Varicose veins treatment

treatment of varicose veins at a phlebologist

Varicose veins (varicose veins) is a very common vascular disease that has been known to people since ancient times. The papyri of Ancient Egypt mention him, even a mummy with manifestations of varicose veins on the legs was excavated. Find information about pathology in Hippocrates, Galen, Avicenna. Modern doctors, too, are often faced with varicose veins in patients, looking for effective methods of treatment.

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 stagnates in the lower parts of the leg because the valves start to work poorly and the walls weaken. Most often, there is a lesion of the vessels on 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 ill. In mature and elderly women, this pathology occurs with a 2-3 times higher frequency than in their men of the same age. This is due to the constant hormonal changes in the female body that occur throughout life.

How the veins in the legs are 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 located deeper, in the thickness of the muscles, next to the arteries and tendons. Deep and superficial vessels are connected by perforating or perforating veins. Their wall consists 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, consisting of circular smooth muscle fibers.
  • On the inside is intima. 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 are opposite each other and resemble swallow nests or patch pockets. They are called valves and are responsible for the correct direction of blood flow.

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

There are several superficial veins:

  1. The large saphenous vein is located on the inner side of the leg, its walls are equipped with several valves, blood from the anterior femoral surface is collected through a series of smaller vessels into this vein.
  2. The small saphenous vein 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 at advanced stages, when the disease is not treated for a long time.

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

Why people suffer from varicose veins at the moment is difficult to say. Only a number of 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 leading 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 down blood flow throughout the body. Excess subcutaneous fat on the abdomen leads to increased pressure in the abdominal cavity, clamping of the great veins. This leads to stagnation of blood in the vessels of the legs, and then 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, the blood thickens, clots are formed that clog the small vessels and provoke stagnation.
  • Static professional loads such as lifting heavy loads, standing or seated work. Muscular tone in such a situation decreases, blood moves worse from the lower extremities to the heart, stagnation occurs, the veins in the legs expand because of this.
  • Congenital blood clotting abnormalities. Hypercoagulation, in which too many factors are produced that are responsible for the formation of clots in the blood, provokes thrombosis and makes it difficult for blood to move through the vessels.
  • Wrong diet. A diet deficient in a number of vitamins (C, E, PP), plant 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 is pinched, which provokes a difficult outflow of blood 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. Overstrain of the calf muscles, insufficient contraction, causes the blood to stagnate in the veins.
  • Hot climate. In summer, during the heat, the body becomes dehydrated. If you do not compensate for the problem by drinking a sufficient volume of fluid, the risk of blood clots in the vessels will increase.
  • Pathology of the heart and kidneys. These can be congenital or acquired heart defects, renal failure.
  • Excessive doses of drugs that affect clotting. In this case, the blood vessels can become clogged by the formed blood clots.
  • Operation. The risks of thrombus formation in this case are increased due to blood loss, compression of the veins during the intervention.

How varicose veins can be complicated

  • Thrombosis due to blood stasis.
  • Vascular thromboembolism as a result of the separation of a thrombus.
  • Thrombophlebitis or inflammation of the venous wall.
  • PE (pulmonary embolism). In this case, the blood flow in the pulmonary circulation is sharply disrupted, 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 tissue nutritional disorders. 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 seeps into the intercellular space. Edema is soft in consistency, elastic, 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 upward to empty the superficial veins. The next step is to apply a tourniquet to the upper half of the thigh, after which the patient rises from the couch. Healthy shin veins should fill after 15 seconds.
  • Duplex ultrasound scanning of veins (ultrasound angioscanning) provides the most information, allows you to visualize the vessels and blood flow through them.
  • Doppler ultrasound is a method for assessing blood circulation in the vessels.
  • Phlebography or X-ray examination using contrast, which helps to study the internal structure of the vessel.
  • Phleboscintigraphy is a technique using radioactive substances with further study 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 necessary to study the state of deep or deep veins.

Varicose Veins Treatment

Conservative treatments

  • Drug therapy does not cure varicose veins, but with the help of drugs, the function of valves, vascular trophism, blood circulation is partially improved, and the risk of thrombosis is reduced. For this purpose, venotonics are used. 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 characteristics of the patient.
  • Herbal medicine and additional techniques are of secondary importance. It is advised to wear compression hosiery, do gymnastics, skiing, cycling, and swim. A good result is given by the exercise "bicycle" in a supine position, flexion and extension of the feet, it improves the outflow of blood from the extremities. Exercise can be done if there are no complications. It is also advised to take a contrast shower in the morning (water the leg first with warm water, then gradually lower the temperature to cold). Cool 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 by 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, not to overwork. All patients are advised to wear compression hosiery.
  • You need to eat right, include coarse fiber, foods rich in vitamins 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 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 old patients, in the second half of pregnancy, with local inflammation of the legs (erysipelas, pustular eruptions, eczema).

