Patient information · Urgent care
DVT and a swollen calf
why this is a same-day problem
A deep vein thrombosis is a blood clot in a deep vein, usually in the leg. It matters because part of it can break off and travel to the lungs, which is life-threatening and can happen without warning. A painful swollen calf needs assessing the same day, not next week.
Call 999 if you have
- sudden breathlessness, or breathlessness that is worsening
- sharp chest pain that is worse when you breathe in
- coughing up blood
- a fast heart rate with light-headedness or collapse
- these symptoms alongside a swollen or painful leg
These suggest a pulmonary embolism — a clot that has travelled to the lung. It is a medical emergency and needs an ambulance, not a taxi. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
What a DVT looks like
- Swelling of one leg, usually the calf, developing over hours to days
- Pain or a dragging ache, often worse on standing or walking
- The leg feeling warm, and the skin looking red or discoloured — which can be subtle or absent on darker skin
- Veins near the surface appearing more prominent
- Tightness or fullness rather than sharp pain
Both legs swelling equally is much less likely to be a clot and usually has a different cause. It is the asymmetry that matters.
Do not massage or rub the leg
If you suspect a clot, do not massage the calf, use a foam roller, or have any kind of deep tissue treatment on it. Keep the leg still and get assessed. Also do not simply start aspirin and wait — it is not adequate treatment for a DVT.
Who is at higher risk
Situations
- Recent surgery, particularly hip, knee or abdominal
- Long periods of immobility — illness, a plaster cast, hospital admission
- Long-haul flights or journeys over four hours
- Pregnancy and the six weeks after giving birth
- Significant leg injury
Personal factors
- Previous DVT or clot on the lung, or a family history
- Cancer and its treatment
- Combined hormonal contraception and HRT
- Being significantly overweight, and smoking
- Age over 60, and inherited clotting conditions
How it is diagnosed
Assessment involves a scoring system based on your history and examination, usually a D-dimer blood test, and an ultrasound scan of the leg veins. A negative D-dimer in someone at low risk reliably excludes a clot; a positive one is not diagnostic on its own and needs the scan. Both can be done here on the same day.
Other causes of a swollen painful calf include a muscle tear, a ruptured Baker's cyst, cellulitis, and a superficial vein inflammation. They are distinguished by examination and scanning, not by guesswork.
Treatment
- Anticoagulation — blood-thinning treatment — usually with a tablet, typically for at least three months, sometimes longer depending on the cause.
- Keep walking. Modern advice is to stay active rather than rest; movement helps the leg and does not dislodge the clot once treatment has started.
- Elevate the leg when sitting, and consider compression stockings if advised.
- While anticoagulated, be alert for unusual bleeding and tell any dentist, surgeon or pharmacist that you are on it.
- Some clots need investigation for an underlying cause, particularly if there was no obvious trigger.
Preventing clots on long journeys
- Walk around every hour or two where you can.
- Flex your ankles and calves regularly while seated.
- Stay hydrated and go easy on alcohol.
- Wear flight socks if you have risk factors — they should be properly fitted, not simply tight.
- Speak to us before travelling if you have had a previous clot, recent surgery, or are pregnant.
Book an appointment today if you have a swollen, painful calf, particularly after surgery, a flight, immobility or with any of the risk factors above. We offer D-dimer testing and leg vein ultrasound on site and can start treatment the same day — but if you are breathless or have chest pain, call 999 instead.
Same-day D-dimer and leg ultrasound
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.