It is not only bones, joints and ligaments that make up the substance of our legs and feet, which we so urgently need to move and move around in our environment. Muscles and skin are also part of it. All of these tissues require nutrition and thus a blood supply. That is why today we will talk about the most common leg problems and the most important vascular diseases of the legs, as far as they are of general interest.
What are arteries & veins?
As is well known, the blood is distributed in the organism through an extensive network of blood vessels. In this blood system, a distinction is made between those vessels that carry the blood enriched with oxygen in the lungs to the periphery and others that carry the blood enriched with carbon dioxide and other metabolic products back to the heart. The vessels leading away from the heart are called arteries or arteries, while those leading to the heart are called veins or blood vessels.
In the tissues, the capillary system is switched on between them, a fine network of small and tiny vessels in which oxygen and nutrients are released into the environment. While the larger arteries are mostly covered by the muscles and run deep, a large part of the veins lies close under the skin and is therefore accessible to observation.
According to Phonecations, the course of the blood vessels shows the large arterial vessel of the leg, the femoral artery, which enters the muscle cuff of the thigh from the abdomen. The arteries of the lower leg emerge from under the hollow of the knee and further subdivide further peripherally into the arteries of the foot. In the venous system of the leg, a distinction must be made between deep and superficial veins.
The deep veins roughly follow the course of the arteries. The superficial ones form a wide-meshed network in the subcutaneous tissue, from which two main flow paths, one on the inside of the lower and upper thigh and the other over the calf, collect the venous blood. Both veins flow into the deep venous system of the leg at different heights.
How veins work
You are now probably wondering how the blood in the veins is transported back up against the force of gravity. Several factors play a role that cannot be mentioned here in detail. However, the valves in the veins are particularly important for venous return. They only open when the flow is in the direction of the heart, but normally close automatically when the flow is reversed. The pressure exerted by the muscles during movement transports the venous blood from one section of the vein to the other. You can compare this process with a lock system.
The more common diseases are those of the veins. We know them as varicose veins, which are a common ailment that is particularly observed in middle and old age. Statistical studies have shown that people who suffer from varicose veins often have a general weakness of the connective tissue. Often there are bent, flat or flat feet at the same time. When varicose veins occur during pregnancy, the obstruction of drainage in the area of the pelvic veins plays a role. At the same time, hormonal influences play a role. After the birth, however, there is usually extensive regression.
Symptoms, ailments & signs
When varicose veins begin to develop, there are often no symptoms at all. The varicose veins are noticeable, but only lead to aesthetic problems. However, as the disease progresses, symptoms such as heavy legs, feeling of tension in the legs, frequent night cramps in the calves and generally tired legs can occur.
In the course of this vascular disease, the surface veins in the lower and upper thighs, in particular, expand and become increasingly tortuous, which bulge the skin when the skin is heavily filled. The disease can be unilateral or bilateral, and its development can take years.
In milder cases there are initially no complaints. However, if the varicose veins are more extensive, the lower legs may feel heavy and tight after prolonged exertion. Some patients also complain of stabbing pain, itching and burning in the area of the affected veins. Occasional cramp-like pain gave the disease its name.
It is considered certain that the varicose veins often assume damage to the venous valves described, which can be caused by hormonal disorders, infectious diseases and other general ailments of the body. This leads to a considerable slowdown in venous outflow and, in the case of severe changes, to congestion, which causes increased stress on the vein walls and gradually expands them. As a result of the drainage disruption, the removal of the used blood from the smaller veins of the lower leg and foot is also disturbed.
However, when lying down or when moving, these symptoms improve because the blood flow to the veins is stimulated again. However, warmth makes the symptoms worse. Those affected often complain of excruciating itching on their legs. Depending on the lifestyle and genetic predisposition, venous weakness can progress even further in some patients.
If the blood congestion persists, edema develops in the legs, as the vascular walls become more and more permeable due to the constant strain. Legs and feet swell. Furthermore, reddish and itchy skin changes occur, which are known as congestive eczema. In older patients, the skin can thin and lead to a so-called parchment skin, which is more prone to injuries.
In the most severe stage, due to a lack of oxygen supply to the tissue, open skin ulcers form on the legs, which are difficult to heal and carry the risk of wound infections. Phlebitis also often occurs, which can lead to thrombosis and ultimately to pulmonary embolism.
