Thrombophlebitis

1 What is Thrombophlebitis?

When a blood clots blocks one or more of your veins usually in tour legs is called Thrombophlebitis (throm-boe-fluh-BY-tis). It is also known as phlebitis that affects the veins in your neck and arms which is caused by surgery, trauma or prolonged inactivity.

Sometimes the affected vein is near the surface of your skin that can cause superficial thrombophlebitis which can occur in people with varicose veins or deep within a muscle that can cause deep vein thrombosis (DVT).

If you have a clot deep in your vein it can cause serious conditions such as dislodged clot (embolus) that will travel to your lungs and will block an artery (pulmonary embolism).

Deep vein thrombosis and superficial thrombophlebitis are treated with blood-thinning medications.

2 Symptoms

The symptoms of superficial thrombophlebitis are:

  • redness and swelling;
  • warmth, tenderness and pain in the affected area,
  • while the symptoms of deep vein thrombosis are pain and swelling.

You might see a red, tender and hard cord under the surface of your skin when a vein close to your surface of the skin is affected.

Your leg might be painful and swollen if a deep vein in your leg is affected. Consult your doctor right away if you have these symptoms along with chest pains and shortness of breathe because these may indicate deep vein thrombosis that will increase your risk of a dislodged blood clot.

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3 Causes

Blood clot is the cause of thrombophlebitis and blood clots can be caused by many things when your blood is not circulating properly such as:

  • an injury to a vein,
  • immobility for a long time,
  • and inherited blood-clotting disorder.

4 Making a Diagnosis

Consult your doctor if you are experiencing symptoms of thrombophlebitis so he can diagnose you and give you proper treatment.

You can also call 911 if it is severe and you are coughing blood and have shortness of breath. Before visiting your doctor, write down in a notebook all the symptoms that you are experiencing. You can also write down personal information such as if you have a family history of blood-clotting disorders and a list of all your medications and vitamins that you are taking.

Write down questions that you might want to ask the doctor.

Some of these questions include:

  • What is likely causing my symptoms?
  • Are there any possible causes?
  • What tests do I need?
  • What treatments are available?
  • What are the possible side effects of these treatments?
  • Do I need restrictions in any activities?
  • Do you recommend any alternatives to the primary approach?
  • Do I need to take restrictions with regards to diet?
  • What websites do you recommend?

Your doctor will also ask you questions such as:

  • When did you first experience your symptoms?
  • Do they come and go?
  • How severe are they?
  • Do you have any other medical conditions?
  • Have you had any major surgery or injury in the past three months?
  • Have you had miscarriage before?
  • What are the medications you are taking?
  • What, if anything, seems to improve or worsen your symptoms?
  • Do you have a family history of health conditions that are related to blood clots?

While waiting for the appointment you can take pain relievers to reduce the pain but ask your doctor first if you can have one or put warm compress on the affected area and elevate your leg to relive you of discomfort.

Your doctor will first conduct  physical exam to take a look at the affected veins in your skin and he may suggest some of these tests such as:

  • Blood test – to check for clot-dissolving substance (D dimer) because of an elevated blood level and can help in identifying if you are at risk of thrombophlebitis and to rule out deep vein thrombosis;
  • Ultrasound – to check for a clot by using transducer that can send sound waves and will transform the waves into a moving image on a video screen;
  • CT scan – that can give visual images of your lungs to look out if there are any clots.

5 Treatment

Treatment for thrombophlebitis may include elevating the affected leg, applying warm compress to the affected area and over the counter non-steroidal inflammatory drug (NSAID) and does not require hospitalization.

Other treatments that your doctor may suggest are:

  • Blood-thinning medications - Injection such as anticoagulant like low molecular weight heparin or fondaparinux (Arixtra) so that your blood clots will not enlarge. After this treatment, you will take oral anticoagulant Warfarin (Coumadin) or Rivaroxaban (Xarelto) for several months; prescription strength compression stockings to reduce the risk of complications and to prevent swelling, you may wear this for two or more years;
  • Clot-dissolving medications – such as alteplase (Activse) to dissolve blood clots or if you have a pulmonary embolus;
  • A filter – that will be inserted into your main vein in your abdomen (vena cava) to prevent the clots that will break from going into your lungs; varicose vein stripping – to remove the varicose veins through small cuts to avoid pain and recurrent thrombophlebitis.

6 Prevention

To prevent thrombophlebitis from occurring, follow these guidelines:

  • take a walk – if you are having a long drive, stop, rest and take a walk for an hour so your legs will not be inactive for a long time,
  • move your legs regularly if you are going to stay seated – press your feet against the floor at least 10 times each hour,
  • avoid wearing tight clothing,
  • stretch your calves by walking at least once an hour for long drives or if you are in a flight,
  • drink plenty of non-alcoholic fluids so you will not be dehydrated,
  • use compression stockings before your flight,
  • take any blood-thinning medication that is prescribed by your doctor.

7 Alternative and Homeopathic Remedies

Some of the homeopathic remedies for thrombophlebitis include:

  • Aesculus hipp – to avoid swollen and painful leg,
  • Arnica – from trauma or bruised feeling,
  • Bothrops – for swollen veins and to dissolve blood clots,
  • Belladonna – for onset inflammation with redness and swelling,
  • Lachesis – to dissolve blood clots,
  • Hamamelis – for pain that is worsen by movement with varicose veins an inflammation.

8 Lifestyle and Coping

In addition to medical treatments, there are some self-care measures you can take in order to cope with thrombophlebitis. 

For deep vein thrombosis:

  • elevate your leg if it is swollen,
  • take your anticoagulant medications so there will be no complications,
  • wear your prescription compression stockings.

For superficial thrombophlebitis:

  • elevate your leg;
  • use warm compress to apply to your affected area several times a day;
  • use non-steroidal anti-inflammatory medicines that is prescribed by your doctor.

Ask your doctor first if you are going to take warfarin or about foods high in vitamin K that can affect the way these medications work and also aspirin that is not recommended if you are going to use warfarin.

9 Risks and Complications

You are at risk of thrombophlebitis if you:

  • had a stroke that leads to your legs and arms being paralyzed,
  • you have been in bed for a long period of time such as after surgery or an injury,
  • have a thin catheter in the central vein for treatment in your other medical condition that can irritate your blood vessel wall which leads to decrease in blood flow,
  • have a family history of blood-clotting disorder,
  • used hormone replacement therapy or birth pills which makes your blood clot,
  • had just given birth or pregnant which means you increased pressure in your veins,
  • you are older than 60,
  • have varicose veins,
  • been inactive for long time such as in a flight.

You have a higher risk of having thrombophlebitis if you have one or more of these risk factors. Complications are rare if it is only under your skin (superficial vein) but if there is a blood clot in a deep vein this may lead to serious complications such as:

  • Pulmonary embolism – when the blood clot dislodged and travels to your lungs causing blockage of the artery which can be fatal,
  • Post-phlebtic syndrome – or post-thrombotic syndrome that can cause lasting swelling and pain and may even develop over months or years after you have deep vein thrombosis, compression stockings must be wear for more than two years to prevent this condition.

Veins have valves to prevent blood from flowing back as it pushes uphill towards your heart and if these valves are damaged, some complications may occur such as:

  • varicose veins – pools of blood in your veins will cause them to balloon,
  • skin discoloration – this will happen if there is increased pressure on the skin and if there is chronic swelling and this might lead to skin ulcers,
  • swelling – your leg will be swollen (edema) if the pooling is severe.
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