How to treat varicose veins of the lower extremities?
Author Ольга Кияница
- 1 Description of varicose veins
- 2 Answers to frequently asked questions
- 2.1 What is the medical treatment of varicose veins
- 2.2 What is the surgical treatment of varicose veins ?
- 2.3 Are there homemade treatments for varicose veins?
- 2.4 What is the treatment of folk remedies for varicose veins of the lower extremities?
- 2.5 What is the treatment of ulcers for varicose veins of the lower extremities?
- 2.6 How useful leech treatment for varicose veins of the lower extremities?
Varicose veins (ERV) is a general term for a group of diseases for which deformity and an increase in the size of venous vessels are characteristic. The lesion may concern both small veins, 2-3 mm in diameter, and large ones that have 2-3 cm in diameter.
Varicose veins are determined in 50% of women over 50 years old, so such a wide spread of the disease often requires not only correction for cosmetic purposes, but also urgent medical intervention.
For the diagnosis of varicose veins, ultrasound of the veins is used, which today is considered the most accurate and painless diagnostic method. As a rule, the treatment of the disease at an early stage of development allows for the most effective treatment. Therefore, it is important to know the first signs of varicose veins and when they appear, immediately consult a doctor.
Video: Varicose veins of the lower extremities: symptoms and treatment
Description of varicose veins
Varicose veins begin with the appearance of the so -called venous mesh on the legs or “spider” veins . These vessels have a clearance of several millimeters in diameter. Due to the fact that they are located inside the skin, with the expansion and increase immediately become noticeable. They can be located one at a time, but most often venous filaments, which intertwine with each other.
The expansion of the reticular veins is often the next stage of varicose veins after the venous reticulums, although they often develop independently. Appear on the skin green, purple veins. Most often occur on the hips and legs. The thickness of the varicose reticular veins is larger than the “arachnid” veins, but they are smaller and practically do not protrude above the skin as compared with varicose veins.
The causes of varicose veins
The veins are the blood vessels through which blood from the legs usually returns upward, towards the heart. The blood flow in the venous system must also always move from the superficial veins to the deeper veins in the legs. The blood usually does not move down in the opposite direction or outward from the deep to the superficial veins, since there are one-way valves inside the veins. With their help, the reverse flow of blood is prevented.
In some people, the venous valves can be affected, and then the blood flow changes not only in relation to the heart, but also can move back down the leg, especially when standing, and then they talk about reflux.
The veins in which reflux occurs are called incompetent or have incompetent valves.
Since the valves in some veins do not work normally, the blood pressure in the veins increases, and then the vessels gradually swell up, increase and they are called varicose. Such a pathological process can take many years. The clinical manifestations of varicose veins are most often associated with constant high pressure in the veins.
Varicose veins tend to manifest themselves:
- with age;
- those who have a hereditary predisposition to varicose veins;
- with prolonged standing on the legs or in a sitting position;
- during pregnancy or after childbirth;
- in some cases, after a prolonged load on deep veins.
Removing varicose veins in such circumstances is considered a potentially dangerous action, as this would eliminate an important pathway for blood to flow from the lower limbs back to the heart.
Symptoms and diagnosis of varicose veins
Common symptoms of varicose veins include:
- cosmetically unpleasant appearance, expressed by venous dilatation;
- swelling of the affected lower limb;
- skin pigmentation;
- painful sensations;
The less common symptoms are ulceration, superficial thrombophlebitis and bleeding.
- Venous dilatation
Telangiectasia or reticular varicose veins is the most common initial manifestation of venous disease ( CEAP class 1 classification ).
The development of varicose veins of the gastrocnemius muscles is usually marked with prolonged standing or during menstruation. With the progression of venous disease, the veins become more tortuous and stretched, and patients may notice their appearance in the proximal part of the limb. Many women report that their varicose disease develops rapidly in terms of size and number during the first pregnancy ( CEAP class 2 ).
Edema is an early symptom of venous disease ( according to CEAP class 3 ). It usually occupies the metatarsal area.It is often the result of subcutaneous fibrosis and recurrent infections, although the cause of its development is both varicose veins of the lower extremities and lymphangitis.
