Pain in arm blood vessels

The swelling and pain in the blood vessels in the arms is consistent with the symptoms of superficial phlebitis, but it is difficult to determine whether it is caused by this disease based solely on the pain. The best way is to first have a comprehensive understanding of superficial phlebitis, especially the symptoms of the disease, and then make a comprehensive judgment based on other characteristics of the disease, so as to reach a final conclusion. Next, let’s take a look at the situation of superficial phlebitis.

Clinical manifestations

Ischemia phase:

The main symptom is vasospasm. Symptoms include insufficient blood supply to the affected limb's arteries, resulting in cold extremities, fear of cold, and intermittent claudication. A small number of patients may have migratory superficial phlebitis. The pulsation of the posterior tibial artery and dorsalis pedis artery of the affected limb was significantly weakened; the skin temperature was lower than normal; the Buerger sign was positive; and the filling time of the dorsalis pedis vein was prolonged.

Nutritional disorders:

During this period, in addition to the continued worsening of vasospasm, there is also obvious thickening of the blood vessel walls and thrombosis, resting pain often occurs, and toenails grow slowly, become thickened and deformed, the skin becomes dry, thin and pale, hair loss and muscles atrophy are all present. Muscle twitching is common, especially at night. The pulsation of the posterior tibial artery and dorsalis pedis artery of the affected limb disappeared; Buerger's sign was positive; and the filling time of the dorsalis pedis vein was further prolonged.

Gangrenous stage:

The arteries of the affected limb are completely occluded, and dry gangrene occurs in the distal part of the limb. The skin becomes dark red or dark brown and gradually spreads upward, forming ulcers that do not heal for a long time. If the lesion continues to progress, gangrene may occur on one or more toes, which may turn into wet gangrene after secondary infection. During this stage, patients experience severe pain and often cannot sleep all night. Bending the knees and hugging the feet is a typical posture for this stage.

Clinical diagnosis

The first stage of local ischemia: numbness, coolness, and fear of cold in the affected limb, with mild intermittent claudication, which can be relieved after a short rest. Examination revealed that the skin temperature of the affected limb was slightly lower and the color was paler, the pulsation of the dorsalis pedis or posterior tibial artery was weakened, and migratory superficial phlebitis may occur repeatedly. The causes of ischemia are more functional (spasm) than organic (occlusion).

The second stage of nutritional disorders : the above symptoms become increasingly severe, the distance of intermittent claudication becomes shorter and shorter, until persistent resting pain occurs, which is more severe at night. The skin temperature of the affected limb drops significantly, becomes noticeably pale, or purple spots appear. Dry skin, no sweat, thickened and deformed toenails, calf muscle atrophy, and disappearance of dorsalis pedis artery and/or posterior tibial artery pulsation. At this stage, arterial lesions are mainly organic changes, and the limbs rely on collateral circulation to remain alive. During the lumbar sympathetic nerve block test, the skin temperature may still rise, but it will not reach the normal level.

The third stage is necrosis: the symptoms continue to worsen, and the tips of the toes (fingers) of the affected limbs turn black, shrunken, gangrenous, and ulcers form. The pain is severe and persistent, forcing the patient to sit with his knees bent and his feet touched day and night, or to lower his limbs to relieve the pain, and the limbs are accompanied by obvious swelling. The patient cannot sleep due to the pain and becomes emaciated and anemic. If secondary infection occurs, dry gangrene will turn into wet gangrene, and symptoms of systemic toxemia such as high fever and irritability will appear. In the third stage, the artery is completely blocked, the blood provided by the collateral circulation is insufficient to compensate for the necessary blood supply, and the necrotic extremity cannot survive.