How should I counsel patients regarding lifestyle modifications to manage their varicose veins effectively?

Counsel patients to maintain a healthy body weight, as high BMI is a risk factor for progression and worse outcomes of varicose veins ¹.

Advise engaging in light to moderate physical activity, such as walking or swimming, which may help alleviate symptoms, while avoiding strenuous exercise that could aggravate the condition ¹.

Recommend avoiding prolonged standing or sitting with crossed legs, and suggest elevating the legs when sitting or sleeping to reduce venous pressure ¹.

Encourage simple foot stretching exercises—bending, stretching, and rotating the feet—to promote venous return ¹.

Provide reassurance and tailored information about the natural history and potential complications of varicose veins, addressing misconceptions and avoiding unnecessary anxiety ¹.

Advise patients to seek further medical help if they develop skin changes, such as pigmentation or eczema, or if they experience hard, painful veins, or bleeding from varicose veins ¹.