Treatment of varicose veins

treatment of varicose veins by a phlebologist

Varicose veins (varicose veins) are a very common vascular disease that has been known to people since ancient times. Ancient Egyptian papyri mention it, a mummy with manifestations of varicose veins on the legs was also excavated. Find information on the pathology in Hippocrates, Galen, Avicenna. Even modern doctors are often faced with varicose veins in patients, in search of effective treatment methods.

The term "varicose veins" is of Latin origin, the word "varix" is translated as "expansion". Therefore, the disease and began to be called "varicose veins". With this ailment, the peripheral veins increase in volume, become long, tortuous, deformed, nodular. Blood pools in the lower leg because the valves start to malfunction and the walls weaken. Most often, there is a lesion of the vessels in the legs, since there is the greatest load on the vessels, it is necessary to pump large volumes of blood and overcome the force of gravity.

Varicose veins are diagnosed in about 17-25% of people. Among young people, both boys and girls are equally sick. In mature and elderly women, this pathology occurs 2-3 times more often than in their peers. This is due to the constant hormonal changes in the female body that occur throughout life.

How are the veins of the legs arranged

The legs have two groups of venous vessels: superficial and deep or deep. The first are found in the subcutaneous tissue, that is, on the surface of the leg. The latter are found deeper, in the thickness of the muscles, near the arteries and tendons. The deep and superficial vessels are connected by perforating or perforating veins. Their wall is made up of collagen and elastin fibers, with weak and few smooth muscles.

The venous wall has a three-layer structure:

  • Above is the adventitia, which is made up of loose connective fibers, smooth muscle cells stretched along the walls, surrounded by small capillaries and nerves responsible for the trophism of the vessel.
  • In the middle is the media, made up of smooth circular muscle fibers.
  • Inside it is intimate. The basis of the intima is the endothelium, between its cells there are longitudinal fibers of smooth muscles. The inner shell is folded, the bulges face each other and resemble swallow's nests or patch pockets. They are called valves and are responsible for the correct direction of blood flow.

Venous valves direct blood from peripheral veins to the heart and from superficial to deep veins. They prevent backflow, increase venous pressure. In addition to the valves, the smooth muscles, tendons and muscles of the legs participate in the maintenance of normal tone. With the defeat of any of the layers (most often the median and internal), the veins lose their tone and expand, varicose veins occur.

There are several superficial veins:

  1. The great saphenous vein is located on the inner side of the leg, its walls are equipped with several valves, blood is collected from the anterior femoral surface through a series of smaller vessels in this vein.
  2. The small saphenous is located on the outside of the leg, equipped with valves, collects blood from the veins from the front and back of the leg.

Communication between the large and small veins occurs due to the connective vessels.

The posterior and anterior tibial veins, the popliteal vein and the femoral vein are called deep. Varicose veins develop in them in advanced stages, when the disease is not treated for a long time.

For what reasons do varicose veins appear and who is at risk of getting sick?

Why people suffer from varicose veins right now is hard to say. Only a few risk factors have been identified, due to which the valves weaken, the elasticity and tone of the walls of the superficial and perforating veins decreases.

Here are the factors that lead to the development of the disease:

