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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. nine0005

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. nine0005

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. nine0005

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. nine0005

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. nine0005

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]

Leg cramps in pregnant women: causes, symptoms and first aid

Number of views: 96 195 nine0005

Leg cramps in pregnant women: how to deal with this problem? First of all, you need to try to determine the cause.

Symptoms of leg cramps during pregnancy

Leg cramps are a painful contraction (spasm) of the calf muscles. The pain comes on suddenly and seems to permeate the whole body. Depending on the cause, leg cramps in pregnant women can occur at any time of the day.

Leg cramps in pregnancy: the main causes

The occurrence of leg cramps during pregnancy is most often associated with the following causes:

1. Imbalance in the body of such trace elements as calcium, potassium and magnesium, as well as vitamin B6

Deficiency of these elements can be caused by:

• a large number of trace elements;
• in the second trimester - an increased need for a large amount of mineral salts due to the active growth of the unborn baby to form his skeletal system;
nine0066 excretion in the urine as a result of diuretics not agreed with the doctor;
• unbalanced diet.

2. Anemia

Anemia can result in a lack of oxygen supply needed by the muscles. This can cause leg cramps in pregnant women.

Characteristically, convulsions associated with anemia or a lack of certain trace elements occur at any time of the day.

3. Stagnation of blood circulation associated with low mobility

Convulsions can be provoked by being in an uncomfortable static position for a long time.

4. Varicose veins

As a result of stagnation of blood in the veins, cramps in the calf muscles may appear. They usually occur at rest: in the evening before bedtime or at night.

5. Reduce blood glucose

Glucose is the body's most important source of energy. A drop in this indicator entails energy starvation of the body, which can provoke leg cramps in pregnant women. nine0092 Convulsions associated with this cause are more likely to occur at night or in the early morning.

6. Inferior vena cava syndrome

From the second half of pregnancy, the growing uterus can compress the inferior vena cava, which leads to stagnation of blood in the lower extremities, the development of edema, and as a result, seizures. It is characteristic that leg cramps in pregnant women occur when lying on the back or on the right side.

7. Hypothermia

Cold leads to vasoconstriction, thereby causing calf cramps. nine0005

8. Dehydration

First aid for cramps

How can you help yourself during a cramp?

• Elevate the leg if possible, slowly but firmly pull the big toe towards you, or pull the whole foot towards you
• Try to breathe deeply and calmly while doing this.
• Helps kneading massage of the calf muscle to warm it up. Involve your loving husband. You can use massage balls or a hand massager. You can press your index finger into the center of the calf muscle for at least 20 seconds
• Pinching and pricking the calf muscle helps to take your mind off the pain
• You can try a hot shower or heating pad
• After an attack, you can put on stockings or leggings (preferably pre-warmed) to keep the muscles warm and relax better
• Walking barefoot slowly can help, which improves blood circulation in the muscles of the legs

Treating seizures in pregnancy

Be sure to tell your gynecologist if you experience seizures. To identify the cause of this pathology, the doctor may prescribe additional laboratory tests, as well as examinations by narrow specialists. nine0005

Read in the online magazine: "The best doctors according to moms: voting results"

If necessary, the doctor will prescribe medication, multivitamins for expectant mothers or additional intake of calcium and magnesium supplements. Additional intake of calcium preparations should be agreed with the doctor and stopped after 35 weeks of pregnancy. Never “prescribe” vitamins and supplements to yourself without consulting a doctor!

If the level of glucose in the blood is low, the endocrinologist prescribes drugs to normalize this indicator. nine0005

In case of varicose veins, doctors prescribe wearing special compression underwear (socks, stockings or tights) to normalize vascular tone, restore blood flow, relieve swelling, which significantly reduces the risk of seizures. It is very important to choose the right size and degree of compression of prophylactic underwear.

Leg cramps in pregnancy: prevention

The following rules will help the expectant mother to avoid pain caused by cramps:

1. Proper balanced nutrition

• There should be 5-6 small meals per day
• Prefer complex carbohydrates (cereals, durum wheat pasta, fruits and vegetables), try to limit the intake of "light" carbohydrates (sweets, starchy foods)
• Include in your diet plenty of foods rich in calcium (low-fat dairy products and milk, nuts, eggs, various types of cabbage), magnesium (nuts, seeds, legumes, fish, chicken, broccoli, carrots, spinach, raisins), potassium (bananas , potatoes, salmon, tomatoes, dried apricots, raisins, spinach, oranges, lean beef), B vitamins (dairy products, walnuts, red fish). nine0067

2. Reasonable physical activity

Reasonable and dosed physical activity will help improve blood circulation and prevent venous congestion. An excellent remedy for the prevention of seizures is the pool.

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