Varicose veins are a very common problem.
This disease, which is a circulatory disorder due to stretching and weakening of the walls of the veins, and because of this stagnation of blood in them, has many causes, both congenital and acquired.
Every year people move less and less, spending time at work and at home on computers, and lack of physical activity is one of the most common factors in the occurrence and development of this disease.
We will tell you in this article about what leg exercises for varicose veins exist and what physical activities are indicated for varicose veins in the legs.
Nagging pain and a feeling of heaviness in the legs, burning, blue vascular mesh on the skin - these are the symptoms of varicose veins.
If you do not pay attention to the disease, it will progress, causing painful and life-threatening complications.
A lot of controversy arises around the topic of compatibility between sports and this disease.
Indeed, there are a number of restrictions regarding a person’s lifestyle, but this does not mean that one should give up physical activity.
On the contrary, sport is useful, since muscle contractions promote faster blood circulation, blood is pushed out of the lower extremities without stagnating there and circulating throughout the body, and the walls of veins and capillaries become more elastic.
But is it possible to choose any sport and train as and how much you want? What exercises should you not do if you have varicose veins in your legs?
Only exercises that do not carry a heavy load are permissible, and should be performed using the correct technique . It is unrealistic to cure a disease with physical activity alone, but physical education is necessary as one of the important components of treatment.
Is it possible to walk a lot with varicose veins? It is advisable to include in your daily schedule walks lasting at first about thirty minutes, gradually increasing their duration.
Shoes should be comfortable, not tight or tight, and the pace of walking should be measured, without making sudden movements or running.
It is important to observe correct breathing - inhale three steps, exhale three steps . As practice shows, walking with varicose veins of the lower extremities is very, very useful.
If you have varicose veins, it is necessary to eliminate the pressure of your own weight on your legs; for this, it is recommended to do fitness while sitting or lying down. A bicycle will be a good friend, and at home or in the gym you can pedal an exercise bike.
Rhythmic exercises for varicose veins on the legs - rotations spare the joints and help speed up blood circulation, moreover, there is no impact of your body weight on the vessels of the lower extremities.
For the same reasons, smooth walking on an ellipsoid is recommended..
Remember that exercise equipment should be used sparingly for varicose veins of the legs.
Physical exercises for varicose veins of the legs in the pool, for example, water aerobics, are very useful, because water practically eliminates the impact of your body weight on the veins, and vigorous breathing causes blood to move intensively through the vessels. Regular swimming is also recommended for varicose veins of the legs.
Gentle stretching exercises such as yoga, Pilates, and stretching are also recommended . These complexes contain very useful exercises for varicose veins in the legs.
To cure and prevent varicose veins, it is recommended to engage in physical therapy (physical therapy) daily and regularly, at least twice a day. The day should always begin with morning leg exercises for varicose veins lasting from fifteen to thirty minutes.
After a working day at home, you must first rest your tired legs and ensure the blood flows out of them . To do this, lie down with your feet on a pillow and raise them above the level of your heart by about twenty centimeters. After this, you can proceed to the implementation of the treatment complex. Move softly and smoothly.
The daily exercise program for varicose veins on the legs must include:
As exercise therapy for varicose veins of the lower extremities, there is a specially developed set of exercises for varicose veins of the lower extremities “Flexible body, improving venous outflow from the lower extremities, toning the walls of blood vessels and accelerating blood circulation.
Each approach can initially be performed twenty to twenty-five times, then increase the number of repetitions.
Flexible body exercises for varicose veins of the legs include:
Try to stand as long as you can. Next, stretch your arms along your body, move your legs down behind your head and slowly, grouping, vertebra by vertebra, lower yourself to the floor. We get to our feet, rising in a smooth wave.
The result is lightness in your legs after exercises for varicose veins. Flexible body. This is perhaps the best exercise for legs with varicose veins .
You can often hear the question: is it possible to pump up the abs with varicose veins in the legs? The answer is yes, you can, one of the abdominal exercises is even included in the set of exercises for varicose veins Flexible body.
Therapeutic exercise in combination with drug treatment helps to achieve relief from the symptoms of varicose veins, but if it has become significantly easier and the discomfort has ceased to bother you, you cannot stop exercising.
Without strengthening external influences through fitness classes, blood vessels will quickly lose their tone again and the disease will return. Therefore, you will always need to perform physical exercises for varicose veins of the lower extremities.
Now let’s talk in more detail about which exercises against varicose veins of the legs are acceptable.
