Why do my legs cramp when pregnant and what to do?

Leg cramps during pregnancy are as common a problem for pregnant women as manifestations of toxicosis. This pathology most often bothers in the third trimester of pregnancy, which is associated with a violation of vitamin metabolism. But there may be other reasons for this phenomenon, so it is necessary to know about the main ones and conduct adequate therapy, because the severity of symptoms sometimes disrupts the normal sleep of a pregnant woman and daily activities.

Epidemiology

The epidemiology of this problem indicates a wide prevalence of this problem among pregnant women, which is more than 85% of pregnant women. Considering the etiological factor, this problem occurs in 96% of women who did not receive any additional vitamins during pregnancy, and the cause in such women is a deficiency of calcium and magnesium. Secondary causes of leg cramps during pregnancy are less than 5%. Such data allow us to judge not only the possible causes, but also provide grounds for primary prevention of this pathology.

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Causes leg cramps in pregnancy

Pregnancy is a period when, for the sake of a little happiness, a woman has to endure many unpleasant moments that disrupt her general condition. One of these conditions is the feeling of paresthesia and muscle cramps.

Under normal conditions, the human body has a normal ratio of different electrolytes that provide nerve conductivity and good muscle excitation. This process is controlled by the content of calcium, magnesium and potassium in the body. During pregnancy, these microelements are redistributed in such a way as to ensure the development of the child, so they may not be enough for the mother. Vitamin and microelement deficiency during pregnancy is a common occurrence, but not everyone is bothered by leg cramps. Therefore, other factors must also be taken into account.

To understand the pathogenesis of the development of cramps in muscle tissue, it is necessary to know about the role of certain electrolytes in the human body.

Calcium is a microelement that ensures cardiac activity, the work of muscle and nerve fibers, and the structure of bone tissue. Calcium also takes part in normal impulse conduction and muscle fiber contraction. It is the main initiator of muscle contraction at the moment when it enters the cell through calcium channels. During pregnancy, a huge amount of calcium is needed for the structure of the child's bone tissue, so an increased supply of this element from the external environment is necessary. Under conditions of calcium deficiency, the work of the channels is disrupted and open calcium channels are replaced by sodium, which causes an increase in the sodium level in the muscle cell. Increased calcium content inside the cell causes a huge influx of water, which in turn contributes to intracellular hyperhydration. Swelling of muscle fibers causes compression of nerve ganglia and nerve endings - this worsens the conductivity of the nerve impulse from the muscles to the centers of the brain. This is perceived as a feeling of numbness in the legs or their cramps.

Magnesium is an element that ensures the conduction of impulses through nerve cells. The work of the nerve that provides innervation of a particular muscle fiber, in this case, depends on the amount of magnesium. Under normal conditions, there is a balance between magnesium and calcium, and the processes of nerve impulse conduction are regulated. Calcium enters the cell through slow channels and muscle contraction occurs, and then magnesium ensures the relaxation of the muscle fiber by means of a nerve impulse from the nerve fiber. When there is not enough magnesium, the process of conducting the impulse to the nerve ganglion from the muscle fiber does not occur properly, which can lead to numbness or excessive muscle contraction in the form of cramps of individual muscle groups. Thus, a combined deficiency of magnesium and calcium is the reason why legs cramp.

Considering the deficiency of microelements as the main reason for the development of the problem of numbness of the legs during pregnancy, we should not forget about other possible causes of such a pathology. Very often, women in the second half of pregnancy are concerned about the problem of fluid retention and the occurrence of edema in the legs. This occurs due to the fact that the increase in fetal weight disrupts the outflow of venous blood through the inferior vena cava system, and the lymphatic drainage is also disrupted. Therefore, the problem of swelling of the limbs can be quite pronounced. In this case, not only the innervation processes are disrupted, but the severity of the edema can be the cause of compression of the nerve canals, which causes a violation of innervation. This can be one of the reasons that the legs cramp during pregnancy, especially in the evening, after long walks or stress on the limbs.

It should also be noted that in women with varicose veins of the lower extremities, the cause of numbness in the legs is very often due to the fact that the process of venous blood outflow is disrupted, and dilated veins cause significant discomfort.

