Certain factors can lead to deep vein thrombosis (DVT) -- a blood clot in a deep vein. These factors are injury to the inside of a vein, disorders that raise your risk of clotting, and lack of body movement. Around 5.5 million people -- 2.3% of the U.S. adult population -- use a wheelchair. If you’re one of these people, most of your time is spent in a sitting position, and your risk of DVT is higher than someone who can stand and move.
Normal leg movements contract your leg muscles, which helps send blood from the lower part of your body up to the heart quickly. Without it, your blood flow slows. It may start to pool and become sludge, which leads to clotting.
How Is Sitting in a Wheelchair Different?
When you sit for long periods -- like on a long flight or at your desk during work hours -- you raise your risk for DVT. But if you’re able to move your legs or get up, you naturally move from time to time. You may get up for a bathroom break or to walk to the printer. Or you might just fidget as you sit.
Wheelchair sitting is different. Even if your wheelchair use is temporary due to an injury, you’re likely sitting for much more of the day without breaks than you were before. And if your wheelchair use is permanent because your legs are paralyzed (you can’t move them), your risk goes even higher.
In a small study of people with multiple sclerosis who must use a wheelchair, 43.9% developed DVT. A look at multiple studies on people with spinal cord injuries shows that 40% get DVT when they aren’t on preventative treatment for it.
What Are the Signs of Wheelchair-Related DVT?
Some of the symptoms of DVT may be more difficult to catch if you can’t use your legs. The most common ones include:
- Swelling in the affected leg (this will look different than mild swelling caused by sitting)
- Pain or tenderness in the affected leg (if you don’t have feeling in your legs, you won’t notice this symptom)
- Warm skin where the blood clot is
- Red or discolored skin
- Visible surface veins
Leg fatigue, or tired legs, is another symptom that’s difficult or impossible to feel if you have limited use of your legs. Call your doctor ASAP if you have any of these.
How Do I Stop DVT?
Manage your weight. Carrying extra pounds adds to the pressure in your veins in your pelvic area and legs and raises your chance of DVT.
Move how and when you can. All movement helps, even if someone else has to move your legs for you. Try to stretch or exercise your limbs at regular intervals. Simple exercises are enough: Move your feet (or have someone else move them) in a circle or up and down 10 times an hour to improve circulation.
Address other risk factors.Smoking ups your DVT risk. If you smoke, quit. Check on your blood pressure -- high blood pressure can double your risk. Your doctor can help you with methods to help lower your numbers.
Take a blood thinner. Also known as anticoagulants, you can take them to lower the chance of clots forming in your blood if your doctor approves.
Wear compression hose. These are elastic stockings that fit tightly around your legs. They help keep blood flowing toward your heart by putting consistent pressure on your legs.
Use a sequential compression device or intermittent pneumatic compression. These cuffs go around your legs and fill with air to squeeze your legs at intervals and keep blood moving.
What Do I Do if I Get DVT?
If your doctor diagnoses you with DVT, you’ll need treatment to help keep the clot from getting bigger or moving to another location. Options include:
Blood thinners. These medications don’t break up blood clots, but they keep the clots you have from getting bigger. You may already be taking them to help with DVT. You take them by mouth or by a shot under your skin for 3 months or longer after a DVT.
Clot busters (thrombolytics). If you have a more serious type of DVT, or if other medications aren't working, your doctor may prescribe these drugs. You take them by IV or through a tube called a catheter so they go directly into the clot. Clot busters come with serious risk of bleeding, so doctors typically only use them for severe blood clots.
Filters. If you have a condition that prevents you from using a blood thinner, your doctor might use a vena cava filter. Your vena cava is a large vein that carries blood from your lower half back to your heart. A vena cava filter goes into the vein in your abdomen area and prevents any clots that break loose from traveling to your lungs.