What are varicoses, varicose veins? Why they appear, how they manifest and cure

Varicose veins of the lower extremities, also professionally referred to as varicose veins lower extremities, are among the most common diseases in developed countries.

They are classified as diseases of civilization. They affect about 10-40% of the world's population.

This disease only occurs in humans, does not affect animals, and is associated with an upright posture and a sedentary lifestyle. 

Most often bothered pregnant women.

An increasing percentage of the incidence is also due to increasing age, which rarely occurs in childhood. Varicose veins are not only an aesthetic problem but also the cause of various difficulties.

Varicose veins are divided into primary and secondary.

The secondary is the cause of another disease, and thus deep vein thrombosis or injury.

The cause of the primary may not be obvious and arise from various risk factors. We know the birth (congenital) varices, which are present after birth or shortly thereafter.

Between the ages of 30 and 70, they affect approximately 25% of the population.
And after the 70th year of life up to 70%.

Varicose veins are classified as chronic venous insufficiency, otherwise also chronic venous insufficiency. In general, the term varixi is defined by Arnoldi (1957) as any dilated, elongated or coiled (twisted) veins, regardless of their size.

In 1978, Dodd and Cockett defined varicose veins as veins that have dysfunctional valves, which, as a result of constant pressure, dilate, lengthen, twist, widen and deform pocket-like. Widmer's 1978 classification divides them into three levels.

Widmer classification of varieties in the table

Varicose veins also occur in other parts of the human body, not just in the lower limbs. Information about them is provided in the article Extended Veins. Bleeding from esophageal varices is life-threatening.

This disease arises due to the weakening of the wall of the vessel, vein. The result is a buildup of blood in these veins. The lower limbs are most often affected, due to the difficult return of blood from the lower limbs to the body.

Blood must return from the feet to the heart, overcoming the earth's gravity. 

As a result of the accumulation of blood, the pressure in the veins rises. During long-term action, it damages the wall of the vessel, thus creating various dilations, folds and protrusions of the veins to the skin surface. 

Although most people perceive varicose veins mainly as an aesthetic and cosmetic problem. Neglecting them can also cause more serious health problems.

Therefore, an early professional examination is important.

 The varicose veins of the lower limbs are caused by impaired function of the valves, which are located in the blood vessels. The valves help the blood to flow back from the lower limbs to the body.

The blood is affected by the earth's gravity, which makes it difficult for it to flow upwards into the heart.

The flaps prevent blood from entering the legs again. In addition to the valves, the muscles of the lower limbs, which act as a pump, also help the blood to flow.

This pump does not work well when sitting or standing in one position for a long time and with an excessive load on the muscles.

Subsequently, blood accumulates in the blood vessels for a long time, its outflow is difficult and imperfect, there is an increase in pressure in the veins. When it works chronically, it damages the blood vessel wall.

The vessel dilates, which in turn contributes to imperfect blood flow in the veins. Venous insufficiency occurs.

Also read the article on: 
Chronic venous insufficiency
Chronic venous disease

What is the reason for the varicose veins of the lower limbs:

1. impaired or impaired valve function
2. blood reflux in superficial or deep blood vessels
3. venous pump insufficiency
4. peripheral venous emptying disorder
5. chronic venous hypertension

Varicose veins may be primary when their exact cause is unknown. And a combination of risk factors contributes to their emergence.

Secondary varices are the result of another disease. This can be, for example, inflammation or thrombosis of the veins, but their origin can also be an injury.

Risk factors that determine the formation of varicose veins:

• older age, aged 65 and over
  • they are not so common at a young age, which does not rule out a genetic predisposition
  • more rarely, varicose veins can also occur in children
• female gender and especially the period of menopause, ie transition
  • hormonal changes
  • use of contraception and hormonal treatment
  • pregnancy, for increased intra-abdominal pressure
  • varicose veins in other parts of the body after childbirth
• workload and lifestyle
  • sedentary lifestyle
  • lack of physical activity
  • disproportionate muscle load
  • sedentary work
  • long standing
• overweight and obesity
• heredity and family history
• a genetic factor, such as congenital weakening of the vascular wall or insufficient valve function
• heart disease
• hypertension, ie high blood pressure
• increased intra-abdominal pressure
• deep vein thrombosis, thromboembolic disease, postrombotic syndrome
• inflammation of the veins
• after injury, after surgery
• unsuitable clothing such as tight underwear, suspenders, corsets
• unsuitable shoes, high heels for women
• long-term stay in a hot environment
• smoking
• traffic jam

The symptoms of varicose veins are differentiated based on their stage. And they also occur as non-specific difficulties.

