Home Diseases Inflammation of the veins (phlebitis): definition, symptoms

Inflammation of the veins (phlebitis): definition, symptoms

by Josephine Andrews
Published: Last Updated on 281 views

In the case of a vein inflammation (phlebitis) , a venous blood vessel becomes inflamed. Doctors also refer to phlebitis as phlebitis. It affects superficial veins (superficial thrombophlebitis) or deep veins. Both types are generally associated with the formation of a blood clot (thrombus). Read here about the symptoms caused by phlebitis and what treatment options are available.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

I82 I80 K75 O87 G08

quick overview

  • Symptoms: pain, redness, local heat, possibly a red swollen strand on the skin, sometimes fever
  • Treatment: Depending on the severity of the inflammation, cooling, elevation, compression bandage , medication
  • Causes and risk factors: varicose veins, mechanical causes such as venous catheters, after operations or clothing that is too tight, bacterial infection
  • Diagnostics: querying the medical history and physical examination, ultrasound , sometimes additional blood tests, computed tomography or magnetic resonance imaging
  • Course of the disease and prognosis: If treated early, healing usually occurs without complications; the health risk is higher in the case of inflammation of a deeper vein
  • Prevention: No basic prevention possible, movement and avoidance of the causes

What is phlebitis?

Inflammation of the veins (phlebitis) is a localized inflammation of the vein wall . It often occurs in the superficial veins of the legs, phlebitis in the arms or hands is less common. Phlebitis causes a blood clot to form. Conversely, a thrombosis sometimes develops into a phlebitis.

A distinction is made between superficial vein inflammation (thrombophlebitis) and inflammation of the deep veins. This is almost always accompanied by thrombosis and is therefore also referred to as deep vein thrombosis or phlebothrombosis. The distinction is important because the therapy and the course of the disease differ between the two forms.

Learn more about thrombophlebitis here .

Superficial phlebitis occurs more frequently in connection with varicose veins (varicose veins, varicose veins) because the vein wall changes here. In this case, the disease is called varicothrombosis. Varicose veins mainly form on the legs, so phlebitis is often found in the leg.

Overall, phlebitis is relatively common. It is important to have them treated by a doctor. Because if left untreated, superficial phlebitis in some cases leads to deeper venous thrombosis and thus to serious complications.

What are the symptoms of phlebitis?

The symptoms of phlebitis are usually quite characteristic. Typical signs of inflammation often appear: the affected vein section hurts and is visible as a red, often swollen strand on the skin. Overall, however, the respective limb is usually not swollen.

In the case of a superficial phlebitis, the skin over the affected vein also feels significantly warmer. Even slight pressure on the inflamed vessel causes pain. If the inflammation is caused by a bacterial infection, it is often accompanied by a slight fever.

The following symptoms occur with deep vein thrombosis in a leg or pelvic vein:

  • Drawing pain and feelings of tension in the affected leg
  • Bluish-red discoloration of the skin and clearer prominence of the vessels in the area of ​​the venous thrombosis
  • Pain on pressure on inflamed vein
  • Pain in calf, especially when toe is raised or pressure on heel
  • Possibly fever

The closer the phlebitis is to the back of the knee or groin, the higher the risk of the phlebitis spreading to deeper veins. You should therefore consult a doctor at the first sign of phlebitis. With early treatment, superficial phlebitis is not a serious condition. But only doctors are able to distinguish superficial phlebitis from deep vein thrombosis. This is important because deep vein thrombosis leads to serious complications in many people.

How does a pulmonary embolism develop ? If the blood clot (thrombus) detaches itself from the deeper vein, it is swept with the bloodstream to the heart and then to the lungs . It eventually blocks a blood vessel there and life-threatening pulmonary embolism occurs. 

What can you do about phlebitis?

The treatment of phlebitis depends on its type and severity. In the case of superficial phlebitis, the doctor first advises cooling the inflamed area . In many cases, he also applies a compression bandage using elastic bandages or compression stockings. In the case of certain diseases such as peripheral arterial occlusive disease (PAOD), however, a compression bandage should be avoided.

In the case of phlebitis, most of those affected find it pain-relieving if they elevate their leg. Unless the doctor says otherwise, you do not have to be on bed rest and can move around as usual. In many cases it is even advisable that you do not limit your daily activity if you have superficial phlebitis. In general, this reduces the risk of the inflammation spreading, especially to deeper veins.

Drugs from the group of so-called non-steroidal anti-inflammatory drugs, such as the active ingredient diclofenac, are helpful against the pain and inflammation. The remedy is applied in the form of an ointment to the inflamed vein. In addition, it is available in tablet form for oral use. Bacterial infections in phlebitis can be treated with antibiotics.

In some cases of phlebitis, a blood clot forms near the junction of a deeper vein. In this case, drugs that inhibit blood clotting , such as heparin, are used. If varicose veins are the starting point for phlebitis, their treatment, for example by removing varicose veins, may follow in the second step.