For example, squats for varicose veins of the legs, are there any contraindications?
Squats are very effective for training the muscles of the legs and buttocks, it would seem that they should be useful for varicose veins of the lower extremities. But they are performed with the load of their own weight on the legs, so trainers and doctors often exclude them completely from the training complex of people with this disease.
Is it possible to do squats with varicose veins in the legs ? Squats can be performed only at the very initial stage of this disease.
It is important to follow the correct exercise technique for varicose veins of the lower extremities:
Reference! When performing squats, it is important not to lift your heels off the floor, this will ensure even distribution of the load.
For varicose veins, it is also better to alternate exercises performed while standing, with lying down and sitting ones in order to better dose the vertical load . And under no circumstances should squats be performed with any weights. Is it possible to pump legs with varicose veins? Absolutely not! Leg press with varicose veins is a huge risk!
Now you know what exercises you can do for varicose veins on the legs, but is there anything that is strictly prohibited? More on this later.
In addition to exercises using weights, intensive leg work should not be allowed - jumping, aerobics, step aerobics, exercises with a skipping rope.
Long-term static exposure, for example callanetics, is also harmful.
Dancing is useful in the fight for health, but not all of them are allowed - Irish folk dances, as well as African and step dances, are contraindicated, as they contain sudden movements and jumps.
It is also prohibited to engage in sports professionally, as this involves unacceptable loads, in contrast to simple exercises for the legs for varicose veins.
We hope our article was useful to you and you now know what leg exercises for varicose veins you can do at home.
For more information about leg exercises for varicose veins, see the video below:
Varicose veins are the most common vascular disease (30-40% of the population; in women over 40, every second woman suffers from varicose veins).
Venous outflow from the lower limb is carried out by:
a) system of superficial veins : v.saphena magna? v. femoralis; v.saphena parva? v. poplitea
b) deep vein system : v. femoralis, v. poplitea
c) system of perforating veins : normally, through them there is an outflow from the superficial veins to the deep ones; main groups of perforating veins: medial surface of the leg - Coquette group, knee joint area, thigh area
Causes of varicose veins:
1. failure of the ostial valves at the point where the superficial veins flow into the deep ones (safenofemoral, safenopopliteal) - the result of this is a vertical retrograde discharge of blood from the deep veins to the superficial
2. incompetence of the valves of the perforating veins - the result of this is a horizontal retrograde discharge of blood
Treatment of varicose veins:
1. medicinal - the use of drugs that increase the tone of the vein wall - phlebotonics (troxevasin, detralex)
2. compression – wearing elastic stockings and bandages
3. sclerotherapy (biological coagulation, electrocoagulation, injection-sclerosing method) - currently injections of new generation phlebosclerosing drugs (ethoxysclerol, fibro-vein) are used more often
A) ligature methods : interruption of the dilated saphenous veins of the extremities and cessation of blood flow through them, provide for percutaneous or subcutaneous application of ligatures along the course of the altered veins:
a) suprafascial ligation of perforating veins (Coquette method)
b) subfascial ligation of perforating veins (Linton method)
c) endoscopic subfascial dissection of perforating veins (SEPS)
B) removal of varicose trunks of the great or small saphenous vein:
a) Babcock method - removal of the great saphenous vein from two small skin incisions on the medial surface of the thigh (at the point where the great saphenous vein flows into the femoral vein and at a place slightly above the knee joint using a Babcock extractor). Technique: the vein to be removed is mobilized through the upper incision? its proximal end is ligated and divided? A special flexible probe with a button is inserted into the distal lumen at the upper end of the vein and passed to the level of the lower incision? here the vein is ligated and crossed, the proximal section is fixed to a button probe? probe retraction? turning the vein inside out.
b) Narata method - small skin incisions along the course of varicose saphenous veins of the thigh, followed by removal of the corresponding sections of the vessel over the greatest possible extent
c) Madelung operation - removal of dilated saphenous veins on the thigh and leg from a longitudinal incision on the medial side along the entire length of the limb along the great saphenous vein to the level of the internal femoral condyle
C) operations on the deep veins : extra- and endovasal correction of valves, transposition of venous segments with intact valves preserved into the femoral or popliteal vein in the presence of pathological reflux in the deep veins
Operations for phlebothrombosis:
1. Radical phlebectomy - removal of a thrombosed vein in order not only to eliminate further spread of vein thrombosis, but also to prevent a possible relapse of thrombophlebitis.
