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. This condition usually resolves on its own without further complications. However, when phlebitis occurs in a deep vein, a condition called deep vein thrombosis (DVT), a clot could dislodge from the vein and lodge in the lungs. This is a life-threatening condition.
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 harder to diagnose. It can occur without any symptoms until the clot reaches the lungs. However, in about half of the 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.
Risk factors for any type of phlebitis include recent surgery or childbirth, varicose veins, inactivity, or sitting for long periods (such as on a long airplane ride). Prolonged placement of intravenous catheters can also cause phlebitis, possibly requiring antibiotic treatment.
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.
Deep vein thrombosis requires more aggressive treatment, including hospitalization, strong anticoagulants, and a variety of possible surgical procedures.
There are no well-established natural treatments for phlebitis. There is some evidence, however, that certain natural treatments might help prevent DVTs.
Note: Because phlebitis is a potentially life-threatening disorder, you should seek a doctor's advice before attempting any natural treatments. The presence of DVTs constitutes a medical emergency and requires immediate medical care.Oligomeric Proanthocyanidins
It is thought, though not proven, that the immobility endured during a long plane flight increases risk of potentially dangerous blood clots in the legs, DVTs.6 Travellers at high risk are often recommended to take aspirin to "thin" their blood prior to flying. Oligomeric proanthocyanidins (OPCs), a derivative of pine bark or grape seed, may have a similar effect.7
Because of this, a large double-blind, placebo-controlled study was performed to evaluate whether OPCs from pine bark could help reduce risk of blood clots on long airplane flights.8 The study followed 198 people thought to be at high risk for blood clots. Some participants were given 200 mg of OPCs 2-3 hours prior to the flight, 200 mg six hours later, and 100 mg the next day; others received placebo at the same schedule. The average flight length was about 8 hours. The results indicated that use of OPCs significantly reduced risk of blood clots. There were five cases of DVTs or superficial thrombosis in the placebo group, as compared to none in the OPC group, a difference that was statistically significant.
Another substantial double-blind study (204 participants) suggests preventative benefit in high-risk patients given Flite Tabs, a product that contains pycnogenol (an OPC) combined with nattokinase.9 Nattokinase, also known as natto, is an extract of fermented soy thought to have some blood clot dissolving properties. However, the incidence of DVTs was not reported.
For more information, including dosage and safety issues, see the full OPC article.Other Treatments
Vitamin E, when taken in high doses, is thought to have a blood-thinning effect. One study found a bit of evidence that regular use of vitamin E at a dose of 600 IU daily may help prevent deep venous thrombosis.11
Bromelain is an enzyme found in the stems of pineapple. Because it has anti-inflammatory properties and may be able to prevent blood platelet aggregation, it has been suggested as a treatment for phlebitis.1,2,3 However, there is no good evidence as yet supporting this use.
Mesoglycan is a type of substance found in the tissues of the body, including blood vessels. It is closely related to the anticoagulant drug heparin. Preliminary evidence suggests that mesoglycan might be helpful in treating phlebitis,4 although not all studies agree.5
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 there is as yet no real evidence that it works.
Homocysteine is a substance that occurs naturally in the body. It has been suggested that when homocysteine levels are too high, risk of such cardiovascular diseases as heart attack, stroke, and DVT are increased. However, in a very large study, reduction of homocysteine through the use of folate and vitamins B12 and B6 failed to reduce risk of DVT.10
1. Seligman B. Bromelain: an anti-inflammatory agent. Angiology. 1962;13:508-510.
2. Seligman B. Oral bromelains as adjuncts in the treatment of acute thrombophlebitis. Angiology. 1969;20:22-26.
3. Taussig SJ, Yokoyama MM, Chinen A, et al. Bromelain: a proteolytic enzyme and its clinical application. A review. Hiroshima J Med Sci. 1975;24:185-193.
4. Scondotto G, De Fabritiis A, Guastarobba A, et al. The use of a minor fibrinolytic drug (Mesoglycan) in phlebopathies [in Italian; English abstract]. Minerva Med. 1984;75:1733-1738.
5. Prandoni P, Cattelan AM, Carta M. Long-term sequelae of deep venous thrombosis of the legs. Experience with mesoglycan [in Italian; English abstract]. Ann Ital Med Int. 1989;4:378-385.
6. ten Wolde M, Kraaijenhagen RA, et al. Travel and the risk of symptomatic venous thromboembolism. Thromb Haemost. 2003;89:499-505.
7. Putter M, Grotemeyer KH, Wurthwein G, et al. Inhibition of smoking-induced platelet aggregation by aspirin and pycnogenol. Thromb Res. 1999;95:155-161.
8. Belcaro G, Cesarone MR, Rohdewald P, et al. Prevention of venous thrombosis and thrombophlebitis in long-haul flights with Pycnogenol. Clin Appl Thromb Hemost. 2004;10:373-7.
9. Cesarone MR, Belcaro G, Nicolaides AN, et al. Prevention of venous thrombosis in long-haul flights with Flite Tabs: the LONFLIT-FLITE randomized, controlled trial. Angiology. 2003;54:531-539.
10. Ray JG, Kearon C, Yi Q, et al. Homocysteine-lowering therapy and risk for venous thromboembolism. Ann Intern Med. 2007;146:761-767.
11. Glynn RJ, Ridker PM, Goldhaber SZ, et al. Effects of random allocation to vitamin E supplementation on the occurrence of venous thromboembolism. Report from the Women's Health Study. Circulation. 2007 Sep 10. [Epub ahead of print]
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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