DVT & Pulmonary Embolism: Travel Advice

A deep vein thrombosis (DVT) is a blood clot that forms in one of the deep veins of the body, most often in the calf or thigh. If part of that clot breaks away, it can travel through the bloodstream to the lungs and block a blood vessel there, causing a pulmonary embolism (PE). A large PE is life-threatening, which is why DVT is taken seriously even though it often starts with mild symptoms. Long-distance travel is linked to a small increase in risk because sitting still for many hours slows the flow of blood in the leg veins, allowing clots to form more easily. This is sometimes called 'travellers' thrombosis' or, informally, 'economy class syndrome', although it is the length of time spent immobile rather than the class of seat that matters. The risk applies to any prolonged journey — flights, long coach or train trips and long car drives — typically those lasting around four hours or more.

For most fit, healthy travellers the extra risk from a long journey is very small, and serious clots are uncommon. However, some people carry a higher baseline risk and should take prevention more seriously. Risk factors add up, so anyone with several of them — or who is unsure — benefits from advice before travelling. The most important factors include a previous DVT or PE or a family history of clots, recent major surgery (especially hip or knee operations) or a serious injury such as a leg fracture, active cancer or recent cancer treatment, and known clotting (thrombophilia) disorders. Pregnancy and the weeks after giving birth, the combined contraceptive pill and hormone replacement therapy (HRT), being significantly overweight, being over about 60, and reduced mobility all add to the risk. People who are very tall or very short may find standard seating encourages awkward, cramped positions. If any of these apply to you, it is worth discussing your trip before you book.

The single most effective thing most travellers can do is to keep the blood moving in their legs. Where it is safe and the seatbelt sign is off, get up and walk along the aisle every hour or two; on a long drive, stop regularly to stretch your legs. When you cannot move around, keep your lower legs active in your seat by flexing and circling your ankles, raising your heels and toes, and tensing your calf muscles — a few minutes of these exercises each hour makes a worthwhile difference. Drink water regularly to stay well hydrated, and go easy on alcohol and caffeine, which can leave you more dehydrated and more likely to sleep heavily in a cramped position for hours without moving. Avoid taking sleeping tablets purely to get through a flight, as they keep you immobile for long stretches. Wear loose, comfortable clothing and try not to sit with your legs crossed for long periods.

Graduated compression stockings — often sold as 'flight socks' — apply gentle, firm pressure that is greatest at the ankle and eases higher up the leg, helping blood return to the heart and reducing pooling in the lower legs. Good evidence shows that correctly fitted compression stockings reduce the risk of DVT on long-haul flights, and they can also ease leg swelling. They are especially worth considering for travellers at higher risk. Fit matters: stockings that are the wrong size, rolled down or bunched can be ineffective or even harmful, so they should be measured and fitted properly, and people with certain circulation problems should check suitability first. Compression stockings are a supplement to movement and hydration, not a replacement for them. They do not remove the need to keep your legs active throughout the journey.

Most travellers do not need any medication to prevent travel-related clots, and routine aspirin is not generally recommended for this purpose. For a small number of people at high risk — for example those with a recent clot, recent major surgery or certain medical conditions — a doctor may consider a prescribed blood-thinning (anticoagulant) injection or other measures for a specific journey, but this is an individual clinical decision that should be made with your GP or specialist, not something to start by yourself. If you already take an anticoagulant, continue it as prescribed and seek advice well before you travel about timing, supplies and what to do across time zones. Never start or stop a blood thinner, or take aspirin to prevent a clot, without professional advice. If you are unsure where you stand, a pre-travel assessment can help clarify whether any extra measures are appropriate for you.

Symptoms of a travel-related clot can appear during a journey but more often develop in the hours, days or even up to a few weeks afterwards, so stay alert after you arrive home. The signs of a DVT usually affect one leg and include pain, tenderness or cramping (often in the calf), swelling, warmth, and redness or discolouration of the skin. A pulmonary embolism is a medical emergency: warning signs include sudden breathlessness, sharp chest pain that may be worse when breathing in, a rapid heartbeat, feeling faint or collapsing, and coughing up blood. If you have symptoms suggesting a DVT, contact a doctor or NHS 111 urgently for advice. If you have any symptoms of a PE, call 999 or go to the nearest emergency department immediately — do not wait to see whether it settles. After returning to the Crewe, Nantwich, Sandbach, Alsager or Stoke-on-Trent area, you can also speak to our team, but anything pointing to a PE always needs emergency care first.

A little planning before a long-haul trip from Cheshire or Staffordshire makes prevention easy to follow. Choose comfortable, loose clothing for the journey, pack a water bottle to refill once through security, and pre-position your compression stockings near the top of your bag so you can put them on before you sit for hours. If you have any of the higher-risk factors, arrange a pre-travel review well in advance so there is time to organise correctly fitted stockings or, where genuinely needed, to involve your GP. Travel-related clot prevention also sits alongside the wider pre-travel checklist — vaccinations, antimalarial tablets where relevant, and general health advice for your destination. Crewe Travel Clinic, the travel health service at Crewe Pharmacy & Travel Vaccination Centre, supports travellers across Crewe, Nantwich and Stoke-on-Trent and the surrounding Cheshire area with practical advice on reducing DVT risk as part of a complete pre-travel consultation.