2. Thrombectomy - isolation of the vein, longitudinal dissection of its wall and removal of the thrombus with a Fogarty catheter
3. Creation of an arteriovenous fistula to prevent recurrent thrombosis.
Methods of surgical prevention of pulmonary embolism:
a) ligation of the inferior vena cava (not currently used)
b) suturing of the inferior vena cava (plication)
c) applying clips to the vein, which compress its lumen and turn the vein into several valves
d) endovascular implantation of vena cava filters
On the anteromedial side there is v. saphena magna accompanied by n. saphenus, on the lateral side - branches of v. saphena parva and p. cutaneus surae lateralis. Saphenous veins through perforating veins, w. perforantes, connect to deep veins .
Operations for varicose veins.
The indications and purpose of the operation are the removal of pathologically altered venous trunks with impaired venous hemodynamics in conditions of sufficient patency of the deep veins. Depending on the condition of the deep veins, their branches connecting the deep and superficial veins (communicant veins), as well as their valve apparatus, operations are performed that eliminate the discharge of blood from the deep veins to the superficial ones, tying the functionally defective communicative veins.
Numerous methods of surgical treatment of varicose veins of the superficial thigh and leg are used in combination, depending on the pathogenesis of the disease and the condition of each part of the venous system of the patient’s limb.
Babcock's operation. The principle of the method is to remove the vein using a special flexible rod with a club-shaped head at the end inserted into it through two (upper and lower) small skin incisions. When removing the extractor, the vein attached to it is simultaneously removed through the lower incision.
The Troyanov-Trendelenburg, Coquette and Linton operations are aimed at eliminating the discharge of blood from the deep venous system to the superficial one. Troyanov-Trendelenburg operation. This operation involves high ligation of the great saphenous vein of the leg in order to prevent pathological reflux of blood from the femoral vein through the saphenofemoral anastomosis.
The principle of the Troyanov-Trendelenburg operation is completely preserved in relation to ligation of the small saphenous vein of the leg. If the valves of the communicating veins are incompetent, the latter should be ligated in order to eliminate the pathological reflux of venous blood from the deep veins to the superficial ones.
No. 127 Area of the medial malleolus. Medial ankle tunnel. Paths of spread of purulent leaks from the medial ankle canal.
The skin is thin and inactive. In the subcutaneous tissue there are sources of v. running in the transverse direction. saphena magna, lying on the anterior surface of the medial malleolus; pass through arterial and neural ankle branches. The posterior tibial artery is projected along an arcuate line located posterior to the medial malleolus by the width of a finger.
Fascia and retinaculum of the flexor tendons, retinaculum mm. flexorum, form the medial wall of the ankle canal, canalis malleolaris medialis, located behind the medial malleolus. The lateral wall of this canal consists of the medial malleolus and calcaneus. The ankle canal passes anteriorly and downward through the calcaneal canal into the median fascial bed of the sole, and upward and posteriorly into the deep space of the posterior bed of the leg.
The heel canal is limited externally by the calcaneus, internally by the abductor pollicis muscle, m. abductor hallucis. It continues into the plantar canal, which is the proximal portion of the median fascial bed of the sole.
Fibrous spurs divide the medial ankle canal into osteofibrous canals, in which the tendons of the tibialis posterior muscle, flexor toes, and the sheath of the neurovascular bundle of the sole, surrounded by synovial sheaths, pass.
In front passes the tendon m. tibialis posterior, closely adjacent to the groove on the posterior surface of the medial malleolus. The synovial sheath of this tendon rises most highly, and distally reaches the attachment of the tendon to the tuberosity of the scaphoid.
behind is the rounded tendon of the flexor digitorum longus, m. flexor digitorum longus, the synovial vagina of which has approximately the same extent as the vagina of m. tibialis posterior.
Third tendon of the flexor hallucis longus , m. flexor hallucis longus, separated from the flexor digitorum longus by the support of the talus, sustentaculum tali, calcaneus and runs along the sulcus tendinis m. flexoris hallucis longi of this support. The synovial sheath of this tendon extends from the sustentaculum tali to the sole; it is closely adjacent to the posterior weak point of the ankle joint bursa and in some cases communicates with the cavity of this joint. Moving onto the sole, it intersects (under the retinaculum mm. flexorum) with the vagina m. flexor digitorum longus in such a way that on the medial edge of the sole it lies anteriorly.
A. tibialis posterior passes in the ankle canal in the space between the flexor tendons of the fingers and thumb. Posterior to the vessels, i.e., closer to the tendon of the long flexor pollicis, there is n. tibialis.
