Treatment regimen for varicose veins of the lower extremities

20 September 2020

Varicose veins are the scourge of modern humanity. But often the treatment of varicose veins, the scheme of which is selected individually, ends successfully. Sometimes the matter is bypassed only with therapy and medication, but sometimes the situation is saved only by surgery. What are the ways to get rid of this unpleasant and serious ailment?

Varicose veins - basic information

Varicose veins are a pathological condition characterized by damage to the venous vessels.

There are special valves in the veins, which act as a kind of closures, preventing blood from flowing down (venous blood in the legs flows from bottom to top).

Valve system failure leads to blood reflux and congestion.As a result of these processes, the veins weaken, stretch and deform, unable to cope with the increasing blood pressure.

The result is a symptom familiar to many - bulging veins on the surface of the skin, which indicates the dynamic development of pathology.

All the insidiousness of the disease lies in the fact that at the initial stages it manifests itself as usual tiredness and heaviness in the legs.

Therefore, many are in no hurry to visit a doctor, and they start to sound the alarm when blue strands become visible on the skin, spoiling the appearance of the legs.

Learn more about the symptoms of early varicose veins here.

The reasons for the development of this pathology are very diverse.These include both congenital abnormalities of the vascular system and some provoking factors: a sedentary lifestyle, excess weight, uncomfortable shoes, professional activities associated with prolonged standing.

Treatment of the disease is always carried out in a comprehensive manner.The necessary scheme is selected by a specialist based on the stage of development of the disease and the individual characteristics of the organism.

Which doctor treats veins?

Varicose veins are not just dilated veins, but also serious dysfunction of valves and a failure in blood circulation, which leads to severe complications throughout the body. And if the first symptoms appear - swollen veins, muscle cramps, constant heaviness in the legs - you should immediately make an appointment with a phlebologist.

Based on the severity of the case, the causes of the disease and the state of health, the doctor will select the most appropriate treatment course from the options available today.

Threatening symptoms

The main reasons that lead to varicose veins are: heredity, excess weight, sedentary lifestyle, sedentary or standing work, hormonal imbalance in the body. According to statistics, 40% of adult women and 20% of men have signs of varicose veins.

A phlebologist is engaged in the diagnosis of the disease, you should contact himif such symptoms appear:

Heaviness in the legs that gets worse towards the end of the day.
Rapid fatigue of the legs during long walking.
Pain in the legs.
The appearance of a fine vascular mesh on the legs.
Swelling of the legs.
Convulsions that increase in intensity at night.
Itching of the skin of the lower extremities.

Graduallyatrophy of muscle fibers of superficial veinsdevelops, blood vessels lengthen, expand, become tortuous, nodes appear on them protruding above the skin surface. The skin over the enlarged veins becomes bluish-red, dry and hot, ulcers appear due to tissue malnutrition.

Due to dystrophic changes in the subcutaneous fat layer, lipodermatosclerosis can develop - a dangerous complication of varicose veins in the legs, the treatment of which with conservative methods may be unsuccessful.

To avoid the severe consequences of varicose veins, phlebologists advise their patientsto start treatment on timewhen the first signs of the disease appear.

Treatment methods

Sclerotherapy is highly effective, which consists in injecting a special sclerosant substance into the vessels using a syringe with the finest needle. The venous lumens are tightened, the edges of the ruptures are soldered, thereby stopping the seepage of blood outside the vessels. The substance itself, having fulfilled its function, is absorbed.

This method removes all blemishes and gives an excellent cosmetic result. But after the procedure, it is necessary to maintain the condition of the veins with additional therapy and wear compression clothing.

Almost 10 years ago, a laser, or rather endovenous laser coagulation, began to be used very successfully in medicine to combat varicose veins. Treat veins as follows:

Using local anesthesia, a small puncture is made in the vein.
An optical fiber is inserted into the resulting hole.
The laser acts on damaged areas, sealing the damage.
Then a new fabric appears on the sealed place.

The operation does not take place "blindly" - the process is monitored through an ultrasound machine, so there is practically no risk of failure. In addition, the absence of significant incisions excludes painful sensations, the formation of hemorrhages, and a violation of adjacent tissues.

After the procedure, you should bandage the affected areas or wear compression stockings and tights.

Radiofrequency ablation is often used, and high-frequency current successfully treats varicose veins. It happens as follows:

The vein is pierced.
A catheter is inserted into the hole.
Radiation enters the vessel through it.
The conductor acts at the molecular level, changing the protein molecules of the damaged vein.

The method allows you to quickly treat all venous nodes, and no special postoperative therapy is required.

