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

**Authors:** Olena Zimba, Mariusz Korkosz, Anvar Sultanov, Bekzhan A. Permenov, Burhan Fatih Kocyigit

PMC · DOI: 10.1007/s00296-026-06070-y · Rheumatology International · 2026-02-02

## TL;DR

Inflammatory rheumatic diseases increase the risk of venous issues like varicose veins and blood clots, which can be managed through lifestyle changes and rehabilitation.

## Contribution

The paper highlights the link between inflammatory rheumatic diseases and vascular complications, emphasizing multidisciplinary rehabilitation approaches.

## Key findings

- Inflammatory rheumatic diseases are associated with higher venous thromboembolism risk due to systemic inflammation.
- Varicose veins in these patients result from vascular damage and reduced muscle function.
- Multidisciplinary rehabilitation improves venous return and reduces thrombosis risk.

## Abstract

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.

## Linked entities

- **Diseases:** venous thromboembolism (MONDO:0005399), varicose veins (MONDO:0008638)

## Full-text entities

- **Genes:** SIL1 (SIL1 nucleotide exchange factor) [NCBI Gene 64374] {aka BAP, MSS, ULG5}, IL17A (interleukin 17A) [NCBI Gene 3605] {aka CTLA-8, CTLA8, IL-17, IL-17A, IL17, ILA17}, F2 (coagulation factor II, thrombin) [NCBI Gene 2147] {aka PT, RPRGL2, THPH1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IL23A (interleukin 23 subunit alpha) [NCBI Gene 51561] {aka IL-23, IL-23A, IL23P19, P19, SGRF}, F3 (coagulation factor III, tissue factor) [NCBI Gene 2152] {aka CD142, TF, TFA}
- **Diseases:** skin pigmentation (MESH:D010859), RA (MESH:D001172), thrombocytopenia (MESH:D013921), venous dysfunction (MESH:D014647), fatigue (MESH:D005221), DVT (MESH:D020246), cramping (MESH:D009120), coagulation (MESH:D001778), fibrosis (MESH:D005355), dilation (MESH:D002311), malignancy (MESH:D009369), joint pain (MESH:D018771), joint deformities (MESH:D016916), VTE (MESH:D054556), SLE (MESH:D008180), SSc (MESH:D012595), muscle pump dysfunction (MESH:D009135), hypercoagulability (MESH:D019851), PE (MESH:D011655), Venous stasis (MESH:D054070), IRD (MESH:D052919), restricted mobility (MESH:D014086), granulomatosis with polyangiitis (MESH:D014890), autoimmune diseases (MESH:D001327), Obesity (MESH:D009765), serositis (MESH:D012700), stroke (MESH:D020521), thromboembolic (MESH:D013923), Virchow's triad (MESH:D007619), vascular disorders (MESH:D002561), Thrombosis (MESH:D013927), Inflammatory myopathies (MESH:D009220), valve insufficiency (MESH:D001022), antiphospholipid syndrome (MESH:D016736), dyspnea (MESH:D004417), triad (MESH:C565803), systemic (MESH:D015619), IRDs (MESH:D012213), uSpA (MESH:C580334), Endothelial injury (MESH:D057772), pulmonary arterial hypertension (MESH:D000081029), pain (MESH:D010146), endothelial (MESH:D005642), Arthritis (MESH:D001168), VVs (MESH:D014648), microvascular disruption (MESH:D017566), Endothelial damage (MESH:D014652), polyarteritis nodosa (MESH:D010488), valvular insufficiency (MESH:D000309), SS (MESH:D012859), connective tissue disorder (MESH:D003240), hereditary coagulation disorders (MESH:D025861), Vasculitis (MESH:D014657), chronic venous insufficiency (MESH:D014689), Chronic inflammation (MESH:D007249), weight gain (MESH:D015430), Rheumatic Diseases (MESH:D012216), AS (MESH:D013167), Crystal Arthropathies (MESH:D000070657), joint stiffness (MESH:C535724)
- **Chemicals:** anticardiolipin (-)
- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Full text

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## Figures

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## References

2 references — full list in the complete paper: https://tomesphere.com/paper/PMC12864313/full.md

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Source: https://tomesphere.com/paper/PMC12864313