  • Heredity. The structure of the walls of blood vessels is genetically determined, with some changes in the genes, they weaken, the valves do not close well. As a result, at the slightest increase in pressure in the veins, a reverse outflow of blood occurs, the vessels overflow and expand.
  • Hormonal changes in the body in women. This situation is typical for pregnant women or for the second half of the cycle, when the amount of progesterone increases and the level of estrogen decreases. As a result, blood rheology changes (coagulability increases), vascular tone decreases, elastin and collagen fibers are destroyed, and the risk of blood clots increases.
  • Obesity. Overweight people move little, which slows blood flow throughout the body. An excess of subcutaneous fat on the abdomen leads to an increase in pressure in the abdominal cavity, blocking of the large veins. This leads to blood stagnation in the vessels of the legs and thus to varicose veins.
  • Diabetes. Sugar, the level of which rises in this disease, damages the vascular endothelium, which increases the risk of blood clots.
  • Alcoholism. When large doses of alcohol are consumed, dehydration occurs, blood thickens, clots form, blocking small vessels and causing stagnation.
  • Static professional loads such as heavy lifting, standing or sitting work. Muscle tone in such a situation decreases, blood moves worse from the lower limbs to the heart, stagnation occurs, the veins in the legs expand due to this.
  • Congenital anomalies of blood clotting. Hypercoagulation, in which too many factors responsible for the formation of blood clots are produced, causes thrombosis and makes it difficult for blood to circulate through the vessels.
  • Wrong diet. A diet deficient in a number of vitamins (C, E, PP), vegetable fiber leads to disturbances in the structure of the endothelium and other structural elements of the vascular walls.
  • Tight underwear. When wearing tight underwear, part of the veins are pinched, causing difficult blood flow from the lower half of the body.
  • Frequent constipation. People suffering from this problem have to constantly push, this increases the pressure inside the abdomen, as a result, there is a difficulty in the outflow of blood.
  • High heel. Overloading of the calf muscles, insufficient contraction, causes blood to stagnate in the veins.
  • Hot weather. In the summer, during the heat, the body dehydrates. If you don't compensate for the problem by drinking enough fluid, your risk of blood clots in your vessels will increase.
  • Pathology of the heart and kidneys. These can be congenital or acquired heart defects, kidney failure.
  • Excessive doses of drugs that affect clotting. In this case, the blood vessels can become clogged due to the formed blood clots.
  • Operation. The risks of thrombus formation in this case are increased due to blood loss, compression of the veins during surgery.

How complicated can varicose veins be

  • Blood stasis thrombosis.
  • Vascular thromboembolism following separation of the thrombus.
  • Thrombophlebitis or inflammation of the venous wall.
  • PE (pulmonary embolism). In this case, the blood flow in the pulmonary circulation is sharply stopped, which leads to death. Small blood clots can become trapped in the small pulmonary arteries and cause a heart attack or pulmonary edema.
  • Trophic ulcers, eczema on the skin of the legs due to nutritional disorders of the tissues. With poor blood circulation, little oxygen and nutrients enter the tissues, which disrupts regeneration or causes massive cell necrosis.
  • Edematous syndrome. As a result of a violation of the outflow of blood and stagnation through the walls of the vessels, fluid enters the intercellular space. Edema is of a soft, elastic consistency, most often appears near the affected vein, regardless of the time of day.
  • Dermatitis. The inflammatory process in the skin develops due to impaired blood flow and tissue nutrition.
  • Hyperpigmentation, cyanosis of the affected skin.
  • Compaction of subcutaneous fat due to edema and hemorrhage.

How to diagnose varicose veins

  • With the help of functional tests (application of a tourniquet), the condition of the valves is studied. They are named after their authors: Troyanov-Trendelenburg, Pratt, Sheinis, Delbe-Perthes, etc. In this position, the doctor strokes the limb from the foot upwards to empty the superficial veins. The next step is to apply a tourniquet to the upper half of the thigh, after which the patient gets up from the sofa. Healthy shin veins should fill up after 15 seconds.
  • Duplex ultrasound of the veins (ultrasound angioscan) provides most of the information, allows you to view the vessels and blood flow through them.
  • Doppler imaging is a method of evaluating blood circulation in vessels.
  • Phlebography or X-ray examination using contrast, which helps to study the internal structure of the vessel.
  • Phleboscintigraphy is a technique that uses radioactive substances with further studies on a special device for their distribution.

To examine the superficial veins, they are examined and palpated. The first three methods are used as additional surveys. The last two methods are needed to study the state of deep or deep veins.

