Treatment

For superficial thrombophlebitis, your doctor might recommend applying heat to the painful area, elevating the affected leg, using an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) and possibly wearing compression stockings. The condition usually improves on its own.

Your doctor might also recommend these treatments for both types of thrombophlebitis:

  • Blood-thinning medications. If you have deep vein thrombosis, injection of a blood-thinning (anticoagulant) medication, such as low molecular weight heparin or fondaparinux (Arixtra), will prevent clots from enlarging. After the initial treatment, taking the oral anticoagulant warfarin (Coumadin, Jantoven, others) or the newer rivaroxaban (Xarelto) for several months continues to prevent clots from enlarging.

  • If your doctor prescribes a blood thinner, follow directions carefully. Their most serious side effect can be excessive bleeding.

  • Clot-dissolving medications. Treatment with medications such as alteplase (Activase) dissolves blood clots. Also known as thrombolysis, this treatment is used for extensive DVT, including some cases that involve a blood clot in the lungs (pulmonary embolus).
  • Compression stockings. Prescription-strength compression stockings help prevent swelling and reduce the chances of complications of DVT.
  • Filter. In some instances, especially if you can't take blood thinners, a filter can be inserted into the main vein in your abdomen (vena cava) to prevent clots that break loose in leg veins from lodging in your lungs. Usually, the filter is removed when it's no longer needed. If you have a filter placed, ask your doctor if and when it should be removed.
  • Varicose vein stripping. Your doctor can surgically remove varicose veins that cause pain or recurrent thrombophlebitis in this procedure. It involves removing a long vein through small incisions. Removing the vein won't affect circulation in your leg because veins deeper in the leg take care of the increased volumes of blood.
Nov. 30, 2016
References
  1. Nasr H, et al. Superficial thrombophlebitis (superficial venous thrombosis). British Medical Journal. 2015;350:u2039.
  2. Scovell S, et al. Phlebitis and thrombosis of the superficial lower extremity veins. http://www.uptodate.com/home. Accessed July 11, 2016.
  3. Bauer KA. Approach to the diagnosis and therapy of a lower extremity deep vein thrombosis. http://www.uptodate.com/home. Accessed July 11, 2016.
  4. Di Nisio M, et al. Treatment for superficial thrombophlebitis of the leg (review). Cochrane Database of Systemic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004982.pub5/abstract. Accessed July 11, 2016.
  5. Deep vein thrombosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/dvt#. Accessed July 11, 2016.
  6. Alguire PC, et al. Post-thrombotic (postphlebitic) syndrome. http://www.uptodate.com/home. Accessed July 11, 2016.