VARICOSE veins are a chronic condition causing much pain and discomfort in the legs of the affected person. In this condition, the veins of the lower limb become dilated and tortuous, resulting in many problems.Veins bring impure blood back to the heart, from the entire body.   Those of the legs have to pump blood towards the heart against gravity. This   occurs through contraction of the muscles of the leg and the valves located in the walls of the veins which prevent back flow of blood. As such varicosity of the veins can develop at any age but chances increase with advancing age. Women are more affected than men, because of the fragility of the walls of the veins.  Due to this, upward blood flow does not occur smoothly. Resulting pressure on the veins makes them dilated and ungainly. Standing for a long time continuously is a risk factor causing varicose veins. Because when one stands for a long time, muscle contraction needed to propel blood upwards is absent. Blood flow upwards becomes sluggish and this puts pressure on the walls of the veins weakening them. Thus soldiers, surgeons, teachers, e.t.c., all whose profession demands standing for long hours are more prone to develop varicose veins. Obesity, pregnancy, e.t.c. conditions which put a stress on legs and its blood vessels predispose to varicosity of the veins. Thrombophlebitis, i.e. inflammation of the veins which develops in bed ridden patients also predisposes to varicose veins.   Wearing high heeled shoes is a big risk for development of varicose veins with advancing age.Once varicose veins develop, there is much pain, which may be severe and burning in character. People like chronic  smokers  who have associated peripheral vascular disease tend to have more severe pain.   While walking or standing, there may be giddiness because of reduced venous return to the heart.  Ulcers can form over the legs at site of veins, due to sluggish circulation. Slow return of blood also predisposes to formation of clots, which can break into small pieces, pass through circulation and lodge in brain, heart or lungs, creating complications. Apart from all this suffering, the visible dilated, kinky blue colored veins look bad cosmetically.  If neglected, the condition progresses and causes more pain and complications.  Corrective measures taken early  can help prevent the progress of the varicose process. This is important because there is no medical cure for varicose veins.  Corrective surgery is often done in severe cases but the condition tends to relapse if the causative factors persist.Varicose veins are seen and recognized very easily clinically. Doppler test is used to ascertain the site of damage. When standing for a long time, a person should try to move his feet or at least toes slightly intermittently, so that there is some movement of the leg muscles, thus preventing stasis of blood. While sitting down, it is good to keep legs stretched in front on a stool or table for some time.  Pregnant women should adopt this posture for sitting to avoid varicosity of the veins. Sitting with legs dangling for a long time continuously is not good, particularly for those suffering from varicose veins. Even a bed ridden patient should be encouraged to move their feet and legs to avoid venous thrombosis and varicose veins. High heeled shoes can cause and augment varicose veins and therefore should be avoided.A person suffering from varicose veins should use elastic stockings or tie a crepe bandage on the legs while standing or walking. The compression exerted by the stockings or bandage assists in upward flow of blood and also prevents augmentation of varicosity. Light exercises of the legs when done regularly are very useful in preventing progress of varicose veins. Pande is a specialist –Internal medicine Ruhengeri Hospital.