Q: My uncle is 85 years old. He has been operated twice for varicose veins. He feels pain in his legs when he ascends or descends the stairs. He has no past history of diabetes, heart disease etc. What should he do to alleviate pain?

A:The patient is 85 years old and there is a distinct possibility that he is suffering from a combination of venous and arterial disease. I would like to suggest that he be investigated for arterial disease, which may well turn out to be the cause of his pain in the legs. This is quite likely in view of the pain coming while climbing the stairs, and walking, which are signs of claudication (deficient blood going to the muscles during activity). I have to add that it is unusual to get disabling pain from varicose veins. I would add a word of caution that whether it is arterial or venous disease one has to be conservative regarding treatment of people in this age group. It has to be either medications or simple physical means like compression stocking and in very exceptional circumstances invasive procedures.