the slowing down of blood flow in varicose veins. Thrombophlebitis can progress and lead to deep vein thrombosis. Chronic venous insufficiency is a painful condition of venous outflow with varicose veins. It is characterized by edema, darkening of the skin, the appearance of trophic ulcers and varicose dermatitis.

Varicose trophic ulcer

Venous trophic ulcer with varicose veins

A trophic ulcer is a sign of an extreme degree of chronic venous insufficiency. This is a long-term non-healing wound that occurs with a severe violation of the venous outflow through the deep and superficial veins. It occurs in 1% of the general population and in 20% of patients with venous disease. Every fifth patient with varicose veins who does not receive treatment sooner or later gets a trophic ulcer. It can develop both with varicose veins and with secondary varicose veins. Without the elimination of pathological venous discharges, a varicose trophic ulcer does not heal, or constantly recurs. Trophic ulcers with varicose veins occur in most patients and cause serious suffering. Modern minimally invasive methods allow you to reliably eliminate varicose trophic ulcers without incisions and pain.

Venous thrombosis and thromboembolism

Pulmonary embolism is a severe complication of venous thrombosis. Varicose veins are an important risk factor for thrombophlebitis and deep venous thrombosis. Thromboembolism leads to the development of severe heart and respiratory failure, with a mortality rate of more than 50%.

Prevention of varicose veins of the lower extremities

Any modern person should understand what varicose veins in the legs are, how to treat and prevent their occurrence. With a hereditary predisposition, factors contributing to varicose veins should be avoided. The use of venotonic drugs, wearing compression stockings during exercise, periodic examinations by a phlebologist and ultrasound of the veins are shown.

When working in conditions of concomitant factors, it is necessary to use compression stockings of the 1st compression class at work, therapeutic exercises, outdoor activities, daily walks for at least 1 hour in medical stockings, foot massage and swimming. Refusal to use oral contraceptives with complicated inheritance of varicose veins. It is better to adhere to these simple rules than to treat varicose veins on the legs.

Avoid producing factors during heavy physical work. This requires compression stockings, especially with a predisposition to varicose veins. Medical knitwear is indicated for all pregnant women, and in cases of predisposition to varicose veins and thrombophlebitis, special compression stockings are worn for childbirth. It is advisable for all pregnant women to see a phlebologist and perform an ultrasound of the veins in the last weeks of pregnancy. This will help reduce the risk of problems with the venous system.

How to treat varicose veins in the legs

Over the past 10 years, "barbaric" methods of treating varicose veins are becoming a thing of the past, thanks to the emergence of more gentle and effective methods that are successfully used in clinics.

Vein sclerotherapy for varicose veins

Modern sclerotherapy of varicose veins of the lower extremities

Sclerotherapy is the introduction into the lumen of a varicose vein of a drug that causes the walls to "glue" together with the disappearance of the veins. For sclerotherapy, a number of chemicals are used, there have been attempts to treat with ozone. At one time, the appearance of foam sclerotherapy revolutionized phlebology. For the first time, an effective method of treating varicose veins without major surgery has appeared. Currently, foam sclerotherapy is used to remove varicose veins of medium diameter after laser obliteration of pathological venous discharges. Sclerotherapy is indispensable in the treatment of spider veins and reticular varicose veins, where it has no real competitors.

Treatment of varicose veins with a laser

Treatment of varicose veins on the legs with a laser

Laser treatment for varicose veins of the lower extremities (EVLT) is the most modern, radical and inexpensive method of treatment that allows you to both treat varicose veins in the legs and eliminate the causes of trophic ulcers. The meaning of laser treatment lies in the thermal heating of the venous wall from the inside and the subsequent resorption of the varicose vein. The latest achievement in EVLT is a 1470 nm laser and a radial light guide, which were introduced into medical practice by phlebologists. The postoperative period after this technique is completely painless, and the result is superior to other treatment options - the radicalness of laser intervention is at least 98%.

Surgery to remove varicose veins

Miniphlebectomy is the most cosmetic treatment for varicose veins

Surgical treatment of varicose veins with the removal of the main venous trunks is a thing of the past. The risk of complications of stem vein removal forced phlebologists to look for other approaches, which led to the development of laser techniques and other methods of thermal obliteration of veins. However, the modification of classical phlebectomy into microphlebectomy according to Müller and Varadi allowed for a remarkable combination of laser treatment and removal of large varicose veins through punctures without incisions or sutures. Varadi's technique saved patients from painful sclerotherapy of large varicose veins. Miniphlebectomy allows you to both treat leg varicose veins and remove visible varicose veins anywhere on the body.

Radiofrequency obliteration of varicose veins

RFO is a safe treatment for varicose veins

Radiofrequency obliteration (RFO) of varicose veins of the legs is a modern and safe method of treatment. The method is based on the use of microwaves that heat a metal probe, which is narrower than the vein wall and causes destruction of the inner membrane. In terms of its painlessness, the method corresponds to laser coagulation with lasers with a wavelength of 1470 nm, it is easy to perform, and there is little postoperative pain. However, RFO is much inferior to the laser in terms of long-term results of treatment. The effectiveness of RFO is 85% without recurrence. The method is not suitable for the treatment of perforating veins.

