Call to ration varicose vein surgery

An Edinburgh study shows that there is no reliable link between pains and aches in the legs and varicose veins.

And much surgery may have little beneficial health effect.

The Edinburgh University researchers say many people complain of pains and aches, believing this will help them get surgery when their main reason for wanting it is cosmetic.

More than 50,000 varicose vein operations are carried out in England and Wales every year at a cost of between £400m and £600m.

Varicose veins have been linked to a number of symptoms, including swelling, itchy legs, cramps and heavy limbs.

The presence of one or more of the symptoms is an important factor in whether doctors will suggest surgery.

But the researchers say little work has been done on the link between symptoms of vein disorders and disease.

Aches and pains

They studied 1,566 people aged 18 to 64. They found that women were much more likely than men to complain of aches and pains in their legs although men were more likely to have varicose veins.

Women most commonly complained of aching in their legs, while men complained of cramps.

In men, only itching was significantly linked to varicose veins while in women symptoms of stress, heavy limbs, aching and itching all indicated varicose vein problems.

The researchers found, however, that the symptoms were very common in people who did not have varicose veins and that they increased with age.

Writing in the British Medical Journal, they say: "Although tens of thousands of varicose vein operations are performed in the United Kingdom each year, the scientific basis for this activity is lacking."

They say there is little evidence to show a link between the symptoms and varicose veins and that operating on varicose veins improves the symptoms.

"It is therefore unsurprising that funding bodies in the United Kingdom are becoming increasingly reluctant to pay for the surgical treatment of venous disease," they write.

They suggest that surgery should be targeted at those most likely to benefit from it.

This can be discovered, they say, by taking a careful clinical history and examination of the patient.

Varicose veins are caused by a weakness in the walls of veins which caused the veins to swell.

The condition is usually inherited and is most prevalent in Europe and North America.