For those severely affected, a major problem can be internal bleeding into joints, muscles and soft tissues.  All of us damage our muscles in small ways in the activities of everyday life. Most people repair that damage automatically.  For the person with a severe bleeding disorder, however, the tiny breaks in the blood vessels in joints and muscles may continue to bleed as a result of normal everyday activity.  These bleeds are sometimes described as “spontaneous” because it is impossible to identify a cause.

An ache or irritation in an affected area is usually an indication that a person with haemophilia is getting a bleed.   If left untreated pain may become excruciating.  In the case of joint bleeding, the blood which has escaped into the joint has a very damaging effect on the surface of that joint.  Once a joint becomes damaged then bleeding will occur more frequently resulting in a “target joint”. The majority of bleeds into joints and muscles occur in the lower limbs, with ankles and knees being the worst affected in most people.

The most common types of internal bleeding are into the joints or muscles and may occur without any obvious cause.  Repeated or untreated bleeding into joints and muscles can cause permanent damage such as arthritis, chronic pain and joint damage requiring surgery.  Older children should tell you if they have a bleed. Younger ones may seem upset or may protect a limb by limping or not using it.