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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]

Cramps in the leg with cramps in the calf: causes, treatment and prevention

"Cramps in the legs" is a household description of painful muscle spasms and cramps in the lower extremities. In some cases, spasms are not accompanied by pain, but only rapid rhythmic muscle contractions are observed. Muscles twitch chaotically, either contracting or relaxing.

Leg cramps develop as a result of various diseases and conditions, from electrolyte disorders to neurological disorders and hormonal imbalances. Therapists, neurologists, endocrinologists, phlebologists, etc. are engaged in the diagnosis and treatment of the causes of leg cramps (spasms themselves are not a disease), etc. It all depends on the nature of the problem.

Causes of cramps

Involuntary muscle contractions (cramps in the legs) are a symptom of various diseases and pathological conditions. In healthy people, painful spasms occur against the background of excessive physical exertion, uncomfortable body position, unsuccessful movement, but in such cases, convulsions do not recur. In diseases, a repetition of episodes is possible, as well as an increase in symptoms.

Crampy syndrome

Crampy develops against the background of a number of diseases (avitaminosis, liver cirrhosis, neurological disorders, etc. ), hypothermia, intense physical exertion. The exact reasons are unknown.

The disease is accompanied by short-term muscle spasms in the calves. The intensity of convulsions in the lower extremities is different, the pain syndrome is pronounced. Most of the attacks occur at night.

Treatment is aimed at eliminating the cause of the pathology, as well as stopping the symptom. Doctors prescribe vitamins, minerals, anti-inflammatory drugs.

Flat feet

In flat feet, lower extremity spasms develop in response to uneven load distribution. Legs cramp during activity, less often at rest.

Spasms develop suddenly. Muscle contractions last from a few seconds to several minutes. After the attack, severe discomfort persists.

Treatment - orthopedic. The task is to achieve the correct distribution of the load on the lower limbs. Rarely resort to surgical correction.

Vascular diseases

Spasms (painful contractions) affecting the calf muscles occur in response to hypoxia and impaired energy metabolism in tissues. Spasms also develop as a result of such pathologies:

• varicose disease;
• endarteritis;
• atherosclerosis;
• thrombosis.

The clinical picture is complemented by sensations of heaviness and pressure in the legs. The phlebologist is engaged in the treatment of such conditions. Its task is to restore blood flow, venous-lymphatic outflow, eliminate inflammation, etc.

Endocrine diseases

Leg cramps are typical for thyroid pathologies (hypothyroidism, hyperthyroidism, hypoparathyroidism, diabetes mellitus). Diabetes insipidus can be an indirect cause, since the patient loses a lot of fluid, and with it, electrolytes.

The clinical presentation depends on the cause of the seizures. Treatment is the task of the endocrinologist. It is carried out with the help of medications, replacement therapy is also indicated. According to the situation, surgical treatment is carried out (tumors, tissue injuries).

Fluid and electrolyte disorders

Cramps (painful contractions in the legs) may be a symptom of a deficiency or excess of potassium, sodium, calcium, magnesium. Seizures occur spontaneously and often recur. Seizures develop at night and last up to several minutes.

Treatment is the work of a therapist or other specialist (depending on the cause of the disorder). Restoration of electrolyte balance is carried out with the help of drugs, a therapeutic diet.

Hypovitaminosis

Most often, leg cramps develop in response to a lack of vitamins B1, B2, B6, D. Hypovitaminosis is accompanied by additional symptoms: reduced sensitivity of the lower extremities, burning in the legs, insomnia, dry skin, decreased vision, immunity. It all depends on the specific pathology.

Treatment is the work of the therapist. It is necessary to eliminate the primary disease, restore the level of vitamins and minerals in the body.

Intoxication

Convulsions are possible in case of poisoning with salts of heavy metals, vapors of volatile substances. Most often suffer laboratory workers, employees of hazardous enterprises. Intoxication occurs when using poisonous plants: belladonna, fly agaric, ergot. However, drugs are more often to blame. Painful muscle spasms develop as a side effect of certain medications.

Spasms occur after the influence of a substance on the body. Muscle contractions can be persistent - it can be difficult to remove them even in a hospital setting. Treatment - detoxification with drugs, observation. Many poisonings are life-threatening.

Pathologies of pregnancy

Muscle cramps may occur in pregnant women. Often cramps of the calf muscles develop as a result of hypovitaminosis, electrolyte imbalance. There are more threatening conditions: inferior vena cava syndrome, eclampsia.

Patients with recurrent muscle spasms are managed by OB/GYNs. They figure out why the problem has developed, prescribe treatment.

Other causes

There are other factors that cause cramps in the legs. Other causes of calf spasms include:

• alcohol intoxication;
• high body temperature;
• tumors of the central nervous system and endocrine system;
• jumps in blood pressure;
• traumatic brain injury;
• infections;
• dehydration;
• heat stroke.

This also includes leg injuries. Less commonly, the symptom occurs due to anemia.

Night cramps in the legs

Spasms at night develop with varicose veins, lack of trace elements, vitamins. They also occur with intense physical exertion, wearing uncomfortable shoes. There are more serious causes of night cramps. For example, epilepsy. To put an end to the question, you need to undergo an examination.

Why does the calf cramps - doctors should understand. The reasons are not always obvious. It is possible to understand why a symptom developed only after a thorough diagnosis. Diagnosis is by sighting or exclusion.

First aid for cramps in the legs

First aid is aimed at relieving an attack. To get rid of cramps, you need to:

• raise your legs above the level of your head;
• pull the toe up;
• if it does not help, do a light massage of the calves and feet.

Actions to be repeated until improvement. After stabilization of the condition, it is worth taking a warm bath and moving around a little.

Diagnostics

The doctor evaluates complaints, collects anamnesis, prescribes general and biochemical blood and urine tests, if necessary, performs a toxicological test. An important role is played by instrumental research methods for establishing the cause of spasms: electromyography, EEG, ultrasound of the vessels of the lower extremities, MRI of the brain, organs of the endocrine system, etc.

Treatment

Treatment can be conservative or surgical. Surgical methods are used in rare cases.

Conservative therapy

Conservative treatment includes medication, physiotherapy, massage, exercise therapy. Relieve an attack, there is little tension in the muscles during convulsions. If nothing is done about the cause of the symptom, a relapse is likely. Attacks can be repeated and become more frequent. Medicines are selected individually.

Surgical treatment

Surgical treatment is possible with flat feet, varicose veins, vascular diseases, tumors. Surgical care is an extreme measure that is needed to restore the normal functioning of the body.

Prevention

There is no single approach to prevention, it all depends on the underlying disease. General recommendations might be:

• eat right;
• avoid hypothermia;
• avoid dehydration;
• give the body moderate physical activity, do not sit in one place;
• wear comfortable shoes;
• do not take drugs without a doctor's prescription (especially diuretics, cardiac, hormonal).

Regular preventive check-ups play an important role.

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