The varicose vein is a common health hazard among long-standing people, older people, and obese/ weight loading people.

The vein is said to be varicose when it is dilated, tortuous, and elongated.

The varicose ulcer is a clinical manifestation of chronic venous insufficiency.

ETIOPATHOLOGY

Normally blood from the superficial venous system is passed to deep veins through perforators and then blood is pumped to heart with help of limb muscle contraction and negative intrathoracic pressure and competitive veins. This mechanism is hampered in varicose veins due to the destruction of venous valves, perforators of superficial veins.  As a  result, the vein got distended, tortuous, and elongated. The dysfunction of venous valves causes venous hypertension which stretches veins and causes an ulcer.

The lower limb is the most common site of venous disorders. Due to prolonged standing blood in veins along with gravity puts pressure on weak valves of veins leading to varicosity of long and short saphenous veins and also calf muscle cannot push blood upwards.

Obesity leads to varicose veins is due to poor support of fatty tissue in subcutaneous veins.

Varicose vein after pregnancy is due to the pressure on inferior vena cava by pregnant uterus causing obstruction to the blood flow.

In old age, atrophy and weak valves of veins lead to varicose veins.

In athletes, forcible contraction of calf muscles causes varicose veins.

Static blood within superficial veins led to hypoxia causes tissue death and then leads to a venous ulcer.

AYURVEDIC  VIEW ON VARICOSE VEIN AND ULCER

Ayurveda consider it as siragata vata or siragranthi involving vata and rakta as main dosha predominance with sira /blood vessels as main dushya.

According to ayurveda acharyas ,it is caused due to excess of vyayama I,e exercise or like related activities done by atiheena person or weak person cause tortuous and distended vein which is painful .

Management of varicose vein in Ayurveda

1. Upanaha chikitsa i.e herbal paste application and wrapping the limb with vata hara leaves.
2. Sira vyadha chikitsa or jalouka chikitsa /bloodletting

Jalouka chikitsa or leech therapy is one of main treatment in varicose vein where leech is made to suck the blood from vein . Leech saliva contains an anticoagulant enzyme Hirudine which is having thrombolytic action and enhance proper circulation.

3. Appropriate Ayurvedic Oral medication to be given to reduce pain and swelling and to strengthen the valves.
4. Mrdu abhyangam ( mild massage) to correct circulation.