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What Is Thrombophlebitis ?

  • Phlebitis means inflammation of a vein.
  • Thrombo(sis) means a blood clot in a vein.

A Vein is a blood vessel that takes blood towards the heart. If a vein becomes inflamed, a blood clot commonly forms inside the inflamed portion. So, the term thrombophlebitis is used to mean an inflamed vein, with or without a small blood clot inside the vein. (Thrombophlebitis is commonly just called phlebitis.)

Deep Vein Thrombosis (DVT)

What Is Superficial Thrombophlebitis ?

The superficial veins are the ones that you can often see or feel just under the skin. Most bouts of superficial thrombophlebitis occur in a leg vein, but any superficial vein can be affected. A typical site is in a varicose vein in a leg. Varicose veins are common, particularly in pregnant women. Superficial thrombophlebitis is not usually serious, but complications can sometimes occur (see below).

Note: this leaflet does not deal with inflammation or thrombosis of deep veins. The deep veins are larger, pass through the muscles in your arms and legs, and you cannot see or feel them. Some people get confused between superficial thrombophlebitis and deep vein thrombosis. They are quite different. A deep vein thrombosis (DVT) is more serious. See separate leaflet called 'Deep Vein Thrombosis (DVT)' for more detail.

Symptoms of DVT

Many blood clots that cause DVT are small and don't produce any symptoms. Your body will usually be able to gradually break them down with no long-term effects.

Larger clots can partly or completely block the blood flow in your vein and cause symptoms such as:

  • Swelling of the affected leg
  • Pain and tenderness in the affected leg - you may also find it difficult to stand properly with your full weight on the affected leg
  • A change in the colour of your skin, for example, redness
  • Skin that feels warm or hot to the touch

Causes of DVT

You are more likely to get a DVT if you :

  • Are over 40
  • Are immobile, for example, if you have had an operation (especially on a hip or knee) or are travelling for long distances - and so are not able to move your legs
  • Have had a blood clot in a vein before
  • Have a family history of blood clots in veins
  • Have a condition causing your blood to clot more easily (this is called thrombophilia)
  • Are very overweight (obese)
  • Have cancer or have had cancer treatment
  • Have heart disease or circulation problems
  • Are a woman taking a contraception pill that contains oestrogen, or hormone replacement therapy (hrt)
  • Are pregnant or have recently had a baby

Diagnosis of DVT

Your GP will ask about your symptoms and examine you. If he or she thinks that you might have a DVT, you may be referred to a specialist.

You may have the following tests in hospital.

  • A blood test called a D-Dimer. This measures a substance which develops when a blood clot breaks down. If this is negative it's unlikely that you have a DVT.
  • A Doppler ultrasound. This is a test that uses sound waves to look at your blood as it flows through your blood vessels. It's the best test to detect blood clots above your knee.
  • A venogram. In this test, a special dye is injected into your vein, which shows up the vein on X-ray. This is the best way of showing clots below your knee.

What Is The Treatment For Superficial Thrombophlebitis ?

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.

The following treatments may be helpful:

  • Keep active. Try to keep up with normal activities as much as possible.
  • A hot flannel (cloth) placed over the vein. This may ease the pain.
  • Painkilling tablets. Anti-inflammatory painkillers such as ibuprofen may ease the pain (but are not advised if you are pregnant). Paracetamol is an alternative. Some people may not be able to take anti-inflammatory painkillers. Check with your doctor or pharmacist. Always read the packet leaflet that explains possible side-effects. See separate leaflet called 'Anti-inflammatory Painkillers' for more detail. (There is also some limited evidence that anti-inflammatory painkillers taken by mouth may reduce the risk of superficial enlarging or extending within a vein and/or it coming back. However, more studies are needed to confirm this.)
  • Anti-inflammatory creams or gels. An example is ibuprofen gel. These are an alternative if superficial thrombophlebitis is mild and only affects a small area of vein. They tend to produce fewer side-effects than those taken by mouth.
  • Raising the affected leg. When you rest (when watching TV, or reading a book, etc), if you raise an affected leg so that your foot is higher than your hip, it helps to reduce swelling and discomfort. You can do this by lying on a sofa and putting the leg up on some cushions. When sleeping in bed, you can keep your leg raised by putting it on a pillow.
  • Compression (support) stockings. These may be advised by your doctor if a vein in your leg is affected. They may ease discomfort and reduce swelling whilst the inflammation settles.

If varicose veins are the source of the problem, once the inflammation has settled, you may wish to consider treatment to remove the varicose veins. See your doctor for advice. There is another leaflet that discusses varicose veins in more detail.

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