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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]

How to get rid of leg cramps during pregnancy

Many people face this problem, especially pregnant women. Sometimes even during the day.

They suffer from convulsions in the second and third trimesters. Mostly they occur in the calves, but sometimes spread to the foot. Sometimes the whole leg hurts.

Convulsions last from a couple of seconds to several minutes, and the sensitivity in the muscles lasts almost a day.

Olga Andreevna Mardanova

Pulmonologist, therapist

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Performs diagnostics of respiratory diseases using data from an objective examination, as well as additional research methods, including specific blood tests, examination of the function of external respiration, pulse oximetry, measurement NO level in exhaled air, radiography and computed tomography of the chest

Is it dangerous if you cramp your calves during pregnancy?

No. Convulsions cause pain and interfere with normal sleep, but they do not threaten the health of the mother and child.

However, this does not mean that they should be ignored. Sometimes this symptom indicates a more serious pathology that needs to be treated.

Fortunately, medical attention is required only in rare cases.

Usually the cramps are unpleasant but pass quickly.

In this case, it is necessary to eliminate the cause of this problem and therefore we will talk further about why convulsions occur.

The main causes of leg cramps in pregnant women

Unfortunately, it is difficult to quickly determine the source of the problem. The fact is that legs during pregnancy reduce for various reasons, so some tests may be required to obtain a diagnosis.

A signal comes through the nerves to the muscular system, in response to which a chemical reaction begins.

Muscle fibers are reorganized. This is what we call muscle contraction.

When the signal from the brain disappears, the muscle fibers return to their original state, that is, they relax.

For various reasons, sometimes muscles contract too much and stay in this position for a while. Seizures can occur in anyone. Expectant mothers are more prone to this problem due to numerous changes in their body.

Quite often they suffer from a lack of minerals.

Micronutrient deficiencies

We have already mentioned the chemical reaction in the muscles that occurs before they contract. Microelements play an important role in this process.

Convulsions appear when there is not enough:

The lack of these trace elements is largely associated with pregnancy. The expectant mother should consume much more of these substances, because she supplies them to her child.

During vomiting, a woman loses many trace elements, both from food and from digestive enzymes.

Pregnant women also often do not eat certain foods. Therefore, important trace elements do not enter the body in the required amount.

Now let's talk about each of them separately

Lack of this substance causes many problems: insomnia, irritability, bleeding gums, high blood pressure.

A lot of calcium is found in dairy products, and also in vegetables: cabbage, turnips, broccoli, asparagus.

Both deficiency and excess of this element are harmful for people. High concentration causes drowsiness, thirst and low blood pressure. Hands go numb due to lack of magnesium. People are worried about the feeling of anxiety. Most importantly, magnesium deficiency increases muscle excitability, that is, provokes cramps, lower back pain, and sometimes miscarriages.

Pregnant women should consume up to three times more magnesium than usual. Because of the pregnancy itself and increased neuropsychic stress.

Magnesium is abundant in sunflower seeds. They are also rich in green onions, spinach, nuts and carrots.

Expectant mothers often lose a lot of potassium due to vomiting and diarrhea. As a result, problems appear: dry skin, thirst, constipation, depression, high cholesterol, severe muscle fatigue and convulsions.

Apricots, bananas and potatoes will help replenish this mineral. There is also a lot of it in milk and beans.

It does not cause convulsions by itself. However, this vitamin helps to absorb other trace elements, such as magnesium. Without B6, minerals do not stay inside the cells and are quickly excreted from the body. That is, their benefits are reduced.

Deficiency of this vitamin also causes anemia, nausea, depression and hair loss.

B6 found in meat: chicken, beef, pork. They are also rich in salmon and tuna. Unfortunately, up to 70% of the vitamin in meat is lost during cooking.

Its deficiency is often associated with smoking and drinking alcohol.

As you can see, the wrong diet during pregnancy can easily cause cramps, and therefore the optimal diet can solve this problem.

Trace elements are found not only in food.

You can use mineral complexes. But first, check with your doctor about what and in what doses you can take.

And we move on to the next cause of convulsions.

