Superficial thrombophlebitis is a painful condition affecting veins under the skin, often related to varicose veins. It can be caused by infection, injury, blood disorders, or poor blood flow. It presents with pain, tenderness, and swelling, and can lead to more serious conditions if left untreated. Treatment includes addressing the cause and providing symptom relief with antibiotics, heparin, NSAIDs, and other therapies. People with superficial thrombophlebitis should be screened for deep vein thrombosis and pulmonary embolism.
Superficial thrombophlebitis is a painful and sometimes disabling condition of the veins just under the skin that commonly affects the legs, groin, and arms; it is often related to varicose veins. Superficial thrombophlebitis is also called superficial phlebitis. Its main mechanism is an inflammatory-thrombotic process, which can be secondary to infection, injury, blood disorder or poor blood flow.
Normally, blood flows through the vessels in a regular and uninterrupted manner. Blood clots form when a person has predisposing factors, such as atherosclerosis or uneven thickening of the blood vessel wall, blood disorders such as leukemia or polycythemia, trauma to the blood vessels, or simply not enough blood flow. A thrombus is simply a blood clot that remains in one place within the blood vessel, which in this case is a vein. What causes this thrombus to adhere to the walls of the vein is an inflammatory reaction that increases the viscosity of the platelets. The combination of inflammation and thrombosis leads to the typical symptoms of thrombophlebitis.
When superficial phlebitis occurs secondary to an infection, it is called septic thrombophlebitis. Usually, such an infection follows the use of intravenous catheterization among people who are undergoing intravenous drug treatment for other diseases. When there is no infection involved, superficial phlebitis is simply called sterile thrombophlebitis.
Regardless of the cause, a person who has superficial thrombophlebitis often feels pain or tenderness in the affected area. This pain usually occurs with swelling. After some time, a red streak may appear along the path of a vein, which normally appears as a blue or green vessel under the skin. If this red stripe is felt or felt along its length, it would have the texture of a raised hard cord.
A serious venous disease called deep vein thrombosis (DVT) should not be mistaken for superficial thrombophlebitis. DVT causes little or no inflammation, which is why it doesn’t present with tender veins. Also, because DVT involves deep veins, it usually lacks skin manifestations.
This does not mean that a person with superficial phlebitis should be complacent. Studies show that people with superficial thrombophlebitis often have concurrent DVT. This is because both conditions have similar risk factors and developmental mechanisms. Additionally, untreated superficial phlebitis could eventually invade deeper veins, leading to postphlebitic syndrome, DVT, or even pulmonary embolism. Therefore, a person with superficial thrombophlebitis should be screened for DVT and pulmonary embolism and treated as soon as possible.
Treatment targets the cause and provides symptom relief. If there is an infection, antibiotics are given. To address thrombosis and pain, low molecular weight heparin (LMWH) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin are given. Other therapies that might help are regular walking, applying warm compresses, and wearing compression stockings.
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