Blood clot in the leg

A blood clot is because the blood lives and forms a blood clot in a blood vessel. It then becomes more difficult for the blood to pass. Blood clots in the bones that come off can accompany the blood and get stuck in the lungs. A plug that is detected and treated early is usually not dangerous. However, if it gets bigger, it can seriously hamper blood circulation.

Blood clots are most common in the legs and often begin in a blood vessel in one calf. It is very unusual for blood clots in both legs at the same time. A blood clot that loosens and gets stuck in the lungs can cause serious symptoms.

Symptoms of a blood clot in the leg

Here are some common symptoms:

  • One calf or leg swells and gets warmer. Sometimes redness or other discoloration also occurs.
  • The wad can be sore and tense if you squeeze it.
  • You may get aches in the leg, calf or in rare cases in the hollow foot, especially when walking and using the calf muscle.
  • Superficial blood vessels on the bone can be seen more clearly and can also feel sore.
  • The leg can feel heavy.

The inconvenience can sometimes be very mild, which is why it can be difficult to find that you have a plug.

When and where should I seek care?

If you think you have a blood clot in your leg, contact a health care center or an on-call clinic immediately. 

How can I reduce the risk of blood clots in my leg?

The risk of getting blood clots decreases if you stop smoking and lose weight if you have severe obesity.

To avoid blood clots in the legs, it is important that you use the calf muscles by moving as best as you can. When you do not use the calf muscles, there is worse blood flow in the bone and it can then swell. It applies whether you lie, sit or stand.

It’s good to walk. You can try to tread your feet, wiggle your toes and touch your legs several times each day if you are in bed. The contractions of the calf muscles compress the veins and help to move the blood towards the heart. Keeping the leg high can also facilitate the flow of blood.

When you have varicose veins, the blood circulates a little slower because the so-called flaps in the veins already work a little worse than usual. The flaps act as a kind of valve and more blood can be collected in the legs if they do not hold tightly. Because blood circulates more slowly, clots can form. Therefore, it is good if you avoid sitting still or standing for a long time.

It is also good if you use support socks that can prevent blood from accumulating in your legs. Support socks counteract blood clotting and leg swelling. Support socks are available for purchase at pharmacies or in stores that sell different types of assistive devices. The upper border of the sock should end two to three centimeters below the kneecap. Ask the store staff for advice on the size. 

You may need special socks to sit even harder if you have previously had a blood clot and still have swollen legs. Consult your doctor.

Good to touch the legs during air travel

It is good if you regularly move and step with your feet if you sit still for a long time, for example during a flight. Even better is to walk around the plane if you have the opportunity. You should also use support socks to prevent blood clots when sitting still for a long time, for example when traveling. 

In some cases, such as for a longer flight, you may receive a blood-thinning drug for preventive purposes if you have a known increased risk of getting blood clots. You will receive such a drug in the form of a syringe or tablet after consulting a doctor. There are blood-thinning tablets that work faster than warfarin and can replace syringes.

Medicines and special support socks prevent new plugs

Prior to major surgeries, it is common to receive drugs that prevent blood clots from forming during or after surgery. Treatment can begin as early as the evening before surgery and then continue for a few days. Sometimes you may need to take blood thinners for up to a month, for example after a cancer or hip surgery. 

You can also use special support socks after an operation. They should usually be used only during the days and reinforce the pumping effect that the calf muscles have when they contract. There are also so-called compression stockings. They are divided into different classes with different pressure and must be tested to fit as well as possible. You get compression socks at some hospitals, but they can also be bought in stores that sell different types of tools. Having your legs high is also good for counteracting blood clotting in the leg.

Investigations

Even if you have problems that are typical of a blood clot, it is difficult for the doctor to diagnose just by looking and feeling the bone. For the doctor to be completely safe, you need to go through one or more examinations.

It often starts with the doctor measuring the extent of the wad and comparing it with the other wad. Any differences in temperature are investigated and the doctor feels on the calf to assess if it is sore and tense.

Ultrasonography

You usually get an ultrasound examination . You do not need to prepare in any particular way and the investigation does not hurt. With the help of the examination, the doctor can immediately see if a blood clot has formed in a blood vessel. If you do not have a blood clot, the examination may show other causes of the leg being swollen.

Radiographic examination

It is unusual, but sometimes you get to undergo a type of x-ray examination called phlebography. It means that contrast agents are injected into a vein in the foot. Then X-rays are taken and the doctor can see how the contrast agent spreads up the veins. In the X-ray image, the contrast medium becomes white. Where the clot is located, the contrast agent cannot reach. Therefore, a dark area is visible in the blood vessel where the plug is located. It can hurt when the contrast agent is injected, but it goes over quickly. You will usually receive a reply to the survey within a few hours.

