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Last updated August 27, 2016 (September 16, 2010)

By Muireann Prendergast, Contributing Columnist

[Health and fitness articles are reviewed by our team of Registered
Nurses, Certified fitness trainers and other members of our Editorial

Ever notice a hard, rope-like swollen vein in your leg? Are you
too-self conscious to wear a skirt in summer because swollen
veins have popped up on your legs? Then, pay attention. You
could have a condition called "phlebitis".

Phlebitis is far more than just an aesthetic concern. In its most
severe form, phlebitis, can be fatal.

According to The Texas Heart Institute, around 6 million
Americans have a blood clot in their veins in some part of their

The National Heart and Lung Institute suggests that around
300,000 Americans are hospitalized annually with
deep vein
, a life-threatening condition. What are the causes of
phlebitis? Are there natural remedies for phlebitis? When is
phlebitis serious and when can you try home remedies? Does
massage helps phlebitis or is massage harmful to phlebitis?

What Is Phlebitis?

The National Heart and Lung Institute, an agency within the US
National Institute of Health, defines "phlebitis" as the
inflammation of
a vein usually in the leg, but it can also occur
on the arms.

Phlebitis can occur in surface veins (superficial phlebitis) and in
this form it can generally be easily treated with medication.
However, when it is associated with the formation of
(thrombosis) deep in the veins of the leg, this is called
"deep vein thrombophlebitis".

Phlebitis can cause an obstruction in the veins, blocking blood
flow. If untreated these blood clots can travel to the lungs and
if they block the main artery of the lung a fatal pulmonary
embolism can occur.

What Is the Difference Between Phlebitis and Varicose Veins?

Phlebitis and varicose veins are different conditions. Varicose
veins are veins which have failed in their primary duty of
helping push de-oxygenated blood back upwards toward your
heart. The veins in your legs are most often affected by
varicosity because they bear the weight of your body which
makes the job of pushing against gravity that much harder.

Varicose veins may become blocked and enlarged and inflamed,
in which case they exhibit superficial thrombophlebitis, also
simply called "phlebitis".  Veins, whether varicose or not, can
also become blocked deep in your legs, in which case the
condition is deep vein thrombosis.

As you can see, varicose veins may cause you no problems
from a health perspective. Phlebitis and thrombosis, on the
other hand, are conditions that you must act on because they
involve blockage.

What Are the Causes of Phlebitis?

Superficial Phlebitis

The National Heart and Lung Institute suggests that phlebitis in
surface veins generally can be caused by injury to your veins.  
Using an intravenous (IV) line or catheter can also cause
phlebitis. With superficial phlebitis, some sufferers can "see"
their veins. (Read more about
conditions that cause visible

According to The National Heart and Lung Institute, phlebitis
can also be caused by chemical irritation to the skin, blood
disorders that can cause blood clotting (hypercoagulability),
blood infections, as well as varicose veins.

Sitting or standing still for long periods can also cause phlebitis.
If you're pregnant, you are at higher risk for phlebitis because
of the increase in estrogen in the body occurring during
pregnancy or from the use of birth control pills. The National
Heart and Lung Institute also reminds us that inflammation of
the veins can result from abdominal and pancreatic cancers.

A 2001 Mexican study pointed out the role of protein C and
protein S deficiencies in the development of Phlebitis. A 2008
publication from Stanford University noted that the risk for
developing superficial phlebitis can also be genetic.

How Is Phlebitis Different From Deep Vein Thrombosis?

Is phlebitis the same as deep vein thrombosis? How do the
symptoms differ?

Both phlebitis and deep vein thrombosis are caused by
blockages in your veins. The difference is that with phlebitis,
you can actually see and feel the vein on the surface of your
skin and it will be tender to the touch.

deep vein thrombosis, as the name suggests, the blockage
is in an internal vein deep in your leg, where you will not be
able to see it or touch it.

Here's another big difference. Does the swelling affect your
whole leg? If so, it's not phlebitis.  

The National Heart and Lung Institute suggests that deep vein
thrombophlebitis has many of the symptoms associated with
superficial phlebitis such as the hard, rope-like vein, redness,
tenderness, burning, itching and even fever. However, it points
out that patients with deep vein thrombosis can also manifest
the swelling of the
whole limb rather than just the vein itself.
Worryingly, the Mayo Clinic also points out that over half of
those with deep vein thrombosis show no symptoms.