The fascial sheath of the neurovascular bundle is located superficial to the three osteofibrous canals of the muscle tendons. Therefore, here it is possible to feel the pulse at a. tibialis posterior. The calcaneal artery, which is the main source of blood supply to the calcaneus, departs from the posterior tibial artery at various levels.
Damage to the posterior tibial artery proximal to the level of the origin of the calcaneal artery during osteoplastic amputation of the tibia according to Pirogov can lead to necrosis of the calcaneal bone flap taken to cover the bones of the tibia.
In the distal part of the region , approximately at the level of the apex of the medial malleolus, there is a place of division of the tibialis into the lateral and medial plantar nerves, nn. Plantares lateralis et medialis.
The medial plantar nerve is located anteriorly, and the lateral plantar nerve is located posterior to the vessels. Vessels and nerves can be traced distally and anteriorly under the upper edge of the abdomen of the abductor hallucis muscle, m. abductor hallucis longus. At this level, the posterior tibial artery divides into the medial and lateral plantar arteries, aa. plantares medialis et lateralis.
Varicose veins or varicose veins are dilation of superficial veins associated with insufficient venous valves and impaired blood flow.
This disease is the most common vascular pathology among people of working age.
Traditionally, risk factors for the development and progression of the disease have been identified. Heredity and its contribution to the occurrence of varicose veins have not been clearly proven. It has been noted that in some families, varicose veins constantly occur over generations, but it is currently believed that nutritional factors, lifestyle features, and conditions associated with changes in the hormonal cycle play a predominant role in the onset of the disease.
Obesity is one of the main risk factors for the development of varicose veins . Moreover, the incidence of varicose veins increases with increasing severity of obesity. Obesity is often accompanied by an immobile or sedentary lifestyle and poor nutrition. The diet of the population of industrialized countries is currently dominated by highly processed products, but there remains insufficient consumption of plant fibers, which are found in raw vegetables and fruits. Plant fibers are necessary to strengthen the vascular wall, in addition, they prevent chronic constipation, which, in turn, leads to increased intra-abdominal pressure and the formation of varicose veins.
We must not forget about the improper organization of the labor process. Often, we spend most of our working time in a sitting or standing position, and this is very bad for the valvular apparatus of the veins. Also unfavorable is hard work associated with a sharp (jerky) load on the lower limbs, for example, when lifting heavy objects. In our dynamic times, long flights or transfers are not uncommon, which are accompanied by stagnation of blood in the veins of the legs and are also a risk factor for the development of venous diseases.
Adhering to fashion trends, many do not think that tight underwear leads to compression of the veins at the level of the inguinal folds, and corsets increase intra-abdominal pressure, so it is not recommended to wear them all the time. Also, do not forget about the dangers of wearing high-heeled shoes with uncomfortable arch supports.
Repeated pregnancies are also a proven risk factor for the development of venous diseases. An enlarged uterus increases intra-abdominal pressure, and a hormone such as progesterone has an adverse effect on the vein wall, destroying the collagen and elastic fibers it contains. Some diseases, such as osteoporosis and rheumatoid arthritis, occur with changes in hormonal status. At the same time, the risk of varicose veins increases sharply.
Speaking about the reasons leading to the expansion of veins, it is necessary to dwell on the structure of the veins of the lower extremities. There are a system of superficial veins (great and small saphenous veins), a system of deep veins (deep veins of the leg and thigh) and communicant or perforating veins that connect the superficial and deep veins. Under normal conditions, the outflow of blood in the leg area occurs through the system of deep (90%) and superficial veins (10%). In order for blood to move towards the heart, and not in the opposite direction, there are valves in the walls of the veins, which, when closed, prevent blood from moving from top to bottom under the influence of gravity. In addition, muscle contractions are of great importance, which also contributes to normal blood flow. The worst conditions for the movement of blood are provided by standing in the complete absence or insufficiently active muscle contractions. At the same time, the blood stagnates, the pressure in the veins increases and they expand. Insufficiency of the valve apparatus is formed, when the valve flaps do not close completely, and improper movement of blood from the heart is formed.
Valve insufficiency in varicose veins.
The valves of the deep vein system are especially quickly affected, as they experience maximum stress. Due to abnormal blood flow, overload of the deep veins with additional blood volume develops. To reduce excess pressure, blood is discharged through the system of communicating veins into the superficial veins, which, in turn, are not designed to transport a large volume of blood. As a result, their walls become overstretched with the formation of characteristic varicose veins. But the increased volume of blood continues to flow into the deep veins, and insufficiency of the valves of the communicating veins is formed with the presence of unimpeded horizontal blood flow in the direction of both deep and superficial vessels. In the end, chronic venous insufficiency is formed with swelling, pain and trophic ulcers.
