Superficial Thrombophlebitis vs Chronic Venous Insufficiency: What’s the Difference?

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Rahul Sood

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Vein diseases can get scary, especially if you don’t know what you’re dealing with. Both superficial thrombophlebitis and chronic venous insufficiency (CVI) may cause pain, but differ in many aspects. These two are among the most common vein-related conditions across adults, although many still get confused about their differences.

So what sets superficial thrombophlebitis and CVI from each other? Superficial thrombophlebitis happens when a blood clot forms under the skin, causing pain in the arms and legs. On the other hand, CVI occurs when leg circulation becomes restricted due to a malfunction in the veins.

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Superficial Thrombophlebitis

Superficial thrombophlebitis is a venous disease that happens when blood clots block circulation in a vein. The condition may cause pain and swelling in the legs, depending on the location and severity of the clots.

How It Happens

Superficial thrombophlebitis begins when a blood clot forms. Clots happen for a variety of reasons, including long periods of bed rest and sitting. People who recovered from major surgery are at higher risk. Those who already have varicose veins are also prone to Superficial Thrombophlebitis because of blood pooling. 

While superficial thrombophlebitis isn’t life-threatening, it may be painful and uncomfortable for the patient. The pain can negatively impact daily tasks and functioning, such as walking. The condition may also make it more difficult to have a healthy sleep cycle because of the discomfort. 


Medical procedures are necessary to treat superficial thrombophlebitis. Many treatment plans are non-invasive, which means you’ll be having no surgical scars and less recovery time. Some of the most obvious symptoms of the condition include:

  • Redness and swelling 
  • Pain
  • Leg pain
  • Warmth or coldness in the leg

These symptoms shouldn’t be ignored, and it’s best to see a doctor right away. They will prescribe you the right medication and treatment to address the problem in the superficial veins. More severe symptoms, such as coughing up blood or breathlessness, require an immediate visit to the emergency room.

How It’s Diagnosed

A doctor’s consultation will begin with taking down your medical history. Questions about prior illnesses and treatments will help give your doctor an idea of the possible diagnosis. A physical exam might follow, depending on the initial assessment. Blood tests and other procedures may also help determine if you have superficial thrombophlebitis. 

Doctors may order a duplex ultrasound for some patients. This imaging procedure primarily uses sound waves to show a picture of the legs, making it easier to find the area which has blood clots. Some doctors also order blood tests to look for D-dimer, a protein produced by the body when it breaks down clots.  

In severe cases, doctors may order a CT scan to check if a clot moved to other areas of the body, like the lungs. These more severe cases will need more urgent medical intervention.

Chronic Venous Insufficiency

Chronic venous insufficiency (CVI) happens when blood circulation in the veins doesn’t work normally. Instead of flowing towards the heart, blood flows backward. The pooled blood may turn into large clots. If not resolved as soon as possible, CVI may lead to complications like ulcers and deep vein thrombosis (DVT).

How It Works

Superficial veins work by returning blood back to the heart. The blood flows upward from the leg veins through muscle contractions. The veins only have one-way valves to prevent the blood from flowing back. When a person has CVI, their valves malfunction, causing blood to pool in the veins. 

Valve malfunction is more common in older people, due to the weakening of the blood vessels. Most older people also experience a decrease in physical activity. Prolonged sitting or standing may also hasten valve damage, which can then lead to CVI. 


CVI symptoms become more obvious as the disease progresses. Patients with a history of cardiovascular diseases should routinely go on check-ups with their doctors to check for possible signs of CVI. The earlier the diagnosis, the easier the treatment will be.

Some of the most obvious symptoms include:

  • Swelling in the legs
  • Fatigue
  • Varicose veins
  • Flaky skin around the legs

If symptoms don’t resolve, CVI can lead to increased pressure and swelling. In the worst case, the capillaries could burst, leading to bruising and skin damage. The inflammation may even affect nearby organs, causing open sores on the skin. These sores, called venous stasis ulcers, are prone to infection. If not treated, the ulcers may lead to cellulitis.

Although not particularly fatal, varicose veins are commonly linked to CVI. These veins are most common around the legs. 

How It’s Diagnosed

Doctors typically diagnose CVI through a combination of tests. The first thing that doctors do is ask questions about a patient’s medical history. Information about prior illnesses and medical procedures will help assess if you’re at risk for CVI. A physical exam of the legs may also follow, to determine the location of any pain or swelling.

Some doctors also order other procedures, such as a vascular ultrasound. A handheld device passes through the patient’s skin to release sound waves over the vein. The sound waves work to produce an image of the blood vessel. The doctor will use the result to determine the next course of action. 

If you have CVI, the doctor will work with you to discuss your treatment options.

Vein Center Doctor: Effective Outpatient Treatment Methods for Your Vein Problems

Injection to spider veins in leg

While some people seek out vein treatment for aesthetic reasons, pressing issues like superficial thrombophlebitis and chronic venous insufficiency need fast action. Not only do these conditions cause pain and discomfort, but they can also lead to more damage to the body. 

