Symptoms of varicose veins on the legs - Causes, symptoms and treatment. MF.

Perhaps the disease of the veins of the legs is the most common vascular disease that occurs among people. Women are more often ill. With age, venous diseases progress and eventually lead to complications. The most frequent causes of venous diseases are the following two: varicose veins and the consequences of the transferred thrombosis. Rare are the congenital malformations of the vascular system( more often located on one limb), the manifestations of which we can already observe in a newborn baby, fortunately, this is a rare situation.

Varicose veins on the shins

First signs of varicose veins

When can I suspect a vein disease and when should I see a doctor?

Varicose veins of the legs are most often hereditary, that is, the family has references to enlarged veins and edema from relatives. Factors contributing to the manifestation of hereditary predisposition to varicose veins of the legs: excessive body weight, sedentary lifestyle( long standing and sitting), hormonal background( for example, pregnancy).

While a previous thrombosis of the leg veins is an acute condition, which could be caused by trauma, prolonged bed rest( due to illness), loss of fluids( eg, diarrhea), and a congenital or acquired predisposition to increased blood clotting.

Both these causes( varicose veins and the consequences of the transferred thrombosis) lead to edema of the legs, the appearance of dilated veins or a small network of "vascular asterisks" visible under the skin of the skin, with the progression of the disease, skin defects( ulcers) that do not heal for a long time.

Vascular asterisks( left pathology, right norm)

Veins of the legs carry blood to the heart, this is facilitated by several factors, the main one of which is the work of the calf muscles, that is, walking. In healthy people, there are two systems of leg veins connected to each other: superficial veins( the expansion of which we observe in varicose veins) and "deep veins"( located together with arteries in the depth of tissues).With varicose veins, the superficial veins in the first place suffer.

Deep( blue) and superficial veins of the legs( blue color)

The consequences of the transferred thrombosis are associated with the formation of a thrombus in the "deep veins" and the subsequent compensatory expansion of the superficial veins, that is, the visible widening of the veins with the transferred deep vein thrombosis is secondary. This is important for understanding the approach to surgical treatment: in case of varicose veins, an operation or a combination of it with other methods( laser, injectable sclerotherapy of veins) can often be suggested. On the contrary, with the transferred thrombosis indications for surgery are rare and the possibilities of surgery in this case are severely limited. And here, approaches to conservative( that is without operation) treatment at all diseases of veins of legs or foots similar.

Initial signs of varicose veins

If you notice the appearance of "vascular asterisks"( a network of small vessels under the skin in the leg area), worries about the feeling of heaviness in the shins by the evening, swelling of the legs or visible enlarged subcutaneous veins is an occasion to consult a doctor.

Recommendations for a lifestyle with the first symptoms of varicose veins

In varicose veins, general recommendations for all patients with leg vein diseases should be followed:

• Lifestyle and nutrition changes, namely daily walking, reduction in overweight,, sufficient drinking regimen and prevention of chair delay

• Wearing elastic compression knitwear( bandage or medical knitwear - tights, stockings or stockings), degree of compressionssia( the force with which the jersey presses against the square centimeter of the skin of the limb) is assigned by the doctor. The size of the product is individual and is selected in the pharmacy with the direct participation of the patient.

Compression elastic knee

• Treatment of concomitant diseases that affect the dynamics of outflow through the veins: treatment of flatfoot, joint diseases

• Reception of medications that affect the venous wall is most often used by coursework( within 2 months with interruptions)

Ifswelling of the tissues of the upper and lower extremities is caused by chronic diseases of the veins, the following measures are applicable:

• Elastic limb compression( knitwear or compression bandage worn in the morning for 20-30 minutes after waking, wear knitwear all day before night sleep, including weekends), lymphodrene massage, medications( as directed by a doctor and in conjunction with wearing elastic knitwear)

