Venous pain

What is deep vein thrombosis?

Deep vein thrombosis (DVT) is a serious condition that occurs when a blood clot forms in a vein located deep inside your body. A blood clot is a clump of blood that is in a gelatinous, solid state. Deep vein blood clots typically form in your thigh or lower leg, but they can also develop in other areas of your body. Other names associated with this condition include thromboembolism, post-thrombotic syndrome, and post-phlebitic syndrome.

RISK FACTORS

Who is at risk for deep vein thrombosis?

DVT occurs most commonly in people who are over 50 years in age. Certain conditions that alter how your blood moves through your veins can raise your risk of developing clots. These include:

  • having an injury that damages your veins such as a bone fracture

  • being overweight, which puts more pressure on the veins in your legs and pelvis

  • having a family history of DVT

  • having a catheter placed in a vein

  • taking birth control pills or undergoing hormone therapy.

  • smoking (especially heavily)

  • staying seated for a long time while you’re in a car or on a plane, especially if you already have at least one other risk factor

Some diseases and disorders can increase your risk of having blood clots. These include hereditary blood clotting disorders, especially when you have at least one other risk factor.Cancer and inflammatory bowel disease can also increase the risk of developing a blood clot.Heart fallure, a condition that makes it more difficult for your heart to pump blood, also occurs with an increased risk of clots.

Surgery

DVT is a major risk associated with surgery. This is especially true if you’re having a surgery in the lower extremities, such as joint replacement surgery. Your doctor will discuss the risk of DVT if you need joint replacement surgery.

Pregnancy

Being pregnant increases your risk of DVT. Increased hormone levels, and a slower blood flow as your uterus expands and restricts blood flowing back from your lower extremities, contribute to this risk. This elevated risk continues until about six weeks after giving birth. Being on bed rest or having a cesarean delivery also increases your risk of having DVT.

SYMPTOMS
What are the symptoms of deep vein thrombosis?

According to the National Heart,Lung and Blood Institute symptoms of DVT only occur in about half of the people who have this condition. Common symptoms include:

  • swelling in your foot, ankle, or leg, usually on one side
  • cramping pain in your affected leg that usually begins in your calf
  • severe, unexplained pain in your foot and ankle
  • an area of skin that feels warmer than the skin on the surrounding areas
  • skin over the affected area turning pale or a reddish or bluish color

People may not find out that they have deep vein thrombosis until they’ve gone through emergency treatment for a pulmonary embolism. A pulmonary embolism is a life-threatening complication of DVT in which an artery in the lung becomes blocked.

 

 

SEE A DOCTOR
When to see a doctor

When should you see a doctor if you’re concerned about deep vein thrombosis?

DVT is a serious medical condition. You should call your doctor right away if you think you’re experiencing symptoms of DVT, or go to the closest emergency room. A healthcare provider can check out your symptoms, review your medical history, and then let you know the best course of action.

If you don’t think you have DVT but are concerned that you may be at risk, you can schedule a regular appointment with your doctor. Your physician can let you know if preventive treatment may be an option for you.

 
TREATMENT
What are the treatment options for deep vein thrombosis?

DVT treatments focus on keeping the clot from growing. In addition, treatment will attempt to prevent a pulmonary embolism and lower your risk of having more clots.

Medication

Your doctor might prescribe medications that thin your blood, such as heparin,warfarin, enoxaparin, or fondaparinux. This makes it harder for your blood to clot. It also keeps existing clots as small as possible and decreases the chance that you’ll develop more clots.

If blood thinners don’t work or if you have a severe case of DVT, your doctor might use thrombolytic drugs Thrombolytic drugs work by breaking up clots. You’ll receive these intravenously.

Compression stockings

Wearing compression stockings can prevent swelling and may lower your chance of developing clots. They don’t demonstrate a reduction in recurrent DVT.

Compression stockings reach just below your knee or right above it. Your doctor may recommend you wear these every day.

Filters

You might need to have a filter put inside the large abdominal vein called the vena cava if you aren’t able to take blood thinners. This form of treatment helps prevent pulmonary embolisms by stopping clots from entering your lungs.

However, there is a risk to filters being placed. If left long term, they can actually cause DVT. They should be used short term until the risk of thromboembolism is reduced and anticoagulation can be used.

 
COMPLICATIONS
What are the complications associated with deep vein thrombosis?

A major complication of DVT is a pulmonary embolism. You can develop a pulmonary embolism if a blood clot moves to your lungs and blocks a blood vessel. This can cause serious damage to your lungs and other parts of your body. You should get immediate medical help if you have signs of a pulmonary embolism. These signs include:

  • dizziness
  • sweating
  • chest pain that gets worse with coughing or inhaling deeply
  • rapid breathing
  • coughing in blood
  • rapid heart rate
 

PREVENTION

How do I prevent deep vein thrombosis?

You can lower your risk of having DVT by making a few lifestyle changes. These include keeping your blood pressure under control, giving up smoking  and  losing weight if you’re overweight.

Moving your legs around when you’ve been sitting for a while also helps keep your blood flowing. Walking around after being on bed rest can prevent clots from forming.

Take any blood thinners your doctor prescribes if you’re having surgery, as this can lower your chance of developing clots afterward.

Your risk of developing DVT during travel is low, but it becomes higher if you’re sitting for more than four hours at a time while driving or flying. You can lower risk by moving around every so often — get out of your car and move around at intervals during long drives. Walk in the aisles if you’re flying, taking a train, or riding a bus. Stretch your legs and feet while you’re sitting — this keeps your blood moving steadily in your calves. Don’t wear tight clothes that can restrict blood flow.

 

 

What causes vein pain?

Vein pain can result from a variety of causes, ranging from mild to severe. Commonly, vein pain in the legs occurs due to poor circulation, varicose veins, or cellulitis, a common bacterial skin disease. Vein pain in other parts of the body can be related to the outside temperature or muscle strain. In severe cases, vein pain can result from thrombophlebitis (vein swelling due to a blood clot) or a thromboembolism (a potentially life-threatening blood inflammation and clot in the veins).

Circulatory system causes of vein pain

Vein pain may be caused by problems with blood circulation including:

  • Chronic venous insufficiency (poor blood flow through the veins)

  • Thrombophlebitis (inflammation, swelling and clotting of the veins)

  • Varicose veins

Other causes of vein pain

Vein pain can also arise from:

  • Cellulitis (common bacterial skin infection)

  • Muscle aches

Serious or life-threatening causes of vein pain

In some cases, vein pain may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting, such as deep vein thrombosis (a blood clot in a leg vein that can break loose and cause a pulmonary embolism in the lung or a heart attack or stroke).

Questions for diagnosing the cause of vein pain

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your vein pain including:

  • Are you at risk of developing blood clots?

  • Do you have any other symptoms, such as enlarged or visible veins?

  • How long has your pain persisted?

  • What medications are you taking?

  • When did you first notice your vein pain?

  • Where do you feel your vein pain?

What are the potential complications of vein pain?

While in most cases vein pain is mild and arises from poor circulation, it can indicate a more serious condition, such as a blood clot. Potential complications of severe conditions leading to vein pain include:

  • Adverse effects of treatment

  • Chronic venous insufficiency

  • Deep vein thrombosis (blood clot in the leg that can break loose from the leg and cause a pulmonary embolism in the lung, a heart attack, or stroke)

  • Postphlebitic syndrome

  • Progression of symptoms

  • Myocardial infarction (heart attack)

  • Stroke