Vein Center Doctor offers 4 different outpatient methods to resolve your vein problems fast and hassle-free. These are:

  • ScleroTherapy
  • VenaSeal
  • Venous Compression Therapy
  • RFA For Varicose Veins

The team at Vein Center Doctor will help you work on a treatment plan fitting for your condition. 


Sclerotherapy is one of the most popular treatment options for vein conditions. It involves a suspension directly injected into the damaged vein, sealing off the malfunctioning blood vessel. The blood then flows into the other veins, restoring healthy blood circulation in the area. The sealed-off vein slowly deteriorates before the body absorbs it.

The procedure helps patients who suffer from both varicose and spider veins, which are risk factors for both superficial thrombophlebitis and CVI. Sclerotherapy acts as a solution to pain caused by damaged blood vessels. Although the legs are the most common area for varicose and spider veins, people may also experience them in other body parts. Some doctors also use this treatment method on the face. 

Vein Center Doctor offers Sclerotherapy to patients experiencing vein issues. The team has conducted thousands of procedures to treat varicose and spider veins, easing the pain and discomfort of many patients.

Patients with obesity, hormone issues, and leg injuries are typical candidates for Sclerotherapy. Some people may experience an allergic reaction to the treatment. Skin irritation typically resolves on its own within a few days. Brown spots may also appear on the treatment area, although they disappear in 3 to 6 months.  


Another minimally invasive procedure used to treat vein conditions is VenaSeal. This method involves the use of a catheter to shut off the damaged vein. The catheter contains a special adhesive designed to cut off blood flow in the area. VenaSeal works best for patients who experience symptoms such as swelling, pain, itchiness, and heaviness in the legs. Patients with spider and varicose veins will also experience relief from the procedure.

Before the procedure, the doctor will place a local anesthetic to numb the area. The doctor will then create a small incision, which will serve as the entry point for a small catheter. The adhesive will pass through the catheter to shut off the vein. Overall, the entire procedure is minimally invasive and recovery time is typically very short. 

Patients may feel minimal discomfort during the operation. The anesthetic helps ease this for most people, and patients can return to their daily routines right away. After the treatment, relief may be felt right away. 

People with multiple damaged veins may need more VenaSeal sessions, depending on the decision of the doctor. Some patients are eligible to have multiple treatments in one leg at the same time, provided that they do not have any conflicting medical issues. After treatment, bruising and skin irritation may occur in the treatment area. These typically go away after a few days.

If you experience inflammation in the area after a week, contact your doctor right away. 

Venous Compression Therapy

Venous compression therapy is a form of treatment that aims to improve blood circulation in the legs. People with spider and varicose veins, CVI, and other similar conditions may find relief after undergoing this procedure. The process happens with the use of compression garments or bandages. Some doctors may also use compression boots or air pumps.

These instruments pad the body to add external pressure onto the affected area. The pressure encourages healthier blood circulation, restoring the veins’ appearance and functioning. This form of therapy should be used in tandem with other treatment methods for maximum effectivity.

When paired with other treatments, venous compression therapy improves circulation and speeds up the recovery time for other procedures. The compression garments help the body absorb scar tissue at a faster rate, allowing patients to feel better after a couple of weeks. 

Skin irritation and slight discomfort are the most common side effects of venous compression therapy. In most cases, these only persist for a couple of days.

RFA for Varicose Veins

Radiofrequency ablation (RFA) is a new form of treatment that uses electricity and ultrasound waves to seal off damaged veins. Like the other methods, RFA is minimally invasive and patients won’t feel much pain during the procedure. Ultrasound waves are used to guide the doctor in the procedure.

Patients will receive a local anesthetic via injection. A catheter goes inside the damaged vein to release more numbing agents. The catheter then releases heat to close off the vein entirely. People who undergo RFA will feel relief after a couple of days. Varicose and spider veins may take some time to disappear, depending on the number and level of visibility.

After an RFA procedure, patients can go back to their daily routines almost immediately. Some light bruising may happen, although this resolves within 1 to 2 weeks. 

Get Your Vein Conditions Treated at Vein Center Doctor

At Vein Center Doctor, our team prioritizes the safety and comfort of patients. We offer different treatment plans to help you recover from your vein diseases without hassle. Besides cosmetic procedures, our treatment packages also resolve conditions like superficial thrombophlebitis, CVI, and varicose veins. 

Through consultations, we can help you decide on the right path to take for your relief and recovery. Contact us today to discuss your next steps in vein treatment

Your First Step To Being Vein Pain Free

Find exactly what you need to get rid of your vein-related problems. Dr. Sood and the rest of our team at Vein Center Doctor are ready to help: schedule your free consultation today.

Rahul Sood


About Rahul Sood

Dr. Rahul Sood is a triple board-certified physician who specializes in cosmetic vein treatment, namely spider veins and varicose veins, as well as any accompanying issues related to venous insufficiency such as leg pain. He has carried out over 10,000 leg procedures during 10-plus year career and is highly regarded throughout Westchester County and New Jersey.

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