What Are The 4 Signs of Phlebitis?

Written By Center for Vein Restoration

Phlebitis is a common vein condition that has many causes and treatments. It can occur for various reasons, such as after medical procedures where you’ve had an IV or if you’ve had an injury to the vein. It’s important not to ignore any new changes to your veins and to tell your physician if you’ve noticed any difference, warmth, or swelling, especially after venous procedures.

We take vein health and treatment seriously, so please read on to learn more about the signs and symptoms of phlebitis, how it’s treated, and its causes.

What is Phlebitis?

Phlebitis occurs when a vein becomes inflamed, usually as a result of an injury to the vein. Inflammation of the blood vessels impedes blood flow and can cause serious health complications. Phlebitis is more common in the lower extremities, especially the calf and thigh area.

There are two types of phlebitis: superficial and deep. Superficial phlebitis may be caused by a mild injury or the presence of an intravenous catheter and be present in the veins near the surface of the skin. Superficial phlebitis isn’t likely to cause a blood clot, but the accompanying swelling, if untreated, can cause problems that could lead to a blood clot, deep vein thrombosis, or pulmonary embolism. Deep vein phlebitis may be caused by an infection, trauma, inactivity, or even a clot forming (thrombophlebitis) and occurs deeper in the legs. Phlebitis is common and treatable, but if left untreated, it can have serious consequences and lead to major health complications.

Phlebitis can affect anyone, but some individuals are more susceptible than others. Patients at risk for blood clots, such as those with connective tissue disorders or certain cancers, are at greater risk of phlebitis. If you notice you have symptoms of phlebitis, seek medical attention.

What are the Four Signs of Phlebitis?

Pain and discomfort are the first noticeable signs of phlebitis, often described as an “aching, dull, or throbbing feeling” that varies if you touch or apply pressure to the vein or affected area. Some people may find the pain mild and be able to tolerate it, while for other people it may be more severe. Don’t ignore pain or discomfort in your legs if you know your veins have been affected. If you’re experiencing pain or discomfort in your legs and you suspect you may have phlebitis, consult with your doctor for evaluation.

Individuals with deep vein phlebitis will feel a heaviness in their limbs or a deep-seated pain that radiates outward from the inflamed vein. This could be a precursor to a deep vein thrombosis or the beginning symptoms of a blood clot. Tell your medical provider about your symptoms if you have a history of blood clots.

Swelling due to phlebitis can cause the surrounding area to feel tight and puffy. Swelling caused by phlebitis is usually concentrated around the inflamed vein and may spread beyond it. Some patients may experience very noticeable swelling; others may not. Swelling caused by phlebitis is also accompanied by a symptom called “palpable cord,” meaning that you can feel the inflamed vein if you palpate or touch the affected area. The inflamed vein would feel rope-like under the skin, feel warm to the touch, and is typically rigid or stiff. If you’re experiencing this symptom, consult with your physician. If you’re suffering from deep vein phlebitis, it's unlikely that you’ll be able to feel the vein.

Seek medical treatment if you’re experiencing the symptoms mentioned above.

Redness and warmth spreading from the inflamed vein are other symptoms of phlebitis that should be taken very seriously. The redness and discoloration often look like a streak or line along the inflamed vein and may spread outward from the vein itself. This indicates there’s increased blood flow and inflammation. These visual changes and symptoms can indicate more significant vascular issues. Seek medical attention if you’ve developed redness in addition to swelling or pain.

Skin changes aren’t uncommon with vein diseases but are an indicator that there could be underlying, potentially dangerous problems. The skin near the inflamed vein may be itchy, burn, or throbbing. When it comes to vein health, never ignore skin changes, especially if they come on suddenly and are accompanied by symptoms like pain, discoloration, or burning.

