Raised Veins and Discomfort After Injection: What to Do?

The veins on the back of the hand are prominently protruding, accompanied by a sensation of foreign body presence?

Hello Dr.
Lee, I referred to the response in #62631.
I had knee surgery a month ago (hospitalized for one day), and an injection was administered in my hand.
Before discharge, the injection site was flushed, and a week after discharge, the bruising on my hand dissipated (with no soreness).
About three weeks post-surgery, I suddenly experienced soreness in my hand.
Initially, I thought it was due to using crutches or the injection.
Upon closer observation over the past two days, I noticed that the veins (from the knuckles to the wrist, where the injection was given) are slightly raised, and pressing on them causes soreness.
It feels like there is a foreign object moving within the vein, and sometimes it swells into two points (not merging into a single point).
Could this be phlebitis or another condition? Is there a way to manage this at home to see if it improves? Which department should I visit at the hospital? Thank you for your response.

Cris, 30~39 year old female. Ask Date: 2024/01/04

Dr. Li Han reply Cardiology

Hello, it may be superficial venous thrombophlebitis.
You may want to consult your trusted family physician to see if a referral is necessary.
The Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2024/01/04

More Info

It sounds like you're experiencing some discomfort and changes in your hand after the intravenous injection during your knee surgery. Based on your description, it is possible that you may be dealing with a condition known as phlebitis, which is inflammation of a vein. This can occur after an intravenous (IV) injection or catheter placement, especially if the vein was irritated or if there was some trauma during the procedure.

Understanding Your Symptoms
1. Pain and Tenderness: The pain you are experiencing, especially when pressing on the area, suggests that the vein may be inflamed. Phlebitis can cause localized pain, tenderness, and sometimes swelling along the vein.

2. Visible Changes: The appearance of the vein, such as it being slightly raised or swollen, can also indicate inflammation. If you notice that the area feels warm to the touch or if there is redness, these are additional signs of phlebitis.

3. Movement of a "Foreign Body": The sensation of something moving within the vein could be related to a clot or a reaction to the IV catheter. It’s essential to monitor this closely, as it could lead to more serious complications if not addressed.

Recommended Actions
1. Observation: Keep an eye on the symptoms. If the pain persists or worsens, or if you develop additional symptoms such as fever, increased swelling, or redness, it is crucial to seek medical attention promptly.

2. Home Care: You can try some home remedies to alleviate discomfort:
- Warm Compress: Applying a warm compress to the affected area can help reduce pain and inflammation.

- Elevation: Keeping your hand elevated can help reduce swelling.

- Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation.

3. Avoid Strain: Try to avoid activities that put strain on your hand or arm, especially those that may aggravate the area where the IV was placed.

When to Seek Medical Attention
If your symptoms do not improve with home care or if you experience any of the following, you should contact a healthcare provider:
- Increased pain or swelling
- Development of a fever
- Redness or warmth spreading from the injection site
- Any signs of a blood clot, such as sudden swelling, pain, or discoloration in the arm or hand

Which Specialist to See
For your symptoms, it would be appropriate to consult with a vascular surgeon or a general practitioner. They can evaluate your condition and determine if further treatment is necessary, such as ultrasound imaging to rule out a clot or other vascular issues.

Conclusion
While it is common to experience some discomfort after an IV injection, persistent or worsening symptoms should not be ignored. Monitoring your symptoms and seeking appropriate medical advice will help ensure that any potential complications are addressed promptly. If you have any concerns about your symptoms or if they change, do not hesitate to reach out to a healthcare professional for further evaluation.

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