Treatment of varicose veins

Conservative treatments

  • Drug therapy does not cure varicose veins, but with the help of drugs, the function of the valves, vascular trophism, blood circulation is partially improved, and the risk of thrombosis is reduced. Venotonics are used for this purpose. They can be prescribed for any type of varicose veins. Ointments with non-steroidal anti-inflammatory drugs are indicated for thrombophlebitis. Also in this situation, anticoagulants are used, which effectively dissolve blood clots. Treatment should be selected by a doctor, after a thorough diagnosis and taking into account the patient's characteristics.
  • Herbal medicine and additional techniques are of secondary importance. We recommend wearing compression socks, exercising, skiing, cycling and swimming. A good result is given by the "bicycle" exercise in the supine position, in flexion and extension of the feet, it improves the flow of blood from the extremities. Exercise can be done if there are no complications. It is also recommended to take a contrast shower in the morning (first water the leg with warm water, then gradually lower the temperature to cold). Fresh baths with decoctions of oak bark, horse chestnut, chamomile, St. John's wort, rubbing the skin with tincture of acacia flowers, Kalanchoe leaves, apple cider vinegar help. Leeches help get rid of thrombophlebitis.
  • Mode. Get out of bed slowly, 5-10 minutes. The legs should be raised 10-15⁰ at night, for this, a roller is placed under the heels. You need to walk calmly, it is undesirable to cross your legs when sitting, do not work too hard. All patients are advised to wear compression stockings.
  • You need to eat right, include coarse fiber, vitamin-rich foods in the menu. Citrus fruits, tomatoes, rose hips, black currants, nuts, legumes, liver, onions, eggs, seafood will be useful. It is important not to drink alcohol, not to smoke, and to drink enough water throughout the day. With persistent constipation, it is recommended to drink a laxative.

Surgery

Phlebectomy or complete removal of the veins

The indication for such a radical operation is varicose veins, in which a large number of veins are involved. At the same time, there are complications: trophic ulcers that are difficult to treat, thrombophlebitis, persistent edema in the legs, general symptoms (fatigue, dizziness, fainting).

The operation is contraindicated in CHS, severe infections, in very elderly patients, in the second half of pregnancy, with local inflammation of the legs (erysipelas, pustular eruptions, eczema).

Only a surgical intervention is able to radically relieve the patient of varicose veins, to resume the functioning of the valves. If the situation is too serious, left untreated and neglected, this method of treatment remains the only one. The disadvantages of the intervention are the need to administer anesthesia and keep the patient under observation for several days in the hospital, postoperative trauma with scars and scars.

Laser therapy (endovascular microthermocoagulation)

Laser treatment of varicose veins is used if the pathology is associated with diseases of the cardiovascular system (CHS, hypertension), changes in peripheral vessels (phlebitis, thrombophlebitis), diseases of the respiratory system (asthma, chronic bronchitis, pleurisy), gastrointestinal pathologies (cholecystitis, ulcer, peritonitis), the nervous system (FM trauma, meningitis, encephalitis and their consequences), the genitourinary system (inflammation of the kidneys, prostate, pathology of the uterus with appendages), with skin diseases (furunculosis, psoriasis, etc. ).

Contraindications to the use of a laser are oncology, decompensated pathology of the kidneys, liver, heart, cerebral sclerosis, pregnancy.

The main advantages of laser therapy are its effectiveness in eliminating the expansion of superficial veins, speed (the duration of the manipulation is 15-20 minutes), no need to go to the hospital, low trauma.
Among the shortcomings, it is worth highlighting the low availability of the technique; not all clinics have the appropriate equipment. The treatment is expensive and is not very helpful in removing severely affected and deep veins. If the laser is used incorrectly, it is possible to get a thermal burn, sometimes depigmentation occurs at the sites of exposure.

Radiofrequency coagulation (ablation)

The operation is indicated for extensive lesions of the saphenous veins, trophic ulcers resulting from long-term and untreated varicose veins.

Radiofrequency coagulation is contraindicated in acute thrombophlebitis, limited patient mobility, pregnancy, mental disorders.

The main advantages of the method are its painless, no trauma, no need to stay in the hospital. Patients can return to their normal activities the next day.

The disadvantage is the high cost of the intervention.

Sclerotherapy

It is indicated for varicose veins of small and large superficial veins (on large vessels it is performed under the control of duplex Doppler) in the initial phase and without complications.

