What non-surgical management options are available for patients with varicose veins who are not suitable for surgery?

For patients with varicose veins who are not suitable for surgical intervention, non-surgical management options primarily include the use of compression stockings and self-care measures.

Compression stockings can provide symptom relief, particularly for symptoms such as heavy or tired legs, and leg swelling associated with varicose veins, including during pregnancy. However, they should only be offered when interventional treatments are unsuitable, as per NICE guidance. It is important to exclude arterial insufficiency before prescribing compression stockings to avoid complications such as limb ischaemia.

Self-care advice includes avoiding prolonged standing and sitting with crossed legs, elevating the legs when sitting and sleeping, undertaking light to moderate physical activity (e.g., walking or swimming), performing simple foot stretching exercises, and managing body weight to reduce progression and symptoms.

Patients should be advised to seek further medical help if varicose veins become hard, painful, bleed, or if skin changes or venous ulcers develop.