The symptoms of varicose veins: Difficult to determine and difficult to study

Objectives. To investigate the activities which may exacerbate symptoms in patients with varicose veins. Methods. Questionnaires sent to patients before clinics and at least six months later. Results. Both questionnaires were returned by 149 of 203 patients (74%) but only 124 contained adequate data for comparison - 55 from patients who had surgical treatment and 69 who had no surgery. At initial presentation, worsening of discomfort attributed to varicose veins was common during (58%) or after (48%) standing and in hot weather (44%), but less when sitting with the feet down (31%), and after (31%) or when walking (19%). Surgery significantly reduced the total number of symptoms reported by patients at follow-up (p < 0.02). However, none of the symptoms reported during specific activities was significantly lessened by surgery compared with no treatment - possibly because the attrition of patients during the study resulted in small numbers for analysis. Conclusions. Symptoms are a common indication for treating varicose veins and it is therefore important to be sure that they are due to the veins, rather than other causes. This report highlights traditional and logical questions which may help to identify symptoms caused by varicose veins but illustrates the difficulty of validating them. (c) 2007 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.