How To Prevent Blood Clots In The Legs

You have probably heard someone mention pulmonary embolism or thrombosis, or even the plain old blood clot, and you are wondering what any of these things mean. Well, you are in the right place. 

Blood clots in the legs can be prevented simply by ensuring that your legs are not in one position for too long. You may want to try including exercise in your daily routine, even if it is just for your legs. That will go a long way in preventing clots from forming. 

Blood clots are a familiar phenomenon to your doctors or health practitioners, although they can be scary but having information sometimes makes things less scary. We will be exploring blood clots and deep vein thrombosis further. 

About blood clots

You already know that blood is essentially the vehicle that moves nutrients and minerals through the body; as such, blood is present everywhere in the body. Blood moves through the body in blood vessels i.e., the veins and arteries, which are present in every part of your body. The fluid nature of bloodies what makes it easy for itto move easily through the blood vessels. However, sometimes blood clots develop, which can make blood flow a lot more difficult. Blood clots are gel-like blood collections that form in your veins or arteries when blood changes from liquid to partially solid. Of course, when this happens, it becomes more difficult for the clotted blood to move around. Clotting is a normal function that prevents excessive bleeding when you are injured. Sometimes, blood clots can occur in blood vessels where there is no prior injury and just as they form, they sometimes dissolve on their own. Blood clots that form in specific areas and do not dissolve on their own, on the other hand, can be dangerous to your health.¹ Once formed, these clots can be found traveling to other parts of the body, where they can cause harm.²

Causes, symptoms and treatment

Blood clots can occur in any of the blood vessels in the body, especially the parts where the vessels are larger as in your arms, pelvis, lower legs, and thighs. They are more commonly found in the thigh and lower leg regions. Sometimes, if they are located deep in the tissues,  these types of clots are referred to as deep vein thrombosis (DVT, see below). Thrombosis is the term used to describe clots in any blood vessel. When blood clots move away from the place where they are originally formed, to blood vessels in other parts of the body, they are referred to as embolisms. These embolisms can get stuck in blood vessels carrying blood and nutrients to the lungs, brain or heart, and when this happens, it can be fatal. ³ A very common example of this is the pulmonary embolism, which is a blood clot, i.e., an embolism that was formed in a blood vessel elsewhere in the body but has migrated to the lungs. 

Thromboses are classified as either deep vein or superficial, depending on how far away from the skin they are. A thrombosis is referred to as superficial, when it occurs close to the surface of the skin, making the affected area look visibly swollen and red.⁴ DVT, as the name implies, refers to blood clots that are located deeper within the tissues and farther away from the skin. They can occur unexpectedly, resulting in an urgent or emergency situation. It can also be a chronic condition in which blood clots cause circulation problems, usually in the lower body. Chronic blood clots can cause venous insufficiency, which is when your body has trouble returning blood to your heart.

In the United States, one to three out of every 1,000 adults develops a DVT or pulmonary embolism (PE), and up to 300,000 people die as a result of DVT or PE each year. In the United Kingdom, DVT affects approximately 1 in 1,000 people each year.  After heart attacks and strokes, it is the third most common vascular disease. 

Causes of blood clot in the legs

Injury to the vein: Veins can be damaged during surgery or an injury to an arm or leg, by the injection of irritants, by inflammation, or by certain disorders such as thromboangiitis obliterans. They may also be injured by a clot, increasing the likelihood of the formation of a second clot.^9,10

Increased blood clotting tendency: Some diseases, such as cancer and certain inherited blood clotting disorders, cause blood to clot when it should not. Some medications, such as oral contraceptives, estrogen therapy, or estrogen-like drugs (such as tamoxifen and raloxifene), can cause blood to clot more easily. Cigarette smoking is also a risk factor. After childbirth or surgery, blood clots more easily. Dehydration can lead to blood clots  in older people, which can contribute to DVT.^9,10

Slower rate of blood flow: Blood flow slows during prolonged bed rest and other times when the legs are not moving normally (for example, after a leg injury or a stroke) because the person is lying down and the calf muscles are not contracting and squeezing the blood toward the heart. DVT, for example, can occur in people who have had a heart attack or another serious disorder (such as heart failure, chronic obstructive pulmonary disease [COPD], or a stroke) and have remained in a hospital bed for several days without moving their legs sufficiently, or in people whose legs and lower body are paralyzed (paraplegics). DVT can occur following major surgery, especially pelvic, hip, or knee surgery. Even healthy people who sit for extended periods can develop thrombosis.^9,10

There also certain factors, which may not directly cause thrombosis but can increase the chances of developing DVT. These risk factors include: 

Age: as with many other health events and conditons, age is a predisposing factor for the development of DVT in the legs. The body typically begins to produce more proteins that aid blood coagulation or clotting, like fibrinogen, without a proportionate increase in the anticoagulant factors. What this means is that the body would find it easy to form blood clots but it would be more difficult for the blood clots to dissolve.^6,7

Family history of DVT: havinga family member who currently has or has had DVT increases the chances that you may develop DVT when you are older. There is some research, which shows that some people are carriers of genes that predispose them to developing DVT, and this can be inherited.⁸

Symptoms of blood clot in the legs

Many people who presently have or have had DVT report no symptoms at all. Chest pain or shortness of breath caused by pulmonary embolism may be the first sign of a blood clot in these people. If a deep leg vein is affected, sometimes, the calf may swell and become painful, tender to touch, and warm. Depending on which veins are involved, the ankle, foot, or thigh may also swell. Similarly, if a vein in the arm is involved, the arm may swell.¹⁰

Treatment for blood clot in the legs

In treating DVT, the main goal is usually to prevent pulmonary embolism, which is fatal in most cases. 