Methods for treating varicose veins

There are two of them: conservative and surgical. The patient is faced with an urgent question: how to treat varicose veins on the legs without surgery. When choosing a method, the doctor takes into account the signs, stage of the disease, the presence of complications, concomitant diseases, the age of the patient. Non-surgical methods for eliminating varicose veins of the lower extremities give good results only when the symptoms of pathology are still weakly expressed.

To stop the degradation of the affected vessels help:

drug therapy;
compression treatment;
physiotherapy exercises;
physiotherapy;
massage;
traditional medicine recipes;
diet.

Phlebologists try to choose for patients during pregnancy exclusively non-drug means of treating varicose veins of the lower extremities. First of all, these are compression underwear, gymnastic exercises, physiotherapy, massage, diet. If medications are still needed, only medications for external use are prescribed.

The debate continues about whether hirudotherapy helps with varicose veins. The hirudin produced by leeches, penetrating into the venous system of the lower extremities, dilutes the thickened blood. However, today there are many modern drugs with the same property. In addition, there are risk factors for the use of leeches - vascular infection, allergic reactions.

If necessary, treatment of varicose veins is carried out using radical methods. This:

sclerotherapy;
ozone therapy;
cryotherapy;
electrocoagulation;
laser coagulation;
surgical intervention.

Sclerotherapy - injection into a diseased vein of a drug that "glues" the dilated vessel. It stops pumping blood and gradually dissolves. The maximum effectiveness of sclerotherapy is achieved at an early stage of the pathology. A similar method is ozone therapy: a portion of this gas is injected with a syringe into the lumens of small veins, and the vessels also "stick together".

Cold is used during the course of cryotherapy procedures. During electrocoagulation, a high-frequency current is supplied to the vessels through a very thin electrode. Laser treatment of varicose veins is also an effective modern method, especially when used in combination with conservative methods. At the same time, the cosmetic result is high: after a few weeks, the patient has no scars or scars.

However, surgical removal is the most effective treatment that allows you to radically get rid of varicose veins when drug therapy does not lead to the desired result. Sick vessels are removed through local subcutaneous incisions. After surgery, the leg is tightly bandaged, and after three to four hours the patient can walk.

Principles of medical treatment of varicose veins

Effective treatment of varicose veins is possible only if the selected drugs prevent the mechanisms of pathology development, destruction of vascular walls and valves.

The main tasks of medical treatment of varicose veins are:

restoration of blood circulation;
strengthening of the venous walls;
increased vascular tone;
lowering blood viscosity;
prevention of blood clots;
normalization of the valve system;
elimination of inflammatory processes;
normalization of blood circulation in the capillaries.

Medicines are indispensable in the complex treatment of the disease.

They are also widely used for preventive purposes, which is especially important for people at risk of developing pathology.

To date, there are a large number of drugs for the treatment of varicose veins on the legs and they all differ in composition and mechanism of action.

See a doctor

Varicose veins are a serious disease, which, if treated incorrectly or not, can threaten various complications that are dangerous to human health and life.

Help. Thromboembolism of vital vessels, thrombophlebitis, trophic ulcers - this is not a complete list of complications of varicose veins that pose a threat to humans.

In this regard, you should not even try to self-medicate.

Experiments at home with drug selection can either make the situation worse or be ineffective.

In any case, this is lost time, health and funds.

Therefore, you should contact a phlebologist. Only a specialist will be able to correctly select the drugs and build a treatment regimen so as to get the maximum benefit for the patient.

What drugs are used

Complex treatment of varicose veins consists in the use of several groups of drugs at once:

Phlebotonics.
Anticoagulants.
Anti-inflammatory.
Fibrinolytics.

Also, to enhance the therapeutic effect,means of systemic and local influence are used.

Creams, gels, ointmentsare used as topical preparations. When choosing preparations for varicose veins and thrombophlebitis, it should be borne in mind that it is theagent in the form of an ointment that is characterized by the highest content of the active ingredient.

Important!A common contraindication for all local remedies is a violation of the integrity of the skin.

As a rule, such medications are applied several times a day, and the product should be rubbed in with light movements from the bottom up.

Groups of drugs and their effects

In case of venous varicose veins, medicinal substances are classified according to the type of action onthree main groups:

venotonic or phlebotropic drugs;
blood thinning agents (anticoagulants) and medications that inhibit platelet adhesion (antiplatelet agents);
anti-inflammatory drugs.

Research and medical practice have proven the effectiveness of phlebotonics developed on the basis of natural flavonoids- diosmin and hesperide. These substances not only protect the cells of the veins, but stimulate the outflow of lymph and stabilize the work of the capillaries. The simultaneous administration of combination drugs in which both flavonoids are present is especially effective.

