varicose veins exercise guidance

Overview

Varicose veins are swollen, twisted veins that appear just under the skin, usually on the legs. They happen when small valves inside the veins stop working properly, allowing blood to pool and making the veins bulge.

Yes, varicose veins are very common. In the UK, about 1 in 3 adults may have some form of them, and they become more likely as you get older.

They affect more women than men, and are more common in older adults, people who are overweight, and those whose jobs involve long periods of standing or sitting.

Symptoms

Common symptoms

• Bulging, twisted veins that look blue or dark purple
• Aching, heavy, or tired feeling in the legs
• Swelling in the ankles and feet
• Itching or burning around the veins
• Cramping in the legs at night

Causes

Main causes

• Weak or damaged valves inside the veins that normally stop blood from flowing backwards
• Weak walls in the veins, causing them to stretch and lose their shape
• Increased pressure in the veins, often due to being on your feet for long periods or from pregnancy

Risk factors

• Getting older
• Being female
• Family history of varicose veins
• Obesity or excess weight
• Pregnancy
• Standing or sitting for long periods at work
• Not getting enough regular exercise

When to see a doctor

See a doctor urgently if:

• If you have sudden leg swelling, pain, redness, or warmth – this could be a blood clot requiring urgent medical help.
• If a varicose vein starts bleeding or you develop an open sore on your leg.

Book a routine appointment if:

• If your veins are painful, heavy, or interfering with daily activities.
• If you are concerned about how they look and would like to discuss treatment options.
• If you have skin changes like darkening, hardening, or itching around the veins.

Diagnosis

A doctor can usually diagnose varicose veins by looking at your legs while you stand. They may ask about your symptoms, medical history, and daily habits. In some cases, they will recommend an ultrasound to see how blood is flowing through your veins.

Tests that may be done

• Duplex ultrasound scan – a painless test that shows blood flow and vein structure
• Visual and physical examination – looking at and feeling the legs while standing

What to expect at your appointment

The examination is quick and painless. You may be asked to stand so the veins are easier to see. If an ultrasound is needed, a small handheld device will be moved over the leg – no needles or injections are involved.

Treatment

Treatment for varicose veins focuses on relieving symptoms, preventing complications, and improving the look of the legs. For many people, regular exercise and self-care are enough. When needed, there are several non-surgical and surgical procedures that can be very effective.

Self-care at home

• Walk or do other leg exercises, like calf raises, for at least 30 minutes most days
• Keep your legs raised above hip level when resting – for example, on a pillow
• Wear compression stockings as advised by a doctor or nurse
• Move and stretch regularly if your job involves sitting or standing still for long stretches
• Maintain a healthy weight and avoid tight clothing around the waist, groin, or legs

Medical treatments

Medical procedures are usually done in a clinic or operating room. Common approaches include laser or radiofrequency treatment to close the vein from the inside, sclerotherapy (injection of a solution to make the vein seal shut), and surgery to remove the vein through small cuts. Your doctor will explain which options are suitable for your situation – and no medication is a substitute for these procedures.

When is surgery considered?

Surgery may be suggested if varicose veins cause severe pain, skin ulcers, repeated bleeding, or if they do not improve with lifestyle measures and other treatments.

Living with this condition

Living with varicose veins is often just a matter of keeping your legs comfortable. Exercise, leg elevation, and wearing compression stockings can make a daily difference. Try to plan short activity breaks into your day, especially if you have a desk job or spend long hours standing.

Lifestyle tips

• Take a 10-minute walk after meals to boost circulation
• Do simple leg exercises while sitting – point and flex your feet, or roll your ankles
• When possible, sit with your feet up rather than on the floor
• Choose comfortable shoes with low heels instead of tight, high-heeled ones
• Cool off with a refreshing splash of water on your legs after exercise

Diet and exercise

Eating a balanced diet with plenty of fibre, fruits, and vegetables can help prevent constipation and maintain a healthy weight. Too much salt (sodium) can cause fluid retention, so try to limit salty snacks and processed foods. Regular exercise – like walking, swimming, cycling, or gentle aerobics – is one of the best ways to improve blood flow in your legs.

Mental health and emotional wellbeing

Varicose veins can sometimes make people feel self-conscious about how their legs look. It's normal to have these feelings. Talking to a trusted friend, family member, or healthcare professional can help. Remember, your legs are doing a lot for you, and exercise can help you feel more in control and positive about your body.

Prevention

You cannot always prevent varicose veins, especially if they run in your family. But regular exercise, keeping a healthy weight, and avoiding long periods of sitting or standing can lower your chances and keep symptoms mild if they do appear.

Complications

If left untreated

• Skin changes like dryness, itching, darkening, or a rash (varicose eczema)
• Swelling that worsens over time
• Open sores (ulcers) that can form on the skin near the ankle
• Inflammation of a vein (phlebitis), which can be painful
• A blood clot in a deeper vein (deep vein thrombosis) – rare but serious

Long-term outlook

The outlook is generally very positive. For most people, varicose veins are a cosmetic and comfort issue, not a serious health threat. With the right habits – especially regular exercise – most people can manage their symptoms well. And when medical treatment is needed, modern procedures are safe, effective, and often done without a hospital stay.

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