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How to recogise bleeds if you have haemophilia

Your Health / Conditions / Haemophilia / How to recogise bleeds if you have haemophilia

Published on Sep 23, 2020​​​​​​​
Authored by Pfizer Medical Team


People living with haemophilia will experience bleeds either due to injury, increased activity or for no apparent reason. The most common areas of bleeding are the joints and muscles of the arms and legs. Less commonly, bleeds may occur in the mouth, gums, nose, urinary tract or brain. By knowing how to recognise the early signs of a bleed, you are in a better position to treat it as quickly as possible. Ideally, this should occur before swelling and pain develop in the affected joint or muscle to help prevent permanent damage.

The signs that you have a bleed may vary depending on where it is located. If you have any questions about recognising signs of bleeding, contact your Haemophilia Treatment Centre.

Joint Bleeds

  • Occur most commonly in the knees, elbows and ankles.
  • Usually starts by feeling warm and tingly, and then as blood fills the joint capsule, the joint swells and becomes painful and difficult to move.
  • Repeated bleeds can weaken a joint over time, which may eventually lead to permanent damage to the joint.

Recognising joint bleeds:

  • Initially, you may experience a tingling sensation and tightness within the joint, often described as an ‘aura’.
  • The affected joint will become increasingly warm and discomfort with movement will occur, particularly at the ends of your range.
  • Later, you may experience pain at rest, swelling, tenderness, and extreme loss of motion.
  • Children may avoid using their arm or leg, or they might cry for no other apparent reason.

Muscle Bleeds

  • Mostly affects muscles of the hips, calves, thighs and forearms.
  • Can go unnoticed for some time before discomfort develops.
  • Immediate management is critical to prevent permanent damage and loss of function.

Recognising muscle bleeds:

  • Initially, you may experience aching in the muscle and want to keep the affected limb in a position that you find comfortable.
  • May cause the limbs to swell and become warm and painful to touch.
  • Bruising can occur near the surface.
  • In deeper muscles, the swelling may press on nerves or arteries, which can cause numbness and then pins and needles. This may eventually lead to muscle spasm and cause the muscle to seize up temporarily.
  • Children may avoid using their arm or leg, or they might cry for no other apparent reason.

Other types of bleeds

  • Many children with haemophilia have nose and mouth bleeds
  • Some adults will also continue to have these types of bleeds.
  • Children with haemophilia often bruise more easily than other children, especially when they’re learning to walk. This is often what leads to the initial diagnosis of haemophilia.

Brain Bleeds

  • A brain bleed is a serious medical emergency and requires immediate treatment.

Recognising brain bleeds:

  • Symptoms include headache, nausea, vomiting, clumsiness or weakness of an arm or leg, sensitivity to bright light, feeling drowsy, seizures or loss of consciousness.
  • Recognising the early signs of a bleed is vital so that it can be treated as quickly as possible.

If you have any questions about recognising serious bleeds, contact your Haemophilia Treatment Centre for additional information. Your treating doctor will have outlined what to do when you experience a bleed.

Last reviewed: 23/09/2020

External Resources

-Haemophilia Foundation Australia
-Haemophilia Foundation of New Zealand

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