Massage and bath for varicose veins

Therapeutic massage of the lower extremities with varicose veins

Massage is a method of active treatment for varicose veins.

All types of modern massage are used, especially in the pathology of the lymphatic and venous systems. Among the exclusive methods is the technology of lymphatic drainage massage with bandaging, which very effectively relieves chronic venous insufficiency.

In chronic venous insufficiency, massage is used to eliminate venous hypertension in varicose veins and post-thrombotic syndrome. The combination of this massage with bandaging allows you to effectively eliminate all clinical manifestations of the disease.

Bath with varicose veins, thrombophlebitis or post-thrombotic disease is very dangerous. Any thermal stress can provoke the formation of blood clots in deep veins with all the ensuing consequences.

Unfortunately, it is impossible to achieve a complete cure for varicose veins without eliminating venous discharges and varicose veins. Although the reduction of symptoms associated with the stagnation of venous blood in the legs is quite possible with the help of modern therapy. However, the prevalence of varicose veins and chronic venous insufficiency sometimes gives rise to a desire to speculate on this problem. Consider modern methods of treatment and fooling.

Medicines for varicose veins

The goal of drug therapy for venous pathology is to reduce symptoms and prevent complications, but these goals are not easy to achieve. Today, the abundance of means that can be applied has given rise to another problem: which one to choose? Unfortunately, most of the proposed drugs have a rather low efficiency, despite the theoretically justified expediency of use. This is due to a number of reasons, the main of which is the low absorption of the medicinal substances of these drugs by the body. An ideal drug for the treatment of venous insufficiency should affect as many pathogenetic links of chronic venous insufficiency as possible, while having a minimum number of side effects and high absorption by the body. A fairly large number of venotonic agents are represented on the modern pharmaceutical market. However, they have similar medicinal substances (plant flavonoids) and therefore the effectiveness of one or another depends only on the concentration and digestibility of the active principle.

You should not expect the disappearance of varicose veins from these drugs, however, lightness in the legs, a decrease in edema and the disappearance of night cramps can be.

Creams and gels for varicose veins

Despite the high efficiency promoted by sellers and manufacturers, creams and gels do not bring relief from varicose veins and varicose veins do not disappear from them. At the initial stage of venous insufficiency, phlebologists do not object to the use of these agents, since their rubbing promotes venous outflow, like a light massage, and has a calming effect on the skin. With advanced forms of venous insufficiency, these creams and ointments can cause dermatitis and allergization, and therefore are very harmful. Some drugs are used in the development of acute thrombophlebitis and help to subside the inflammatory process, but varicose veins do not disappear from them. Thanks to the right advertising, shamanic products with leeches have gained great popularity among the people, but they have no attitude towards medicines, and even leeches, and there is no point in expecting from them.

Medicines for blood clots in varicose veins

A frequent complication of varicose veins is thrombophlebitis, especially during pregnancy and the postpartum period. A proven drug for the prevention of blood clots is a low molecular weight acidic sulfur-containing glycosaminoglycan. To prevent thrombophlebitis after treatment of varicose veins, tablets are used in clinics. They are taken 7 days after laser or radio frequency intervention.

Compression stockings for varicose veins

Compression stockings for the treatment and prevention of varicose veins in the legs

Compression hosiery is undoubtedly one of the most effective means of treating venous edema and reducing the degree of chronic venous insufficiency. Being invented more than 100 years ago, having gained immense popularity in the 20th and even more so in the 21st century, compression stockings and stockings have become an integral part of the treatment by a phlebologist. This is due to the effects that it has:

  • improvement of venous and lymphatic outflow from the lower extremities,
  • improvement of microcirculation,
  • slowing the progression of the disease,
  • prevention of complications of varicose veins (varicothrombophlebitis, trophic disorders),
  • prevention of deep vein thrombosis.

How to use compression stockings

So, if you have varicose veins and plan to treat it, then during treatment you will undoubtedly use compression stockings for a period of several days or several months (individually). If your feet are swollen towards the end of the day after work and you suffer from heavy leg syndrome, you can also use compression stockings during the day to avoid these symptoms in the evening. If you have complications of untreated varicose veins - trophic ulcers or thrombophlebitis - you will, of course, also use compression to improve the condition of the legs and reduce unpleasant symptoms.

