How to Avoid Getting Deep Vein Thrombosis (DVT)

Medically reviewed by Thomas Wright, MD

Last Updated: May 6, 2021 References

Deep vein thrombosis, or DVT, is a medical condition in which blood clots (thrombi) form in deep veins, usually of the calf, thigh or pelvis.^{[1]
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Research source} Your body can break down and resolve most mild-to-moderate clots with time and a healthier lifestyle. However, there's always a risk that a DVT can completely block or occlude a vein, which can lead to fragments of the thrombus breaking off and occluding blood vessels in the lungs, pulmonary arteries, or arteries connecting to the brain. This invariably leads to serious damage or death. If you are at risk for DVT, taking precautions and seeking helpful therapy is highly recommended.

Part 1

Part 1 of 3:

Eliminating the Risk Factors

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Lose some weight, especially if you're obese. The risk of DVT is much greater if you are overweight or obese.^{[2]
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Research source} The additional weight makes it more difficult to circulate blood around the body, particularly back to the heart from the feet and legs. Consequently, the increase in blood pressure tends to damage blood vessels and promote the formation of plaques and clots. Losing weight makes it easier on your heart and blood vessels, thus reducing the risks of DVT and atherosclerosis.
- Lose weight by increasing cardiovascular exercise (such as walking) and decreasing your caloric consumption.
- Reducing your calorie intake by 500 calories daily will result in about 4 pounds of fat tissue loss per month.
2
Stop smoking. The risk of DVT is also greater if you are a chronic cigarette smoker.^{[3]
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Trustworthy Source

Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} Various compounds and additives in cigarettes negatively affect blood clotting, blood vessels and circulation in general — essentially by making your blood thicker and hypercoagulating — which increases your risk of DVT and other vascular diseases.^{[4]
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Research source} Try to stop smoking gradually (with the help of nicotine patches), cold turkey and/or with the help of suggestive subliminal tapes or hypnotherapy.
- When a blood clot breaks loose within a vein and begins moving through the bloodstream, it becomes an embolism, which can get stuck in the vessels supplying the lung or heart. This can lead to instant death in some cases. Only a fraction (10-15%) of people with a pulmonary embolism die from it shortly thereafter.
- Approximately 2,000,000 Americans experience a DVT each year and smoking is a significant causative factor.^{[5]
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3
Be more physically active. Being sedentary for long periods of time is a risk factor for DVT, so increase your cardiovascular exercise by walking, jogging, cycling or swimming.^{[6]
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Trustworthy Source

National Heart, Lung, and Blood Institute
Research and education center within the National Institutes of Health

Go to source} Your calf muscles can act like a secondary heart in a sense, helping to pump the blood in the leg veins back up to your actual heart, but only if they are contracting from some type of exercise on a fairly regular basis.
- If you're seated while working or flying on a plane and can't exercise properly for hours at a time, then at least move your legs and feet around periodically while you're seated.
- Being immobile with a cast on a broken leg is especially risky for DVT, so try to frequently wiggle your toes while your leg is kept elevated.
- The most common signs and symptoms of DVT include: swelling, redness and pain in the calf or lower leg (especially along the path of a vein), difficulty weight bearing (especially running), and skin that feels warm or hot to touch.^{[7]
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- Symptoms may be subtle. Half of patients with DVT have no symptoms when diagnosed.^{[8]
  X
  Trustworthy Source
  
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  
  Go to source}
4
Wear compression stockings. Compression stockings provide support to muscles and blood vessels of the lower leg, which reduces edema / swelling, as well as the risk of DVT. Compression stockings are particularly important for people who have venous insufficiency (leaky vein valves) or varicose veins.^{[9]
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Trustworthy Source

Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source} The stockings should reach to your knee or higher, but may or may not have closed toes. They are found online, at medical supply stores and sometimes at pharmacies or physiotherapist offices.
- Purchase class 1 stockings, which exert the lightest pressure, unless your doctor recommends class 2 or 3 compression stockings.
- Use graduated compression stockings during times of high risk such as car, bus and plane travel. Graduated compression stockings, sometimes sold as "elastic flight socks," are tighter at your ankle than your thigh, which increases the speed of blood flow.
5
Drink more uncaffeinated fluids. Keeping well hydrated impacts your blood volume and "thins" it out somewhat, which can reduce your risk of DVT. As such, drink plenty of purified water and fresh fruit juices, especially if you live in a hot and/or dry climate.^{[10]
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Research source} Avoid caffeine-rich liquids such as coffee, black tea, soda pop and energy drinks because caffeine is a diuretic, which stimulates excessive urination and tends to dehydrate your body with time.
- During the summer months, try to drink a gallon of water on a daily basis.
- Remember that most fresh fruit and veggies are great sources of water also.
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Part 2

Part 2 of 3:

Seeking Alternative Therapies

1
Get a leg massage. Get a massage therapist or sympathetic friend to give you a calf and thigh muscle massage as a preventative measure for DVT. Massage reduces muscle tension and promotes better blood and lymph fluid circulation.^{[11]
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Trustworthy Source

Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} Start rubbing from the lower calf and progress up to the thigh so you help the venous blood return back to the heart. Begin with a 30-minute massage and go from there. Allow the therapist (or friend) to go as deep as you can tolerate without wincing.
- Always drink lots of water immediately following a massage in order to flush out inflammatory by-products and lactic acid from your body. Failure to do so might cause a headache or mild nausea.
- If you have an acute, symptomatic DVT (swollen and tender), then a deep tissue massage might be contraindicated, so talk with your doctor.
2
Try acupuncture treatments. Acupuncture involves sticking very thin needles into specific energy points within the skin / muscle in efforts to reduce pain and inflammation, and promote better circulation.^{[12]
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Trustworthy Source

Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} Acupuncture for reducing the risks of circulatory issues in the leg may be effective, although it's not commonly recommended by medical doctors. Based on the principles of traditional Chinese medicine, acupuncture works by releasing a variety of substances including endorphins and serotonin, which act to reduce discomfort.
- Acupuncture points that may help your leg symptoms are not all located near in your leg — some can be in distant parts of the body.
- Acupuncture is practiced by a variety of health professionals including some physicians, chiropractors, naturopaths, physical therapists and massage therapists — whoever you choose should be certified by NCCAOM.
3
Consider vibration therapy. An interesting alternative option for potentially reducing the risk of circulatory problems developing in the legs is vibration therapy. By placing your feet on or in a vibrational device, multiple small contractions occur deep within the calf and thigh muscles, which help to push the blood through all the small veins. Vibrating frequencies also seem to relax and strengthen musculature while stimulating nerves to reduce pain.
- Full-body vibrating machines are difficult to find in rehabilitation facilities and likely too expensive to buy for home use, so consider smaller machines that vibrate just your feet and/or lower legs.
- A hand-held vibrating massage device is another option that may work well to stimulate the muscles of your leg.
- If you have an acute, symptomatic DVT, then vibrational therapy might be contraindicated, so talk with your doctor before you experiment.
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Part 3

Part 3 of 3:

Seeking Medical Attention

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See your family physician. Despite efforts to avoid a DVT, if your leg (especially your calf) becomes swollen, red and tender to touch and it doesn't resolve itself within a few days, then make an appointment with your doctor. Your doctor will examine your leg and foot and ask questions about your family history, diet and recent travel routine. If female, your doctor might also ask if you're pregnant, recently gave birth, taking birth control pills or undergoing hormone replacement therapy because higher levels of estrogen can easily precipitate blood clotting.
- The birth control pill is riskiest during the first year of use, although modern formulas tend to be much safer than their predecessors several decades ago.
- Your doctor may prescribe a blood thinner (anticoagulant) such as heparin if he/she suspects a DVT. Blood thinners decrease your blood's ability to clot, although they don't break up existing blood clots^{[13]
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  Trustworthy Source
  
  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source}
- Your family doctor is not a circulatory specialist, so you may need a referral to another doctor with more specialized training.
2
Get a referral to a specialist. A circulatory specialist or vascular surgeon is trained to distinguish between all the potential vascular issues that can occur in the leg and elsewhere. There are a number of serious conditions that cause leg swelling and pain including diabetic neuropathy, venous insufficiency (leaky vein valves of the lower leg), chronic compartment syndrome (swelling of the lower leg muscles), popliteal artery entrapment, bacterial infections and cellulitis.^{[14]
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Research source}
- Your specialist may use a diagnostic ultrasound to try to see clots in the upper leg, or a venography (x-ray with injected dye) to test for clots in the lower leg. Ultrasounds are compared over time to see if a clot has grown or reduced.
- The specialist may also conduct a D-dimer blood test to detect if a clot exists. D-dimer is a chemical that is produced when a clot gradually dissolves.
3
Talk to your doctor about more powerful medications. If a DVT is detected, then your doctor may decide to give you stronger, more powerful drugs to stop the clot's progression and then to ultimately dissolve it. After starting heparin injections, you might be given other injectable blood thinners (such as enoxaparin) or pills such as warfarin (Coumadin).^{[15]
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Trustworthy Source

Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} If you have a serious, high-risk DVT, your doctor may give you a thrombolytic-type drug via an intravenous line, which can quickly dissolve a clot.
- You may be prescribed a new oral medication that has been recently approved by the FDA that does not require blood monitoring, such as dabigatran, rivaroxaban, or apixaban. ^{[16]
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  Trustworthy Source
  
  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source}
- Commonly used thrombolytic agents for DVT include streptokinase, urokinase and recombinant tissue-type plasminogen activator (r-tPA).^{[17]
  X
  Trustworthy Source
  
  PubMed Central
  Journal archive from the U.S. National Institutes of Health
  
  Go to source}
- Thrombolytics can trigger serious internal bleeding and are traditionally used on DVT that are considered life-threatening, although these drugs have evolved considerably in recent years, prompting discussion as to whether they should be used on all types of DVT.^{[18]
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- If you cannot take blood thinners, your doctor may have a small filter surgically placed in a vein in your abdomen, preventing clots from moving to areas where they could cause harm.^{[19]
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- If you're in the hospital, a mechanical device for compressing your feet or legs may be used for a few days. These are especially useful in conjunction with blood thinners.^{[20]
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Tips

Early treatment greatly reduces the risk of complications such as pulmonary embolism.

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Don't sit or stand in the one place for too long. Move around often, especially if you're desk bound while at work.

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Propping your feet up above the rest of your body (against a wall or on some pillows) will help decrease the swelling caused by standing at work.

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Warnings

If you have had hip or knee replacement within the last three months, long journeys are not recommended even with medication.

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Genetics play a role. You may be at higher risk if a family member has had an occurrence of DVT in the past, or another blood clot event such as a pulmonary embolism.

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