Varicose veins are a pathology of the blood vessels of a chronic course, as a result of which the walls of the veins are deformed, weaken and expand. Vascular wall dystonia causes venous valve dysfunction . The general complex of the disease has a negative effect on the entire cardiovascular activity of the body. In the World Classification of Diseases, varicose veins have the following position: the ICD code (varicose veins of the lower extremities) is 183.0-183.9.
General information
Varicose veins of the lower extremities are a common and long-standing disease of mankind. They encountered pathology in Ancient Egypt and even then they tried to treat it. The great scientists of the past were interested in the problems of vessels: Hippocrates, Avicenna and other luminaries. Nowadays, the disease has not lost its relevance and even "rejuvenated." According to statistics, middle-aged women are most susceptible to vascular pathology. Men are much less likely to experience this disease.
The name of the disease is a derivative of the word varix (lat.), Which translates as "extension". The disease has a chronic course, it is not yet possible to cure it. The vessels of the lower extremities are most often affected by it, since the main load on the outflow of blood occurs in this part of the body.
Causes
There is no single verdict that causes varicose veins in modern medicine. Known factors that provoke the occurrence of pathology:
- weakening and deformation of the veins;
- vascular valve dysfunction;
- increase in blood pressure;
- loss of elasticity of the vascular walls of the entire venous structure.
Factors stimulating varicose veins of the lower extremities:
- Predisposition (heredity). Varicose veins occur due to mutations in the gene responsible for the structure of blood vessels, the number of valves and their functionality. The mutation is inherited, as a result, most family members suffer from the disease, have high blood pressure.
- Clotting pathologies - hypercoagulation. The disease proceeds with the formation of blood clots, which complicates blood flow through the vessels.
- Hormonal changes. Vein disease, as a result of this factor, is experienced by women during pregnancy or during menopause. During pregnancy, the amount of the hormone progesterone increases and estrogen decreases significantly, which entails an increase in the speed of blood coagulation, a decrease in venous tone and the formation of blood clots, and vascular deformity.
- Excess weight. An obese patient cannot move fully, resulting in a slowdown in many processes, including blood circulation. Excess body fat provokes an increase in intra-abdominal pressure. These and several other factors disrupt physiological circulation, the outflow of blood through the veins is difficult, stagnation occurs, which provokes the occurrence of thrombophlebitis, a change in the vascular walls, and varicose veins.
- Diabetes mellitus. High glucose damages the walls of blood vessels, contributes to the formation of blood clots.
- Alcoholism. High-alcohol drinks dehydrate the body, leading to thrombophlebitis.
- Hard physical work, standing or sitting work. Working conditions provoke an increase in pressure, impaired blood circulation, its stagnation in the lower extremities.
- Chronic constipation causes an increase in intra-abdominal pressure, destructive outflow of blood from the legs.
- Unbalanced diet. The low content of vitamins, biologically active substances, plant fibers in the diet helps to weaken the tone of blood vessels.
- Tight clothing and underwear cause constant compression of the veins, resulting in obstructed blood flow.
- High-heeled shoes disrupt the functionality of the venous valves and the movement of blood through the vessels.
- Inadequate water consumption during the hot season dehydrates tissues, thickens blood, and leads to blood clots.
- Chronic myocardial pathology, kidney disease.
- The constant use of a number of medicines, a side effect of which is blood clotting.
- Surgical interventions and their consequences, gypsum fixation of the limb, etc.
Classification
World medicine has assigned a varicose code (according to ICD-10) code 183.0-183.9 and considers several stages of the disease, namely:
- Zero - the clinical picture is not visible, the diagnosis does not reveal deviations, the patient complains of vague sensations in the legs (severity, periodic swelling, fatigue after a short walk, etc.).
- The first is the appearance and spread of spider veins, burning in the muscles, cramps during night rest.
- The second - itching is added to the existing symptoms, pigmentation of the skin in the affected area, numbness, severe pain with swelling of the legs, nodes (bumps) of the veins become noticeable.
- The third - the veins lose their tone, the skin in the places of vascular lesions cracks, darkens, the ankles acquire a brown or bluish tint. Cones of veins are pronounced, their slight injury can cause the destruction of the walls of swollen vessels. If an injury has occurred, then a trophic ulcer will form in this place, which is fraught with infections, suppuration, and ultimately amputation of the limb.
In the practice of Russian medicine, not all doctors use this classification, citing the fact that a chronic disease necessarily goes through all stages. The specialist’s task is to delay the onset of the next stage of the development of pathology for as long as possible, as well as apply those methods of therapy or surgery in which any subsequent stage of the disease does not occur.
Possible problems
Complications of varicose veins of the lower extremities are diverse in their manifestations and overtake every patient who neglects treatment. The extreme manifestation of the pathology is fatal.
Varicose veins of the lower extremities are a sluggish, chronic disease requiring conservative treatment. Lack of proper medical attention leads to consequences such as:
- Blood clots.
- Pigmentation of the skin, the appearance of seals in the affected area.
- Separation of a blood clot with subsequent migration in the bloodstream, leading to blockage of the vessel.