Most often phlebotropic agentsare taken from 2 to 3 months in courses. It is important that the reception coincides with the hot season, when the load on the vessels increases due to the high air temperature and the use of large volumes of water. If varicose veins are accompanied by chronic venous insufficiency, phlebotonics are constantly taken in half the dose.

A patient with a diagnosis of varicose veinsshould receive systematic treatment from the very beginningto prevent the development of the disease and reduce the likelihood of complications.

The second task is solved by drugs that thin the blood (anticoagulants) and improve its flowing properties, preventing the formation of thrombotic clots (antiplatelet agents).

The formation of blood clots, their separation from the vascular wall and movement along the venous bed leads to the overlap of the vessels of the heart, lungs and human brain. As a result, the likelihood of developing a heart attack, pulmonary embolism and ischemic stroke is very high.

Antiagretates are not a cure for varicose veins, but are used as a means to prevent its serious complications- thrombosis and thrombophlebitis. We can say that these drugs save the patient's life and reduce the threat of disability to a minimum.

Operation

Removal of damaged veins of the lower extremities or their parts is carried out through incisions or punctures. The elimination of diseased vessels in the clinic is necessary if:

veins in the legs are pathologically enlarged;
the skin is affected;
trophic ulcers appeared;
thrombophlebitis worsened.

Surgical treatment of varicose veins of the legs is contraindicated:

for severe hypertension, coronary artery disease, infectious diseases, eczema;
if the patient has already reached old age;
during pregnancy (over 5 months).

Complementary therapy

In addition to medical and surgical treatment, additional therapy is of considerable importance, including a number of measures to bring the veins back to normal:

The wrap has a relaxing effect, removes the feeling of heaviness in the legs. When purchasing the necessary funds, it is worth remembering that hot wraps are contraindicated for varicose veins.
Foot baths are another way to help take stress off your feet. Using medicinal herbs and oils, you can strengthen blood vessels, get rid of puffiness and redness. But the effect will be only with the daily use of the method.
Contrast shower. 10 seconds of cold drenching and 30 seconds of warm (hot water is best avoided) for 5-7 minutes each morning will help keep your veins in good shape. For these purposes, you can use the Alekseev or Charcot shower.

Phlebologists often include physiotherapy in complex treatment - laser, magnetotherapy, electrophoresis.

They do not cause discomfort and pain, inexpensive and quite effective. In addition, the treatment takes place under the supervision of medical professionals. The main condition is regular visits to the office.

Physiotherapy has a beneficial effect on the condition of the venous walls, muscle tissue and valve activity.

Compression therapy is an important component of not only treatment, but also prevention and postoperative period. The use of bandages will avoid stagnant processes, support damaged vessels, and stop the progression of the disease.

Applying bandages requires certain knowledge and dexterity, as excessive overtightening can lead to a deterioration, and weak bandaging will not give the desired effect. Therefore, for the correct use of bandages, it is worth consulting a doctor.

Massage for varicose veins is not acceptable in all cases, so only a doctor can say whether it is worth using it in a particular case or not. If the method is chosen correctly, then after the first session you can feel the result. This method can lead to an improvement in blood microcirculation, relieve the main symptoms of the disease, including external ones.

The more advanced the disease, the more difficult it is to fight it, and sometimes patients come too late, and then there is only one way out - phlebectomy. To prevent this from happening, one should not wait for complications, but receive timely qualified assistance.

Conservative method

Phlebologists in the treatment of varicose veins strive to do without traumatic operations that are not needed in the early stages of the disease. For example, this is typical for reticular varicose veins, the manifestation of which is limited only to blue venous networks. Drugs help to improve the condition of the valves and vessel walls. Men, like women, should wear compression hosiery. The pathology cannot be completely cured. However, conservative methods stop the development of varicose veins and protect against complications.

Gymnastics

Exercise therapy specialists know how to remove veins on the legs by performing physiotherapy exercises. This is possible provided that exercise, which improves blood flow in the legs, is done systematically. For example:

In a standing position, the heels of the feet are vigorously lifted alternately.
In the same standing position, they slowly rise on their toes and just as slowly descend.
Sitting on a chair, roll a small ball on the floor with your feet back and forth.

Wearing special underwear

Doctors recommend combining medical treatment of varicose veins with the wearing of compression underwear - these are products made from a special type of knitwear that put pressure (compression) on the veins. The degree of pressure of the linen on the walls of the vessels can be adjusted by purchasing products with different degrees of compression.

There are four degrees of compression in total: the first is used for prophylaxis, the rest for treatment. With varicose veins of the lower extremities, tights, stockings, knee-highs and leggings are worn, the doctor selects the required degree of compression.