The feeling of pressure or pain in the limbs that occurs after prolonged standing, as well as when walking or lifting weights, is characteristic of venous disease, while the pain from arterial pathology increases with physical exertion. With severe chronic venous insufficiency with outflow obstruction, a symptom such as “venous lameness” can be detected - the patient feels pain while walking, so he needs to stop and wait until it passes and it will be possible to move further ( class 4 according to CEAP ).
Patients usually also experience pain and sensitivity as varicose veins expand. In the presence of strong reflux, severe skin pigmentation may be observed ( class 5 according to CEAP ).
Lipodermatosclerosis can dramatically break the integrity of the affected skin, and a minor injury can lead to the formation of ulcers - the final stage of chronic venous disease ( class 6 of CEAP ).
- Physical examination
During a physical examination, an assessment of the lower limb is carried out in the standing position. As a rule, the doctor notes:
- Spider veins or venous reticulum.
- Telangiectasia (dilated intercutaneous venules up to 1 mm).
- Reticular veins (non-palpable subcutaneous veins 1-3 mm).
- Varicose veins (vessels with a diameter of more than 3 mm).
- Swelling of the tissues.
- Pigmentation of the skin.
- Venous ulcers.
More information can be obtained using duplex scanning of the leg vessels. The study allows to determine the permeability and competence of the superficial and deep venous system of the lower extremities. It also specifies such moments as the location and relationships of the safen-popliteal joint,
diameter of affected vein.
Basic principles of prescription varicose veins therapy
The need for the treatment of varicose veins occurs when the vessels in the lower limbs are dilated; increased pain and general discomfort in the affected areas. Sometimes this disease can indicate serious circulatory problems, which often require the use of advanced therapeutic procedures, such as sclerotherapy, laser surgery or endovascular surgery.
Before any treatment strategy is used, the symptoms of the disease are determined. In some cases, they are completely absent or mild. In others are determined:
- dark purple veins:
- itching and burning at the site of injury;
- bleeding from veins;
- severe pain after sitting or standing for a long time.
Deadlines for seeking treatment are when problems arise with the self-service process. However, often independent attempts to control or eliminate varicose veins were unsuccessful.
According to the experience of many victims of varicose veins, the most effective is the treatment of varicose veins of the lower extremities - in the early stages of the disease.
Answers to frequently asked questions
What is the medical treatment of varicose veins
With varicose veins, manifested by weak and less serious symptoms , doctors first recommend several changes in lifestyle, which most often leads to varicose veins. First of all it should be practiced:
- Abstinence from sitting or standing for a long time.
- Avoid crossing the legs in a sitting position, and you should always raise your legs while sleeping or sitting.
- Exercise should be exercised to ensure free circulation of blood through the venous system.
- Overweight or obese people are advised to shed those extra pounds in order to reduce the pressure on the venous vessels.
- It is useful to wear loose clothing; since tight pants tend to contribute to the progression of varicose veins.
- It is advisable to wear low-heeled shoes, because high heels and platforms contribute to muscle tension, thereby worsening the course of varicose veins.
- Many doctors recommend wearing compression stockings that reduce the likelihood of blood clots (blood clots) with subsequent swelling of the legs.
Drugs are prescribed in cases where milder modes of action do not help. However, do not hurry to turn to drugs, as they can harm not only the stomach, but also the heart and liver. Common medications prescribed for varicose veins are detralex, phlebodia, troxevasin, and others.
- Detralex (Detrallex)
It can cause such side effects as nausea, vomiting, headache, diarrhea, also provokes the development of colitis.
This is one of the most commonly prescribed drugs for toning the venous walls and relieving pain during varicose veins.Treatment for them should not last more than six months. Good to start before the summer season.
- Phlebodia (Fleabody)
Phlebodia has the same effect as detralex. Nevertheless, the drug should be taken with caution with a tendency to allergic reactions to cochino dye.
- Antiflegmin (Antiflegmin)
Antiflegmin is most commonly used to treat wounds in ruminants. Helps to eliminate inflammation of the umbilical cord and contains camphor, and in large quantities.
There are many people who have previously used this drug and claim that it helped them cope with injuries of the limbs, muscles and tendons, hemorrhoids and varicose veins.
