How it develops
The veins in the legs have valves that allow blood to flow only up to the heart. The lower leg muscles act like a pump when walking. If the valves stop closing, some of the blood flows back (reflux), the pressure in the vein increases, the wall stretches - and the process becomes self-sustaining.
This makes it clear why prolonged standing and sitting worsen the condition, while walking and raising the legs improves it.
- Heredity is the most important factor: weakness of the venous wall is inherited
- Working standing or sitting without moving
- Pregnancy: hormones and uterine pressure on pelvic veins
- Overweight
- Heavy lifting, chronic constipation, persistent cough
- Taking hormonal medications
Stages and symptoms
- Сосудистые звёздочки и сеточки (телеангиэктазии) — пока только косметический дефект.
- Появление расширенных извитых вен под кожей.
- Отёки к вечеру, тяжесть, распирание, ночные судороги в икрах.
- Изменения кожи: потемнение, уплотнение, экзема в области лодыжки.
- Зажившая или открытая трофическая язва — самая тяжёлая стадия.
Survey
The main and essentially the only necessary method is ultrasound duplex scanning of veins. It shows exactly where the valves are not working, whether there is reflux, whether the deep veins are patent and whether there are any blood clots. It is the ultrasound result that determines the treatment method.
- Examination by a phlebologist in a standing position
- Duplex scanning of the veins of the lower extremities
- When planning an operation - vein mapping
- Blood tests before surgery, in case of repeated thrombosis - examination for thrombophilia
Treatment
Neither ointments nor tablets eliminate an already dilated vein or restore damaged valves. They reduce symptoms, but do not eliminate the need for intervention for severe varicose veins.
- Compression hosiery is the basis of conservative treatment; The class and size are selected by the doctor, you need to put it on in the morning without getting out of bed
- Venotonics - reduce heaviness, swelling and cramps, but do not remove veins
- Sclerotherapy is the injection of a drug into a vein, which is then “glued together”; suitable for stars and small veins, outpatient
- Endovenous laser or radiofrequency obliteration is a modern, low-traumatic method of closing a vein trunk
- Crossectomy and combined phlebectomy - removal of incompetent veins; performed for severe varicose veins
- After the intervention - compression and early walking, no need for bed rest
What you can do yourself
- Walking, swimming, cycling - act as a venous pump
- Rest with your legs elevated 15–20 cm for 15 minutes several times a day
- Avoid prolonged standing or sitting; every hour - 2-3 minutes of movement
- Contrast shower on feet, ending with cool water
- Weight loss, combating constipation
- Compression stockings for flights, standing work and pregnancy
