Varicose Veins

What is Varicose Veins?

Varicose veins are swollen, twisted veins just under the skin, usually 3 millimeters or wider, most often in the legs. They are a common visible sign of chronic venous disease, in which the veins do not return blood to the heart efficiently.^{[1, 2]}

Common symptoms

Varicose veins can cause no symptoms beyond how they look, or they can cause a heavy, achy feeling and itching or burning that gets worse with prolonged standing.^[3]

• Heaviness, aching or tiredness in the legs
• Swelling of the ankles and lower legs
• Itching, burning or throbbing along the veins
• Skin darkening or hardening near the ankle in longer-standing disease
• Open sores (venous ulcers) in advanced cases^[2]

Causes and risk factors

Varicose veins develop through a mix of inherited tendency, valves that no longer close properly, weakened vein walls and higher pressure inside the veins.^[3] Risk factors include family history, female sex, older age, obesity, pregnancy, and prolonged standing.^{[3, 4]}

A pooled analysis of studies from six continents found chronic venous disease to be common, with female sex, age, obesity, long periods of standing, family history and number of pregnancies among the reported risk factors.^[4]

How it is diagnosed and treated conventionally

Diagnosis rests on a history and examination, and a duplex ultrasound scan is used to look for backward flow (reflux) in the veins.^{[1, 5]}

Conservative care includes compression stockings, leg elevation, exercise, weight loss and avoiding long periods of standing. A review notes that evidence for compression in varicose veins without ulcers is limited, while in people with venous leg ulcers, compression probably speeds healing.^{[3, 6]} Procedures such as thermal ablation, sclerotherapy and surgery treat the faulty veins, and endovenous ablation has largely replaced surgery.^[3] Clinical practice guidelines cover when each option is appropriate, including the role of drugs and supplements.^[5]

Why Varicose Veins calls for a whole-person approach

Varicose veins are not only a problem of one weak valve. Genes, body weight, pregnancy history, hours spent standing and sitting, and inflammation in the vein wall all contribute, and symptoms can vary widely between people with similar-looking veins.^{[3, 7]}

Complementary care therefore focuses on comfort, activity and daily habits. It sits beside the vein-specific treatments decided with your physician or vascular specialist.

Raised pressure in the veins

Chronic venous disease is driven by sustained high pressure in the leg veins while standing, called ambulatory venous hypertension, which then promotes inflammation and changes in the vein wall.^{[2, 7]}

Inflammation

Inflammation is part of the disease process in the veins and the surrounding tissue.^{[2, 7]}

Body weight and pressure inside the abdomen

Obesity, pregnancy and chronic constipation raise pressure inside the abdomen and are listed as risk factors for varicose veins.^[3]

Standing, sitting and movement

Long periods of standing are a recognized risk factor, and exercise is part of standard conservative advice.^{[3, 4]}

Acupuncture for Varicose Veins

What the research shows

The research on acupuncture for varicose veins is very limited, and no large well-controlled trial has tested whether it improves the veins or their symptoms.

A small randomized trial of 70 people having an endovenous ablation procedure found that acupuncture the day before reduced pain during and analgesic use after the procedure, and changed some inflammatory markers. It treated procedure pain, not the varicose veins themselves.^[8]

A Chinese study of 260 people with leg varicose veins treated trigger point acupuncture with self-massage and stretching and reported lower symptom scores after the course and at one year. It had no control group, used an in-house scoring tool, and its claim that the method "could cure" varicose veins is not supported by that design, so it should not be taken as evidence of benefit.^[9]

How acupuncture may work

Researchers propose that acupuncture may release nerve peptides that widen blood vessels and act against inflammation.^[10] This was described in a general review of inflammatory conditions and has not been shown to change varicose veins. These remain proposed explanations, not settled facts.

What treatment involves

Treatment uses fine, sterile, single-use needles placed at points on the legs and elsewhere, usually left in place for about 20 to 40 minutes, with a course of several visits and a reassessment. Serious problems from acupuncture are rare. In prospective studies, about 9 in 100 patients had a minor reaction such as bleeding, pain or redness at a needle site, and serious events occurred in about 1 in 10,000 patients.^[11] Tell the practitioner first if you have a bleeding disorder, take blood thinners, are pregnant, have a pacemaker (relevant to electroacupuncture), or have a leg ulcer, a recent blood clot or skin infection.

Ayurvedic medicine for Varicose Veins

The Ayurvedic view

Ayurveda describes enlarged, twisted veins as Siragranthi, with related conditions including Vata-Rakta and Dushta Vrana (a poorly healing wound), depending on the presentation.^[12] In this traditional framework, vitiated Vata and blood are thought to cause obstruction in the vessels. These are traditional categories, not biomedical diagnoses.