In recent years, more and more celebrities have turned to antifleene. The fact is that drugs for animals are more concentrated and can cause a quick effect in humans. But do not forget about security measures, because harm is much easier than cure.
(Some experts oppose the use of animal medicine by humans, although there are some who strongly recommend it.)
This drug is available in the form of tablets, capsules and ointments for external use. With its use, not only improves the condition of the venous walls, but also relieves edema by improving lymph flow. It is also recommended in the presence of diabetes.
Additionally, homeopathic remedies can be used, which should be prescribed by a homeopath. Medicines that can help in this case:
- Arnica - from pain and tension in the legs and in the presence of a tendency to bleeding.
- Hamamelis - minimizes swelling and relieves the feeling of heaviness.
- Esculus (wild chestnut or horse) is used for varicose veins, varicose ulcers and hemorrhoids.
- Carbo vegetabilis - is prescribed to treat varicose ulcers with inflammation and bruises on the lower limbs.
- The drug from the company U-Ways is recommended for cleaning vessels.
- Apis mellifera - is used for burning sensation, which is relieved by cold.
What is the surgical treatment of varicose veins ?
Some patients need improved and more cardinal treatment of varicose veins. Such tactics are most often associated with the removal or blocking of affected veins. These are open operations and minimally invasive procedures, which include:
- Sclerotherapy is a simple procedure that consists in closing a varicose vein by injecting a chemical fluid into an expanded vessel. Under the influence of a substance, irritation and final blockage (occlusion) of the veins occurs.This type of surgical treatment is most suitable for smaller and less pronounced varicose veins. Sclerotherapy is most often performed every 4 weeks; During this period, the patient's legs should be wrapped in elastic bandages, which reduce the severity of the pathological process.
- Microsclerotherapy - as the name suggests, the procedure is aimed at treating small varicose veins. The amount of chemical fluid injected is also small, and the procedure gives the same results as sclerotherapy.
- Laser surgery : This treatment method does not include surgery or injection of liquid chemicals. To eliminate the varicose veins in the lesions affected by a laser beam.
- Endovenous ablation therapy - with this method of treating varicose veins, the doctor uses laser irradiation or radio waves. Unlike laser surgery, which works at the expense of light, during this procedure, heat is generated, causing the veins to expand and close, and then completely turn into connective tissue strands. In this case, the doctor cuts off the skin around the affected veins, and then inserts a catheter, the tip of which supplies the heat needed for the healing process. Since the procedure is not a complicated one, the only area that requires postoperative care is the affected tissue.
- Endovascular surgery - like ablative therapy, during this procedure, the doctor must cut the affected part, then a surgical instrument is used, with which venous occlusion is performed. This method of treatment is mainly intended for the removal of severe varicose veins that contribute to the formation of wounds on the skin.
Are there homemade treatments for varicose veins?
For violations of the venous system, you should pay attention to the following recommendations that are suitable for use at home:
1. You need to warm up for at least one minute . Researchers at the Mayo Clinic say that even super-short walks reduce pressure on the legs and stimulate blood circulation, which helps keep blood from clotting, and small veins in the lower legs and ankles from brittleness. If you regularly do foot progresses, then you can reduce your risk of developing peripheral arterial disease, which occurs against the background of accumulation of fat deposits in the arteries of the lower extremities.
2. It is worth replacing salt with garlic powder . “Excess sodium can contribute to swelling of the legs much more, and swelling causes tiny cracks in the walls of the capillaries, which lies in the main formation of the venous network,” explains Valencia Thomas, MD, dermatologist at the University of Texas Health Research Center. Correct: Replacing the taste of salt in the usual diet is capable of garlic powder, which, according to research analyzes, causes a decrease in inflammation and helps reduce tissue swelling along with the appearance of pain in the legs.
3. Massage the muscles . A study by the University of Illinois evaluated rubbing the feet with a massaging motion from the bottom up or with a dry brush. Both methods improve blood flow up to 72 hours. And the better blood circulation in the lower extremities, the less likely that venous spider veins or varicose veins will occur.
4. Compression stockings. If painful, sensitive legs are often disturbed due to prolonged standing, worsening of vein problems and an increase in the severity of symptoms can occur. In such cases, cheap knee compression stockings help. Stretch fiber stockings helps to gently push blood from the veins of the ankles. There is also a more even distribution of blood in the lower extremities, which prevents the increase in veins, the occurrence of pain and ulceration.