Do not treat pregnant and lactating mothers in this way, with drug allergies, with deep vein thrombosis, infectious and inflammatory skin lesions on the legs.

The main advantages are the low cost, the quick recovery, the absence of hospitalization. The procedure leaves no residue and does not cause injury.

The disadvantage is the risk of getting a sclerosing drug in a deep vein, a decrease in efficiency in contact with blood, the ability to use only in the initial stages.

Can varicose veins be treated at home?

At home, it is allowed to use auxiliary methods for the treatment of varicose veins, which relieve symptoms. They use pharmacy or self-made ointments, herbal baths and lotions, compresses, decoctions and infusions to improve blood flow and relieve swelling. There are some recipes below.

Tincture on chestnuts

Take about 200 g of ripe and peeled chestnuts. Pass through a meat grinder or grind with a blender. Pour everything with a liter of vodka, put it in a dark corner and insist for a couple of weeks. To make the product smell good, add a couple of drops of peppermint oil. In the evening, they lubricate the legs with tincture to eliminate heaviness, itching, strengthen blood vessels and prevent their fragility. It is also recommended to make a compress from the tincture. If there is no chestnut, replace it with nutmeg, the recipe remains the same. Musk nut tincture can not only rub sore legs, it is recommended to drink 20 drops a day. After the bottle runs out, make a new tincture. But there should be a 2 week break between taking the next serving.

Calendula ointment

An infusion from calendula flowers is prepared: a spoon is poured with a glass of boiling water, put on fire, boiled for a couple of minutes, insisted for 3 hours in a thermos. Filter the infusion and add some fat, lanolin, petroleum jelly, badger fat will be fine. For the perfume it is recommended to add a drop of aromatic oil (rose, bergamot, citrus, sage, lavender, etc. ). Rub the ointment in the morning and in the evening, with gentle movements from the lower leg to the knee, until completely absorbed. Thyme, hop cones and nettle are also added to the marigold infusion.

Chamomile oil

Medicinal chamomile flowers are folded into a half-liter jar of dark glass so that the container is filled to the top. Pour half a liter of any type of vegetable oil, for example, olives, corn, hemp. They insist for a month, shaking or stirring from time to time. Subsequently, the oil infusion is filtered. For the scent, add a couple of drops of tea tree oil, mint, lavender, grapefruit. Chamomile oil is applied to the leg early in the morning and late in the evening, while doing a light massage at the same time. You can also make night compresses from the infusion.

Wormwood bitter compress

Take a packet of kefir or fermented cooked milk, 3 tablespoons of dry wormwood. The grass is mashed, mixed with kefir (fermented cooked milk). When the grass gets wet, spread it on gauze along with a thick liquid. Then put a compress on the leg, cover it with wax paper on top (cellophane film is not used), fix everything with several layers of bandage. Keep your legs raised, the compress is removed after half an hour. It is recommended to carry out the procedure twice a day. Instead of wormwood, you can take hops, chamomile flowers, twine, clover, oak or birch leaves, St. John's wort, horsetail, tricolor purple flowers, yarrow. Combinations of different plants give a good effect. To enhance the effect of the compress after the procedure, it is recommended to lie down slightly with the legs upside down. All of these herbs can be infused into a foot bath. The water in such a bath should be warm, the duration of the procedure is about 25 minutes. Relieves fatigue, swells well, reduces itching and pain.

Folk recipes for internal use

Various phyto-preparations well improve blood flow in the veins. The following herbs are used:

  • Clover
  • Succession
  • Leaves and berries of cranberry, viburnum, strawberry, raspberry
  • Mother and stepmother
  • Calendula
  • Japanese Sophora
  • Melissa
  • Schisandra
  • Hawthorn

The grass is dried, then crushed and a mixture of different types of plants is obtained. Then they take 3 tablespoons, pour a liter of boiling water, insist all night in a thermos and drink 1/3 cup before meals.

It is good to treat varicose veins with bee pollen and honey. Pollen should be ingested. You can also eat honey, but it still makes great wraps. It is recommended to add infusions of various herbs to honey.