If the surveys do not provide a secure answer, you may return home, but if the inconvenience does not go over or worsen, you should return after a few days for a new survey.

Treatment for a blood clot in the leg

Blood clots in the deep veins must be treated by a doctor as soon as possible. The plug does not disappear by itself but can increase in size if left untreated. You cannot treat blood clots on your own or with alternative medicine. However, it is good if you move to help the body dissolve the blood clot.

Blood-thinning treatment to dissolve the plug

You are given blood-thinning medication which means that the blood is not delivered as easily as before if the doctor has found that you have a blood clot in your leg. The treatment prevents the plug from becoming larger and facilitates the body to dissolve the plug so that the blood vessel opens again. In addition, the risk of new plugs is reduced.

Treatment usually lasts for three to six months. You may need longer treatment if the blood clot is large if you have had a blood clot before or if your doctor considers the risk of new clots to be high.

Treatment with syringes or tablets

In case of a blood clot, you can get heparin syringes and tablets with the active substance warfarin. It has also become common with a new type of blood-thinning drug. They are taken as tablets and do not require regular blood tests.

The syringes and tablets contain substances that prevent blood from being delivered as easily as before. Sometimes you get the syringes in a hospital, but you usually learn how to take the syringes yourself at home, perhaps with the help of a relative. You can get help from a district nurse if needed.

Sometimes the doctor recommends that you continue with syringes only throughout the treatment period. This is especially true for increased bleeding risk and tumor diseases, or if you have difficulty eating or getting regular blood test checks.

Since the warfarin tablets do not start to work fully until after five to ten days, you need to take syringes during these days.

The effect of the tablets is controlled

The effect of warfarin tablets is checked regularly with blood samples. Initially, you may submit tests every week, but when the values ​​become more stable it may be sufficient if you submit tests every two to eight weeks. Contact your doctor straight away if the inconvenience does not decrease as this may mean that the treatment you are receiving is not sufficient or that you have any other illness affecting the treatment.

It is important that you eat a balanced diet when you are given medicines containing warfarin. Changed eating habits can affect the drug’s effect. Contact your nurse or doctor if you cannot eat due to, for example, any illness. It is also important that you tell us which other medicines and health food preparations you are using as they may affect warfarin treatment.

New blood-thinning tablets

There are newer blood-thinning tablets with active substances apixaban, dabigatran, edoxaban and rivaroxaban. The active substances are similar in the treatment of blood clots but have some practical differences. Dabigatran and edoxaban require heparin injections the first week while receiving apixaban and rivaroxaban at a higher dose at the beginning of treatment. Rivaroxaban and edoxaban are taken once a day while dabigatran and apixaban are taken twice a day. These newer drugs do not require regular blood tests as with warfarin. The doctor treating you will determine if you are suitable for using any of these tablets.

Sometimes you need to be cared for in hospitals

It is uncommon, but if the plug is large and you have severe symptoms, you may get the blood-thinning agent heparin which drips directly into the bloodstream. You will receive it instead of syringes for a few days at the beginning of treatment. You must be hospitalized if you get heparin. You will also be admitted if you have an increased risk of complications such as bleeding or if you have other illnesses. You may also need to lie in a hospital if your doctor finds you having difficulty managing the treatment yourself at home.

Advantages and disadvantages of both treatments

There are advantages and disadvantages to both tablets and syringes. Many people find it easier to swallow a tablet than to take a syringe. For example, when treating cancer at the same time, you may only need syringes. You will then not have the blood samples necessary to control the dosage of warfarin tablets. The newer tablets with blood thinners can sometimes be used if you have cancer with blood clots.

Other treatment may be needed

In order to reduce bone swelling if you have severe swelling, you can, in addition to the blood-thinning treatment, for a shorter period of time also get liquid drugs, called diuretics.

You often get painkillers with for example paracetamol if you are in pain. Paracetamol does not increase the risk of bleeding, but so does painkillers containing acetylsalicylic acid. Even painkillers and anti-inflammatory drugs with ibuprofen or diclofenac increase the risk of bleeding.

Before you are prescribed new medicines, you should tell all the doctors you see if you are using a blood-thinning drug. You should always tell you about any medicines or supplements that you use for those who are prescribing a blood-thinning drug.