Deep Vein Thrombophlebitis

The National Heart and Lung Institute explains that deep vein
thrombosis happens when something slows or changes the
blood flow in the veins. This can occur after a pacemaker
catheter has been passed through the vein in the groin.
However, deep vein thrombosis also results from fractures in
the pelvis or legs and even
heart failure. Deep vein thrombosis
can also occur through inactivity such as long periods of
bedrest when the blood is still for long periods of time.

Planning an airline trip? A 2001 UK study led by Sir John Scurr
also found that symptom-less deep vein thrombosis might
occur in up to
10% of long-haul airline travelers. Those in the
confined space of economy class and with pre-existent
conditions such as varicose veins are more likely to develop
deep vein thrombosis.  

In all fairness, this study's estimate that 10% of those traveling
on long-haul flights develop thrombosis has been sharply
criticized by others. A 2002 critique of the study by  Dr. K.G.
Burnand and Dr. C.L. McGuinness of Guy's King's and St
Thomas' School of Medicine strongly suggested that this 10%
figure is unrealistically high, and that only about 1% of
passengers can be expected to develop deep vein thrombosis
due to long-haul airline travel. Whether the true number is 1%
or 10%, it's still a very large number of people given the tens
of millions of travelers a year.

Cigarette smoking puts you at grave risk for phlebitis. A 2008
Dutch study revealed that deep vein thrombosis can result from
the toxins that accumulate in the blood from cigarette smoking.
Young smokers and young women taking oral contraceptives
who also smoke are at especially high risk for deep vein

A 2002 French study noted that deep vein thrombosis can
develop from increased estrogen in the body following
pregnancy, birth control pills and hormone replacement
therapy. The National Heart and Lung Institute also suggests
that the six week period following pregnancy can also be
optimum for the development of deep vein thrombosis due to
hormonal changes. As is the case of Superficial Phlebitis,
certain cancers can also cause deep vein thrombosis as well as
blood disorders causing blood clotting. The National Heart and
Lung Institute concludes that deep vein thrombosis can occur
in patients at any age although it is most common in patients
over 60.

Symptoms of Phlebitis?

The Maryland Vein Professionals Association explains that
superficial phlebitis can manifest itself as a firm, rope-like,
swollen vein that pops up in the vein of the leg and is
accompanied by a tender, warm, red area along the superficial
veins of the skin. The skin around the vein can be irritated,
even itchy or with a burning sensation. These symptoms can
become aggravated when the leg is lowered like when getting
out of bed in the morning. Sufferers can also have a low-grade
fever if the swollen vein has become infected.

Ways to treat Phlebitis

First, Here is what not to do if you have phlebitis.

1. Do Not Massage.

If you think you many be suffering from Phlebitis, consult a
medical professional as soon as possible. Your first urge maybe
to massage the affected area. Don't.

Many health professionals, including the Canadian Association
of Therapists in Complementary Medicine, warn against this.  
Massage can loosen and dislodge a bloody clot lodged in the
affected vein, which might then be forced to lodge itself
somewhere else in the organism such as in the lung or brains.
This could be fatal. The Association suggests that on these
grounds no massage, even of the non affected zones, must be
carried out.

2. Don't Delay Seeing a Doctor.

See a doctor as soon as you first suspect phlebitis and before
you try any at home remedies. Most cases of phlebitis clear up
on their own in a few days. But don't take any chances. See a
doctor first.

Top 10 Natural Remedies for Phlebitis

The Cleveland Clinic suggests that in the treatment of Phlebitis
the goal is to alleviate pain and inflammation and to reduce the
risk of complications. Here are 10 natural remedies for phlebitis
that can help:

Improve your diet--But there's a Caveat.

Eat more fish, fruit and vegetables. A study carried out by the
University of Minnesota School of Public Health published in
2007 found that the increased intake of these foods can be
linked to lower risks of deep vein thrombosis.

