Thrombophlebitis

1. Definition

Thrombophlebitis is a circulatory problem that develops when a blood clot slows the circulation in a vein. “Phlebitis” means a vein with inflammation (can be the result of swelling or irritation caused by trauma). [1]

2. Causes

Thrombophlebitis occurs mostly in the lower extremity. [2] It can happen right under the skin (superficial thrombophlebitis) or deeper in the leg (deep venous thrombosis).
The forming of the blood cloth can have many causes: sitting down for a long time, being hospitalized for a surgery, disorders that make you more likely to develop blood clots, trauma, … [2]
But it also can be caused by varicose veins, underlying cancer, disruption of normal venous system drainage because of the removal of lymph nodes, intravenous drug use and patients with burns [3].
Also cigarette smoking combined with birth control pills is a risk factor. [3]

3. Symptoms

Symptoms associated with thrombophlebitis are inflammation and swelling of the body part, pain, skin redness and warmth and tenderness of the vein. [2]

Low grade fever may also be a symptom of superficial and deep phlebitis, higher fever may suggest and infection of the thrombophlebitis. [2]

4. Diagnosis

Thrombophlebitis can be diagnosed based on physical examination and how the affected area looks. It may be needed to have your pulse, blood pressure, temperature, skin condition checked. [2]

You can also take a D-Dimer blood test (a normal D-Dimer makes the diagnosis of thrombophlebitis unlikely) or take an ultrasound of the area which can help in making the diagnosis of phlebitis or excluding it. [3]

5. Preventation

Routine changing of intravenous (IV) lines helps to prevent thrombophlebitis related to IVs.

If you are taking a long car or plane trip, walk or stretch your legs once in a while and drink plenty of liquids. Wearing support hose may help.

If you are hospitalized, your health care provider may prescribe medicine to prevent deep venous thrombosis.[4]

5. Treatment

Treatment may depend on location, extent, symptoms and underlying medical condition, but in general it can be treated with:

  • warm compresses
  • elevation of the limb
  • encouraging circulation (walking around)
  • external compression with fitted stockings
  • anti-inflammatory medication 
  • if deep venous thrombosis is the case: anti-coagulation (blood thinner)

Recovery can take from a few weeks to a couple of months. [3]

6. Physical Therapy Treatment

The role a physical therapist can play in the DVT treatment, detection and prevention can make all the difference to patients.DVT can be undiagnosed for some time, there is a lot of potential for collateral damage, ranging from vascular malfunction to muscle atrophy. These are two areas where physical therapists can be an important part of a DVT patient's recovery.There are varying levels of massage that are useful for stimulating better vascular response in affected areas, specific exercises that can help to re-tone damaged muscles and even specialized compression techniques that help the body recover from the stresses of a deep vein thrombosis.[5]

6. References

  1. Bryg R, Understanding Thrombophlebitis -- the Basics, WebMD, 24 Oct 2010
  2. 2.0 2.1 2.2 2.3 2.4 Nabili S, Phlebitis and Thrombophlebitis, Medcine.net.com, 5 Jan 2009
  3. 3.0 3.1 3.2 3.3 Vorvick L, THROMBOPHLEBITIS, Medline, 5 oct 2010
  4. http://www.nlm.nih.gov/medlineplus/ency/article/001108.htm trusted health information mediplus
  5. http://physical-therapy.yoexpert.com/physical-therapy-general/what-is-the-role-of-physical-therapy-in-dvt-treatm-1578.html