Treatment of varicose veins in pregnant women

Carrying a child is accompanied by a hormonal storm in the female body, overload, which often provokes varicose veins. The treatment is carried out in this period conservatively, with the help of local creams, ointments and gels.

The most effective ointments have a decongestant effect, relieve heaviness in the limbs. They are applied in a thin layer, moving from the bottom upwards, with soft massage movements. The frequency of manipulations is 1-3 times a day.

Folk remedies also help. It is recommended to prepare baths with herbal decoctions (from chamomile, thyme, hop cones, calendula, wormwood, coltsfoot, oak bark, birch leaves, etc. ).

You can fight edema by applying battered raw cabbage leaves or potatoes to your feet. Cover the waxed silt compress with regular thick paper, not cellophane, so that the skin can breathe. The procedure is done before bedtime, and the lotion is left overnight.

Doctors also prescribe drugs for internal use to pregnant women. There are venotonics that do not adversely affect the development of the fetus and the health of the mother. Most often, they are based on plant extracts.

After taking drugs, the venous tone increases, the walls become elastic, not so stretched, the lymphatic flow improves, the liquid part of the blood ceases to penetrate the intercellular space, and the edema passes. You can not drink these funds without a doctor's prescription.

Traditional methods of treating varicose veins

There are many popular recipes for infusions, decoctions, lotions and compresses. It is recommended to take a number of funds also orally. Below are several treatment options for varicose veins using alternative methods.

Tincture of lilac

They take a container with a volume of one and a half liters, pour lilac flowers and leaves into it. Then everything is poured with vodka or medical alcohol so that the liquid completely covers the herb (up to the edge of the container). Insist for a week, shaking from time to time, then strain and rub the legs with the tincture every day. Rub the skin with gentle massage movements, from the fingers to the knees.

With the help of tincture, they fight inflammation, edema, cramps, pain in the legs.

Garlic ointment

Cloves of garlic from a whole head are peeled, ground in a meat grinder or squeezed through a garlic maker. After that, you need to take the butter (unsalted) and mix it with the crushed garlic, in a 1: 2 ratio (2 parts of butter and 1 part of garlic). Apply this mixture on the affected leg, cover with wax paper, bandage, the compress can be kept all night.

The compress eliminates pain, burning sensation, has antiseptic properties, softens the skin and helps tighten wounds.

Honey with garlic

You need to take a head of garlic and 250 ml of honey (preferably linden or buckwheat). Both ingredients are thoroughly mixed and infused for a week. Drink one tablespoon, three times a day, before meals.
The tool relieves swelling and fatigue, pain, varicose veins become less noticeable.

Potato juice

Raw potatoes are chopped on a grater or in a blender, gruel is applied to the sore spots. The compress is kept for about half an hour, if desired, you can leave it overnight. To increase efficiency, drink half a glass of potato juice at the same time. The product relieves swelling and discomfort in the leg, eliminates heaviness, reduces fatigue and inflammation.

What is the effect of wearing compression underwear for varicose veins?

Compression underwear cannot cure varicose veins. But wearing it slows down the disease, alleviates many of the symptoms caused by it, and improves well-being.

After wearing compression stockings, the lumen of the saphenous veins narrows, the blood and lymph flow better, they do not stagnate in the limbs. At the same time, the swelling is removed, the convulsive contractions of the calves disappear, the legs get tired less, there is no feeling of heaviness.

The main types of compression underwear, which are prescribed for varicose veins, leggings, stockings, stockings, long tights. It is recommended to wear the products every day, it is necessary to wear them in the morning, before getting out of bed, always in a lying position.

There are different degrees of compression of knitwear, they are chosen according to the stage of varicose veins. Only correctly selected underwear will have the desired therapeutic effect. It is better to be prescribed by a doctor, but low compression stockings or tights, for prevention, are easy to buy on their own.

Before buying, you need to determine exactly which compression class you need. Request information on the characteristics of the product labeling of the chosen company. Reputable companies always use the word "compression" to define the class and define it in mm Hg. If "DEN" is written on the package, this product has nothing to do with medicated linen.