Pregnancy is a risk factor for the development of gestational diabetes, even if the woman has not had diabetes before. Therefore, diabetes can also be the cause of leg cramps during pregnancy. The pathogenesis of the development of such symptoms is that with insulin deficiency, glucose does not go through the full metabolic pathway and a huge amount of an intermediate metabolite is formed - sorbitol. Sorbitol is a substance that can accumulate in the vessels that supply blood to nerve fibers - vasa vasorum. This disrupts the trophism of nerve fibers and paresthesia occurs, that is, a feeling of numbness in the hands. Therefore, with this pathology, it is very important to exclude diabetes mellitus as a possible cause of paresthesia.

Another possible cause of cramps or numbness in the legs during pregnancy can be considered a neurological disease in the form of osteochondrosis or arthrosis of the lumbar spine. In this case, compression of the nerve endings occurs, which causes a violation of the normal conductivity of the nerve impulse with a feeling of numbness. This pathology is more serious and requires correction, and is more common in older women.

If your legs cramp during pregnancy, you should also remember about the inferior vena cava syndrome - the compression of this structure by the fetus causes a violation of the outflow from the lower extremities. This can lead to a violation of the blood circulation of the pelvic organs, and the innervation of the organs and lower extremities is provided by the nerve plexuses of the pelvis, which is why these symptoms occur.

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Risk factors

Taking into account all the above-mentioned reasons for the development of pathology, it is necessary to highlight the main risk factors that can lead to leg cramps:

1. pregnant women with insufficient diet and intake of microelements with food;
2. varicose veins of the lower extremities in women;
3. late gestosis of pregnancy with the development of edema of the lower extremities;
4. diabetes mellitus in pregnant women;
5. excess body weight before pregnancy.

Given these causes and risk factors, it is necessary to carefully diagnose this problem in order to exclude the most serious causes and carry out adequate correction of the condition.

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Symptoms leg cramps in pregnancy

Leg cramps during pregnancy often occur after a long working day, when a woman lies down to rest. This is due to the fact that the conductivity of the nerve impulse after intense stress on the limbs worsens, since swelling and muscle fatigue are expressed, their contractile abilities decrease. As for the period, numbness most often occurs in the third trimester of pregnancy, when the woman's body weight increases significantly and the processes of excretion of metabolic products are disrupted. At the same time, the outflow of blood from the lower limbs is also disrupted.

Very often, legs cramp during pregnancy at night and this is associated in most cases with a deficiency of trace elements - potassium, calcium and magnesium. A feature of such numbness is their uniform nature, that is, there is no severe pain or increase in symptoms with different movements. At the same time, the severity of symptoms can be such that cramps in the limbs are felt, which leads to the fact that the woman wakes up and cannot fall asleep for a long time. More often, it is the calves of the legs that cramp, since these muscles are the most developed and located most distally, which disrupts their innervation and blood circulation during sleep.

Numbness of the legs can often be combined with other symptoms. If your arms and legs cramp during pregnancy, and this is also accompanied by pain, then you need to pay attention to these symptoms, since this may be a manifestation of osteochondrosis. Swelling and numbness may also be observed. In this case, we are talking about a violation of kidney function or the possibility of hypertension. If numbness of the lower extremities is accompanied by their swelling and generalized swelling is observed, then you should analyze whether this is simply excess fluid in the body and it is simply necessary to remove it. If there is an accompanying headache, then it is necessary to exclude late gestosis - preeclampsia, so you need to monitor blood pressure.

If your toes cramp during pregnancy, then you need to analyze and exclude a violation of peripheral blood circulation. Then such symptoms may be accompanied by cold extremities and their white color - this should be taken into account when prescribing treatment.

If your legs cramp during late pregnancy and this is accompanied by swelling, you need to pay special attention to this symptom and exclude late gestosis. If your legs cramp during early pregnancy, this may indicate a deficiency of trace elements. This can be observed with severe early toxicosis, which is accompanied by severe vomiting. As you know, during vomiting, a lot of water and useful electrolytes are excreted from the body, which disrupts homeostasis. And one of the manifestations of this can be spasms in the muscles of the lower extremities, especially against the background of hypochloremia. This must be taken into account when diagnosing the causes and possible treatment methods. It is imperative to take into account other symptoms when analyzing the general condition of the pregnant woman in order to avoid possible complications.

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Complications and consequences

Complications that can develop against the background of cramps of the lower extremities are reduced to a violation of the general condition of the woman. If the deficiency of trace elements increases, this can disrupt the work of the heart and blood circulation. In the future, this can cause disturbances in the uteroplacental circulation and cause chronic hypoxia of the fetus. The consequence of untimely diagnosis of osteochondrosis can be a pronounced compression syndrome with a violation of the innervation of the pelvic organs. Then there is a violation of the function of the bladder.