Although hospitalization may be required at first, advances in treatment have made it possible for most people with DVT to be treated at home. Except to help relieve symptoms, bed rest is unnecessary, so people are free to be as active as they want. Physical activity does not increase the likelihood of a blood clot breaking free and causing a pulmonary embolism.¹⁰

Treatment options could be either anticoagulant drugs, clot dissolving drugs, or in some cases, drugs that act as blood clot filters. 

Anticoagulant drugs 

These are basically blood thinners. They make it more difficult for blood to clot so they can dissolve the clots that have already been formed and stop them from getting bigger. They do not ‘thin’ the blood but they target the blood clotting agents and increase the time it takes for blood to clot. When used correctly, blood thinners can prevent blood clots, heart attacks, strokes, and other heart- and blood vessel-related complications.^1,6

Some common examples of anticoagulant drugs are warfarin, heparin, enoxaparin, dabigatrin, rivaroxaban, and apixaban. You can read more about then here. These drugs can have serious complications, which include excessive bleeding, when taken incorrectly. Hence, they should only be used under the instructions of your general practitioner or cardiologist.¹⁰

Clot dissolving drugs 

Intravenous drugs, such as alteplase, are only used on rare occasions by doctors to dissolve venous blood clots. These drugs (also known as thrombolytic, fibrinolytic, or clot-busting agents) can be given to a person with extensive blood clots if the clot has been present for less than 48 hours and the person does not have risk factors for excessive bleeding. This is becuse blood clots typically become more difficult to dissolve after 48 hours. While clot-dissolving medications are great, they also increase the risk of bleeding complications.^2,6,10

In patients with large clots in their upper legs, doctors may use clot-dissolving drugs with mechanical removal methods. In such cases, doctors may insert a small, flexible tube (catheter) into the blocked vein, remove as much of the clot as possible with an instrument, and administer the clot-dissolving drug through the catheter.

Blood clot filters 

As an alternative to anticoagulant drugs, place a filter (formerly known as an umbrella) is placed inside a large vein between the heart and the area affected by DVT, such as the inferior vena cava. This is a large vein that returns blood from the lower body to the heart. The filter has the ability to trap emboli, preventing them from reaching the lungs.

Filters, unlike anticoagulants, do not prevent new clots from forming. Filters are typically reserved for patients for whom anticoagulant therapy is either impossible or ineffective.

Prevent blood clot in the legs: Tips

• Get your legs moving as frequently as possible. If you have had surgery or are on bed rest, try to get moving as soon as it is safe to do so. Also try to sit without crossing your legs because this can obstruct blood flow
• If you travel often, take frequent breaks to stretch your legs while traveling. When flying, stand or walk every now and then. If you're traveling by car, take a walk every hour or so. If you are unable to walk, perform lower leg exercises. Raise and lower your heels while remaining on your toes. Then, while keeping your heels on the floor, raise your toes²
• Maintain a healthy weight. Obesity increases the risk of DVT. Exercise reduces the risk of blood clots. Aim for at least 30 minutes of moderate physical activity per day as a general goal. You may need to exercise more if you want to lose weight, maintain your weight loss, or meet specific fitness goals²

FAQs

Who is most at risk of blood clot in the legs?

Anyone can develop blood clots in the legs. However, it is more common with people over the age of 40, people who have been immobile for long periods like those who travel a lot or have just had surgery, people who are pregnant or recently delivered of a baby, and people who are overweight or obese. 

What should I do if I think I have blood clot in the legs?

The best thing would be to speak with your general practitioner or healthcare provider immediately. Blood clots, whether real or suspected, should not be taken for granted. 

Where is the most common place to have blood clots in the leg?

DVT in the legs usually occurs in the lower leg or thigh. If you notice any alteration in the way that your legs look or feel, maybe some redness, warmth, or swelling, you should have it checked out. 

When should you  see a doctor?

Once you observe anything out of the ordinary in your legs, do not wait until it gets worse. Your general practitioner would be in the best position to determine whether any change in your body should be ignored or not. So run, dont walk, to your doctor once you notice any unexplained symptoms. 

Summary

The blood is expected to clot because that is one of the factors that helps to prevent excessive loss of blood when there are external injuries. However, blood clots that occur internally, in your blood vessels can be dangerous. Blood clots, whether they remain in the place where they are formed or they migrate to other parts of the body, they are almost bound to cause harm. The good news is that doctors and scientists have found ways to get these unwanted visitors out of the body. Please check with your doctor if you think you may have a blood clot or be at risk of developing one.