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What Causes Leg Cramps in Pregnancy? | UNM Health Blog

By Kathleen Kennedy, MD | July 01, 2021

Safe At-Home Treatments & When to Call a Doctor

Did you know around half of pregnant patients get leg cramps by their third trimester? Leg cramps tend to strike at night when you’re about to fall asleep. You might feel a sudden tightening of your muscle followed by a sharp pain.

Usually, leg cramps in pregnancy are nothing to worry about, however, sometimes they can be a sign of a more serious health problem. Let’s take a look at the common causes of leg cramps, how you can handle them at home and when to call the doctor.

Common Causes of Leg Cramps

There are many potential causes for leg cramps during pregnancy. They tend to show up in the second and third trimesters as your body is rapidly changing.

Low Vitamin or Mineral Levels

Why: During pregnancy, hormone and diet changes can decrease your calcium and magnesium levels.

Try This:

• Taking a prenatal vitamin can help. Get tips to find the best prenatal vitamins.
• Vitamin B complex supplements might also help with leg cramps.
• Eat food high in potassium, such as bananas, kiwi and spinach.
• Eat food high in magnesium, such as dark chocolate, avocados and nuts.
• Eat food high in calcium, such as seeds, cheese and salmon.

Circulation Changes

Why: Your blood volume will almost double during pregnancy. That can cause slower circulation, leading to swelling and cramping.

Try This: Here are a few tips for improving circulation during pregnancy:

• Sleep on your left side: This position takes pressure off your liver, which is on the right side of your body and helps improve circulation.
• Elevate your legs: Not only does putting your feet up reduce swelling, it also pushes blood flow back to your heart and lungs. 
• Sleep with a pillow between your knees: This position helps facilitate blood flow through a major vein carrying blood to the heart and back. This position may also relieve stress.
• Stay active: If you sit a lot during the day, get up and walk around every couple of hours. Movement helps increase overall blood flow.

Dehydration

Why: Do you remember to drink enough water? Leg cramps are a common symptom of dehydration. Water keeps your body hydrated, making the heart’s job of pumping blood easier. The heart sends oxygen to your organs and muscles, reducing the likelihood of cramps and circulation problems.

Try This: While pregnant, you should drink 8-12 cups of water per day. Try adding a slice of fruit or low-sugar flavoring if plain water is too boring.

Muscle Fatigue and Weight Gain

Why: During pregnancy, you might already feel tired. That goes for your muscles, too. Some of that weak, heavy or tired feeling might be coming from the added weight of the baby. Some may be from gaining additional weight during pregnancy.                        

Your uterus is also putting extra pressure on your blood vessels. When the blood vessels in your legs and feet are strained, it can lead to increased leg cramps.

Try This: For this type of cramp, we recommend stretching before exercise and bed. Wearing compression socks also helps move the valves in your blood vessels closer together, keeping blood flowing better in the legs.

Staying active during pregnancy can help relieve and prevent leg cramps caused by weight gain. Work with your doctor or midwife to eat a healthy diet during pregnancy. The goal is to gain enough weight to nourish the baby, but not so much that it negatively affects your health.

Tips to Treat Leg Cramps at Home

Cramping muscles are no fun. Here are some safe at-home treatments you can try to reduce pain:

• Massage the cramping muscle and nearby muscle groups to release the tightened muscles to restore proper blood flow, oxygen and nutrients to the muscle.
• Gently hold your leg in a stretched position until the cramp stops. This lengthens your muscle fibers so they can properly contract and tighten, allowing your muscle’s oxygen supply to be restored.
• Rotate applying ice, to ease the pain of the cramp, and heat, to relax your muscle and increase blood flow.
• Soak in Epsom salt bath. When Epsom salt dissolves in water, it releases magnesium which plays a big role in muscle contraction.