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Diagnostics leg cramps in pregnancy

Considering the fact that more than 95% of cases of leg cramps during pregnancy are caused by a lack of calcium and magnesium, then for diagnosis it is first necessary to determine the level of these trace elements and monitor them throughout the pregnancy. It is very important to take into account any details, clarifying all complaints and other symptoms. It is necessary to find out how other pregnancies proceeded, whether there were similar symptoms before. It is necessary to find out the dynamics of the pregnant woman's body weight and detail the issue of the presence of swelling and fatigue of the legs, pain. Anamnestic data allow you to exclude or confirm the presence of diabetes mellitus, varicose veins of the lower extremities and osteochondrosis, which can also be the cause of such numbness in the legs. It is necessary to pay attention to the presence of flat feet in a woman, because such a harmless reason, at first glance, can become a serious problem. After all, with an increase in the child's body weight, the load on the legs and feet increases, so even if there were no manifestations of flat feet before, then during pregnancy this can manifest itself as numbness in the legs.

Tests are an important indicator for diagnosing changes in the level of basic electrolytes, as well as for monitoring the main indicators of the pregnant woman's condition. General and special tests are carried out - a general blood test, a general urine test, feces, a biochemical blood test with diagnostics of the main electrolytes. As a rule, in the case of a normal pregnancy, there are no specific changes that would indicate pathology. When determining electrolytes, there may be a decrease in the amount of calcium, magnesium and potassium, but they can also be normal, since their level decreases only in the cell, and in the blood it still remains normal. The normal level of calcium in the blood is 2.25 - 2.75 mmol / l. If this indicator is significantly below the norm, then it is necessary to think about a serious deficiency of this microelement, because in this case, leg cramps can be aggravated by symptoms of osteoporosis and severe pain in the joints and bones may appear.

The biochemical blood test also needs to determine the level of total protein.

To exclude pathology of the venous system, it is also necessary to conduct a blood test to determine the main indicators of the coagulogram. If the indicators indicate thickening of the blood, then it is necessary to think about pathology of the veins of the lower extremities, which can also cause pain and cramps in the legs.

To exclude gestational diabetes, it is necessary to conduct a blood glucose level test, as well as a glucose tolerance test. This will help in the differential diagnosis of the pathology.

A general urine analysis should include mandatory diagnostics of daily proteinuria, which allows excluding late gestosis and the presence of hidden edema of the extremities, as one of the possible causes of numbness in the legs.

Instrumental diagnostics are performed to exclude neurological pathology, pathology of the pelvic organs, and to monitor the condition of the fetus. For this purpose, an ultrasound is required to determine the condition of the fetus, and in the late stages of pregnancy - cardiotocography, which allows determining the state of the fetal heartbeat and the tone of the uterus. Also, with the help of ultrasound of the pelvic organs, it is possible to determine the presence of circulatory disorders in the pelvis and possible sources of compression.

Special instrumental studies can also be used for the purpose of differential diagnostics to exclude osteochondrosis or other neurological symptoms. A consultation with specialists is also necessary - a therapist, neurologist, surgeon (in case of varicose veins).

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Differential diagnosis

Differential diagnosis of leg cramps during pregnancy should first of all exclude such serious problems that can harm the child - diabetic neuropathy, osteochondrosis, preeclampsia, arterial hypertension.

Diabetes can be ruled out by analyzing blood glucose levels and testing with glucose load. Neurological problems in the form of osteochondrosis can be differentiated during examination and consultation with a specialist. In this case, pain and impairment of other types of sensitivity will be observed, and numbness will not only be local, but there will also be other pains of a somatic nature or impairment of the pelvic organs.

If the legs are cramping and this is accompanied by pronounced edema, then it is necessary to measure blood pressure for the purpose of differential diagnosis with late gestosis. It can be confirmed or refuted by determining the level of protein and daily proteinuria.

In any case, diagnostics should be as broad as possible to exclude pathological conditions that may disrupt the normal condition and development of the fetus.

Treatment leg cramps in pregnancy

Treatment of this problem should not only involve influencing the cause, but also take into account the principle of minimal harm to the child. Considering the fact that in most cases leg cramps are caused by a lack of trace elements, it is necessary to replenish this deficiency not only through medications, but also through rational nutrition. First, it is necessary to adhere to a sufficient calorie and drinking regime. If in addition to cramps there is also swelling of the legs, then it is necessary to limit the amount of liquid consumed. This can reduce the severity of symptoms. It is also necessary to exclude excessive static loads on the legs and increase the duration of rest and sleep.

