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How can I help prevent leg swelling during long airplane trips?

Anthony L. Komaroff, MD
Internal Medicine
Developing mild swelling in the feet, ankles, and lower legs is common during long-haul flights. Sitting still is the culprit -- blood and fluid pool in the lower extremities because they aren't aided in their return to the heart by contractions of the leg muscles. When the swelling occurs in both legs, it is benign, though annoying (especially when it is difficult to put your shoes back on at the end of the flight). Swelling in one leg, however, may be worth further evaluation.

Wearing below-the-knee vascular compression stockings that exert a small amount of pressure (20 to 30 millimeters of mercury) can prevent or diminish the swelling. In-seat exercises, involving contraction of the calf muscles or wiggling the feet up and down in rapid repetition, may be helpful in promoting circulation from the legs.

The big worry on a long-haul flight is the development of a blood clot, also known as deep-vein thrombosis (DVT). Such a clot can cause long-lasting problems in the affected leg. And if the clot breaks away and lodges in an artery in the lungs (this is called pulmonary embolism), it can cause chest pain and breathing problems. A large embolism can cause sudden death.

The best way to prevent DVT is to stay well hydrated. Drink enough non-alcoholic beverages (water and Diet Coke are my two favorites) to require frequent trips to the toilet. Getting up to go to the lavatory also increases circulation in the lower legs and exercises the calf muscles. Alcohol, which dehydrates, should be limited or avoided entirely.

Some clinicians advocate taking aspirin or even an injection of low molecular weight heparin. This is usually unnecessary unless a person has had a DVT in the past. Check with your doctor before taking either of these steps.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.