Impact of Physiotherapy Interventions on Pain, 6-Minute Walk Test, CIVIQ-20 Scores, and Edema in Patients with Varicose Veins: A Literature Review

Introduction: As a result of chronic venous insufficiency, varicose veins develop in almost 30% of the adult population across the globe. It causes myriad symptoms like fatigue in legs, pain, swelling, and alteration in skin texture. Conservative physiotherapy interventions—Buerger’s exercise and Manual Lymphatic Drainage (MLD)—aim to improve venous and lymphatic return. Objective: To compare the effects of Buerger’s exercise versus MLD on limb volume, venous hemodynamics, symptom relief, and quality of life in varicose vein patients. Approach: A systematic search was carried out from February 2020 until the date this study was completed in June 2020 on PubMed, Scopus, CINAHL, PEDro and Google Scholar using MeSH terms 'Buerger’s exercise', 'Manual Lymphatic Drainage', and 'Varicose Veins'. Ten studies (5 RCTs, 5 quasi-experimental) met PICOS criteria. Data were narratively synthesized per PRISMA guidelines. Results: MLD reduced limb volume by 10–15%, Buerger’s exercise increased VRT by 20–35s, combined therapy yielded up to 18% volume reduction. Discussion: Buerger’s exercise leverages gravity and calf pump action; MLD stimulates lymphatic contractility. Conclusion: Both are effective; combined protocols recommended. Future research should standardize protocols and assess long-term outcomes.