Therapies that may be used

Care is individualized and traditionally combines:

• Diet and daily routine, with regular movement and avoiding long periods of standing or sitting
• Warm herbal oil application to the legs
• Herbs and classical formulas, prescribed individually by a qualified practitioner
• Panchakarma procedures, only where medically sensible

Panchakarma is not appropriate during pregnancy, acute illness or frailty, or when a leg ulcer, infection or suspected blood clot has not been medically assessed. Basti (medicated enema therapy) is described in a published Ayurvedic case report of a varicose ulcer.^[13]

What the research shows

The research on Ayurveda for varicose veins is very limited. A PubMed search found no controlled trials. A 2024 observational study of 25 people with chronic venous insufficiency taking a Terminalia arjuna bark extract reported improved clinical severity scores and ulcer healing over 90 days, but it had no control group.^[12] A case report described healing of one varicose ulcer after Ayurvedic cleansing treatment.^[13]

Studies without a comparison group and single case reports cannot show that the treatment caused the change.

Herbal medicine for Varicose Veins

Herbs and formulas that have been studied

Plant-based products studied for chronic venous insufficiency, the vein-valve problem behind varicose veins, include horse chestnut seed extract, Centella asiatica (gotu kola), maritime pine bark extract, grape seed extract and Ruscus extract.^{[14, 15, 16]} Most studied products are standardized extracts used in pharmacy-type preparations. Traditional herbs from Ayurveda and Chinese medicine are not well tested for this condition.

What the research shows

The evidence is moderate for short-term symptom relief in venous insufficiency but is limited by study quality. A Cochrane review of horse chestnut seed extract found that leg pain and leg volume improved more than with placebo in most trials, with mostly mild side effects. The authors called it an effective short-term treatment while noting that larger trials were needed.^[14]

A larger Cochrane review of 69 trials of oral phlebotonics (a group that includes plant-derived and synthetic compounds, among them two trials of Centella asiatica) found moderate-certainty evidence of slightly less leg swelling than with placebo, little or no difference in quality of life, and low-certainty evidence of no effect on ulcer healing. Side effects were slightly more common than with placebo, most often gastrointestinal.^[15]

A 2025 review judged some venoactive compounds to have the best evidence, such as purified flavonoid fraction and a Ruscus combination, and supported using them alongside compression and procedures.^[16] These are pharmacy preparations rather than traditional herbal formulas, and the results show these products help symptoms, not that they remove varicose veins.

Safety and herb-drug interactions

Herbs are active substances and can interact with medicines. Case reports describe bleeding when warfarin was combined with herbs including ginkgo, dang gui, dan shen, garlic, ginger and ginseng, so people taking blood thinners need a practitioner's review before using any herb.^{[17, 18]}

In one study, about one fifth of Ayurvedic products bought online contained detectable lead, mercury or arsenic.^[19] Herbs should come from tested sources and be prescribed individually. Tell us if you are pregnant or breastfeeding, have liver or kidney disease, or have a procedure planned. Transdermal medication therapy, an herbal preparation applied to the skin, is also offered, and no evidence for it in varicose veins was found.

Translating traditional medicine into modern biological language

The links drawn here are interpretation, not equivalence. Chinese medicine describes varicose veins in terms of qi deficiency and blood stasis, with dampness settling in the legs. Researchers studying the veins measure things that loosely parallel this picture, such as vein-wall inflammation, edema, vein tone and microcirculation.^{[7, 16]}

Ayurveda's description of blocked, disturbed blood and Vata in the vessels likewise refers to a pattern of heavy, swollen or painful legs. No study has shown that a dosha or a pattern corresponds to a specific biological process in the veins.

How this care fits with your medical care

Integrative care for varicose veins is complementary. We do not diagnose vein disease or treat, close or remove varicose veins, so new leg swelling, skin changes or sores should be medically evaluated. Keep your physician or vascular specialist, continue compression if prescribed, and do not stop or change prescribed medicines without your prescriber.

Please bring your diagnosis, any ultrasound results, a full list of medicines and supplements, and details of any vein procedures, planned or past.

When to seek urgent medical care

Some changes in the legs can signal a blood clot or serious vein complication and need prompt assessment.^[3]

• A leg that suddenly becomes swollen, warm, red or painful, which can signal a blood clot
• A varicose vein that bleeds heavily and does not stop with firm pressure
• An open sore on the leg or ankle that is not healing, or that is red, hot or draining pus
• A hard, tender, red cord along a vein, with fever
• Sudden shortness of breath, chest pain or coughing blood

If any of these occur, call 911 or go to the nearest emergency department.