What is Superficial Phlebitis?
Phlebitis simply means inflammation of a vein. Most cases of phlebitis in the legs are due to thrombosis (blood clots), called thrombophlebitis. The two primary types of thrombosis are superficial vein thrombosis (SVT) and deep vein thrombosis (DVT). Deep vein thrombosis is a medical emergency. Some DVTs are without symptoms, while others are associated with the acute development of leg swelling, pain and tiredness. If a DVT is suspected, you should seek an emergency evaluation to determine if hospitalization and treatment with anticoagulants (blood thinners) is required to reduce the risk of further leg damage and life threatening pulmonary emboli, blood clots that lodge in the lungs. Risk factors that increase the likelihood of DVT include:
- Prolonged bedrest
- Cigarette smoking
- Giving birth within the last 6 months
- Taking oral contraceptives, hormone replacement or other medications containing estrogen or estrogen-like substances.
- Recent surgery (especially of the hip, knee, or female reproductive organs)
- Sitting for a long periods of time, such as on a long plane or car trip
- Blood that is more likely to clot (hypercoagulability)
- Active cancer
Patients with varicose veins have only a slight increase in risk of developing a DVT as compared to those who do not have varicose veins. However, there is a significantly higher likelihood of developing superficial phlebitis when varicose veins are present. The superficial veins are closer to the skin surface and, by definition, are above the level of the muscle. A superficial phlebitis may initially be noticed as a tender area, hard nodules or cords that develop in pre-existing varicose veins or in the underlying varicose veins. Superficial phlebitis alone is rarely a serious condition, but a medical evaluation and duplex venous ultrasound are important to make a proper diagnosis. The combination of varicose veins along with a period of immobility (eg. a long plane or car trip) is frequent cause of superficial phlebitis.
How is Superficial Phlebitis Treated?
Treatment of superficial phlebitis may depend on the symptoms, location, extent and underlying medical conditions. An ultrasound scan of the leg will determine the severity of the condition. The primary treatments for superficial phlebitis include:
- Leg elevation
- Application of ice
- Anti-inflammatory medications such as ibuprofen (MotrinTM, AdvilTM)
- Ambulation (walking)
- Avoidance of prolonged sitting or standing
- Medical grade compression hose External compression with fitted compression stockings is also a recommended for patients with superficial phlebitis of the legs.