Exercises to reduce leg pain:

• Ankle Pumps: Lie on your back with your feet slightly elevated. Point and flex your feet.
• Calf Stretches: Put one foot against the wall with your toes pointing up, brace yourself with your arms and lean toward your foot, keeping your leg straight.
• Good Mornings: Feet hip width apart, put your hands behind your head, with a slight bend in your knee, bend at your hips until you’re parallel to the floor or feeling a good hamstring stretch

When to See a Doctor

If leg cramps are keeping you awake at night and at-home treatments aren't working, talk with your doctor or midwife. They can prescribe safe medication to ease the pain and help you sleep.

Less commonly, some leg cramp symptoms are signs of deep vein thrombosis (DVT). This is a serious medical condition that can cause blood clots. Pregnant women are 50 percent more likely to get blood clots than non-pregnant women.

Call for help right away if you have any of these symptoms:

• Extreme leg pain when you stand up
• Severe, persistent or worsening leg cramps
• Very swollen legs
• Red spots that are warm to the touch
• Enlarged veins in the legs

If you are struggling with leg cramps during pregnancy, help is available. Talk to your doctor or midwife to discuss your options.

To find out whether you or a loved one might benefit from Ob/Gyn care

Call 505-272-2245.

Categories: Women's Health

Interventions for leg cramps during pregnancy

What is the problem?

Leg cramps manifest themselves as sudden, intense involuntary contractions of the leg muscles. This is a common problem during pregnancy, especially in the third trimester. They are painful and can interfere with daily activities, disrupt sleep, and reduce quality of life. Various types of interventions are used to treat leg cramps during pregnancy, including medications, electrolytes (magnesium, calcium, sodium) and vitamins, as well as non-drug therapies such as muscle stretching.

Why is this important?

The aim of this review was to find out which treatment for leg cramps during pregnancy is effective and safe.

What evidence did we find?

In September 2019, we searched for evidence and identified eight randomized controlled trials in 576 women 14 to 36 weeks pregnant comparing magnesium, calcium, calcium with vitamin D or B vitamins versus placebo or no treatment, and compared vitamin C with calcium. All drugs were given as tablets to chew or swallow.

Magnesium supplements may reduce the incidence of leg cramps in women compared with placebo or no treatment, although studies have not been consistent. Different studies have assessed the effect of magnesium supplementation differently. Some studies have shown magnesium to help reduce the incidence of leg cramps, while others have shown little or no effect. Data on the effect of magnesium on pain reduction was also inconclusive, with only one study showing a reduction in pain intensity, while others showed no difference. Differences in the occurrence of side effects such as nausea and diarrhea were negligible or non-existent.

Calcium did not always reduce the incidence of leg cramps in women after treatment compared to those who did not receive any treatment. It also found that the evidence was of very low quality, so we cannot be sure of the results.

More women who received B-vitamin supplements made a full recovery compared to those who received no treatment; however, these results were based on a small sample size and the study had design limitations.

Frequency of leg cramps did not differ between women receiving calcium and women receiving vitamin C. with placebo.

What does this mean?

The quality of the evidence was low to very low. This was mainly due to small study sample sizes and study design weaknesses. Four studies were well-conducted and presented their reports. The remaining four had flaws in their design: in several studies, women were not best assigned to different treatment groups, and in two studies, women knew whether they were receiving treatment or not. Adverse effects, such as the effect of treatment on complications of pregnancy, childbirth and child, were not reported. Several studies have focused primarily on serum calcium and magnesium levels. The frequency and intensity of seizures and duration of pain were not uniformly reported, and there was often no information on whether they were assessed during treatment, at the end of treatment, or after treatment was discontinued.

It is not clear from the evidence reviewed whether any oral interventions (magnesium, calcium, calcium with vitamin D, B vitamins, vitamin D, or vitamin C) are an effective and safe treatment for leg cramps during pregnancy. Supplements can have different effects depending on how women usually take them. None of the trials looked at forms of treatment such as muscle stretching, massage, relaxation, or heat therapy.