As you can guess from the name, the main visible sign of varicose veins is a sac-like or cylindrical expansion of the superficial veins.
Varicose veins on the legs.
They become convoluted and protrude above the surface of the skin in the area of the legs and feet. Varicose veins are most pronounced after heavy or prolonged physical activity. Very often, dilated veins appear at a young age, in women - during or after pregnancy.
At the early stage of varicose veins, symptoms are few and nonspecific. All the signs of this stage are combined into “heavy leg syndrome” . At the same time, you are concerned about increased fatigue, a feeling of heaviness in the legs, burning, bloating, the severity of which is maximum after physical activity. Transient swelling and aching pain along the veins may also occur. This is characterized by slight swelling of the ankles and dorsum of the foot, which occurs in the evening, especially after prolonged static load. A characteristic sign of edema is that in the morning it goes away without a trace. The presence of visible dilated veins is not necessary for this stage. As a rule, most patients with varicose veins noted the presence of certain signs at the onset of the disease. Therefore, timely contact with a specialist, even at the initial stage of the disease, will prevent further development of the disease.
Varicose veins develop slowly, sometimes over decades. In case of inadequate treatment, chronic venous insufficiency forms as the disease progresses.
With varicose veins, in addition to the symptoms, patients are often concerned about the cosmetic side of the issue. Doctors recommend surgery. And in order to reduce the risk of complications and speed up recovery, doctors prescribe Detralex before and after surgery, a micronized drug based on bioflavonoids, which helps increase the tone of the veins, stops the inflammatory reaction and stimulates lymphatic drainage. Detralex is the only drug that has proven the possibility of pharmacological protection during surgery.
Particular attention should be paid to considering the issue of “spider veins” as an important symptom of venous insufficiency. “Spider veins” are a web of capillaries dilated by more than 0.1 mm, visible through the skin.
As a rule, women regard these “stars” as a cosmetic defect; men simply do not notice. Indeed, in some cases these are manifestations of dishormonal disorders, abuse of the sauna, solarium, while avoiding high temperatures and eliminating hormonal imbalances (for example, the use of oral contraceptives) will completely cure the disease. But, in most cases, the appearance of “spider veins” is the first and perhaps the only sign of congestion of the superficial veins and the development of varicose veins. Therefore, even if there is a small area of the expanded capillary network, consultation with a specialist is necessary.
Varicose veins are not only a cosmetic problem, but also a dangerous disease, primarily due to its complications. With improper or untimely treatment, such dangerous conditions as thrombosis and thrombophlebitis, as well as bleeding from dilated veins, develop. Thrombosis (complete or partial closure of the lumen of a vein with a blood clot) or thrombophlebitis (inflammatory disease of the venous wall due to thrombosis) occurs suddenly and is not associated with physical activity. The swelling rapidly spreads to the lower limb, which is accompanied by unbearable bursting pain. Redness or bluish discoloration and local soreness of the skin may occur. If a blood clot breaks off, it enters the blood vessels of the lungs with the bloodstream, and in the case of complete or partial closure of the vessel, it can lead to a serious illness - pulmonary embolism. This complication is often fatal. If you suspect these complications of varicose veins, you must immediately take a horizontal position, raise your leg up, and contact emergency medical help by phone. You cannot squeeze your leg muscles, use ointments, or step on your leg.
Injury to the area of dilated vessels is also considered dangerous, as severe bleeding may occur. In this case, you urgently need to apply a tourniquet (medical or improvised) to the leg above the bleeding site, strong enough to stop the bleeding. It is also necessary to urgently call an ambulance team.
If at least one of the above signs is detected, it is necessary to examine a phlebologist - a specialist in vein diseases and, if necessary, consult other specialists, for example, a vascular surgeon, therapist, gynecologist.
When you see your doctor, you will likely be asked to:
Treatment of varicose veins is a complex process, the duration of which directly depends on the stage of the disease. Therapeutic measures are divided into surgical and conservative (non-surgical).
Non-surgical treatment of varicose veins of the lower extremities gives good results only at the onset of the disease, when skin manifestations are not very pronounced and only moderately reduce the ability to work. Conservative therapy is also indicated in the presence of contraindications to surgical treatment. In addition, these methods must be used in the postoperative period to prevent relapse of the disease.
