What can I do to relieve the symptoms?

Photo of a couple riding bikes

Exercising and moving the calf muscles helps to pump the built-up blood out of the leg veins. It is also a good idea to put your legs up to take the strain off. Good skin care can relieve itching and protect the skin.

About 20 to 50% of all people develop post-thrombotic syndrome (PTS) after they have deep vein thrombosis (DVT). But it is not always possible to tell the symptoms of PTS apart from the symptoms of DVT at first. That is why a clear of post-thrombotic syndrome is only possible after a few months.

PTS symptoms can stay more or less the same, but may also become more or less severe. Medical advice is important if you have severe symptoms or develop new symptoms which don't go away again after about a day.

Various treatments can relieve the symptoms, and there's a lot you can do yourself. A good mixture of exercise, strengthening and taking the strain off the affected leg is a good idea. Good skin care helps with itching and protects against cracked skin.

How can I strengthen my calf muscles?

The calf muscles alternately push and pull on our veins every time we move our legs. That helps to pump blood out of the leg and back to the heart. Taking regular exercise and specifically training your calf muscles can support this natural “muscle pump.”

One study looked into whether people with PTS can relieve their symptoms by taking regular exercise. It suggested that a specific training program can relieve the symptoms and strengthen the muscles. The program included:

  • 60 to 120 minutes of moderate endurance sport per week
  • strengthening exercises for the lower leg and thigh muscles every two days
  • daily stretching exercises

Participants in the study had a free choice of the type of endurance sport, for instance 30 minutes of Nordic walking or jogging three times a week.

People who have never done endurance sport before and can't manage 30 minutes right away can start off doing 15 minutes each time and gradually build on that, or alternate between walking and jogging. Cycling and step aerobics are also suitable.

Doctors can also prescribe physical therapy with exercises to treat PTS symptoms. The aim of that is to put together your own personal exercise program.

Strengthening exercises for the calf muscles: Calf lifts

Stand up straight with your feet in line with your hips. Your toes should be pointing straight ahead or slightly outwards.

  • Lift the heels of both feet off the floor and shift your weight to the balls of your feet.
  • Then slowly lower your heels again.
  • 3 sets of 10 repetitions, with a minute’s break between each set.

It is a good idea to hold on to a stable chair, table or railing when doing these exercises in case you lose your balance. But make sure that the lifting force always comes from the calf muscles.

To make the exercises a little more strenuous, you can raise one foot completely from the floor and shift your bodyweight upwards with just one leg. You can also increase the number of repetitions per set. The exercises should feel strenuous but not cause pain.

Image: Calf lifts to strengthen the calf muscles

Strengthening exercises for the thigh muscles: Knee squats against the wall

In this exercise, you lean with your back flat and straight against a flat wall or door. Keep your feet in line with your hips about half a meter from the wall. Your kneecaps and feet should be parallel and be pointing forwards.

  • Cross your arms and slowly slide up and down the wall.
  • The aim is to slide your upper body so far down until your thighs and lower legs form a right angle. If you can't manage that yet, lower your body as far as you can in a controlled and safe way.
  • 3 sets of 10 repetitions, with a minute’s break between each set.

If you can't manage that many sets or repetitions at first, try doing fewer repetitions or do not go quite so far down when doing the squats. Later you can increase the number of repetitions per set.

It is important that your feet can grip well when doing the exercises.

Image: Knee squats against the wall to strengthen the thigh muscles

How can I take the strain off my veins?

It is best to avoid standing up for long periods of time if at all possible, because that can cause blood to build up in the legs. You can take the strain off the leg veins when sitting down by putting your feet up. And it’s not a good idea to cross your legs when sitting down.

People with severe symptoms or who have been stood up for a long time might also find it pleasant to lie down with their back flat on the floor and their legs stretched out against the wall. Place your feet on the wall so that the angle between your legs and the floor is about 45 to 60 degrees.

Why is good skin care important?

Dry skin cracks easily and can be itchy. Scratching can then easily cause small wounds. Cracked skin and wounds offer easy entry to germs. That is why it's a good idea to take good care of your skin and use skin creams when needed.

Moisturizing or lipid-replenishing creams, gels, lotions and ointments are well suited for treating dry skin. Special (and often expensive) products are usually not necessary. People with allergies to certain substances should check the ingredients list first. Perfumes, surfactants (sodium lauryl sulfate) and antibacterial ingredients can sometimes cause contact allergies.

You should try not to scratch yourself as much as possible to avoid damaging your skin. It can also help to keep your fingernails short. The risk of damaging the skin is then lower if you do scratch yourself.

Kahn SR, Shrier I, Shapiro S et al. Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial. CMAJ 2011; 183(1): 37-44.

Makedonov I, Kahn SR, Galanaud JP. Prevention and Management of the Post-Thrombotic Syndrome. J Clin Med 2020; 9(4): 923.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on June 2, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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