Translation notes:

Translation: Luzan Maria Alexandrovna. Editing: Yudina Ekaterina Viktorovna. Russian translation project coordination: Cochrane Russia - Cochrane Russia, Cochrane Geographic Group Associated to Cochrane Nordic. For questions related to this transfer, please contact us at: [email protected]

〚 Why do pregnant women have cramps at night and should I be worried about it? 〛|| Blog BABYSTART

March 13, 2020

Pregnancy is a natural state for a woman. However, her body at this time is subject to increased stress, which sometimes causes various ailments. These include leg cramps, which disturb the expectant mother, as a rule, during a night's sleep. Why they arise and whether it is worth sounding the alarm, let's look at this article.

Spasm - a sharp and painful spasm of a muscle (or a series of contractions). It comes suddenly and does not depend on the will of man. Everyone has experienced this phenomenon at least once in their life, but especially pregnant women experience convulsions. Leg cramps at night, usually in the calf muscle. A spasm can portend a feeling of heaviness or fullness in the leg.

This causes pain, the nature of which can be called aching. Localization of convulsions - in the place of the greatest rigidity of the muscle. It does not last long - as a rule, no more than two minutes, but the woman feels quite significant discomfort. After the experience of pain, she often cannot sleep.

Why muscle contractions occur

During pregnancy, a number of factors can contribute to leg cramps at night:

• Slowing of blood circulation at night.
• Accumulation of lactic acid in the muscles during the day, which provokes cramps in the calves when they relax.
• Decreased hemoglobin. When there are few red blood cells in the body, muscle fibers do not receive enough oxygen, and, in addition to convulsions, a pregnant woman often experiences bouts of weakness and dizziness.
• Increased load on the lower limbs, which is often noted in the later stages. The problem is exacerbated by wearing tight, uncomfortable clothes and shoes with heels, prolonged stay on the feet due to the profession.
• Insufficient fluid intake in the body. This happens not only because a woman drinks little water. Overheating in the sun, drinking coffee, alcohol and nicotine can lead to dehydration. As a result, toxins settle in the muscles and can cause them to contract involuntarily.
• Excessive compression of the inferior vena cava by the growing uterus, which occurs if the expectant mother often sleeps on her back. The muscles of the legs suffer from oxygen starvation, to which they react with repeated convulsions.
• Deficiency of important vitamins and microelements, primarily potassium, calcium and magnesium, vitamin B6. At the same time, a pregnant woman has concomitant symptoms - brittle nails, hair loss, dental caries, problems with stools, chronic fatigue and depression.
• Varicose veins. This, unfortunately, is a frequent companion of pregnancy. Often, the disease first manifests itself or worsens precisely during the period of bearing a child. Cramps in the calf muscles in this case are caused by circulatory disorders.
• Changes in blood sugar levels. If a woman eats irregularly, and eats rarely and in large portions, then the concentration of glucose in the blood will constantly change dramatically, which is fraught with convulsions.

When you need to see a doctor immediately

Most often, leg cramps in pregnant women are a common occurrence and do not mean any pathology. However, there are cases when they indicate serious health problems, such as:

• Eclampsia. This is the most severe form of late pregnancy toxicosis. It is expressed by a dangerous increase in pressure, threatening the life of both the mother and the fetus. Convulsions in eclampsia are accompanied by numbness of the legs and their pronounced edema. With this condition, a woman needs emergency medical care.
• Deep vein thrombosis of the lower extremities. Circulatory failure and convulsions occur due to blockage of large blood vessels by a blood clot.
• Serious vitamin deficiency. At the same time, muscle contractions appear not only in the legs, but also in other parts of the body, including in the abdomen. And this can already lead to abortion or premature birth. Therefore, strong and frequent convulsions are a reason to see a doctor.

Leg cramps are quite common in pregnant women, as many factors predispose to them. You must tell your doctor about them so that if necessary, he prescribes the necessary treatment on time.

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