In the first stage, there are visible thin veins, their tangles, cobweb-like nets in the skin, which do not protrude above the surface of the skin and do not touch.

Their size is more than 1 mm.

This form of varicose veins is not serious and represents mainly an aesthetic problem for women. It does not cause any problems and is not a risk for any other health problems.

They are also referred to as whipped venectasia -  telangiectasia.

The second type is reticular venectasia, which reaches a size of about 4 millimeters.

They are characterized by a typical appearance when a tangle of dilated, elongated and variously wound (twisted) vessels is present in the skin. Aesthetically, they are more pronounced than the first stage and also do not touch.

However, the problem of unsightly appearance is already accompanied by subjective difficulties. Such as pain or restless lower limb syndrome, during long-term sitting or lying down, when movement alleviates the feeling of discomfort in the lower limbs.

For example, itchy skin is also involved.

The most serious form is the third stage, which is characterized by the presence of distinct varicose veins.

Their size is over 4 mm, the vessels are significantly dilated, elongated, and also wound, various large pockets protrude from the vessel wall. The blood vessels are well palpable and are associated with swelling of the legs or even skin changes such as eczema or ulcers.

Summary of symptoms of varicose veins of the lower extremities:

• bluish, purple blood vessels
• at first intangible, later prominent over the surface of the skin and well palpable
• they most often occur on the legs, in the ankles and forelegs, on the calves
  • but also in the area below the knee and thighs
• feeling heavy legs
• tension, feeling of pressure in the calves, in particular:
  • after standing or sitting for a long time
  • after exercise
  • in women during menstruation and during pregnancy
• pain in the muscles of the legs and legs
• muscle weakness, fatigue
• leg muscle cramps
• tingling sensation in the legs
• itchy skin, tingling, tingling, tingling in the legs
• swelling of the lower limbs
  • first the foot pushes up around the ankle and then the upper parts of the foreleg
  • it is initially after exertion and present in the evening after an all-day load
  • later in the day
• skin changes such as increased pigmentation
• later leg ulcer, that is, lower leg ulcer (ulcer) - typically at the bottom of the calf
• nocturnal convulsions are not typical of varicose veins, but rather for the ischemic disease of the lower extremities

Subjective difficulties usually subside after unloading the lower limbs to a higher position, when walking, but also due to the cold.

Everyone has a different threshold for perceiving pain and difficulty. Smaller varicose veins are reported to cause greater subjective difficulties in women. Conversely, men also have worse-looking varicose veins smaller. However, varicose veins are a risk for various complications.

Varicose veins can cause complications such as:

• inflammation of the veins
  • thrombophlebitis
  • phlebothrombosis - deep vein thrombosis
• thrombosis and post-thrombotic syndrome
• pulmonary embolism
• infection such as erysipelas
• swelling of the limbs and lymphedema
• trophic skin changes, eczema
• shin ulcer
• bleeding due to damage to the vessel wall, injury scratches

TIP:  More information about pulmonary embolism in a separate article on Health .

Do you know when a professional examination is necessary?

1. for difficulty walking
2. inflammation of the skin and surrounding veins
3. if the skin of the forelegs is red and hot
4. with increased skin pigmentation
5. in case of swelling of the ankles
6. if subjective difficulties occur
   • such as pain
   • feeling heavy legs
   • itching, tingling, numbness in the limbs
7. for eczema in the forelegs and legs
8. in forearm ulcer, which is a manifestation of a severe form
9. if the difficulties are long-term and recur

Varicose veins are diagnosed mainly on the basis of changes that are well visible on the surface of the skin of the lower limbs. And thus the presence of dilated veins.