Video: Treatment of varicose veins at home
What is the treatment of folk remedies for varicose veins of the lower extremities?
To strengthen the vessels, including veins, various herbal remedies and methods of exposure can be used. Some of them suitable for the treatment of varicose veins at home are discussed below.
5. Pine bark extract . Picogenol (pine bark extract) contains high levels of plant compounds that inhibit capillary drainage and control the process of inflammation. This in turn reduces varicose veins and pain, eliminates the feeling of pressure, fatigue, swelling and discoloration of the skin. Similar manifestations most often accompany varicose veins, according to a study at New York University. With medical consent, 50 mg of product, such as Nature's Way Pycnogenol, should be taken daily.
6. Oil extract of Hypericum . Prepared from 60 grams of herbs and 100 grams of olive oil. For two weeks, infused and used for foot massage.
7. Bath with a decoction of lavender, mint and juniper works wonders . The same combination can be found in the form of bath salts.
8. Horse chestnut is another tried remedy for eliminating unpleasant problems. Earlier, the ancient healers recommended this medicine for severe swelling and tension in the legs. You can cook chestnut bran (sold in cosmetic stores and are used for peeling) by mixing them with warm water and a small amount of apple cider vinegar. The prepared ointment is applied to problem areas, then wrapped in a towel and left for half an hour. The body must be at rest.
9. Apple cider vinegar , known as a temperature reducing agent. It can also alleviate the condition of tired legs. Instant effect give compresses with towels soaked in apple cider vinegar. Wrapped in their legs you can sleep like that all night.If you need to instantly eliminate pain or swelling, you should put the waffles in apple cider vinegar for a few minutes and refrigerate them, then attach them to the affected places on your feet.
10. Magnesium oil . Magnesium chloride, contained in the more popular magnesium oil, produces more than 320 enzyme reactions upon contact with the skin. As a result, the elasticity of muscle fibers and blood vessel walls is improved. They become more resistant to the pressure that blood has on veins. It is not by chance that this useful oil is used by athletes. It is easy to use and its price is affordable.
11. Cabbage leaves . The cabbage compresses also have an instant effect. It is better to impose the outer leaves of cabbage on his feet after thorough washing. The cabbage literally “pulls” the pain out of the legs, so after such a treatment, the former lightness is felt again.
There are still options for the treatment of varicose veins with hydrogen peroxide and dry horseradish leaves, but they are less effective and do not always help, as evidenced by reviews of already tried users.
Video: Treatment of varicose veins. The simplest penny remedy for varicose veins and pulling veins in the legs
What is the treatment of ulcers for varicose veins of the lower extremities?
Patients with ulcers and skin eczema arising on the background of varicose veins, is engaged in a vascular surgeon.Treatment of ulcers due to varicose veins is to control the pressure in the veins of the legs and directly affect the ulcers themselves.
- Pressure control in the legs
Pressure control is extremely important for patients with venous ulcers. In particular, it takes several times during the day and during sleep to raise the legs to the level of the heart or higher. Such an effect can help reduce tissue swelling.
- Treatment of ulcers with varicose veins
Wraps are carried out or bandages are applied to the affected part of the leg. They are changed as the fluid flowing from the ulcer is soaked: sometimes several times a day, sometimes once a week.
The first few weeks when using a compression bandage, the ulcer is usually painful. The attending physician prescribes a painkiller in such cases. As the ulcer heals, the pain subsides.
After the ulcer has decreased in size or is almost healed, elastic compression stockings can be used. This therapeutic underwear is selected according to the size of the legs. It is usually worn in the morning before lowering the legs out of bed and worn during the day.
