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Physiotherapy Exercises for Varicose Veins

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Varicose veins are a problematic condition occurring in the legs. Read this article to know the management of varicose veins through exercises in physiotherapy.

Written by

Dr. Kayathri P.

Medically reviewed by

Mohammed Wajid

Published At March 27, 2023
Reviewed AtSeptember 14, 2023

What Are Varicose Veins?

Varicose veins are a condition most commonly occurring in the lower extremities and esophagus characterized by enlarged, dilated superficial veins. Walking helps in emptying veins and helps move blood out of the legs. When the walls of the veins weaken or are enlarged, the valves cannot function properly, and blood pools in the veins. Eventually, the veins become distended, leading to varicose veins.

What Are the Risk Factors?

The risk factors include:

  • Old-aged patients over 50 years of age are more at risk of developing varicose veins.

  • A family history of varicose veins is a significant risk factor.

  • Patients with an inactive lifestyle and sedentary work are more prone to varicosities.

  • Obesity is a high-risk factor.

  • Pregnant women can develop varicose veins if they remain seated for a long time.

  • Varicose veins can also develop after a trauma or an injury.

  • Women that have attained menopause are at higher risk of developing varicosis.

  • Individuals with motion difficulties and those who consume less fiber are also at risk.

  • The use of oral contraceptive pills has also been proven to be an associated risk factor.

What Are the Symptoms of Varicose Veins?

The following symptoms are associated with varicose veins:

  • They usually appear as bluish or purplish-colored veins protruding from the skin.

  • Swelling can be seen prominently along the course of protruded veins.

  • Pain and discomfort in the legs that is relieved by elevating the leg.

  • Skin hyperpigmentation is seen over the affected area with eczematous dermatitis. Eczematous dermatitis also called atopic dermatitis, causes dry, itchy skin with an inflammation of the skin.

  • Sometimes leg ulcers develop in untreated cases.

  • Sudden cramping when the patient gets up too fast.

How Is It Diagnosed?

Diagnosis is usually made by a thorough physical examination, and the diagnosis is confirmed by asking the patient to stand and observe for any protruded veins. An ultrasound is taken, followed by a physical examination to check for any obstruction or block in the veins. The speed of blood flow and any other abnormalities in the vein is detected using a color duplex ultrasound scan.

Perthes Test: The patient is asked to elevate the legs, and a tourniquet is applied to the thigh. The patient is asked to stand up and down, and the rapid filling of veins confirms the diagnosis.

How Is Varicose Veins Managed?

Medical management is by giving pain medications to manage pain. Elastic stockings and compression garments are used over the affected legs to provide comfort and ease the symptoms.

Surgery: Surgical treatment involves vein stripping, radiofrequency ablation, and sclerotherapy.

  • Vein stripping is a procedure that involves the removal of the varicose veins through incisions, followed by ligation and stripping.

  • Radiofrequency ablation involves inserting a catheter in the vein, and radiofrequency energy helps the vein contract, and the vein is denuded after narrowing.

  • Sclerotherapy involves an injection of a solution (sodium tetradecyl (STS), Polidocanol, and hypertonic saline) directly into the vein.


  • Low-level cold laser therapy is done to reduce pain and improve blood circulation.

  • TENS (transcutaneous electrical nerve stimulation) is another method used in physiotherapy to reduce pain and discomfort caused by varicose veins. Transcutaneous electrical nerve stimulation is a technique in physiotherapy that involves the use of the electric current application over the affected area with electrodes that contain low-voltage electric current.

  • Ultrasound is used to improve circulation while also producing heat which will numb the pain. They are used to treat soft tissue injuries, and this uses ultrasonic wave application over the affected area.

  • Contrast baths are used to relieve pain. A contrast bath is done by using two buckets, one containing hot water and the other cold water. The patient is then asked to dip the affected leg alternatively in both buckets five times. This can be done once a day.

Physiotherapy Exercises for Varicose Veins:

  1. Walking: Walking is the best exercise to improve overall blood circulation in the body. Daily walking for about 30 to 45 minutes is recommended for a healthy lifestyle. It helps pump blood faster and does not allow blood to pool in the legs.

  2. Swimming: Swimming is also a low-impact good cardio exercise that does not have the disadvantage of heaviness. In water, the body feels weightless, and the heaviness of the legs is not much appreciated. Daily swimming of around 20 to 30 minutes can help act on the muscles of the legs and improve blood circulation in the legs.

  3. Pedaling: Stationary or outdoor cycling is recommended for about 30 minutes daily. It helps strengthen the calf and leg muscles and also improves the flexibility of the joints.

  4. Rebounding: Jumping on a trampoline daily for a few minutes helps prevent the pooling of blood in the legs.

  5. Leg Lifts: Lie flat on a mat or on the floor with both legs apart. Slowly, raise one leg above the floor and hold for a few seconds. Repeat the same in another leg. Repeat this exercise several times as tolerated.

  6. Ankle Rotation: Sit straight in a chair and lift one leg above the floor. Start drawing circles in the air by rotating the feet and ankles. Repeat the same in the opposite direction and do this in the other leg. Repeat this exercise several times or as tolerated.

  7. Calf Raises: Sit behind a chair, holding the chair using both hands. Now slowly lift one leg above the floor with a good balance on the other leg. Hold this position for a few seconds, and slowly return to the starting position. Repeat the same in the other leg and repeat this exercise as tolerated.

  8. Knee Bends With Ankle Flexion: Lie flat on the floor and slowly pull the affected knee towards the chest, holding it behind the kneecap. Slowly point the knees and flex several times. Return to the original position and repeat the same in the other leg.

How to Prevent Varicose Veins?

Varicose veins can be prevented by adopting the following methods:

  • Maintain a healthy weight and weight loss programs in obese patients.

  • Regular exercising to improve the calf muscles.

  • A diet rich in fiber should be consumed.

  • Sit with the feet elevated.

  • Avoid using high heels for a long duration.

  • Change sitting and standing postures continuously.

  • Avoid being sedentary.


Varicose veins though it appears as a complex problem if treated early, lessen the risk of complications. It can also be managed by following certain precautionary measures. However, in the event of an occurrence, management can be done quite quickly at home. Following the exercises that can be done at home can greatly help manage varicose veins. Be careful while performing the exercises, and do not overexert while performing them. Taking it slow will help heal better.

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Mohammed Wajid
Mohammed Wajid


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