The pathological stages of Chronic venous disease have been evaluated with a range of pathological conditions in Ayurveda such as Siragranthi (venous abnormalities), Raktavarita vāta (disorders of vāta occluded by rakta~ blood), Apana Vaigunya (vitiated apānavāyu), Arsha (hemorrhoids), Vata Rakta (rheumatism due to rakta), Kushtha (integumentary disease), and Dushta Vrana (putrified wound) depending upon the presentations of the patient.

Siragranthi mentioned in ayurvedic texts ideally explains the various venous abnormalities and specifically varicose veins. There are various risk factors hypothesised for the development of varicose veins such as obesity, prolonged standing & sitting, constipation and pregnancy¹. But no theory has been proposed as the causative factor for its structural modification of veins and its complications. Astanga Hrdaya has specifically mentioned that a person after any type of exertion like walking or exercise when suddenly washes or dips his legs in water will affect the sira which further undergoes structural changes and results in siragranthi (cyst like venous abnormalities  ~ varicose veins)². It can be understood that when the veins are dilated during exertion will get contracted by sudden exposure of cold water. Continuous practice of this will lead to loss of elasticity of venous walls which results in venous wall collapse. This cause can be extrapolated to current scenario as a sudden limb exposure to temperature alteration following an exertion. This case control study is aimed to study this association with the development of varicose vein and subsequently chronic venous disease.