In strongly developed varicose veins, the disorder affects the smallest vessels of the skin and subcutaneous tissue. Most of the time, the area just above the ankle is affected. The skin is disturbed by the accumulation of metabolic waste in its nutrition and loses its thickness and elasticity, so that even minor effects can cause skin injuries. Small cracks can then easily develop into a larger wound area through infection, which is often very painful. The vernacular speaks in such cases of “open legs” and means the lower leg ulcer caused by the venous outflow disorder.
In addition to the formation of a lower leg ulcer as described, vein dilation can also cause other more dangerous diseases. In the damaged, stretched wall areas of the veins, which are surrounded by poorly nourished tissue, slight inflammatory processes develop. This is what is known as phlebitis, which, however, sometimes also occurs in veins that have not changed from the outside. With such a disease, the inflamed vein is usually reddened, accompanied by pressure-sensitive swelling.
In addition, there is pain when tensing the muscles. Fever can also occur as bacteria enter the bloodstream.
If the person concerned does not seek medical treatment in time, there is a risk that blood clotting in the diseased vein will result in a vein blockage, the so-called thrombosis. This disease usually requires lengthy hospital treatment.
In mild cases of varicose veins, compression bandages prescribed by a doctor as well as medical and physiotherapy treatment can eliminate the symptoms and prevent the progression of the disease. Wearing thrombosis stockings or rubber stockings can also bring relief. In severe and progressive cases, the doctor decides whether the varicose veins can be obliterated by medical means or whether they can be removed by surgery.
As a preventive measure, if you have varicose veins, you should avoid wearing tight suspenders, socks and pants. It is also important to improve venous circulation through functional and healthy shoes.
For example, it has been proven that the calf muscles are strongly contracted by wearing heels that are too high and that the lack of alternation between tension and relaxation (relaxation) results in a disruption of venous drainage. Similarly, shoes that are too tight or too narrow have an adverse effect on the vein circulation in the foot.
All the measures recommended by the orthopedic surgeon to strengthen the posture and musculoskeletal system, such as foot exercises, cool baths, walking barefoot, etc., are used to promote venous outflow. Alcohol and nicotine (smoking) abuse are always harmful when vascular diseases are present.
Symptoms of hardening of the arteries
In contrast to venous diseases, diseases of the arteries do not expand, but mostly narrow the diameter of the arteries. In the event of an unfavorable course, the arterial blood flow can be almost completely interrupted. The cause of the vasoconstriction are often inflammatory processes such as typhoid and typhus. In other cases, damage to the vascular wall occurs as a result of the deposition of pathological metabolic products (plaque). Such changes can be found in hardening of the arteries (atherosclerosis) and gout, or in rare cases of diabetes (diabetes).
The reduction in the blood supply results in a lack of oxygen in the supply area of the vessel, which can cause severe pain. A typical sign of impaired arterial blood flow to the leg is the so-called intermittent limping.
The person concerned observes that after a certain number of steps, increasing pain occurs in the muscles of the lower legs, which intensify so that he is finally forced to stop.
After a short break, the lack of oxygen from the low supply has made up for itself. Some patients also complain of constant feeling of coldness in their feet and the feeling of having their feet asleep. If the arterial blood flow is greatly reduced, poorly healing wounds develop on the toes. The skin temperature is usually significantly reduced when arteries are narrowed in their supply area, as the arterial blood of the arms, hands, legs and feet also supplies heat.
When should you go to the doctor?
Occasional circulatory disorders in the extremities, such as “feet asleep”, do not require medical treatment, especially if they are due to poor posture of the body. However, if such symptoms occur frequently and other side effects appear, such as heavy and swollen legs, thick ankles or sharp pain in the lower legs, a doctor should be consulted as soon as possible. If a venous disease is treated early, conservative treatment methods can often be sufficient. Beginning varicose veins are then treated with support stockings, compression bandages or gymnastic exercises for the veins.
If the incipient venous disease is not adequately treated in good time, there is a risk of serious complications. For example, a venous ulcer can form. In addition, there is an increased risk of thrombosis, i.e. a blockage of veins, which can be life-threatening. Varicose veins should therefore not be underestimated. At the latest when pressure-sensitive swellings form on the veins or when they are clearly turned outwards, an expert must be called in, who will decide together with the patient whether the varicose veins should be sclerosed or surgically removed.