• Sufficient physical activity of

• Excessive position of swollen limbs in sleep and rest

• Hygienic skin care

Incorrect patient actions can lead to venous thrombosis andryvu thrombus( with possible fatal or disability) accelerate the formation of ulcers, enhancement of edema, an increase in the area of ​​"vascular Stars." Symptoms of varicose veins are FORBIDDEN:

• Taking diuretics without prescribing a doctor.
• Restriction of fluid intake.
• Local and general overheating, thermal procedures.
• The use of leeches( leading to the formation of ulcers and infected wounds, rough scars, can cause the formation of thrombi in deep veins, there is a risk of infection with hepatitis B, C and HIV infection).

Symptoms of varicose veins

Edema in chronic diseases of the veins of the lower extremities( varicose veins, transient deep vein thrombosis) occur frequently. Edema almost completely passes after a night rest and gradually increases by evening, if the venous disease is more pronounced on one limb, the swelling is asymmetrical.

Common varicose veins

Expanding pains and a feeling of heaviness in the legs with venous diseases can accompany the edema or manifest themselves in isolation, the so-called "symptom of heavy legs".The origin of this symptom is not yet fully understood, however, it is supposed that it is associated with a slowing of the blood flow through the enlarged veins, which in turn leads to the formation of substances in the vein wall that cause pain. Venous pain to a patient is usually difficult to describe in words and clearly indicate the source of pain. Such pain can appear in the early stages of the disease and is not directly related to the severity of the disease. Venous pain in women can be exacerbated in connection with the menstrual cycle. In different studies, small veins can serve as a source of pain, as a result of a process similar to inflammation.

There may also be convulsions in the legs at night, as a symptom of chronic diseases of the veins.

In the later stages of the disease, inflammatory changes in the skin in the lower third of the shin( dermatitis) may occur, as well as the appearance of a network of small diameter veins in the ankle joint zone, possibly a darkening of the skin of the shins. With further progression of varicose veins, there are long-lasting non-healing wounds - "venous ulcers", also usually located at the bottom of the tibia along the inner surface above the ankle joint. Complications of varicose veins - inflammation and thrombosis

For the treatment of such gross changes, a combination of both local( dressing, physiotherapy, wearing compression knitwear) and general( medication, lifestyle and comorbidities) medications is required. Often, these measures are used before the necessary surgical intervention, which eliminates the cause of ulceration, but, unfortunately, it is not always possible( for example, with deep vein thrombosis or severe concomitant diseases).In these cases, the main method of treatment is the healing of ulcers with the help of dressings, wearing elastic knits and medicamentous treatment - simultaneously.

What diseases can confuse varicose veins and how to distinguish

The most common symptom in diseases of various origins can be swelling of .First of all, it is necessary to distinguish between local( local, for example located only on the legs) and general edema( the face, hands, anterior surface of the abdomen, etc.) can be involved.

For chronic venous diseases, swelling is often located on both legs. Occur and increase gradually over time;In the early stages of the disease, edema is completely gone after an overnight rest. In conditions requiring urgent medical measures, swelling often develops rapidly, with thrombosis of the "deep veins" of the extremities, swelling can be one-sided, very dense to the touch, accompanied by severe pain. The causes of edema formation on only one limb can be acute purulent tissue inflammation, trauma, hematoma, spontaneous muscle rupture( for example, in sports), joint disease.

Often there are edemas with various diseases of the heart and kidneys. In such cases, they are symmetrically located on the lower limbs, if you press a finger on the front of the shin remains a depression from the pressure. These swelling can be combined with shortness of breath( a feeling of lack of air), a reference to the patient's heart disease. Also, edema can be caused by toxic substances, allergies, infectious diseases, kidney diseases, cancer processes, liver diseases.