As for food products, it is necessary to consume those ingredients that are rich in magnesium and calcium. Therefore, it is necessary to increase the amount of dairy products in the diet and give preference to cottage cheese, which is well digested and does not leave a feeling of heaviness, as can happen with whole milk during pregnancy.

You can increase the amount of exogenous magnesium with the help of products that are rich in this microelement. This includes black bread, bread with bran from wholemeal flour, buckwheat, millet, oatmeal, nuts, lentils and peas, chickpeas, and dried fruits. Teas made from dried fruits, which also contain a lot of potassium, are very useful.

It is good to increase the amount of other vitamins, so pregnant women are advised to eat seasonal fruits and vegetables.

As for drug treatment of magnesium and calcium deficiency, it is mandatory for rapid correction of deficiency and regression of symptoms. Therefore, it is necessary to include magnesium and calcium preparations in the treatment in the form of vitamin preparations.

1. Kerkavit is a complex vitamin preparation, the composition of which allows you to restore the deficiency of calcium and other vitamins. Given the rich composition, the drug replenishes the reserves of not only vitamins and microelements, but amino acids, which allows it to be used as a vitamin preparation for the treatment of numbness and cramps, as well as to improve tissue trophism and muscle tone. Kerkavit contains vitamin B1, which improves blood flow in damaged muscle areas and relieves cramps and numbness, increasing the tone of these muscles. The drug also contains calcium, cystine and keratin, which provide trophism of nerve fibers. Due to the complex action of calcium and vitamin B1, numbness and cramps pass very quickly with the restoration of normal levels of electrolytes in the tissues. Kerkavit is available in the pharmacological form of gelatin capsules. Method of administration - one capsule once a day, dissolving in a small amount of water. Side effects are not detected if the dose is observed, a change in urine color is possible due to the composition of the drug. Contraindications to taking the drug are elevated levels of any hormones, serious kidney and liver dysfunction. Precautions - do not combine with other calcium preparations and do not use for more than thirty days.
2. Magvit B6 is a vitamin product that includes magnesium and vitamin B6, which complement each other's actions and effects. Magnesium is the main microelement that helps improve nervous excitation and impulse conduction to muscles. The drug is available in tablets. Dosage - one tablet twice a day, best taken an hour after meals, which improves the metabolism of the drug. The course of treatment is one month. Side effects can be in the form of allergic reactions, as well as dyspeptic phenomena. Contraindications to the use of this drug for treatment are an increased amount of magnesium in the body, malabsorption syndrome and congenital lactase deficiency. The drug is approved for use during pregnancy. Precautions in case of using this drug - you need to take the drug with caution if you are going to drive a car.
3. Berocca Plus is a complex vitamin preparation that can be used as a therapeutic vitamin remedy. Given its rich composition, the preparation replenishes not only vitamins, but also microelements. The preparation contains vitamins - A, B1, B2, B6, B12, C, D, E, as well as microelements magnesium and calcium. Due to the complex action of calcium and magnesium, numbness and cramps pass very quickly with the restoration of normal levels of electrolytes in the tissues. The drug is available in tablet form with a dosage of one tablet once a day, it is better to take fifteen minutes after a meal, which improves the metabolism of the drug. Side effects are possible in the form of allergic reactions, as well as dyspeptic phenomena in the form of constipation. Contraindications to taking the drug are gastritis and ulcers in the anamnesis, urolithiasis, gallstones. Precautions in case of using this drug - do not take it in combination with other multivitamin complexes.
4. Vitrum is a multivitamin complex recommended for pregnant women as a preventive and therapeutic vitamin remedy. The preparation contains vitamins A, B1, B2, B6, B12, C, D, E, as well as microelements - magnesium, calcium, copper, manganese, zinc, phosphorus, biotin, nicotinamide and folic acid. Magnesium, which is contained in the preparation, takes part in the metabolism of electrons of the respiratory chain in cells, which promotes the synthesis of energy necessary for the cell. This restores neuromuscular conductivity and reduces cramps in individual muscles.

This product is available in tablet form in quantities of 30, 60 pieces. Dosage - one tablet once a day. Precautions when using this drug - do not take it in combination with other multivitamin complexes, especially with vitamins A, D.

Physiotherapeutic treatment of this pathology is possible and has a beneficial effect on the condition of nerve fibers. Magnetic therapy, electrophoresis with ions, and therapeutic massage are used. Self-massage of the affected muscles can be used, and during an attack of convulsions, such a massage relieves symptoms.