Hospitalization is usually necessary to treat deep vein thrombosis . The main aim of the treatment here is to prevent a pulmonary embolism. For this purpose, doctors administer anticoagulant drugs. 

Home remedies for phlebitis

Cooling a phlebitis, for example with a cooling element or compresses with cold water, relieves the symptoms somewhat in some cases. Elevating the affected part of the body is also a measure that usually alleviates the symptoms somewhat. In addition, there are no special home remedies that can be used for phlebitis.

Homeopathy and naturopathy for phlebitis

Homeopathic and naturopathic approaches to the treatment of phlebitis can be used in addition to the therapy methods mentioned. They range from external poultices, for example with arnica, to taking certain Schuessler salts, which are supposed to strengthen the veins, to taking homeopathic remedies, such as Acidum nitricum D4.

In the context of homeopathy and naturopathy, a reference to the psychological causes of phlebitis is occasionally made. Overload and stress can cause an imbalance that manifests itself in physical or organic complaints. Scientific evidence for this view does not exist.

Alternative medical approaches can complement conventional medical treatment, but not replace it. The underlying concepts (e.g. homeopathy, Schuessler salts) and their specific effectiveness are sometimes controversial and not clearly proven by studies.

How does phlebitis develop?

Inflammation of the veins occurs due to various causes. In general, as with deep vein thrombosis, three factors play a decisive role:

  • Slowed blood flow in the blood vessels like after surgery
  • Injuries to the vessel wall, for example, caused by indwelling vein catheters
  • Increased tendency of the blood to clot, for example due to hormonal contraceptives

Superficial phlebitis is common in people with varicose veins . Here, the vein wall is abnormally dilated, so that the blood backs up in the affected vein. In some cases, this leads to the so-called platelets, which play an important role in blood clotting, aggregating more easily – a blood clot is formed, which further restricts blood flow. This leads to inflammatory reactions in the vein wall. Standing or sitting for a long time also increases the risk of phlebitis, as the blood flow is reduced.

After operations, being bedridden for a long time or taking hormonal contraceptives (such as the pill ) – especially in connection with smoking – the blood’s readiness to clot increases. Therefore, they are considered risk factors for phlebitis. Being overweight and older also play a role.

A so-called venous catheter is also a common cause of phlebitis. The doctor usually inserts this short, flexible plastic tube into a vein in the arm or hand, more rarely in the head. The venous catheter usually remains there for several days. It serves as a vascular access for medication or infusions and is mainly used in hospitals. If the venous wall is injured when the venous catheter is inserted or if bacteria get into the vein, this can lead to phlebitis in some cases. The same applies to taking blood or when the doctor injects medication into a vein.

Mechanical causes are often involved in the development of phlebitis. It occurs, for example, when the vein is compressed for a long time by clothing that is too tight, tight stocking cuffs or hard chair edges.

How is phlebitis diagnosed?

To diagnose the phlebitis, the doctor first asks about the medical history (anamnesis). He asks, for example, whether phlebitis has occurred before or whether varicose veins are present. Information about taking certain medications, such as the pill, is also important for the doctor.

As part of the physical exam , the doctor looks at the affected limb. He often recognizes a superficial phlebitis at first glance. The affected vein appears as a red, thickened strand on the skin’s surface. Careful palpation of this area causes pain.

An ultrasound examination (sonography) of the inflamed vein is usually carried out. In the case of phlebitis, the vascular wall is visibly thickened. With the help of a so-called Doppler sonography, the blood flow within the vessel can be displayed in color. This allows the doctor to identify flow obstacles such as a blood clot.

If deep vein thrombosis is suspected, further examinations are usually necessary for the diagnosis. These include a blood test and possibly an imaging of vessels using computed tomography or magnetic resonance imaging (CT or MR phlebography). 

Phlebitis: course of the disease and prognosis

Superficial phlebitis that is treated early usually resolves without complications. The disease usually subsides after one to two weeks.

On the other hand, if a thrombus develops near the point where it opens into a deeper vein, in some cases a superficial vein thrombosis develops into a deep vein thrombosis. This is associated with a higher health risk. Occasionally, when the blood clot breaks away, it causes a pulmonary embolism. The prognosis for phlebitis depends on its extent and the time of treatment.

In principle, phlebitis cannot be prevented. However, there are some measures that you can take to reduce the risk of developing phlebitis in most cases. Also includes:

  • Drink enough water. Dehydration thickens the blood, increasing the risk of blood clots.
  • Have varicose veins treated.
  • Avoid standing or sitting for long periods. If this is not possible, do foot exercises to stimulate blood flow in the legs.
  • Quit smoking – this is especially true for women who take the pill.
  • Do not wear clothing that is too tight or constricting, especially on the legs.

Venous catheters should remain in the vessel for as long as necessary and as short as possible. If you have one, look out for changes such as redness or pain in the vein and tell your doctor immediately.

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