Varicose veins and venous thromboembolism in inflammatory rheumatic diseases: vascular complications and rehabilitation approaches

Inflammatory rheumatic diseases (IRDs) compromise vascular integrity through systemic inflammation and (auto) immune reactions, which are associated with an increased risk of vascular complications. Venous stasis, endothelial dysfunction, and coagulation imbalance are the primary pathophysiological factors behind thrombotic events in these individuals. The incidence of venous thromboembolism (VTE) in IRDs is higher than in the general population, although the magnitude of this increase varies across diseases. Inflammatory damage to vessel walls, diminished elasticity, and compromised muscle pump function may contribute to the formation of varicose veins (VVs). A sedentary lifestyle, decreased muscular strength, and weight gain worsen the condition, particularly by adversely affecting venous return in the lower extremities. Consequently, the prevention of vascular issues in IRDs should be facilitated by both pharmaceutical interventions and rehabilitation with lifestyle modifications. A multidisciplinary rehabilitation strategy—encompassing regular physical activity, compression therapy, inflammation management, weight control, and patient education—enhances venous return, mitigates thrombosis risk, and improves quality of life.