Treatment of circulatory disorders
With the help of medical measurements of the pulse fluctuations at several points on the leg with the so-called oscilloscope or computed tomography, characteristic recordings can be obtained, which the doctor can use to assess the strength of the arterial blood flow. Changes in the venous and arterial vascular pathways can also be made visible and precisely localized using special X-ray diagnostic procedures.
With a variety of medications it is possible to widen the narrowed vessel or the adjacent vessel in the case of arterial circulatory disorders, so that the circulatory shortage and thus the oxygen deficiency in the tissues is remedied. Modern vascular surgery has long been concerned with the development of procedures that make it possible to replace diseased vascular sections with transplants or by inserting vascular prostheses (stents).
All of these methods show that even in the late stages of an obstructed arterial blood flow, our legs still have options for help. Unfortunately, in some cases (e.g. smokers’ legs) it is only possible to amputate the leg and replace it with a well-fitting prosthesis. However, it is more important for the majority of people to keep the blood supply to the legs in order through their healthy lifestyle, in particular through a suitable diet and through regular exercise and sport.
In the case of circulatory disorders and varicose veins in the legs, the person concerned usually has only a few measures or options for follow-up care available. The person concerned is primarily dependent on a quick and, above all, an early diagnosis so that no further complications occur. For this reason, a doctor should be contacted and an examination carried out at the first signs of circulatory disorders and varicose veins in the legs.
Self-healing cannot occur with this disease. The treatment of circulatory disorders and varicose veins in the legs is usually based on the exact underlying disease, so that no general prognosis can be given. In many cases, the patients have to take medication, so that it is important to ensure that the dosage is correct and, above all, that it is regular.
Furthermore, obesity should be avoided in any case with these complaints, whereby a healthy lifestyle with a healthy diet is very important. Long periods of standing should also be avoided in the case of circulatory disorders and varicose veins in the legs. Whether this disease will lead to a reduced life expectancy cannot be universally predicted.
Outlook & forecast
With circulatory disorders and varicose veins in the legs, the patient can achieve a good prospect of a cure with cooperation and medical treatment. The circulatory disorders can be alleviated through regular exercise and sufficient sporting activities. Existing varicose veins can be treated and removed in one operation. This process is essential for a good forecast. The person affected should then change their lifestyle so that the varicose veins do not develop again.
Without treatment, the symptoms worsen over a longer period of time. The varicose veins multiply and pain sets in. As a result, it is not possible for the person affected to be able to move as much as necessary. In addition to a lack of exercise, an unhealthy diet, obesity, circulatory problems, anemia and the consumption of nicotine promote circulatory disorders. In these cases, the prognosis is classified as unfavorable.
In severe cases, a thrombus forms. If this dissolves, the patient is at risk of a heart attack or stroke. There is a prospect of recovery as soon as the patient is ready to change their habits after the varicose veins have been removed.
Through measures such as alternating showers, massages or targeted training of the legs, the person affected can independently stimulate the blood circulation at any time. It is possible to achieve freedom from symptoms.
You can do that yourself
Every extra kilo puts pressure on the body and thus on the legs. Switching to a high-fiber and low-fat diet promotes blood circulation in the veins and provides relief. Smoking constricts the blood vessels and thus promotes the formation of varicose veins. It is therefore advisable to give up smoking.
Regular exercise such as cycling or hiking strengthens the leg muscles. Special vein gymnastics such as standing on the toes or rocking with the toes promotes blood circulation. It is best to put your feet up whenever possible. When sitting, the legs stand next to each other at a 90-degree angle. Crossed legs, on the other hand, inhibit the flow of blood. The footwear should be comfortable. Shoes with too flat heels, just like too high heels, have a stressful effect on the leg muscles.
Compression or support stockings are suitable for treating varicose veins. They put pressure on tissue and veins and massage it. To help blood flow back at night, it helps to raise the foot end of the bed 6 inches while keeping the head end straight. Kneipp treatments with alternating showers and treading water train the elasticity of the veins. Herbal remedies such as horse chestnuts or vine leaves support the process.
Brush massages are not advisable, as these lead to spider veins. Avoid sunbathing and hot full baths.