Conservative treatment includes reducing the severity of risk factors, adequate physical activity, elastic compression, medications and physical therapy. The use of these measures together guarantees a good result. Together with a specialist, it is necessary to identify risk factors for varicose veins, for example, obesity, taking oral contraceptives, improper physical activity, and try to influence them.
People who have risk factors for the development of varicose veins, including hereditary predisposition, even in the absence of symptoms of the disease, need to consult a phlebologist at least twice a year with mandatory ultrasound examination of the veins of the lower extremities.
In the absence of complications (thrombosis or thrombophlebitis), it is necessary to regularly train the veins of the lower extremities. Recommended: keep your feet in an elevated position for as long as possible, use comfortable shoes. Walking, swimming, cycling, jogging are preferred. Physical activity (except swimming) should be carried out under conditions of elastic compression. Participation in sports that are traumatic for the lower extremities is contraindicated, as well as in the case of predominant loads on the lower extremities: football, basketball, volleyball, tennis, alpine skiing, various types of martial arts, exercises associated with lifting weights. At home, after consultation with a specialist, you can perform several simple exercises .
Before class, you need to lie down for a couple of minutes, keeping your legs in an elevated position to prepare the body for the exercises. The pace and speed of exercises are individual, in accordance with physical capabilities. When conducting physical education, the main thing is regularity.
In a lying position.
1 "Bicycle". The back and lower back are pressed tightly to the floor, we turn the pedals.
2. "Vertical scissors". Arm along the body, cross the legs like scissors.
3. We work with the feet. In a lying position, we bend and unbend, making circular movements in the ankle joints.
While standing, as well as sitting at your desk, you can perform the following exercises. We repeat each exercise 20 times
1. Lifting (socks together). Socks are parallel, pressed against each other. We rise on our toes, freeze in this position for a few seconds, and lower ourselves to the floor.
2. Lifting (toes apart). Heels together, toes apart. We rise on our toes, then lower ourselves to the floor.
3. Raise (heels apart). Toes together, heels apart. The movements are carried out as in the previous exercises.
It is recommended to use a contrast shower several times a day. Massage your feet alternately with cold and warm streams of water for about 5 minutes each.
Elastic compression is a method of treating varicose veins through elastic bandaging or the use of medical knitwear. This creates a dosed compression of the muscles. This promotes better blood flow through the veins and prevents congestion. By artificially maintaining “tone,” the veins stop expanding, preventing thrombosis.
At all stages of development of varicose veins, the use of phlebotonic drugs is recommended. Their action is aimed at strengthening the vein wall. Today, drugs such as Detralex, Cyclo 3 Fort, Ginkor-fort, Troxevasin, Anavenol, Aescusan, Asklezan, Antistax, Phlebodia 600 are used. The course of treatment is long, 6 months or more. Also indicated are drugs that reduce blood viscosity - antiplatelet agents (aspirin, chimes), anti-inflammatory drugs (diclofenac).
No folk remedies, meaning medicinal herbs, can compare in effectiveness with the listed drugs, so you should not self-medicate. Drug therapy should be used only as prescribed by a doctor. Local treatment, for example various ointments, gels are not recommended in the absence of thrombosis or thrombophlebitis.
Physiotherapy has no independent value. It is used only as prescribed by a doctor, depending on the underlying problem. Using physical methods at home on your own can lead to the development of complications (inflammation, blood clot rupture). If prescribed correctly, diadynamic currents, magnetic fields, electrophoresis, and laser have the best effect.
Varicose veins of the lower extremities is a surgical disease, a complete cure for which is possible only after surgical treatment . Depending on the location of the lesion and the severity of the disease, the following methods of surgical treatment are used.
1. Phlebectomy - surgical removal of varicose veins. The purpose of the operation is to eliminate the pathological discharge of blood by removing the main trunks of the great or small saphenous vein, as well as ligating the communicating veins. This operation is contraindicated if:
severe concomitant disease, in which surgical intervention can sharply aggravate the condition;
late stage of varicose veins;
the presence of any purulent process in the body;
The use of endoscopic treatment methods makes this operation safer and cosmetically beneficial. The set of measures for the best recovery after surgery (rehabilitation) directly depends on the complexity of the operation, but general principles apply. The final formation of sutures takes 6 months, therefore, to prevent their damage and avoid cosmetic defects, it is recommended to exclude rough mechanical impact on them (using a hard washcloth, compressive clothing). Do not wash with hot water. After surgery, it is necessary to use elastic compression, usually for 6 months. In the future, compression hosiery is necessary in case of possible “harmful” load (heavy lifting, long journeys, flights).
