Abstract

Varicose veins are a common form of chronic venous disease caused mainly by venous reflux and persistent venous hypertension. Although many patients first seek care because of visible veins, the condition may also cause aching, heaviness, edema, itching, skin pigmentation, bleeding, thrombophlebitis and venous ulceration. Duplex ultrasonography is central to diagnosis, while management may include lifestyle measures, compression, sclerotherapy, endovenous ablation or surgery, depending on the pattern and severity of disease. Ayurveda has no exact classical equivalent for modern varicose veins. The visible dilatation and tortuosity are often interpreted through Siragranthi, while pain, swelling, discoloration and chronic wounds may be considered through Vata, Rakta, Sira Dushti and Vrana concepts. This narrative review examines Siravedha, Jalaukavacharana and Lepa as possible adjuncts to established venous care. Small Ayurvedic studies report short-term improvement in symptoms, quality of life, inflammatory markers or ulcer features, but the evidence is heterogeneous and cannot establish correction of valvular reflux or equivalence to endovenous treatment. Medicinal leeches have a clearer modern role in acute postoperative venous congestion than in uncomplicated chronic varicose veins. An integrative approach is most defensible when it preserves duplex-based assessment, compression and timely vascular referral while evaluating Ayurvedic procedures with standardized protocols, objective outcomes and careful safety monitoring.