While the human history is important, the doctor examines the clinical manifestations. He performs a physical examination, using a touch or a tap.

Based on palpation, it can determine the condition of blood vessels, the quality of pulsations, but also the temperature and condition of the skin. The appearance of eczema or ulcer is revealed.

Similarly, it also detects swelling of the foot or ankle. Physical examination and clinical presentation are sufficient to establish a diagnosis of varicose veins and venous insufficiency.

If necessary, ultrasonography, ie USG or SONO, can be added. This includes Doppler examination or duplex ultrasonography, but also, for example, phlebography or isotope phlebography.

The doctor then evaluates the overall health condition, measures the pulse, blood pressure, examination of heart function.

The course of the disease can vary from case to case and is asymptomatic in the beginning. The extent of changes on the skin surface does not indicate the severity of clinical difficulties.

The first stage is characterized by a slight dilation of small skin veins in the skin, with a size exceeding 1 mm.

Then there is a small drawing of blue to purple veins in the skin. However, they do not protrude above the surface of the skin and are not palpable. This form is not serious, is not characterized by the risk of complications, and is only an aesthetic problem.

The second form is when smaller veins are affected in addition to the main tangles and trunks. Then the dilation of the vessels is in the range of up to 4 mm. However, at this time, subjective difficulties are already emerging.

And these can be various non-specific symptoms.

For example, there is increased muscle fatigue, a feeling of heavy legs. The problem is especially long-term standing and sitting, but also excessive muscle load.

It is also associated with a feeling of tingling or numbness in the legs and calves. But also itching, stinging, or tingling.

The swelling occurs primarily on the legs. Later, it moves to the area around the ankle and then to the higher parts of the foreleg. Only one lower limb, but also both, can swell.

Which depends on the extent of the damage.

In the third stage, there are large distinct dilatations of the veins, above 4 mm. The vessels are elongated, curled and protruding, and well palpable on the surface of the skin.

The main trunks of the veins are affected. Skin changes are associated, first with eczema, increased pigmentation, or infection of the skin and veins.

The most serious complication of varicose veins and chronic venous insufficiency is the development of a deep skin defect or leg ulcer.

Home and natural treatment of problems with the veins of the lower limbs?

If a person has a sedentary lifestyle or works in which he stands in one position for a long time, he should think about prevention. Alternatively, if he already has a problem with his veins, then for certain lifestyle changes.

Physical activity and regime measures are important.

It is also necessary to adjust the diet and a sufficient drinking regime. Foods should be balanced, with sufficient protein, unsaturated fatty acids, minerals, vitamins, and fiber. If a person does not have time to prepare suitable foods on a daily basis, he can reach for nutritional supplements, which, however, cannot replace a rational diet.

What else can you do to help your lower limbs:

• physical activity
• even if you are sitting or standing in one position, exercise the muscles of the entire lower limbs
  • these exercises help blood flow in the limbs
• breaks every 45 minutes from sedentary work
• position your lower limbs, place them in a higher and more comfortable position
• do sports, cycling, swimming, running, dancing, but also hiking or walking are suitable
• adjustment of overweight and obesity
• beware of high temperatures (sauna, sunbathing)
• massage and lymphatic drainage
• bare feet, grass, sand
• it is suitable to alternate hot and cold water when showering or bathing
  • wash your feet alternately in cold and warm water, repeatedly for several minutes
• restrict wearing unsuitable clothing, such as tight underwear, garter belts, corsets
• women watch out for high heels
• watch out for crossed legs
• seek a doctor, a professional examination will help with early treatment

When eating, it is necessary to think about rational nutrition, what is appropriate and what is inappropriate?

It is necessary to remember that the present problem with varicose veins should be consulted with a doctor. No homemade recipe, ointment, cream, gel or herb, tea, and decoction will cure varicose veins.

Self-treatment has no room even with this disease. However, a lifestyle change is needed.