2. Sclerosis - the introduction of a special substance (sclerosant) into the dilated vein, which causes the walls of the vein to “stick together” and blood flow through it ceases. As a result, there is no pathological discharge of blood, and a cosmetic defect is eliminated, since the vein collapses and becomes invisible. But sclerotherapy is effective only when expanding small branches of the main trunks, which limits its use when the process is severe. The advantage of sclerotherapy is the absence of scars and the need for hospitalization. After vein sclerosis, specific rehabilitation is not required.
3. Laser coagulation is a method based on the destruction of the vein wall through the heat of a laser, resulting in “sealing” of the venous lumen. Indicated only when the vein is dilated no more than 10 mm. The method is associated with anesthesia. It is cosmetically preferable compared to phlebectomy, but, as after vein removal, it requires early activation of the patient, as well as long-term elastic compression.
Prevention of varicose veins
In the modern world, great importance is given to the prevention of varicose veins. Regular implementation of simple measures will significantly reduce the risk of the onset and progression of the disease:
An active lifestyle is the basis of prevention; it is also important to alternate long-term static loads with walking, running, cycling, swimming, and performing simple exercises in the workplace.
Keep your legs elevated as much as possible.
Avoid weight gain.
Wear comfortable shoes with a maximum heel size of up to 4 cm, and if necessary, use orthopedic insoles.
In the case of using estrogens, for example, oral contraceptives, as well as during pregnancy, it is necessary to undergo an ultrasound scan of the veins of the lower extremities.
A new Philips HD 15 expert-class ultrasound scanner has been installed at Blagovest MC!
Classification according to cause
Depending on the clinical course, varicose veins are classified as follows:
Clinical according to clinical manifestations
I stage of compensation
II stage of decompensation
Thanks to the classification, the stage and degree of damage to the venous system is determined. It is the stage and extent that determine the treatment options. Consultation with a specialist is of paramount importance.
Perforating veins Normally, outflow through the main veins occurs from the bottom up and in the direction from the superficial veins through the perforating veins to the deep ones; 85% of the volume of venous blood flows through the deep veins. This direction is provided by valves originating from the endothelial lining of the vein. What is the driving force of venous blood flow, because blood moves against gravity:
There are several reasons that influence the development of varicose transformation of the saphenous veins of the lower extremities:
Pregnancy, during which hormonal changes also occur, and the uterus, which increases during pregnancy, compresses the venous plexuses of the pelvis. It has been noted that varicose transformation occurs in generations of families, and in connection with this, a hereditary nature has been established. It is worth noting that it is not the disease itself that is transmitted, but a predisposition to it.
A high heel prevents the muscles of the lower leg from working while walking, and a constant load on the foot is dangerous for the development of flat feet, then muscle dysfunction will occur even without a high heel.
Working on your feet, when you have to stand in an upright position for a long time, sedentary work disrupts the venous outflow from the lower extremities, since the muscle pump does not work.
Diseases leading to increased intra-abdominal pressure - constipation, obstructive pulmonary diseases, weight gain - lead to disruption of venous outflow and provoke the development of varicose veins.
Food rich in plant products helps strengthen the vascular wall. Particularly useful are rice, fruits, greens, this fact is used in treatment; many drugs used to treat varicose veins are based on extracts from plants. Food that does not contain a plant component may be one of the predisposing factors to varicose veins.
Previously, assessment of the level of impairment and insufficiency of the venous valve apparatus was studied using functional tests:
1. Study of the consistency of the valves in the great saphenous vein:
2. Determination of the consistency of valves in the system of perforating veins:
3. Determination of the functional viability of the deep veins:
These functional tests are a subjective assessment, therefore they do not exclude diagnostic errors.
For an accurate diagnosis, it is necessary to perform Doppler ultrasound and duplex angioscanning. Ultrasound is performed on an outpatient basis, without hospitalization, the study is absolutely painless.
Phlebography is the introduction of a contrast agent into the lumen of a vein (antegrade, retrograde) or into the medullary canal. Allows you to determine the patency of the deep veins, the condition of the perforating veins and the consistency of the valves of the superficial veins. Given the labor-intensive and invasive nature of venography, this technique is used less frequently.