You will also have a small washer around your neck which says what blood-thinning drug you are using. It is important for healthcare professionals to know that if you become ill or have an accident and cannot tell yourself.

It is very uncommon, but if the plug causes serious symptoms despite the treatment, you may need surgery.

Stocking as part of the treatment

In addition to treatment with drugs, you are often advised to use a special support stocking that prevents blood flowing back into the vein, thereby reducing bone swelling. You should put on the sock already in bed in the morning and not remove it until you go back to sleep. You can get help from the home service or the district nurse if you have a hard time wearing the sock and can’t get help from anyone at home. There are also aids that may be easier when wearing the sock. You should always discuss with your doctor what type of stocking is recommended and how long you should use it.

The socks are available in different sizes with different pressures and it is therefore important that you get the right size. It may feel a bit uncomfortable when you put on the sock in the beginning, but it should not hurt. Ask a nurse to make sure you are the right size if it hurts the calf when you have the sock on.

The doctor decides how long to use the sock. A year or more is not uncommon, especially if the leg is still swollen. It’s good if you move. Keep your leg in high position and bend and stretch alternately on the foot every now and then if you sit still for long moments.

The risk of bleeding increases

Because the blood-thinning treatment reduces the blood’s ability to cure, you can more easily get bleeding. For example, you can more easily get bleeding gums or start bleeding when you shave. You can also more easily get nosebleeds, blood in the urine or dark stools. The bleeding can in a few cases be life-threatening. If you experience bleeding or suddenly get severe headaches, contact your doctor immediately.

New plugs can be formed

The risk of having a new blood clot increases if you have had a blood clot once. This is especially true if you belong to one of the groups that is easier to get plugs. Therefore, it is important that you tell your doctor if you have had a blood clot before, for example, if you are going to have an operation.

A blood clot can also be a one-off phenomenon that never returns and that leaves no lasting inconvenience.

To reduce the risk of a further clot, be sure to continue with the blood-thinning drug according to your doctor’s instructions. It is important to use a support stocking from getting up in the morning until you go to bed at night if you have been prescribed to use one. You should also avoid having your legs completely still for extended periods.

Right to information

The healthcare staff should tell you what treatment options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. That way you can help decide which treatment is right for you.

In order for you to be active in your care and make decisions, it is important that you understand the information you receive. The healthcare staff is obliged to make sure that you do so. Ask questions. You can also ask to have the information written down so you can read it peacefully.

Complications and sequelae

It is rarely a blood clot in a vein that leads to stroke or myocardial infarction because the lungs’ network of small blood vessels, called capillaries, prevents the clot from passing through the lung. 

It is very uncommon for vein plugs to lead to a heart attack or heart failure. It can happen if you get large plugs or several small plugs that get stuck in the lungs or if you already have heart disease or lung disease, which makes the strain on the heart too great.

The flaps can be damaged and you can get leg wounds

The veins in the legs have a kind of valves, called flaps, which prevent the blood from flowing backward. The flaps prevent the pressure in the veins of the foot from getting too high when you stand up and blood will not collect so that the lower leg and foot swell.

If you have had a blood clot in the deep veins of the legs, the veins of the veins may have suffered a non-healing injury. Then the blood flows backward and more blood is collected in the leg. It may appear as swelling, darker skin, and a few years later you may in rare cases have severe leg ulcers , usually at the foot tuber on the inside of the foot. You can prevent this with support socks or compression socks.

Pregnancy and breastfeeding

There is a slightly increased risk of getting a blood clot if you are pregnant. This is because you have higher levels of the hormone estrogen in the blood and the blood circulates more slowly as the growing uterus presses the blood vessels.

You should not use warfarin when you are pregnant as the active substance in the drug affects the fetus and can cause birth defects. Also, you should not use new blood-thinning medicines when you are pregnant as it is unclear if they affect your pregnancy. Instead, you can take low-molecular-weight heparins throughout pregnancy and at least a few months after childbirth. 

What is the blood clot in the leg?

Often, there are several factors that together increase the risk of getting a blood clot. You can get a blood clot in the veins for many different reasons. Here are some examples:

  • After surgery in the stomach and pelvis, especially after tumor surgery.
  • After accidents, especially in bone fractures that require plaster and reduce mobility.
  • After hip and knee joints.
  • After lying down for several days without using the calf muscles regularly.
  • After sitting down, for example on long journeys
  • After pregnancy, childbirth and use of birth control pills.

During surgeries and accidents, many changes occur in the body which, among other things, make the blood easier to live than usual. In combination with being still and perhaps even after the surgery or injury, the risk of getting a blood clot increases.

