Low molecular weight heparin (LMWH) and non-steroidal anti-inflammatory drugs (NSAIDs) are the best treatment for superficial thrombophlebitis (ST)

Clinical question: 
What is the best treatment for superficial thrombophlebitis (ST) of the leg?
Bottom line: 
Both LMWH and NSAIDs reduce the incidence of the extension or recurrence of ST by about 70% compared to placebo (NNT=14). Topical treatments relieve local symptoms but the trials do not report on progression to venous thromboembolism (VT). Surgical treatment and wearing elastic stockings are associated with a lower rate of VT and progression to thrombophlebitis compared with elastic stockings alone.
Caveat: 
While the available data are too limited to make clear recommendations, an intermediate dose of LMWH for at least a month might be advisable. Adverse effects of treatment were not discussed.
Context: 
ST is a relatively common problem, and may be associated with VT. Predisposing factors for ST and VT are similar, and include varicose veins, immobilisation of the legs, the period after surgery, trauma, pregnancy and the period immediately following childbirth, active malignancies, use of the oral contraceptive or hormone replacement therapy and obesity.
Review CD#: 
CD004982
PEARLS No: 
19
Date: 
March, 2007
Authored by: 
Brian R McAvoy