Known collectively as post-thrombotic syndrome or post-phlebitic syndrome, symptoms can be painful and debilitating, according to the National Blood Clot Alliance.
Post-Thrombotic Syndrome Facts
Normally, small valves inside veins ensure that blood flows in the right direction and doesn’t leak backwards. When clots form in veins, however, these valves can be damaged and become leaky. Damaged valves allow fluid to pool in the arms and legs. Complicating matters, clots that do not heal completely can block blood flow from the veins back to the heart, says Jae Sung Cho, MD, division director of vascular surgery and endovascular therapy at Loyola University Medical Center in Maywood, Ill. “The residual blood clot impedes blood flow, and the valve function may be impaired,” he explains. This can lead to a number of symptoms. Post-thrombotic syndrome symptoms include:
Pain or achingLeg or arm swellingHeavinessCrampingRednessSkin discoloration or dark pigmentationBluish fingers or toesDry skin or eczemaVaricose veins
If a vein is completely blocked, smaller veins nearby may enlarge to help blood move past the blockage. If these smaller veins get large enough, symptoms are usually mild. However, for some people, the smaller veins that help blood bypass a blockage do not get big enough to drain all the blood that has pooled in the arms or legs. Then, symptoms worsen. Severe post-thrombotic syndrome can lead to sores or ulcers, which can be chronic and tough to treat. These sores affect 5 to 10 percent of people with the condition. Post-thrombotic syndrome is a lifelong condition. Symptoms may come and go over time. They also might not develop right away. Though it’s generally believed that the condition develops 5 to 10 years after DVT, a clinical review of post-thrombotic syndrome, published in the Journal of Thrombosis and Haemostasis in 2013, suggests that symptoms may plateau one to two years later. The researchers note that a third of those who develop severe post-thrombotic syndrome have symptoms that continue to worsen six years after their initial DVT diagnosis.
Easing Pain and Other Symptoms
When it comes to reducing complications associated with DVT, including post-thrombotic syndrome, prevention is key. “Anyone who has had a blood clot in the past needs to be cautious,” Dr. Cho says. “As we get older, we become more prone to develop blood clots. For those who already have a history, their risk is even higher, so they need to take more precautions. This may include taking blood-thinning medications, known as anticoagulants, for the rest of your life.” Aside from medication, if you experience swelling after DVT, it’s important to wear fitted compression stockings to improve blood flow throughout the day while you’re sitting or standing. Various types exist including above-the-knee stockings for swelling in the thigh, and sleeves (known as gauntlets), for arm swelling or pain. Your doctor can tell you what would be best for you. If compression stockings are not effective, your doctor may recommend that you use a device called a compression pump to improve blood flow. Other ways to ease symptoms of post-thrombotic syndrome include:
Elevating your arm or leg above your heart while lying down or sleepingLosing excess weightExercising to strengthen the muscles in your arms and legs
Swimming, in particular, can help, Cho says, because “the hydrostatic pressure of water helps reduce swelling in the limbs.” Certain over-the-counter and prescription medications can also help ease pain associated with post-thrombotic syndrome. But, if you’re taking a blood-thinning medication, you should not take drugs that contain aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, because NSAIDs increase bleeding risk. Pain-relieving medications that could be considered include acetaminophen, tramadol, and oxycodone.
