Phlebitis / Thrombophlebitis

Phlebitis / Thrombophlebitis: Overview

The term phlebitis refers to an inflammation of a vein, usually in the leg, frequently accompanied by blood clots that adhere to the wall of the vein.  When the affected vein is close to the surface, the condition is called superficial phlebitis.

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Contributing Risk Factors

Risk factors for any type of phlebitis include recent surgery or childbirth, varicose veins, inactivity, sitting for long periods (such as on a long airplane ride), and smoking.  Prolonged placement of intravenous catheters can also cause phlebitis, possibly requiring antibiotic treatment.  The use of progestins (synthetic progesterones, but not natural progesterone) will increase the likelihood of deep vein thrombophlebitis by 3 to 4 times.

Signs and Symptoms

Symptoms of superficial phlebitis include pain, swelling, redness, and warmth around the affected vein.  The vein feels hard to the touch because of the clotted blood.

Deep vein thrombosis is more difficult to diagnose.  It can occur without any symptoms until the clot reaches the lungs.  However, in about half of cases, there are warning symptoms including swelling, pain and warmth in the entire calf, ankle, foot, or thigh (depending on where the involved vein is located).  Although these symptoms can also be caused by more benign conditions, deep vein thrombosis is such a life-threatening disorder that physician consultation is necessary.

Treatment and Prevention

Conventional treatments for superficial phlebitis include analgesics for pain, warm compresses, and compression bandages or stockings to increase blood flow.  In more severe cases, anticoagulants or minor surgery may be required.  Superficial phlebitis inflammation generally is reduced within 7-10 days, but it may be 3-6 weeks for the problem to be entirely gone.

Deep vein thrombosis requires more aggressive treatment, including hospitalization, strong anticoagulants, and a variety of possible surgical procedures.

Note: Because deep vein phlebitis is a potentially life-threatening disorder, you should seek a doctor's advice before attempting any natural treatments.

Aortic glycosaminoglycans (GAGs) are substances found in the tissues of the body including blood vessels, and sometimes available supplementally.  They are closely related to the anticoagulant drug heparin.  Preliminary evidence suggests that aortic GAGs might be helpful in treating phlebitis, although not all studies agree. [Ann Ital Med Int. 1989;4: pp.378-85, Minerva Med. 1984;75: pp.1733-8]

Homeopathy (to be taken 4 times daily for up to 7 days):

  • If the condition follows an injury: Arnica 6c
  • If bruising persists: Hamamelis 6c
  • If the veins are worse in heat and when the limb is not elevated: Pulsatilla 6c.

General recommendations:

  • Include niacin in the diet.  This B vitamin helps prevent clotting.  Vitamin C helps strengthen the walls of veins and arteries.
  • Eat a good nourishing diet of fruits, vegetables, raw nuts, seeds, legumes, and whole grains.
  • Do not eat fried, salty, processed foods; dairy products; or hydrogenated vegetable oils.  Do not eat meat.
  • A high-protein diet increases blood-clotting factors.
  • Use enough fiber in the diet, so you do not have to strain at the stool.  Straining increases venous pressure on the legs.
  • Maintain a low-fat diet and drink enough water.
  • It is now known that food allergies can be involved.  Search them out and eliminate them.
  • Avoid dangling the feet.  Pressure against the popliteal vessels may cause obstruction of blood flow.  Do not cross your legs.
  • Deep breathing or singing helps empty out the large veins, thus increasing venous circulation.
  • Quit tobacco.  If you smoke, and seem to keep having recurring phlebitis, you may have Buerger's disease (which see).  Its symptoms are severe pain and blood clots, usually in the legs.  Smoking constricts the blood vessels.
  • Do not wear anything tight about the waist, or bands on the legs.
  • Beware of "economy class syndrome."  A remarkable number of people who fly in the cramped economy class seats of jets develop thrombophlebitis.  You are confined to your seat more on planes than in cars or boats.  So request an aisle seat and get up every 30 minutes and walk up and down the aisles.
  • Once you have had phlebitis, or clots of any type, you can have it again.  Surgery or prolonged bed rests increase the likelihood that you will have another attack.  Keep that in mind when you consider elective surgery.
  • Fasting decreases blood coagulation, and can be beneficial when needed.