The fact is that by improving venous outflow, compression stockings work every second of wearing to improve the return of venous blood from the legs, which is undoubtedly not easy for veins compromised by disease and against the law of universal gravitation. Compression knitwear can be safely called one of the ingenious inventions of mankind, but for it to work for you, several conditions must be met:

  1. Compression knitwear is selected individually (according to the standards). The main requirement is compliance with the anatomical profile of the limb and, therefore, the creation of the correct pressure gradient.
  2. Knitwear is selected by a doctor (phlebologist) individually. Medical products are marked in mm Hg, and are divided into compression classes 1, 2, 3, 4. Each compression class corresponds to a certain pressure. At different stages of varicose veins or chronic venous insufficiency, the appropriate compression class is used. That is why only a doctor has the right to prescribe and choose the right compression stockings - taking into account the nature of the pathology and according to individual standards.
  3. It should be medical, not slimming knitwear. Only proven brands with a RAL certificate.

When do you need knitwear for varicose veins?

  • correction of the syndrome of "heavy legs": reduction of severity, edema, improvement of the quality of life;
  • during treatment with a phlebologist: after surgery or for a period prescribed by a specialist;
  • to slow down the progression of varicose veins;
  • for the treatment of complications of varicose veins (varicothrombophlebitis).

A necessary component of any treatment for varicose veins and chronic venous insufficiency is medical elastic compression. Thanks to compression therapy, it is possible to completely eliminate swelling, heaviness in the legs and create conditions for any kind of radical treatment of varicose veins. Modern medical knitwear has a high therapeutic effect and excellent aesthetic properties.

Comparative characteristics of elastic bandages and compression stockings

Elastic bandages

Therapeutic jersey

The creation of the necessary pressure is determined by the technique and skills of bandaging the doctor or patient

Treatment profile and pressure level specified during manufacture in accordance with the compression class

The need for medical participation in the imposition of a bandage or in patient education

Participation of the doctor is limited to the selection of the compression class and the type of product

Difficulties in providing compression and fixation on the thigh

Provides effective compression and fixation on the thigh

Used for non-standard limb shape

With a non-standard shape of the limb, customization is possible

Daily washing causes bandages to wear out quickly

Daily washing is necessary to maintain compression properties

Needs to be replaced after several washes

Guaranteed preservation of compression properties for 6 months

Possible violations of the water and temperature balance of the skin

Porous binding provides normal temperature and water balance of the skin

Low aesthetic properties, provide convenience and comfort

High aesthetic properties, convenience and comfort in use

Exercises and sports for varicose veins

Power sports for varicose veins and athletics are possible after the elimination of varicose syndrome, or in compression stockings of 2-3 compression classes. Modern treatment is able to bring legs with varicose veins back to normal, which removes all restrictions.

We bring to your attention a complex of therapeutic and preventive exercises developed by leading experts. Its regular implementation will help reduce the manifestations of venous insufficiency in the lower extremities, slow the progression of the disease and reduce the risk of life-threatening complications.

  1. Unloading of leg veins. Breathing deeply and evenly, lie down with your eyes closed, relax. At the same time, place a few pillows under your feet so that they are raised at an angle of 15-20 °
  2. Bicycle exercise. Lying on your back and breathing evenly, imagine that you are pedaling a bicycle.
  3. The exercise consists of several parts, is performed slowly and smoothly. Lying on your back with your legs extended, take a deep breath. Exhaling, bend your right leg, bringing your knee to your chest. Inhaling, straighten the leg vertically upwards. Exhaling, lower it. Repeat this exercise alternately for each leg.
  4. Lying on your back, arms along the body, lift your legs vertically up. Rotate both feet simultaneously inward, then outward.
  5. Alternately bend and unbend the feet at the ankle joint forward and backward.
  6. Alternately bend and unbend your toes.
  7. Stand in a position: legs together, arms along the body. Taking a deep breath, slowly rise on your toes, exhaling, return to the starting position.
  8. Walking in place without lifting your socks off the floor.
  9. Vertical scissors. Lying on your back, arms along the body, breathing evenly, alternately cross your legs, alternating them.
  10. Lying on your back, bend your knees without lifting your feet from the floor. Put your hands on your hips. Inhaling slowly, raise your head and torso. At the same time, the hands slide to the knees. Exhaling slowly, return to the starting position.
  11. Lying on your back, arms along the body, legs at an angle of 15-20 °, hold a small pillow between the feet. Inhaling slowly, bend at the waist, tearing the buttocks off the mattress. Exhaling slowly, return to the starting position.
  12. Lying on your back, arms along the body, bend your knees, keeping your feet on the floor. Exhaling slowly, draw in your stomach. Slowly inhaling, inflate the stomach.
  13. Lying on your back, legs raised at an angle of 15-20 °. Bend your right leg, bringing your knee to your chest. At the same time, tightly clasp the foot with your hands. Slowly straighten your leg up. Hands, tightly clasping the leg, slide along the calf to the level of the knee. Slowly lower your leg, hands sliding over your thigh. The exercise is repeated for the other leg.
  14. Standing, feet together, arms along the body, slowly inhaling, take your shoulders back, slowly exhaling, relax your shoulders and tilt your head forward.
  15. Contrast shower on the legs. Alternating hard jets of warm and cool water. 5-10 minutes for each leg.