Pain associated with venous leg ulcers: the complexity of management

Venous leg ulcers (VLUs) are a chronic and often debilitating condition, affecting a significant number of individuals worldwide. One of the most distressing aspects of VLUs is the persistent pain they can cause, which impacts quality of life, mobility and overall wellbeing. Despite advances in wound care, VLU-related pain remains under-recognised and poorly managed. Pain in VLUs is complex and typically includes nociceptive pain from tissue damage, neuropathic pain due to nerve involvement, and probable central sensitisation. Each type requires targeted treatment, yet clinical awareness and tailored strategies are often lacking. This article explores the multifaceted nature of VLU pain and highlights the importance of a multidisciplinary approach. It reviews the evidence on pain mechanisms, patient experiences, and effective management strategies, both pharmacological and non-pharmacological. By enhancing understanding and applying best practices, health professionals can effectively address VLU-related pain, leading to improved outcomes and better quality of life for patients.