Most often, patients who seek medical attention with a pain in the leg area suffer with joint diseases , or a combination with veins. Pain in joint damage is different from venous pain. Whereas, venous pain is most often intensified toward evening and after exercise, is localized in the area of ​​the leg muscles, pain and discomfort in the joints often arise at the beginning of the movement( walking).The patient notes that he needs to "disperse", and then the discomfort in the leg area decreases. Sharp pains, more often in one of the lower extremities, spreading on the back of the thigh and shin to the buttock or combined with pain in the lower back - may be a symptom of the osteochondrosis of the lumbar spine with the defeat of nerves coming from the spinal cord to the legs. Cramps in the leg muscles can also be associated with diseases of the nervous system, a violation of the composition of the liquid part of the blood( with the administration of some diuretics)

Inflammation of the skin in the leg area with the subsequent formation of long non-healing wounds can also be caused by various causes.

In any case - with all possible variants of the reasons for the patient's complaints, the attending physician should be dealt with, if necessary involving other specialists and using all available and necessary methods of examination. It is strongly advised not to try to explain their complaints on their own, or randomly assign themselves different methods of examination. Time for treatment and prevention of complications can be missed! Therefore, if you have any complaints, it is most rational to immediately consult a doctor, you can start with a competent therapist.

What tests should I take?

The main method of examination for diseases of veins is ultrasound of vessels. It is appointed in all cases. If necessary or doubts in the diagnosis( suspicions of a congenital vascular abnormality), a narrow specialist( vascular surgeon, phlebologist) can prescribe an X-ray examination of the vessels( i.e., the introduction of a contrast agent directly into a vessel and an X-ray image), it is performed only in a hospital andVein diseases are currently rarely used.

If deep vein thrombosis is transferred, if it is not triggered by trauma or other aggressive external factors, a consultation with a hematologist may be prescribed.which, in turn, if necessary, will prescribe an examination of the blood coagulation system, genetic tests are possible. For a patient who has undergone thrombosis of "deep veins" it is necessary to know whether he has a genetic or acquired state of predisposition to thrombosis. When confirming the diagnosis of a hematologist by a doctor, the examination of the next of kin is often recommended, and most importantly, the relatives of the patient of childbearing age. This is necessary because the predisposition to thrombosis in such women can manifest only in pregnancy and end fatal. Whereas, if a woman is aware of her condition predisposing to thrombosis, she will be assigned specific prophylaxis that will allow her to endure pregnancy and give birth to a healthy child.

If necessary, surgical intervention survey is standard and does not require large material costs.

Prognosis

The treatment plan is determined by the stage of varicose disease, the presence of its complications( eg, long-lasting non-healing ulcers), the nature and severity of concomitant diseases, the patient's willingness and commitment to treatment.

The key to successful treatment is the interaction of the doctor and the patient, leading to the understanding, acceptance and consistency of the doctor's recommendations. The possibilities of treating varicose disease in its various manifestations are enormous. Often use a combination treatment: elastic compression of the legs( wearing compression knitwear), drug support, lifestyle correction, if necessary surgical treatment. If the patient is not shown surgery and varicosity is represented only by "vascular asterisks", then they can be successfully removed by injection according to aesthetic indications. It is important to understand that this cosmetic procedure is not of a medical nature, it does not prevent the repeated formation of "vascular asterisks", it is combined with the entire complex of treatment of varicose veins. But it can significantly improve the quality of life of patients, especially women. There are a number of contraindications to this procedure. Sometimes the removal of "vascular asterisks" is combined with surgical treatment, laser treatment or radio-frequency obliteration.

At this stage in the development of medicine, surgical treatment of varicose veins tends to maximize aesthetics in combination with the effect on the cause of edema( removal of dilated veins with inconsistent valves).

Wrong operation of venous valves during their expansion

In the early stages of the disease, treatment without open surgery is possible, namely by laser or radio-frequency exposure. The tactics of treatment is determined by the doctor, the choice of the patient from several suggested options is possible. In any case, it is better not to start the disease, but to boldly consult a doctor.

Doctor cardiovascular surgeon Kuklina MA