With rising percentage of obesity in population its related disorders have placed themselves deep in the surroundings. Out of the all one name that is much talked about is varicose veins. The condition is characterised by a blood vessel (vein) getting dilated and elongated surfacing in form of dark pigmented skin areas revealing the entire course of blood circulation. With higher range of pressure possibilities on the lower limbs its affliction towards the legs is massive.

What are the predisposing factors?

• Obesity as mentioned above put the legs under constant pressure leading to the torturous outcome.   
• Prolonged standing: with rising hours of straight posture the long column of blood with a pull of gravity puts pressure and may result in the above. This is the reason for a greater ratio of traffic police men that are required to be on duty standing for longer periods develop the trouble.
• Pregnancy: a female bearing a child often is seen to develop varicosities. Pregnancy enacts on the venous system through varied mediums, first to mention is the hormonal influence, progesterone causes dilation and relaxation of the veins and the second to mention is the bulk uterus that lays extra pressure on the circulation of the limbs and may cause an extra heave. 
• Old age: with weakening gripping hard from all sides there are chances to develop atrophy of the vein wall and at the same time with ageing even the valves present in the blood vessel gradually become incompetent to maintain standards.
• Athletes: sometimes the condition is noticeable in athletes where forcible contractions and may be even destruction of valves will lead the above.

How will the patient present?

• The commonest feature reported by the patient is tiredness and aching sensation in the affected lower limbs, particularly in the calves at the end of the day. More the pressure more would be the symptom experienced.     
• Sometimes severe bouts of pain may be reported in severely damaged veins.
• Even there may be cases where the patient presents no symptom or complaint just the dilated veins. Simply the patient may be asymptomatic but on inspection the trouble is very much visible with dark dilated veins on the calves and thighs.
• In the personal history the sufferer may refer to a job that required him / her to serve standing for long durations.
• Ankle swelling towards the evening is another feature that may be reported.
• Itching sensation on the pigmented area or even eczema of the affected area

How to combat?

The first and the foremost step lie to avoid prolonged standing. This prerequisite is to be adopted with other measures including a crepe bandage applied from the toes to thighs during the day time and removed while asleep.

Next is to keep the lower limbs on a higher level than the heart while lying, simply placing a small pillow under the feet will do the needful. Exercising is a must but how that is the trick. A patient should lie on the back and perform bicycle running in the air to strengthen.

If the above fail to improve the operative methods such as ligation, phlebotomy are to be applied.

The disease is prevalent; it is just how we tune ourselves to stay away from its niche.