Prognosis; Complications; Seek medical attention if...

This condition usually resolves on its own without further complications.

When phlebitis occurs in a deep vein, it is called deep vein thrombosis (DVT).  DVT is a life-threatening condition because a clot could dislodge from the vein and lodge in the lungs.

If a swollen, painful vein does not disappear within 2 weeks, consult a physician.

Signs, symptoms & indicators of Phlebitis / Thrombophlebitis:

Symptoms - Metabolic

Conditions that suggest Phlebitis / Thrombophlebitis:

Symptoms - Cardiovascular

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Risk factors for Phlebitis / Thrombophlebitis:


Cigarette Smoke Damage

Smoking increases the risk of phlebitis.


Varicose Veins

Thrombophlebitis is common in people who have varicose veins but may be prevented as long as the patient wears support stockings, walks regularly and elevates the legs while sitting.

Supplements, Medications, Drugs

Progestin use

The use of synthetic progesterones (progestins) – but not natural progesterone – will increase the likelihood of deep vein thrombophlebitis by 3 to 4 times.

Phlebitis / Thrombophlebitis suggests the following may be present:


Recommendations for Phlebitis / Thrombophlebitis:

Botanical / Herbal

Grape Seed Extract

A one-month of treatment reduced lower limb circumference and improved subjective symptoms better than horse chestnut seed extract in a study of 40 patients with diagnosed chronic venous insufficiency. [Phytother Res 2002;16(2): pp.1-5]

Horse Chestnut

Horse chestnut is often used for chronic venous insufficiency and varicose veins – conditions related to phlebitis.  For this reason, horse chestnut is sometimes recommended for phlebitis as well, but may be better suited for prevention of the condition.


Therapeutic Fasting

Increased fibrinolysis during fasting may account for the dramatic improvement seen when patients suffering from thrombophlebitis fast.

Digestive Aids


Due to its anti-inflammatory properties and ability to prevent blood platelet aggregation, bromelain has been suggested as a treatment for phlebitis.  There are some positive reports in clinical trials of bromelain improving thrombophlebitis. [Planta Med 1990 56:249, Alt. Med. Rev. 1996 1:243, Angiology. 1969;20: pp.22-6]


Aerobic Exercise

It is important to get regular moderate exercise.  Walking is the best, and swimming may also be helpful.  Regular exercise increases the body's ability to dissolve clots.

Wherever you may be, do not sit for more than an hour at a time without getting up and walking around.  Better yet, every hour exercise the legs for 2 minutes, as if you are riding a bike (lifting the legs) while breathing deeply.  Do not squat (sit back on your heels), except momentarily.  If you have to travel a distance while seated (airplane, car, etc.), stop and walk around every so often.  Do not let the circulation become sluggish.

Physical Medicine

Incline Board

Superficial phlebitis can be treated by elevating the leg frequently.  It is not necessary to rest in bed but, every so often, rest with the leg 6-10 inches above the heart.  This speeds the healing process.  You can also lie on a slant board, if available, with your feet higher than your head for 15 minutes per day, especially if you stand on your feet a lot.

If you have to lie in bed for a long time, move your legs every so often to increase circulation.  Elevate the foot of your bed by several inches to reduce venous pressure in your legs, which also reduces edema and pain.  Do not use pillows under the legs, for doing so may reduce circulation.


Hot packs may be helpful for superficial thrombophlebitis but probably will not benefit deep vein thrombosis.  Taking alternating hot and cold sitz baths or using alternating hot and cold compresses may help improve circulation in the affected area.


Vitamin E

Milroy's disease is a rare, incurable disease due to poor development of the lymphatic system, with a consequent chronic pooling of lymph in the legs often with recurring attacks of thrombophlebitis.  Every case Dr. Shute, MD treated with vitamin E resulted in a positive response, with some cases being fully cured.  The dose of vitamin E used for thrombophlebitis is 600-1,600 IU daily.

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