There's one big exception to the advise to eat more vegetables.
If you have phlebitis, you have to avoid foods and vegetables
high in Vitamin K. Cut down on Vitamin K

The Mayo Clinic warns that people who are susceptible to
Phlebitis and blood clots in general should cut down on their
Vitamin K intake. Vitamin K promotes blood clotting and as
such is an antagonist against blood thinning, anticoagulant,
drugs like Warfarin. Foods such as leafy green vegetables and
soy bean oils as high in Vitamin K, perhaps best avoided or
reduced during periods of phlebitis.

Wear Elastic Compression Stockings during long haul
The 2001 UK study into the possible relationship
between DVT and long haul travel found that the risk of DVT
could be reduced significantly by wearing elastic compression
stockings during long haul flights. The stocking prevents
inflammation as well as the seepage of blood from the affected
veins into the leg tissues.

Move Your Legs! The Mayo Clinic suggests that the best
thing for Phlebitis is to keep as active as possible, as long as
your medical car professional doesn’t suggest otherwise.
Generally, if patients are active the blood is less likely to settle
and clot.

Quit Smoking and Control Your Blood Pressure. If you want
to avoid or reduce phlebitis, The Mayo Clinic says the best way
is to quit smoking and keep blood pressure under control.
Smoking and high blood pressure are all factors that can
contribute to the development of phlebitis.

Ibuprofen. Anti inflammatory medication such as ibuprofen
is frequently recommended to reduce the redness and swelling
of both forms of Phlebitis. This was the subject of an Italian
study published in 1975.

Use Moist Heat.  A 2009 publication by Cornell University
pointed out the effectiveness of massive hot wet compresses
for more severe phlebitis.

Blood Thinners. A study published in 2003 in which the
University of Vermont participated advises that, in more serious
cases of DVT, low doses of blood thinning drugs or
anticoagulants such as Warfarin could be helpful. While these
do not remove blood clots they reduce the possibility of these
getting bigger and further clots forming.

Filters or Umbrellas.  In cases where medication cannot be
taken, filters, sometimes called umbrellas because they look like
the umbrellas wire spokes, are inserted into a large vein in the
patients’ abdomen, says the Mayo Clinic. These filters prevent
loose blood clots from travelling to the patient’s lungs or heart.

Compression Stockings. The Mayo Clinic explains that
compression stockings, worn on the leg from the foot to the
knee, help with the swelling associated with deep vein
thrombosis. This is also recommended by the 2009 Cornell
University publication exploring the most effective ways to treat
Phlebitis. These stockings, which should be worn for a year,
reduce the chances that blood will pool and clot.

Clot Busters.  In more serious cases of phlebitis or if other
medications aren’t working,  clotbusters or medications known
as Thrombolytics might be administered intravenously to break
up blood clots. However, because these can cause serious
bleeding they are generally only applied in life threatening

A 2009 Brazilian study presented a systematic review for
evaluating the efficacy of treatment of phlebitis stemming from
IV therapy.


In cases of superficial thrombophlebitis, where the more
serious problem of
deep vein thrombosis has been eliminated
by examination, another natural remedy to consider are horse
chestnuts. This is the recommendation of several European
studies, such as a 2002 study from Sankyo Pharma GmbH in

Horse chestnut gel, rubbed over your legs, help to re-seal your
veins over time . Horse chestnut extract, taken orally, has been
widely used in Europe for many decades and the gel form is
now available in the US and in Europe.

Superficial thrombophlebitis, varicose veins and spider veins
are all indications of varying degrees of vein insufficiency.
Several studies have established the effectiveness of horse
chestnut extract in treating chronic venous insufficiency
including a 2007 study from the University of Oklahoma Medical
Center, Cardiovascular Section, led by Drs. Rathbun and

Horse chestnut is generally considered safe for use with few
side effects. However, horse chestnut is a natural blood-thinner
(anti-coagulant) and , in some cases, it can create a serious
health problem for you if you should not take anti-coagulant.

One doctor from Adelaide and Meath Hospital in Dublin, Ireland
reported a case in 2011 of a woman who was taking horse
chestnut for venous insufficiency who later had to be treated
for a life-threatening rupture of her kidney.

The doctors cautioned that "Because [horse chestnut]-
containing products are thought to be generally safe in the
treatment of chronic venous insufficiency, it is important to be
mindful of their potential anticoagulant properties and,
therefore, their relative contraindication both in patients taking
other anticoagulants and those with known renal AML
[angiomylolipoma kidney problems]".

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