The wide range of drugs available for sale today will amaze with its breadth. In general, the effect of the drugs is aimed at strengthening the vascular wall and reducing swelling of soft tissues.
Preparations of a number of flavonoids of plant origin - aescusan - an extract from horse chestnut, asklezan - an extract from the fruits of wild hazel, Detralex - an extract from the fruits of wild green orange, Ginkofort - an extract from tree fern and many others. It should be remembered that drugs help slow down or stop further deformation of the vein wall.
Eating a diet rich in fruits and vegetables leads to saturation with flavonoids, which helps strengthen the vascular wall, improves intestinal motility, and as a result, eliminates resistance to venous blood flow in the abdominal cavity. Eating at least 0.5 kg of vegetables and fruits per day for a person weighing 70-80 kg is considered sufficient.
Wearing elastic knitwear is strongly recommended - it is useful both as a means of treatment and as a means of prevention after surgery. The selection of elastic knitwear should be carried out by a doctor, since this underwear is both therapeutic and prophylactic, which needs to be worn for a long time. It is necessary to measure the circumference at the level of the ankle, under the kneecap, the middle of the belly, the thigh circumference below 5 cm from the perineum and three lengths, select the degree of compression - only a doctor can determine this.
Sclerotherapy is an outpatient procedure, but should be performed by an experienced specialist in a hospital. The manipulation is painless, after 2 hours you can go home. For a patient with slerotharpia, it is like an intravenous injection with the drug injected into a vein. Afterwards you will need to wear elastic knitwear or elastic bandages for 7 to 10 days.
Phlebectomy. This operation is aimed at complete removal of the great saphenous vein. The surgeon creates two accesses - the first in the upper part of the thigh, the second at the level of the ankle; a probe is inserted into the lumen of the vein, with the help of which the affected vein is removed. When using cosmetic suture material, the seam is practically invisible and will completely disappear after tanning.
Outpatient phlebectomy. In the event that only tributaries to the main veins have undergone varicose transformation, you can use the technique of outpatient phlebectomy using a hook. This technique does not require an incision in the skin and does not require sutures; it is performed under local anesthesia. Using a hook, the vein is grabbed and pulled to the surface, then the surgeon performs ligation of the vein, division and removal. Only puncture points remain on the skin. After the operation, observation for 2 hours, then you can go home. After surgery, you must wear an elastic bandage for 2 weeks.
The choice of treatment method depends on many reasons - the level of the lesion, the extent of the lesion, the presence or absence of complications. therefore, only a doctor will help to correctly determine the possibilities and scope of treatment.
And if you don’t get treatment, forget about the doctor? Then complications are possible, such as progression of varicose veins, thrombophlebitis.
The progression of varicose veins is not only a cosmetic defect. Over time, you will feel more clearly fatigue in the calf muscles, swelling will appear, usually these symptoms appear in the evening. Violation of the venous outflow leads to stagnation of blood in the venous system and the release of the liquid part of the blood into the surrounding tissue; this is externally manifested by edema. Due to swelling, the trophism of the skin will change, pigment spots and ulcers will appear, which are very difficult to treat. Therefore, prevention and timely treatment are of particular importance in the treatment of varicose veins and the prevention of complications.
In the presence of trophic ulcers on the lower leg, as a consequence of damage to the venous bed, an integrated approach is necessary. Conservative therapy, including droppers to improve blood supply and reduce swelling. It is necessary to heal the ulcers; for this, a number of topical ointments, antibiotics, and powders are used. Only after the ulcers have healed will it be possible to talk about the possibility of surgical treatment - phlebectomy. Without surgery, in less than a month, the ulcers will again bother you, you will need to repeat the course of conservative therapy, and the question of surgical treatment will again arise.
If you have ulcerative defects on the lower leg, you should not delay consultation and treatment. It is necessary to contact a surgeon who will select the necessary and affordable set of conservative therapy. Then surgical treatment will be required - phlebectomy, with ligation of the veins located under the crust of the former ulcer.
In case of bleeding from an ulcer, it is necessary to apply a pressure bandage, tourniquet, and urgently seek help from a surgeon. You will need to stop the bleeding surgically. The use of a bandage and tourniquet does not always stop bleeding.
Thrombophlebitis is a blockage of the lumen of a vein by a thrombus. Thrombophlebitis can affect both deep and superficial veins. The most dangerous complication of thrombophlebitis can be pulmonary embolism. Therefore, if a diagnosis of thrombophlebitis is made, hospitalization in a hospital and conservative therapy are indicated, deciding on the need for surgical treatment