Traditional treatment of leg cramps during pregnancy

Medicines and folk methods that are used are aimed mainly at correcting the lack of microelements and improving nerve conduction. Such methods can be used together with medicinal vitamin products. It is possible to use both medicinal infusions and teas, and rubbing with herbs and biologically active substances.

1. Licorice root has affinity for bone tissue and the muscular system, so it is excellent for limb cramps. For a medicinal licorice infusion, take one hundred grams of licorice leaves and pour half a liter of boiled water over them. Directions for use: one teaspoon of infusion three times a day. This remedy helps to normalize increased excitability of muscle structures and also has a tonic effect on nerve fibers.
2. The largest source of calcium is considered to be eggshell. In order to obtain the medicine, it is necessary to wash the shell of a raw egg, then pound it in a mortar until it is finely ground, add five drops of lemon juice, then when the reaction passes, take it at least once a day.
3. Rubbing the muscles of the lower extremities helps very well to relieve leg fatigue. To do this, you need to use an alcohol tincture of calamus. Add a few drops of olive oil to this tincture and rub at night.

The main herbs used to treat this pathology are the following:

1. Hawthorn is a plant that helps normalize the function of muscle cells and restore the normal structure of nerve fibers. For a medicinal infusion, take three tablespoons of the herb, pour boiling water over it and simmer for another five minutes, cover the infusion and leave for three hours. Take it warm five times a day, two tablespoons at a time. The course of treatment is at least three weeks.
2. Valerian root and nettle leaves reduce nervous excitability and improve the conduction of nerve impulses along the fibers to the muscles and internal organs. To prepare a medicinal tea, take nettle leaves and valerian root, pour water over them and leave for ten minutes. This solution should be drunk in a glass twice a day.
3. Burdock root and golden mustache plants are also used in this case. For this, use an infusion of these herbs and drink half a glass twice a day. It is important to control the amount of fluid in the presence of edema.

Homeopathic remedies are based on restoring the level of microelements, as well as on the tonic effect on the conduction of impulses along the fibers. The main remedies are:

1. Magnicum iodatum is a single-component homeopathic preparation, the main active ingredient of which is the inorganic substance magnesium. The preparation is recommended for the treatment of muscle cramps as a drug with a substitution mechanism of action. The drug is available in the form of standard homeopathic granules and its dosage is ten granules three times a day. Method of administration - under the tongue after meals after half an hour. Precautions - do not use if you are allergic to iodine. Side effects include facial flushing and a feeling of heat.
2. Calcohel is a complex homeopathic remedy, which is the main source of calcium. This remedy is used in a dosage of three homeopathic granules. The course of treatment is three months with daily use of the drug twice a day. Side effects may include difficulty swallowing, but this is rare.
3. Stramonium is a homeopathic remedy of natural origin. The drug is produced in the pharmacological form of a homeopathic solution in ampoules and is dosed in a third of an ampoule once a week with possible oral use. Side effects are possible in the form of facial hyperemia and a feeling of heaviness in the legs, there may also be allergic reactions of varying severity.
4. Graphites is a homeopathic remedy of inorganic origin. The drug is used in the form of homeopathic granules and drops. Dosage - six granules three times a day or two drops under the tongue. It is necessary to dissolve the granules until completely dissolved and not to eat for an hour. Side effects are rare, but there may be diarrhea. Precautions - the drug cannot be used by women with asthenic physique and depressive mood.

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Prevention

Preventive measures for the development of this pathology are non-specific and consist of preventing the development of a deficiency of essential vitamins and microelements. This is proper nutrition for a pregnant woman, its balance, a sufficient amount of vegetables and fruits, vitamins. It is recommended to start taking vitamins prophylactically even before pregnancy, and also to take vitamin complexes throughout pregnancy. To prevent complications of the pathology, when other symptoms appear - headache, swelling of the hands, impaired sensitivity - it is necessary to undergo an examination. You need to monitor your health, especially during pregnancy.

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Forecast

The prognosis for recovery from this pathology is favorable.

Leg cramps during pregnancy are a very common problem that needs to be addressed to improve the condition. Most often, symptoms occur at night and disturb the pregnant woman's sleep, while self-massage can be used, which will relieve all symptoms. But in the future, it is necessary to find out the cause of this, and given the frequency of microelement deficiency, it is necessary to correct the diet and vitamin replacement therapy.

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