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

Laser therapy (endovascular microthermocoagulation)

Laser treatment of varicose veins is used if the pathology is combined 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, dermatitis, 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 (duration of manipulation is 15-20 minutes), no need to go to the hospital, low trauma.
Among the shortcomings, it is worth highlighting the poor availability of the technique; not all clinics have the appropriate equipment. The treatment is expensive and is of little use for removing severely affected and deep veins. If the laser is used incorrectly, you can 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 painlessness, no trauma, no need to stay in a hospital. Patients can return to their usual activities the very 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 carried out under the control of duplex Doppler) in the initial stage and without complications.

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

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

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

Can varicose veins be cured at home?

At home, it is allowed to use auxiliary methods of treating varicose veins, which alleviate the symptoms. They use ointments from pharmacies or self-prepared, herbal-based baths and lotions, compresses, drink 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 get rid of heaviness, itching, strengthen blood vessels, and prevent their fragility. It is also advised to make a compress from the tincture. If there is no chestnut, replace it with nutmeg, the recipe remains the same. Tincture with musk nuts can not only rub sore legs, it is recommended to drink it 20 drops a day. After the bottle runs out, make a new tincture. But there should be a pause of 2 weeks between taking the next portion.

Calendula ointment

An infusion is made from the flowers of calendula - a tablespoon 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 to some fat, lanolin, petroleum jelly, badger fat will do. For the scent, it is advised to add a drop of aromatic oil (rose, bergamot, citrus, sage, lavender, etc. ) Rub in the ointment in the morning and evening, with gentle movements from the lower leg to the knee, until completely absorbed. Thyme, hop cones, nettle are also added to the infusion of calendula.

Chamomile oil

The flowers of medicinal chamomile are folded into a half-liter jar made of dark glass so that the container is filled to the top. Pour half a liter of any kind of vegetable oil, for example, olives, corn, hemp. They insist for a month, shaking or stirring from time to time. After that, 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.

Bitter wormwood compress

Take a package of kefir or fermented baked milk, 3 tablespoons of dried wormwood. The herb is crushed, mixed with kefir (fermented baked milk). When the grass gets wet, spread it on cheesecloth along with a thick liquid. Then put a compress on the leg, cover it with wax paper on top (no cellophane film is used), fix everything with several layers of bandage. Keep the legs raised, the compress is removed after half an hour. It is recommended to do the procedure twice a day. Instead of wormwood, you can take hops, chamomile flowers, a string, clover, oak or birch leaves, St. John's wort, horsetail, tricolor violet flowers, yarrow. Combinations of different plants give a good effect. To improve the effect of the compress after the procedure, it is recommended to lie down a little with your legs upside down. All of these herbs can be infused and made into a foot bath. The water in such a bath should be warm, the duration of the procedure is about 25 minutes. It relieves fatigue, swelling well, reduces itching and pain.

Folk recipes for internal use

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

  • Clover
  • Succession
  • Lingonberry, viburnum, strawberry, raspberry leaves and berries
  • Mother and stepmother
  • Calendula
  • Sophora Japanese
  • Melissa
  • Schisandra
  • Hawthorn

The grass is dried, then crushed and a mixture of different types of plants is made. 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. The pollen should be ingested. Honey can also be eaten, but it still makes good compresses. It is advised to add infusions of various herbs to honey.

Treatment of varicose veins in pregnant women

Carrying a baby is accompanied by a hormonal storm in the female body, overload, which often provokes varicose veins. 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, eliminate heaviness in the limbs. They are applied in a thin layer, moving from bottom to top, with soft massage movements. The frequency of manipulations is 1-3 times a day.

Folk remedies also help. It is advised 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 cabbage leaves or raw shabby potatoes to your feet. Cover the compress with waxed silt with ordinary 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 medications for internal use for 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 medication, the venous tone rises, the walls become elastic, not so much stretched, the lymph flow improves, the liquid part of the blood stops leaking into the intercellular space, and edema passes. You cannot drink these funds without a doctor's prescription.

Traditional methods of treating varicose veins

There are many folk recipes for infusions, decoctions, lotions and compresses. A number of funds are advised to even be taken orally. Several options for treating varicose veins using alternative methods are described below.

Lilac tincture

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

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

Garlic ointment

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

The compress eliminates pain, burning sensation, it has antiseptic properties, softens the skin, and helps to 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 a tablespoon, three times a day, before meals.
The tool relieves puffiness and fatigue, pain, varicose veins become less noticeable.

Potato juice

Raw potatoes are chopped on a grater or in a blender, the gruel is applied to 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 is not able to cure varicose veins. But wearing it slows down the disease, relieves many of the symptoms caused by it, and improves well-being.

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

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

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

Before buying, you need to determine exactly which compression class you need. Inquire about the features of the labeling of products of your 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, then this product has nothing to do with medicated linen.