With the development of poorly healing ulcers on the background of varicose veins, more intensive help and therapy of wounds are needed. New treatment options for varicose veins are minimally invasive, carried out under local anesthesia and safely performed in outpatient surgery centers. The choice of treatment depends on the group of affected veins that cause the symptoms. In particular, it can be used:
- Endovenous ablation - this procedure can be performed on an outpatient basis. The catheter is directed into a large or small saphenous vein. After anesthesia, drugs are injected into the skin along the affected vein, which must be treated, while the vessel is heated with radio waves or a laser. The whole process of heating or ablation takes less than 10 minutes. The blood that was used to pool the treated superficial vein is naturally redirected to the deep vein system.Patients experience almost instant help. It is recommended to walk immediately after the procedure. Pain, which is rarely pronounced and unbearable, is reduced to anti-inflammatory drugs, such as ibuprofen, if necessary. During a follow-up visit to the doctor within a week after the procedure, the presence of any blood clots is checked and, if necessary, medications are prescribed to control blood clotting.
- Ambulatory phlebectomy - this procedure is used to treat varicose veins. Can be performed on an outpatient basis.Patients are asked to stand for a few minutes so that the veins can fill, and then the doctor notes the veins that need to be removed. After the veins are marked and consent is given by the patient, an anesthetic agent is injected into the skin along the vein to be treated. Next, very small incisions are made in the skin, and the veins are removed with a small hook. These cuts are so small that no seams are required. After surgery, a bandage is applied to the leg, and the patient can walk immediately after the procedure. In most cases, any painkillers are not used, but when the pain still worries, it is enough, as a rule, to use an anti-inflammatory drug. Patients may return to work after one or two days, depending on the severity of the performed phlebectomy.
- Sclerotherapy - this procedure for the treatment of varicose veins can be performed on an outpatient basis. Tiny needles are inserted into small veins, most often reticular ones, containing a special liquid that sclerosises or closes the vessel. This treatment does not require any anesthesia or medication. The smallest veins (also known as spider veins) are best treated with this procedure.
How useful leech treatment for varicose veins of the lower extremities?
Leech has been used in the treatment of varicose veins for many years. It is believed that when attached to the body, the leech first bites the skin, but painlessly, since the leech bite is considered anesthetic. The leech can be attached to the skin from 20 minutes to 40 minutes. Leech saliva also has anticoagulant properties, that is, it dilutes the blood. Its entry into the body helps to prevent blood clotting, while at the same time it helps to dissolve existing blood clots. As a result, blood flow improves and nutrients are more actively distributed throughout the body.
In some cases, for untreated varicose veins, treatment with leeches (or hirudotherapy) can lead to various complications, such as trophic ulcers and bleeding.
While leeches suck blood, blood pressure, often increased with varicose veins of the lower leg, decreases. Sometimes the bleeding continues several hours after the leech has separated from the body, but this is not considered a complication and after a while the condition normalizes.
The use of leeches is the ideal treatment for varicose veins at home. However, it is important that leeches are removed after the required time, especially if they do not disappear on their own. Do not be afraid that the leech has become significantly larger in size than it was before; this is due to its consumption of a certain amount of blood. Leeches are usually attached to the problem area to achieve a safe and rapid pressure reduction.
The reason why the ayurvedic method uses this method of treating the severe condition of varicose veins is that it is safe. After hirudotherapy, the veins in the legs tend to become normal, and they are able to perform the function of transporting deoxygenated blood. There are no side effects or complications associated with the use of this therapy.
Video: Hirudotherapy for varicose veins Leeches for varicose veins of the lower extremities Leech therapy
1. Varicose Veins – National Institutes of Health https://www.nhlbi.nih.gov/health-topics/varicose-veins
2. Большаков Олег Петрович, Семенов Геннадий Михайлович. Оперативная хирургия и топографическая анатомия: Учебник для вузов. 2018
3. Darwood RJ, Theivacumar N, Dellagrammaticas D, Mavor AID, Gough MJ. Randomized clinical trial comparing endovenous laser ablation with surgery for the treatment of primary great saphenous varicose veins. British Journal of Surgery. 2008;95(3):294–301.
In the early stages of the development of varicose veins, conservative treatment is most often used, which includes taking tablets of drugs and applying ointments to the affected areas of the body. In severe cases, resorted to the removal of veins. For this purpose, laser varicose vein treatment is widely used today. With its successful implementation, the general well-being of the patient improves markedly.
Many men and women in different countries of the world are familiar with such a disease as varicose veins. The shorter name of this disease is varicose veins or simply varicose veins. A pronounced clinic can lead to disability, so it is extremely important that you begin treatment early as soon as possible.