Introduction
A phlebitis in the foot or ankle describes an inflammatory reaction directed against the vascular wall of the veins. The inflammation leads to swelling and redness of the foot. Pain can also 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 therefore treated differently.
The causes
The causes of phlebitis in the foot or ankle are quite different and are treated by different medical disciplines. Inflammation of the deep-lying veins can be caused by varicose veins or damaged venous valves. The blood in the foot cannot be transported back properly and accumulates in the veins.
The vascular wall is thus severely strained and becomes inflamed over time. Since this process takes place over a long period of time, this clinical picture is also called chronic venous insufficiency. Another cause of phlebitis is cardiac insufficiency.
The diseased heart is no longer able to pump blood in sufficient quantities through the body. As a result, the blood accumulates in the legs or feet and causes the veins to dilate, putting strain on the vascular wall and also causing inflammation. In addition, an increased standing of blood can promote the development of thrombosis.
A thrombosis is a blood clot that leads to the closure of the affected vessel. The blood can no longer flow at this point and as a reaction to the thrombus a very painful inflammatory reaction is triggered. In addition, thrombosis is the most common cause of an inflammation of the superficial veins (thrombophlebitis).
Another cause is autoimmune diseases, the so-called vasculitis. Here, the body’s own immune system attacks and fights against components of the vascular walls. This results in inflammation of the veins, but also of the arteries.
The symptoms
An inflammation of the veins becomes noticeable through the classic signs of inflammation: Redness, swelling, overheating, pain and limited function. The redness and swelling can usually be easily recognized in comparison to the other foot. In addition, the inflamed vein may protrude.
It usually feels hardened and is painful under pressure. You can feel the overheating of the inflamed area by placing one hand on this area and the other hand on the other foot and see if there is a temperature difference. The pain is the leading symptom of phlebitis.
The pain can already occur at rest and gets worse under stress. The swelling and the pain also causes a restriction of 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 cannot heal properly due to the blood congestion and the lack of oxygen supply and must be treated surgically. As already mentioned, 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.
Irritations that are normally perceived as unpleasant can be so painful. In addition, the swelling leads to a tension of the skin, which can increase the existing pain. The character of the pain can vary from patient to patient. Mostly the pain is described as burning and pulling-piercing.
