Everyone has veins in their body. Veins have the responsibility of transferring blood from all over the body to the lungs for oxygenation. In the legs there are two classes of veins- superficial and deep. Phlebitis means inflammation of the veins and thrombophlebitis means that a thrombus has caused inflammation of the veins. Phlebitis is commonly seen in both the superficial and deep veins of the legs. Most individuals get confused between superficial thrombophlebitis and deep vein thrombosis. They are quite different. A deep vein thrombosis (DVT) is more serious condition.
Superficial and deep thrombophlebitis often is caused by prolonged inactivity, such as from sitting during a long flight or from prolonged bed rest after surgery. Such inactivity decreases blood flow through your veins and may cause a clot to form. In some cases, these clots do resolve on their own but frequently they persist.
How does superficial thrombophlebitis happen?
For some reason a blood clot develops in the superficial veins of the leg. When the blood clot sits in the vein, it causes activation of the blood clotting mechanisms which results in the formation of a thrombus. During this period the body releases numerous chemicals Ã¢â‚¬â€œ some which try to dissolve the clot and some which stimulate clot production. All these chemicals are irritating to the vein and cause a condition known as phlebitis.
Is superficial phlebitis harmful?
When blood clots occur in the superficial veins, phlebitis is harmless condition. It may be moderately painful but eventually resolves in 2-4 weeks.
Which veins are prone to superficial thrombophlebitis?
The veins you seen underneath your skin and legs are superficial veins and it is these veins which are usually affected. However, compared to the rest of the body, the superficial leg veins are most commonly affected by phlebitis.
What causes thrombophlebitis?
Any condition that causes irritation of the vein can cause phlebitis. The most common causes of superficial phlebitis include:
- blood clots
- varicose veins predisposes one to blood clots
- Intravenous catheters: sometimes in hospital, the IV solutions and chemicals used are
irritating to the vein and cause phlebitis. In all cases, the needle catheter has to be
removed and placed elsewhere.
- Self injection with dirty needle. This is a common scenario in drug addicts who use dirty
needles which are shared.
- Pregnancy not only cases varicose veins but often in the breast feeding female, the breast
may develop tender veins on the surface of the breast (mondor's disease).
- long flights
- prolonged standing
What are the symptoms of superficial thrombophlebitis?
The symptoms generally depend on the degree of inflammation and extent of vein involvement. In general most individuals will complain of:
Pain: Pain is a constant feature at the site and may be throbbing in nature. It ranges from mild to moderate.
Tenderness: In some cases, the entire segment of the vein will be tender to touch.
Swelling: Swelling may be prominent in the area of the inflammation
Fever: In severe cases, the individual will have a long segment of vein which becomes inflamed and then infected. Fever will then be a common feature.
Hardness: Some individuals will present late to the physician and complain of hard rope like structure along the leg. This usually occurs as the end stage of recovery. Most veins which are inflamed tend to become fibrosed (hard) with time.
Redness: In some cases, the entire leg may be red along the length of the vein.
What is the treatment for superficial thrombophlebitis?
The treatment of superficial thrombophlebitis depends on the degree of symptoms and the amount of vein affected. The general treatment involves:
Compress: Warm and cold compresses may help with the pain and swelling. These compresses work best if applied immediately after the symptoms and for about 24-48 hours.
Pain: In most cases, the pain may be controlled with over the counter pain medications.
Elevation: When phlebitis is severe and the leg swollen, resting and elevating the leg is key to treatment.
Stockings: Compression stockings may be recommended and very helpful in shortening the course of symptoms. Most individuals are unable to wear stockings until the acute symptoms have subsided.
Antibiotics: In the very rare care, antibiotics may be required. If you have a fever and there is redness of the vein, then your physician may prescribe a short course of antibiotics.
How long does it take for superficial phlebitis to resolve?
Most bouts of superficial thrombophlebitis settle within 2-6 weeks. No treatment may be needed if the symptoms are mild. Treatment aims to ease symptoms. If you have recurrent episodes of phlebitis, then treatment of varicose veins may be required.
What are complications from superficial thrombophlebitis?
When there is moderate to severe degree of superficial thrombophlebitis, then treatment is required. If treatment is not available, some of the possible complications include:
Infection: Frequently the vein can become infected and the entire leg will be red and tender. One may develop fevers and a moderate amount of pain. In these cases, antibiotics are a must.
Blood clot extension: Rarely the blood clot in the superficial veins can move up the vein and migrate into the deep vein near the groin. If the clot is still in the superficial vein, it should be removed by either tying off the superficial vein or the physician may start blood thinning medications.
If you suspect you have superficial thrombophlebitis, it is best to have a physician look at the condition. Even though most cases are benign and resolve, occasionally a clot in the deep veins may also be present and has to be treated differently.
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