- Trophic ulcers, dermatitis, eczema. Diseases are provoked by impaired blood flow, malnutrition, oxygen starvation of cells.
- Thrombophlebitis.
- Swelling of the legs. Tissues at the site of the lesion swell, acquire a bluish tint, the patient experiences discomfort, pulling pains, feels excessive pressure in the limbs.
- Thromboembolism, when a detached blood clot reaches the pulmonary artery. In case of coincidence of the diameter of the artery and thrombus, it becomes clogged, the consequence may be the death of the patient. If the clot continues to move along the circulatory system of the lungs, then there is swelling, pulmonary infarction, etc.
The lack of treatment or the wrong treatment strategy quickly leads to manifestations of complications. The disease is treated with conservative methods with strict adherence to the recommendations of a specialist, which include a set of measures.
Symptoms
Varicose disease of the lower extremities captures the body gradually, a person does not notice its primary manifestations, attributing the symptoms to a difficult day, long walks or drinking too much. The appearance of subsequent signs, such as the vascular mesh, is most often regarded as an unfortunate aesthetic defect, but all these minor difficulties are the first signals about the need to undergo a diagnosis.
The clinic of varicose veins of the lower extremities has a certain picture, stages of development and course. A range of instruments is used to determine the diagnosis. The patient comes to understand that he is overtaken by a disease, with the following symptoms and conditions:
- The appearance of a feeling of heaviness, extreme fatigue in the legs at the end of the day, although there were no long walks, no transfer of weights, no physical exertion.
- The feeling that too hot blood moves through the veins, swelling is observed, the color of the feet changes, there is a feeling of expansion of the feet and calves.
- At night and in the evening, leg cramps appear.
- Veins are visible under the skin, some have a swollen condition.
- The skin on the shins darkens, it also changes color over the localized sites of the affected vessels, the veins weaken and venous cones, seals, wounds, and ulcers appear on the legs.
If any, even a minor symptom appears, it is necessary to consult a doctor for an accurate diagnosis and the start of treatment.
Methods for the diagnosis of pathology
Varicose veins of the lower extremities can affect both external and deep vessels. Diagnostic measures are prescribed by a vascular surgeon or phlebologist. To determine the presence of pathology and the degree of development of the disease, a specialist conducts a series of tests, an external and hardware examination.
Diagnosis of varicose veins of the lower extremities is implemented by the following methods:
- Functional tests for blood flow patency and determination of disability of venous valves. The harness tests of Sheinis, Delbe-Perthes, Pratt are used. The most commonly used Troyanov – Trendelenburg test. The patient, while lying down, raises his leg to a small height, contributing to the outflow of blood. Then the doctor puts a tourniquet on the thigh in its upper part, asks the patient to take a vertical position and quickly removes the tourniquet. The norm is the filling of the vessels of the lower leg with blood for 15 seconds. A longer process indicates blood flow disorders.
- Duplex ultrasound scan (angiography) - an assessment of blood flow in each specific highway, visual examination of veins on the monitor.
- Dopplerography - tracking blood flow in a vessel.
- Phlebography - the study of the circulatory system using intravenous injection of contrast agents, the study of the state of the veins using x-rays.
- Phleboscintigraphy - the introduction into the vein of a pharmacological preparation for special purposes and the study of the state of blood vessels using equipment.
- Visual diagnosis and palpation - the method is used to study the condition of superficial veins.
In addition to an extensive examination of the blood lines, varicose veins of the lower extremities are investigated using laboratory tests of blood status for coagulation, composition, hormonal status and other indicators.
Therapy
Today, one of the often diagnosed diseases of the blood vessels is varicose veins of the lower extremities. How to treat the consequences of the disease, or rather to prevent the development of pathology to the last stage? Turning to a doctor who knows and effectively applies various methods. Why the disease occurs and how to safely avoid its occurrence is still unknown.
The main methods of treatment:
- Medication. A number of drugs can improve the elasticity of the walls of blood vessels, normalize the functionality of venous valves, and prevent blood clots. As effective agents, ointments, creams, anticoagulants, etc. are used.
- Traditional medicine, used in combination with traditional therapy, gives positive results to reduce the manifestations and progress of pathology.
- Normalization of the regime of the day and the observance of certain rules of behavior: a slow rise from bed, a night sleep with legs raised on a soft rise, refusal of shoes with high heels, a transition to a slower pace of walking. In addition, it is recommended that you refrain from crossing your legs while sitting on a chair. Also, patients are advised to use elastic bandages, compression underwear, etc.
- Diet therapy. Refusal of products leading to blood thickening, as well as delicacies, smoked foods, pickles, fried foods, etc. Introduction to the diet of a large number of fresh and processed vegetables and fruits rich in vitamins C, E, P, bioflavonoids, copper. Drinking enough water is advised.
As additional measures to normalize the state of blood vessels, moderate sports are recommended: swimming, cycling, skiing. A contrast shower is useful for stimulating blood circulation, foot baths with medicinal decoctions: oak bark, horse chestnut, chamomile, and St. John's wort. They increase the tone of the vessels of grinding with alcohol tinctures from Kalanchoe leaves, inflorescences of white acacia, lilac, etc. Some experts advise treating varicose veins of the lower extremities with concomitant thrombophlebitis with medical leeches.