Compression underwear creates a dense crushing frame on the legs,thanks to this, the following effects develop:

Weakened leg muscles are supported.
The walls of the blood vessels are compressed, thereby preventing them from stretching.
Lymph flow and blood circulation are stimulated.
Stagnation is eliminated.
Venous valves function is normalized.
The load on the dilated veins is reduced.
Thrombophlebitis is prevented.

It is compulsory to wear compression hosiery after surgery for varicose veins. Underwear helps to prevent the recurrence of the disease, creates additional support for the body during the rehabilitation period.

Compression sclerotherapy

Compression sclerotherapy is a modern method of treating varicose veins, which consists in the injection of drugs into the affected veins. As a result, sclerotherapy (adhesion) of the venous walls occurs, the blood flow at the injection site stops, and the vein gradually dissolves or leaves behind a barely noticeable strand that does not bother the patient at all.

Most often, sclerotherapy is performed when spider veins appear, when varicose veins are in the initial stage. With the progressive development of varicose veins of the legs, treatment with sclerotherapy is carried out after analyzing the state of the venous valves and vascular walls, the functional features of the patient's circulatory system.

If a decision is made to conduct compression sclerotherapy, the patient undergoes a blood coagulation test, an ultrasound examination of the veins. When performing sclerotherapy, the patient does not experience painful sensations, since the drug is injected into the vein using the thinnest needle. After the end of the procedure, a sterile bandage is applied to the area of drug administration, and the patient puts on a compression garment. The first week after sclerotherapy, the compression hosiery must be worn around the clock, then it is allowed to take it off at night.

Positive results of sclerotherapy:

Restoration of effective blood flow.
Exclusion of blood clots in the damaged vein.
Prevention of trophic disorders in tissues.
Elimination of clinical symptoms of varicose veins: edema, seizures, pain.
Excellent cosmetic effect due to the fact that distended veins completely disappear.

Diet

For a more effective treatment of varicose veins of the legs, it is important to properly organize nutrition. Berries, apples, citrus fruits, which contain flavonoids, antioxidants, rutin, help to improve the condition of blood vessels. Thinning blood provides a daily intake of a sufficient amount of fluid (1. 5-2 liters). Diet with varicose veins on the legs is incompatible with fatty, fried foods, hot spices, alcohol.

Folk remedies

Treatment of varicose veins with folk remedies at home in summer is especially effective. The following recipes are popular:

15-20 minute leg compresses with tomato paste. It has a high content of lycopene, which actively strengthens blood vessels and prevents blood clots. At the same time, it is useful to eat fresh tomatoes every day.
Infusion of sweet clover, an herb that is indispensable for varicose veins: Art. l. raw materials are brewed with two glasses of boiling water, kept until cooled, filtered. They drink half a glass 3 times daily, the rest of the volume is used as lotions.

What not to do

When diagnosed with varicose veins, one has to pay attention to lifestyle, nutrition and sports.Not allowed:

active physical activity, running, jumping (yoga classes are allowed);
prolonged standing or prolonged sitting position;
use of all medicines without consulting a phlebologist;
long flights with a forced motionless position of the legs. In addition, at high altitudes, a sharp thickening of the blood occurs, which leads to the formation of blood clots;
taking hot baths, visiting a sauna;
cupping and honey massage is strictly prohibited, only manual type of medical massage is allowed.

Possible complications

Trophic ulcersis a form of complication in varicose veins, which manifests itself in the development and deepening of a long-term non-healing ulcer. Usually, a separate painful ulcer develops on the lower leg, inside of which "weeping" is often observed in the form of discharge of serous bloody fluid covering the affected tissues.

Urgent medical attention

Immediate medical attention is required if any of the following symptoms occur:

Increased pain in the affected limb, inability to get out of bed or take a few steps;
The skin on the leg is hot, swollen and firm to the touch.
Skin color changes from pale to bluish or bluish red;
Sudden shortness of breath, shortness of breath, sweating and severe weakness;
Bleeding from affected skin or varicose veins.

Necessary medications for varicose veins of the lower extremities must be included in the complex treatment regimen.Even after surgery, several courses of phlebotonic and antiplatelet agents will be requiredin order to prevent possible trophic disorders, inflammation and complications associated with the disease.

Many multicomponent drugs against varicose veins act in combination, have several functions. The effectiveness of such drugs is more pronounced.It is optimal to use treatment courses in the correct dosage, calculated by the phlebologist, in combination with compression therapy, yoga classes, swimming in the pool, herbal medicine.

Conclusion

Complex treatment of varicose veins of the lower extremities involves the use of various therapeutic techniques.

Along with medication, physiotherapy, special exercises, massage, etc. are prescribed.