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Muscle Cramps During Pregnancy | American Pregnancy Association

Muscle cramps, sometimes called a charlie horse, during pregnancy are one of the common discomforts experienced by approximately half of all expecting mothers.  The majority of muscle cramps during pregnancy occur in the lower extremities, particularly in the calves. A muscle cramp is an involuntary contraction of a muscle or group of muscles that happens abruptly and is most commonly experienced at night.

Symptoms of Muscle Cramps During Pregnancy

Muscle cramps and body aches during pregnancy may occur in any muscle or muscle group but is most commonly experienced in the legs. Muscle spasms that occur in the back or abdomen are also possible.
A muscle cramp or spasm is characterized by the following:

• Involuntary contraction or tightening of a muscle
• Usually sudden
• Accompanied by a sharp pain

You should consult your doctor if your symptoms occur frequently, are associated with swelling or redness, and are not relieved with traditional methods.

What Causes Muscle Cramps During Pregnancy?

• Overuse (carrying the extra weight from pregnancy or exercise)
• Dehydration
• Change in blood flow or circulation
• Lack of stretching before exercise or extensive use
• Nerve compression
• Lack of minerals (potassium, calcium, or magnesium)

If you experience muscle cramps frequently, they are probably related to more than one of the causes noted above.

How to Prevent Muscle Spasms While Pregnant

Below are steps you can take to prevent or reduce the likelihood of experiencing muscle cramps while expecting:

• Drink lots of water and fluids to stay hydrated
• Stretch your muscles well before exercise or extensive use
• Eat well-balanced meals to get the nutrients and minerals you need
• Take a prenatal vitamin that contains calcium, potassium, and magnesium. To avoid overdosing, do not take additional supplements without talking to your doctor.

Eating foods that are high in potassium, such as kiwi, bananas, or cantaloupe, is a great way to get some of the nutrients you need to prevent muscle cramps.

How Do You Treat Muscle Cramps During Pregnancy?

If you are experiencing a muscle cramp, here are the steps you can take to alleviate the pain or discomfort:

• Massage the muscle and nearby muscle groups to provide relief.
• Stretch the muscle.
• Apply heat with a heating pad.
• Take a warm Epsom salt bath.
• Apply cold with an ice pack to reduce the pain.

You may find that massaging the muscle with either heat or ice helps alleviate the pain more effectively.
If your muscle cramps remain frequent and do not respond to the above treatment, contact your healthcare provider. This could be a sign of a different medical condition requiring another type of treatment.
Want to Know More?

• Treating Muscle Cramps Naturally During Pregnancy
• Pregnancy and Leg Cramps
• Role of Vitamin B in Pregnancy

Compiled from the following sources:
Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 1.
MedlinePlus, “Muscle Cramps,” National Institutes of Health, https://www.nlm.nih.gov/medlineplus/ency/article/003193.htm
Mayo Clinic, Muscle Cramps, https://www. mayoclinic.org/diseases-conditions/muscle-cramp/basics/causes/con-20014594

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 the occurrence of 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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