Leg Pain in Pregnancy: Dealing with Cramping and Swelling

Many people experience swollen feet, swollen ankles, and leg pain during pregnancy. Here’s what causes these common symptoms and how to prevent them from happening in the first place.

Pregnancy Woman with Swollen Feet
Photo: comzeal images/Shutterstock

While morning sickness, fatigue, and back pain are frequent complaints during pregnancy, leg and foot problems are just as common, particularly during the third trimester. You may be able to prevent some of these pains with circulation-boosting exercises and (literally) putting your feet up. And in some cases, achy legs and even swollen veins will disappear after delivery. In other situations, some people may need more treatment even after pregnancy to deal with the changes that pregnancy can cause to your legs.

So what causes ankle, foot, and leg pain during pregnancy, and what can you do about it? Here's what you need to know to give yourself a leg up, with expert-approved methods for prevention and relief.

Leg Cramps During Pregnancy

Some pregnant people can't escape leg cramps. These painful muscle contractions (also called charley horses) usually occur in the calf—and often at night, when legs and feet are tired. They're likely caused by calcium deficiency and excess phosphorus (found in diet sodas and processed meats), says Enid Leikin, M.D., an OB-GYN at Westchester Medical Center in Valhalla, New York. Nerve pressure from an expanding uterus, poor circulation, and dehydration might also be to blame.

While annoying and painful, these cramps are usually not dangerous for your baby, and tend to come and go quickly. But if they persist, or your leg begins to swell or feel warm, let your doctor know. This can be a sign of a blood clot, which is very rare but requires immediate treatment.

How to Relieve Leg Cramps

To relieve pregnancy leg pains, Dr. Leikin suggests eating more dairy products or asking your doctor about calcium supplements. Snack on potassium-rich bananas or dried apricots, because people who get pregnancy leg cramps may have a potassium deficiency. You can also boost your circulation by taking a 15- to 20-minute walk in the evening (with your doctor's permission). And avoid standing or sitting in one position for too long, since this can cause fluid to accumulate, making your legs feel heavy or full of pressure.

If you find yourself in the middle of a leg cramp, ease the pain by resting your calf on a hot-water bottle or flexing your foot to stretch the calf. The best solution is walking, but if it's the middle of the night and you don't feel like getting out of bed, try grasping your foot with both hands and gently pressing your thumbs into the arch, pushing toward your toes (ask your partner to help if you can't reach beyond your burgeoning belly!)

Gently stretching your calf muscle can relieve cramping as well. To do this, straighten your leg and flex your foot (heel down, toes up). It may be tempting to point your toes, but this usually makes the pain worse.

Swollen Legs in Pregnancy

Raised hormone levels can cause people to retain water while expecting, leading to swelling and bloating (also known as edema). Your body needs this extra fluid to carry nutrients and oxygen to your baby, explains David S. Levine, M.D., an orthopedist at the Hospital for Special Surgery in New York City.

Typically, fluid retention is most pronounced in your feet, ankles, and calves because your growing uterus puts pressure on the veins that carry blood back from your lower body. This partially blocks blood flow, keeping fluid in your legs and feet. Blood vessels are also the smallest in your foot and ankle, adds Dr. Levine, so your body has difficulty accommodating the extra fluid pouring in there.

Common triggers for swollen feet and swollen ankles in pregnancy include tiredness, exercising, eating salty foods, drinking caffeine, and standing and walking for a long time.

Although edema in pregnancy isn't usually cause for concern, consult your doctor if you notice swelling of your face and hands along with blurred vision, severe or constant headaches, and weight gain of more than a pound a day. These can be signs of preeclampsia, a serious medical condition characterized by high blood pressure.

How to Relieve Leg Swelling

To alleviate leg swelling, avoid sitting or standing for more than an hour at a time. Walking increases blood circulation, which helps alleviate puffiness. Elevating your legs can also help; encourage blood flow to your heart and lungs by raising your legs six to 12 inches above your heart for 12-20 minutes.

Avoid lying on your right side or flat on your back, which puts the full weight of your uterus on the vena cava. Instead, lie on your left side, a position that exerts the least amount of pressure, says Rini Ratan, MD, assistant director of labor and delivery at Columbia-Presbyterian Eastside, in New York City.

Also, be sure to drink plenty of water, which actually helps keep the body from retaining fluids. Drink less caffeine, avoid eating too much salt, and wear comfy shoes—even slippers —whenever possible.

Swollen Veins

Some people might also experience varicose veins during pregnancy. A combination of hormones, gravity, increased blood pressure and volume can cause your veins to bulge through weakened spots and show through your skin. Varicose veins might look like:

  • Bulging veins
  • Heavy feeling in your legs
  • Swelling and pain in your legs
  • Itching around your veins

Most of the times, varicose veins are not dangerous, although they may be frustrating to deal with. However, check with your doctor to make sure you're not at any increased risk of a blood clot and be sure to let your doctor know about any increases in pain or symptoms.

As far as what to expect from your new vein sidekicks, in some people, varicose veins may resolve on their own after pregnancy; for others, they may stick around. But there are treatments available for varicose veins, so if they bother you after your baby is born, talk to your doctor about options.

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