Phlebitis in the foot / ankle


Phlebitis in the foot or ankle describes an inflammatory reaction that is directed against the vascular wall of the veins. The inflammation leads to swelling and redness of the foot. In addition, pain can occur.

One can distinguish between inflammation of the superficial veins (thrombophlebitis) and inflammation of the deeper veins (chronic venous insufficiency). They result from different causes and are accordingly treated differently.

The reasons

The causes of phlebitis in the foot or ankle are quite different and are treated by different specialist disciplines.

Inflammation of the deep-lying veins can be caused by varicose veins or damaged venous valves. The blood in the foot can no longer be transported back properly and builds up in the veins. In this way, the vessel wall is heavily stressed and inflamed over time. Since this process takes place over a longer period of time, this clinical picture is also called chronic venous insufficiency.

Heart failure is another cause of phlebitis. The sick heart is no longer able to pump enough blood around the body. As a result, the blood builds up in the legs or on the feet and leads to an expansion of the veins, which strains the vessel wall and also triggers inflammation.

In addition, excessive standing of blood can promote the development of a thrombosis. A thrombosis is a blood clot that closes the affected vessel. The blood can no longer flow at this point and a very painful inflammatory reaction will be produced in response to the thrombus.
In addition, thrombosis is the most common cause of inflammation of the superficial veins (thrombophlebitis).

Another cause are autoimmune diseases known as vasculitis. Here the body's own immune system is directed against components of the vessel walls and fights them. Inflammation results in the veins, but also in the arteries.

Find out all about the topic here: The phlebitis.

The symptoms

Phlebitis manifests itself through the classic signs of inflammation: redness, swelling, overheating, pain and impaired function.

The redness and swelling can usually be seen well in comparison to the other foot. In addition, the inflamed vein can protrude. It usually feels hardened and is tender on pressure. The overheating of the inflamed area can be felt by placing one hand on this area and the other hand on the other foot and checking whether there is a temperature difference.

The pain is the leading symptom of phlebitis. The pain can already appear at rest and worsens with exertion. The swelling and pain also restrict the movement of the foot / ankle. For this reason, the affected patients are reluctant to move.

In the worst case, an ulcer (ulcus cruris) can develop, which can no longer heal properly due to the congestion of blood and the lack of oxygen supply and has to be treated surgically.

Read more about the topic here: Symptoms of phlebitis.

The pain as a symptom

As mentioned earlier, pain is the leading symptom of phlebitis. As a result of the inflammatory reaction, various messenger substances are released, which lead to a sensitization of the nerve fibers. Stimuli that are normally found uncomfortable can be so painful. In addition, the swelling leads to tension in the skin, which can exacerbate the pain.

The nature of the pain can vary from patient to patient. Usually the pain is described as burning and drawing-stabbing.

The diagnosis

The diagnosis is made through a medical history, physical exam, imaging, and blood count.

When taking the anamnesis, the attending physician asks about the symptoms and the beginning of the symptoms. During the physical examination, one looks at the foot and sees whether there is any swelling or reddening. In addition, one can feel whether a warming can be felt. An ultrasound image can show the blood congestion and, if present, the thrombosis. The blood test can confirm a thrombosis or possibly indicate the presence of an autoimmune disease. In this case, an extended diagnosis would be necessary.

The treatment

Treatment is based on the underlying cause and can vary accordingly.

If there is inflammation of the superficial veins due to a thrombosis, the thrombosis should be eliminated. The body can usually do this on its own. Medicines can be administered to help prevent blood clotting. These should prevent the development of another thrombosis. In rare cases, thrombolysis, i.e. dissolution of the thrombus, may be necessary

The therapy of phlebitis, which arises in the context of chronic venous insufficiency, is often difficult. The problem here is not the inflammation but the poor blood circulation in the feet and the insufficient supply of the cells with oxygen. In order to promote blood circulation, you should regularly do sports (running, hiking, cycling). We also recommend wearing compression stockings. Furthermore, leaky small vessels can be destroyed. This reduces the leakage of fluid from the vessel into the tissue. Both the back pressure and the inflammatory reaction can be reduced in this way.

The therapy for autoimmune diseases is based on an inhibition of the immune system so that the body's own cells are less destroyed. For this purpose, drugs such as cortisone or other immunosuppressants are administered. In recent years, special antibody therapies have appeared that specifically target the immune system and dampen the toxic effects.

General therapeutic measures to reduce pain and swelling are cooling and raising the legs / feet.

Further information on this topic can be found at: Treatment of phlebitis.

The home remedies

Local cold treatments reduce pain and lessen swelling. For this you can use cooling pads or quark compresses. To use a quark wrap, you use chilled quark and spread it on a cloth and then place it on the affected area. In addition to the cooling effect, quark also has an anti-inflammatory effect.

You can also use horse chestnut extract or butcher's broom as a natural remedy. They can lessen the swelling and reduce the feeling of heaviness in the legs.

Learn more about: Home remedies for phlebitis.

The duration

Acute phlebitis affects the superficial veins and usually heals after a few days. However, the superficial inflammation can spread to the deeper veins. For this reason, one should keep an eye on the disease and consult a doctor if the symptoms worsen.

Inflammation of the deep-lying veins is usually caused by chronic venous insufficiency. There is no real cure for this condition, but it can be stopped by exercising regularly and increasing blood flow to the feet.

An autoimmune disease cannot be cured either. If a relapse occurs that worsens the symptoms, you should consult a doctor who will adjust the medication.

Find out more about the Duration of a phlebitis