Surgery
At a certain stage in the development of pathology, surgical intervention is required to eliminate the already arisen consequences of varicose veins of the lower extremities.
Surgery is performed using the following methods:
- Phlebectomy (realized with extensive damage to the veins, trophic manifestations of the disease, acute thrombophlebitis, etc.). Indicated for surgery on the deep veins of the legs. Contraindications for carrying out is ischemic myocardial disease, inflammatory processes in the acute stage, pregnancy.
- Laser therapy is used in cases where the patient has concomitant diseases (myocardial ischemia, high blood pressure, phlebitis, bronchial asthma, traumatic brain injury, kidney disease, boils, etc.). Contraindications: neoplasms, liver pathologies, pregnancy, cerebral sclerosis.
- Radiofrequency ablation is performed for patients with pathology of both saphenous veins complicated by trophic ulcers. The method is not used in pregnancy, mental illness, acute thrombophlebitis of external veins.
- Sclerotherapy. This method of surgery is available for varicose veins of the superficial veins of the lower extremities, with minor vascular damage.
Surgery is the only way to avoid extreme manifestations of pathology. Surgery for varicose veins of the lower extremities is carried out in cases where complications pose a threat to the patient's life or require the elimination of a cosmetic defect (in the early stages of the disease).
Creams and ointments
External agents, such as creams and ointments, at the initial stage of the development of the disease successfully help in the treatment of varicose veins of the lower extremities (according to ICD-10: 183.0-183.9). These drugs help to achieve these results:
- reduce pain and swelling;
- increase the functionality of venous valves;
- improve vascular tone;
- partially restore healthy blood flow;
- to prevent the occurrence of complications.
The most popular remedies for maintaining healthy legs are:
- Troxevasin, Venoruton.
- Rutin, Aescin.
- Detralex, Venitan-Forte.
- Hepatrombin, Essaven Gel.
- "Lyoton", "Lyogel".
- Heparin ointment, Fastum-gel, etc.
Before starting independent treatment of varicose veins (dilatation of the veins of the lower extremities), it is necessary to undergo a comprehensive diagnosis to identify the root cause of the disease. In therapy, you should adhere to the doctor's recommendations, in which attention will be focused on stopping the main problem and reducing the likelihood of consequences. The specialist will prescribe physiotherapy, medications, ointments, advise on recipes of traditional medicine and will adjust the course of treatment, making the necessary amendments.
Prevent and neutralize
Varicose deep veins of the lower extremities is a disease that requires constant attention and patient efforts to prevent complications. Therefore, preventive measures are of great importance in this regard.
Prevention of varicose veins of the lower extremities is to follow a certain set of rules that ultimately lead to a lifestyle where there are no excessive physical and emotional stress, bad habits, and in food, preference is given to natural products.
Prevention measures:
- Wear clothing of your size and avoid over-tightening your lower body.
- Prefer comfortable low-heeled shoes.
- Organize the work process in such a way as to stretch your legs periodically.
- Balance the diet by including fresh vegetables and fruits.
- In the offseason, take a complex of vitamins.
- Avoid weight gain.
- Exercise regularly with exercise on the legs: cycling, swimming, walking, skiing, etc. In the classroom to avoid excessive load.
- When taking water procedures, use hardening methods (contrast shower).
The doctor will recommend physiotherapy in the overall complex of the treatment process. The patient should clarify whether it is possible to do massage with varicose veins of the lower extremities. Some doctors believe that in the initial stages of the disease, massage will be beneficial if it is aimed at establishing blood flow. At all subsequent stages of the pathology, this type of procedure is prohibited, due to the possible separation of the thrombus.
Tinctures and compresses
Proven recipes of traditional medicine offer a huge selection of agents for treating the disease. Doctors recommend using them in complex therapy, some formulations bring tangible benefits.
Popular tinctures and ointments:
- Alcohol tincture of lilac inflorescences. Opened fresh lilac flowers are poured into a bottle of dark glass (up to half) and poured to the top with alcohol or vodka. The composition is prepared over a week, during this period the vessel must be shaken periodically. Strained tincture is used for soft grinding of the legs. The composition helps relieve swelling, pain, eliminate or reduce seizures.
- Garlic ointment. Clean the head (medium), grind it into pulp and mix with high-quality butter in a ratio of 1: 2. A compress is formed from the obtained ointment and applied to the legs for the whole night. Relieves pain, swelling, disinfects, heals wounds.
- Potato compress. Grate raw potatoes, squeeze out excess juice. The resulting mass in the form of a compress is applied to the affected areas (from 20 minutes or for the entire period of night rest). Relieves pain, fever, eliminates pigmentation, soothes skin irritations.
Varicose veins of the lower extremities (with ICD code 10: 183.0-183.9), unfortunately, cannot be completely cured. However, it is within the power of each person to create such conditions under which the course of the disease will not be complicated by the extreme manifestations of pathology.