The fact that you find it easier to get plugs in the veins after giving birth is mainly due to hormonal changes. If a blood vessel is damaged during childbirth, the risk of blood clots can also increase.

Some get plugs easier than others

You are at increased risk of getting a blood clot in the veins in the following cases:

  • If you have an infection.
  • If you are older than 65, but blood clots occur at all ages.
  • If you are pregnant.
  • If you are overweight.
  • If you are a smoker.
  • If you have cancer, especially during surgery or if you are treated with anti-cellulite drugs, so-called cytostatic drugs.
  • If you have unusually large number of blood cells.
  • If you are taking birth control pills or other medicines containing estrogen.
  • If you have disorders, sometimes hereditary, in the blood’s ability to live or dissolve clots.

Blood circulation in the legs becomes slower if you do not move and use the wounds. This makes blood clots easier to form.

What happens in the body?

When you get a blood clot, called a thrombosis, the blood lives and forms a clot inside a blood vessel, but does not dissolve again as it should. The plug makes it more difficult for the blood to pass through the blood vessel. Blood clots are most common in the legs and often begin in the calves. Plugs can sometimes also be formed elsewhere in the body, for example in the arms, but this is not at all common. Occasionally, clots that form in the legs or pelvis may come loose and accompany the blood and get stuck in one or both lungs.

Then a blood clot is formed

Occasionally, blood clots may begin to grow as more and more platelets get stuck in, for example, damage to a blood vessel. When other blood cells also get stuck in connection with the platelets, the clot becomes larger and the blood circulation through the vessel slows down. Eventually, the blood vessel can become completely clogged by the solidified blood.

Because blood flow from the bone is hindered by the blood clot, fluid from the blood is squeezed into the tissues around the vein, causing the lower leg or sometimes the entire leg to swell and hurt. The bone also hurts because the tissues lack oxygen when the blood flow is obstructed by the clot.

Blood clots are usually formed in the veins of the bone

There are two different types of blood vessels, veins, and arteries. The arteries direct the oxygenated blood from the heart into the body, while the veins return the oxygen-poor blood to the heart and lungs for oxygenation again. There are deep veins running in the muscles and superficial, which go superficially under the skin.

In the veins, the vast majority of blood clots form in the veins, a type of valve that prevents blood from flowing backward.

A blood clot, called thrombosis, is usually formed in the deep veins of the calf muscles. Such a blood clot is called deep vein thrombosis and is sometimes abbreviated DVT.

Other types of blood clots

Blood clots that have formed in the left part of the heart or in the arteries of the throat can also accompany the blood, but not through the veins. Instead, this type of blood clot follows the so-called arteries, that is, the blood vessels that carry the blood from the heart to the body.

They can cause strokes if they get stuck in the blood vessels of the brain or heart attacks if they get stuck in the small blood vessels that supply the heart muscle with oxygen-rich blood. They can also get stuck in arteries that go to the arms or legs, but they can never reach the lungs.

There is also thrombophlebitis, they are also called superficial blood clots. This means you have inflammation and sometimes even a plugin a superficial vein. It may feel like a small, tender redness just below the skin. Thrombophlebitis is inherently harmless, but can in some cases spread to the deep veins on the upper part of the thigh and increase the risk of blood clots there. It is more common for you to get thrombophlebitis if you have varicose veins as they occur in the same superficial blood vessels.

The plug can accompany the blood to the lungs

A deep vein plug that is detected and treated early is usually not dangerous and poses no lasting problems. However, a blood clot in the lower leg veins that is not treated and which grows larger, however, is more difficult to treat and can seriously impair blood circulation. A blood clot in a vein can be several inches long. Such a blood clot in the calf can increase in size and eventually reach the femoral and pelvic veins.

Blood clots that form in the veins of the legs or pelvis can loosen and accompany the blood and get stuck in one or both lungs. Sudden shortness of breath, coughing or holding on the side of the chest as you breathe may indicate that a blood clot followed with blood to the lungs and stuck. Read more about blood clots in the lung.

How common is a blood clot in the leg?

More than ten thousand people receive treatment every year for blood vessels in the veins. Blood clots are very uncommon in children, but usually, if you have cancer or are over 80 years old. Many times it is not possible to explain why an individual gets a blood clot. Once you have had a blood clot in your leg or lungs, you have an easier time getting it again. For example, it may be because you have a disease that makes it easier for you to get blood clots. You may also have remnants of a previous plug that obstructs blood flow or makes the vessel wall

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