DVT Prevention
Lowering your risk of leg blood clots, especially in the first 8 weeks.
What is it?
DVT (deep vein thrombosis) is a blood clot in a deep vein, usually in your legs. After a spinal cord injury, your risk is high — paralyzed muscles do not pump blood back from the legs the way working muscles do. Without prevention, a large fraction of acute SCI patients develop a clot in the first weeks.
The clot itself is dangerous because a piece can break off and travel to your lungs. That is a pulmonary embolism (PE) — a medical emergency that can cause sudden death.
When the risk is highest
- Weeks 1–8 after injury: highest risk.
- Weeks 8–12: still elevated.
- After 3 months: much lower for most people. Long-term risk depends on activity level, body habitus, and other medical conditions.
How you might feel
DVT signs:
- Calf or thigh that is warm, swollen, red, or tender
- One leg larger than the other
- A sense of fullness or aching in one leg
PE signs (medical emergency):
- Sudden chest pain or pressure
- Trouble breathing
- Fast heart rate
- Coughing up blood
- Lightheadedness or fainting
In someone with normal sensation, DVT often hurts. After SCI, you may not feel pain — you have to look.
How to prevent it
- Anticoagulant medication for 8–12 weeks after injury (longer if you cannot mobilize). Your doctor chooses based on your risk and other meds.
- Mechanical compression in the acute phase — sequential compression devices (SCDs) and graded compression stockings.
- Mobilize early. Once cleared, get out of bed and into a wheelchair every day. Even passive ROM helps.
- Hydration. Steady fluid intake.
💊 Standard anticoagulant options
- Enoxaparin (Lovenox) 40 mg subcutaneously once daily — most common in early rehab.
- DOACs (apixaban 2.5–5 mg twice daily, rivaroxaban 10 mg daily) — a pill option growing in use.
- Warfarin is older and still works but requires regular INR checks.
🚨 Call 911 right now if you have
- Sudden chest pain or trouble breathing.
- Coughing up blood.
- Fainting or near-fainting with chest pain.
A pulmonary embolism is treatable — but minutes matter.
📞 Call your doctor today if you notice
- One leg suddenly bigger or warmer than the other.
- New, persistent calf or thigh ache that has no obvious cause.
- Redness in a stripe pattern along a vein.
Long-term
Once you are past the high-risk window, lifestyle keeps risk low:
- Stay active. Wheelchair propulsion, handcycling, swimming all count.
- Wear compression on long flights.
- Stop smoking — it doubles your clot risk.
- If you have a history of DVT, talk to your team about extended anticoagulation.
At your next clinic visit
Bring questions about: when can I stop the anticoagulant, do I need a baseline duplex ultrasound, and what about long-haul flights or surgery in the future.
Education only. Not medical advice. If you have a clinical question, talk to your rehab team. For emergencies call 911.