I was told light heat was OK after my first DVT. With the DVT clogging up my veins, it improved blood flow to have the heat help open things up a little bit. I found it very comfortable and helpful during recovery. But some docs are really against it...although a lot of us have found it very helpful, even in just the form of a hot bath.

I don't know about cold. But, if your leg is elevated at the same time you're using it, I don't know that the blood will clot. I mean, it'll still be moving downhill in response to gravity, right? For me, the thought of putting cold on my DVT leg sounds awful, but some folks really like it and were encouraged to do that by their docs. It really can be a personal thing and I don't know that there's any research on it out there.

Honestly, what little medical training I've had has always encouraged patients to do what feels good. If heat sounds good, go with that. If cold sounds good, go with that. That doesn't help you much, but there you have it.

...Whether 'tis nobler in the mind to suffer
The slings and arrows of outrageous clotting....

I have been told either heat or cold -- whatever made it feel best. I will admit to doing neither, but I was told I could do both. By the same doctor in the same sentence. And it was the doctor I trust the most.

I would also normally use ice to help with swelling, but when dealing with circulation the opposite CAN be true, it kind of depends on what the reason is for swelling. For my circulation I greatly prefer heat. It relaxes the blood vessels and opens them up a bit, so blood flows more easily. Heat could possibly help provoke a newly formed, soft and easy to embolize clot from breaking off, which is apparently what your doctor thinks. Logically, I can see his reasoning, because if you think about the combination of what you did, the ace bandage compressed the area physically while the heat relaxed the vein, so you've got this blood trying to pump through there under more than normal pressure. It kind of makes sense to me to think if you had a clot along a side of the vein, under that pressure and especially being a "soft" new clot still, the pressure of the blood trying to circulate could force it to break off.

That should not be a worry you have to deal with now. Whatever is left of the clot which was in your leg, if anything at all, isn't going to break loose now because it's become part of the vein wall, so you don't need to worry about that.

If ice is the thing which you lean toward, just be religious about leaving it on only 15-20 minutes, because longer than that could cause the circulation to slow down too much, but that's true of anyone, regardless of whether you've ever experienced clotting or not. Sometimes I even find that alternating ice and heat helps me the most, just not leaving either for too long.

I think unfortunately you're kind of just going to have to feel your way through it and try each to see what seems to do you the most good. I have at times thought ice would be good and realized very quickly that for whatever reason, it felt really bad on the area, so I switched to heat and that helped. So basically I agree that usually the best thing to do is what feels like it's helping. But I don't believe that either way you're going to provoke either a new DVT or a new embolus.

If you're on anticoagulants I really don't think you have to worry about using ice if you think that would slow down blood flow.

I think for what you're trying to accomplish ice makes more sense. Heat causes your blood vessels to open wide and brings more blood to the area.

And then you can always ask your doctor too. For my DVT specifically, I used neither. But it sounds like you're not trying to address the DVT but the swelling from your surgery or no?

I just have knee swelling sometimes because I twist it the wrong way or whatever....its dumb, but now my knees are so damn finicky!

Thanks all.

I think you may have to experiment and see what helps. To me, usually, ice seems to help with joint swelling and inflammation and heat helps with muscle aches. But I have some arthritis in my hands and heat really helps with that pain so I think it might be a "if it feels good do it" thing.

Hi! So, not sure where you are at with this, but I though you would appreciate this. Cold causes the arteries to constrict, which makes them smaller and slows down the flow of blood through them, but it doesn't do anything to the veins directly, and it won't slow the blood down so much that it could clot. So putting cold on your knee for 20 minutes on and 20 minutes off shouldn't do any damage at all. Hope that helps!