Venous reflux, also known as venous insufficiency, was diagnosed in this patient presenting with symptoms consistent with impaired venous return.  The patient reports leg pain, aching, heaviness, swelling (edema), and fatigue, particularly in the lower extremities, worsening with prolonged standing or sitting.  Physical examination reveals visible varicose veins, telangiectasias (spider veins), and edema.  Skin changes such as hyperpigmentation, lipodermatosclerosis, and venous ulcers may be present, indicating chronic venous insufficiency.  Duplex ultrasound, the gold standard for venous reflux diagnosis, confirmed retrograde flow in the superficial venous system, specifically the great saphenous vein or small saphenous vein.  The Clinical Etiology, Anatomy, Pathophysiology (CEAP) classification was used to assess the severity of venous disease.  Conservative management options, including compression therapy with graduated compression stockings, leg elevation, and regular exercise, were discussed.  Further treatment options, such as endovenous ablation (radiofrequency ablation, laser ablation), sclerotherapy, or phlebectomy, may be considered based on the severity of symptoms and disease progression.  Patient education regarding venous health, risk factor modification, and compliance with compression therapy was provided.  Follow-up appointments were scheduled to monitor treatment efficacy and assess for potential complications such as deep vein thrombosis (DVT) or superficial thrombophlebitis.