Anemia

Pregnant women need more than just potassium and calcium. The need for iron also increases. The baby consumes a large amount of this trace element - by birth, up to 300 mg of iron accumulates in his body.

But the woman herself may miss it.

Iron helps the blood carry the necessary amount of oxygen to the organs.

Its deficiency causes symptoms:

Due to the lack of trace elements, the legs cramp at any time of the day. So this problem worries women not only at night.

Seizures are not the only danger of anemia. Due to the lack of oxygen, people faint and feel dizzy, which can be life-threatening.

To combat anemia, eat foods that contain a lot of iron:

In severe forms of iron deficiency, special preparations are needed. You'll have to see a doctor.

The next cause of seizures has more to do with lifestyle than diet.

Circulatory stasis

Due to poor blood circulation, some people experience cramps in their legs.

Sometimes blood circulation is disturbed due to the static position of the body. That is, from a long immobility.

When a person lies or sits without moving for several hours in a row, the blood in the vessels moves more slowly. Working leg muscles help pump blood. Veins don't do well on their own.

Sudden movements after immobility increase the load on the walls of blood vessels, can cause pain and convulsions.

A similar problem occurs with varicose veins. With this pathology, blood circulation is also disturbed.

Varicose veins

Swollen vessels ruin the lives of millions of people, and women are attacked about twice as often as men. The disease is known for its external signs - twisted thick veins. She has other symptoms as well.

One of the manifestations of varicose veins is sometimes the patient's leg cramps.

Most often, this problem occurs in the late afternoon or at night, when people do not move much.

Impaired blood circulation with swollen veins is associated not only with long-term immobility. The vessels dilate too much. Part of the blood accumulates and presses on the venous walls.

As a result, blood circulation is disturbed, which impairs the nutrition of tissues and muscles near diseased veins. It also increases the risk of thrombosis. If blood clots grow on the walls of blood vessels, they can block the blood flow in this area. Then, in addition to convulsions, the patient is threatened by other unpleasant symptoms.

Varicose veins are a serious disease that will not go away on its own. The help of a doctor is needed.

Consult a phlebologist if you are concerned about convulsions:

These are the first signs of swollen veins. You need to go to the doctor not only with such a pathology. The help of a specialist will be required with a decrease in sugar levels.

Reduce blood glucose

The body needs glucose to get energy from food.

When it is low, symptoms occur:

And this is just the beginning. Gradually, the problem gets worse, and leg cramps may appear. Some patients lose consciousness. Or even fall into a coma.

For pregnant women, the danger of a lack of energy is especially important, because they must provide everything necessary for both their body and the child.

Convulsions due to lack of glucose usually occur at night. Or early in the morning. At this time, the body has already used up the sugar reserves of the previous day and now attracts the patient's attention with characteristic symptoms.

But the next cause of seizures is due to the fault of the baby.

Inferior vena cava syndrome

The larger the fetus, the more it presses on the tissues and vessels next to it. Meanwhile, near the uterus runs the vena cava - an important way in which blood moves from the legs to the heart.

Sometimes a growing baby squeezes this vessel. The lumen of the vein decreases and the blood flows through it with difficulty. Enough blood should accumulate in the lower areas to create a strong pressure and push it up. As a result, the load on the venous walls increases.

They are expanding. Blood stasis begins, which is expressed in edema, and sometimes in convulsions. These symptoms appear when pregnant women lie on their back or on their right side.

The problem is easily solved. If the leg cramps due to pressure on the vena cava, then you need to lie on your left side. Then the load on the vessels will decrease.

Hypothermia

When the temperature drops, the veins constrict. As a result, cramps can occur in the calves.

Due to hypothermia, blood circulation slows down, and the muscles soon react to the lack of oxygen and other necessary substances.

This problem often occurs while swimming. Sometimes people bathe in too cold water, and from a strong temperature difference they cramp their legs. In such a situation, you need to get to the shore as soon as possible. Otherwise, the person may drown.

But the next cause of convulsions appears already from a lack of fluid.

Dehydration

Yes, many women complain of swelling during pregnancy. But the accumulation of fluid in the tissues is a natural reaction that does not have to be fought with radical means.

Some use diuretics.

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