Fever is a very serious potential symptom of phlebitis, typically accompanied by fever, chills, and a flu-like feeling. These symptoms can indicate a more serious type of phlebitis, deep vein thrombophlebitis, where a blood clot forms in a deep vein, obstructing blood flow and causing additional inflammation. Seek medical attention if phlebitis has progressed to fever and flu-like symptoms as untreated, it can turn into a deep vein thrombosis, which has the potential to lead to a pulmonary embolism when a blood clot travels up into the lungs. DVT and pulmonary embolism can be disabling or even fatal.

Am I at Risk of Phlebitis?

Phlebitis is common and treatable and typically affects adults between the ages of 41-60. Risk factors for phlebitis include:

  • A sedentary lifestyle or long periods of inactivity contribute to the risk of phlebitis.

  • Smoking causes venous inflammation that can cause a myriad of problems, including damaging blood vessels and increasing the risk of phlebitis, among many other circulatory issues.

  • Obesity can put pressure on the veins in the legs, leading to an increased risk of phlebitis.

  • Varicose veins aren’t just a cosmetic issue and should be evaluated by a vein specialist to rule out chronic venous insufficiency or phlebitis.

  • Pregnant women are at higher risk of developing phlebitis due to weight gain and hormonal changes.

  • Age can be a factor in developing phlebitis as older adults are likely to have more extended periods of inactivity.

  • Certain medications that increase the risk of blood clots can increase the risk of phlebitis.

  • A previous history of phlebitis can make you susceptible to it again.

  • Venous catheters or central venous lines can increase your risk of developing phlebitis, especially if the catheter is in place for long periods.

What Causes Phlebitis?

The most common causes of phlebitis include, are but are not limited to, the following:

  • Prolonged immobility, often seen in bed-ridden individuals

  • Prolonged inactivity is often seen in people traveling long distances

  • Trauma or injury to a vein such as IV-induced phlebitis caused by a catheter or IV

  • Cancers or clotting disorders

  • Intravenous drug use

  • Varicose veins

  • Surgical recovery

  • Having had lymph nodes removed as typical during a mastectomy

  • Inherited clotting disorders make some people more susceptible to phlebitis

How is Phlebitis Diagnosed?

The primary goal of diagnosing phlebitis is to make sure no blood clots have begun to form. Your doctor will perform a visual and physical exam on the affected limb. They may need to perform a non-invasive ultrasound to confirm a diagnosis of phlebitis and rule out any more serious underlying issues.

What is the Treatment for Phlebitis?

Treatment for phlebitis depends on the underlying cause and the severity. Luckily, the diagnosis and treatment of phlebitis is fairly simple once issues such as thrombotic deep vein phlebitis and blood clots have been ruled out:

  • Rest and elevation can help reduce swelling in the affected limb and improve blood flow.

  • Compression stockings are an often-recommended treatment that can improve circulation and prevent phlebitis from progressing.

  • Lifestyle changes are often part of long-term phlebitis management and treatment, including maintaining a healthy weight, getting regular exercise, and avoiding prolonged periods of inactivity.

  • Medication management may range from over-the-counter pain relievers like NSAIDs to help with inflammation, to blood thinners if your doctor finds a clot. A regimen of blood thinners could last up to six months to prevent the clot from traveling to other parts of the body by dissolving it. If an underlying infection is the cause of phlebitis, your doctor may prescribe antibiotics.

  • Surgical intervention may be necessary in serious cases where deep veins are involved or if complications like pulmonary embolism have occurred.

On its own, phlebitis is treatable and curable. It’s essential to consult with your doctor or vein specialist if you are concerned about any symptoms mentioned above. Your provider can help you determine the cause and severity, and come up with a treatment plan. Untreated or mismanaged phlebitis can lead to serious, life-threatening complications such as deep vein thrombosis or pulmonary embolism.

If you suspect you’re having symptoms of phlebitis, including pain, swelling, redness, and discomfort, can feel your vein or a “palpable cord,” or are running a fever, reach out to your medical provider to be screened for phlebitis and to ensure you’re not at risk for a blood clot.

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