Why does it reduce legs during pregnancy and what should I do?
Reduces legs during pregnancy - this is a common problem for pregnant women, as well as manifestations of toxicosis. This pathology often worries in the third trimester of pregnancy, which is associated with a violation of the metabolism of vitamins. But there may be other causes of this phenomenon, so you need to know about the main of them and conduct adequate therapy, because the severity of the symptoms sometimes disrupts the normal sleep of the pregnant woman and daily activities.
Epidemiology
The epidemiology of this problem indicates a widespread prevalence of this problem among pregnant women, which is more than 85% of pregnant women. Given the etiologic factor, this problem occurs in 96% of women who during pregnancy did not receive any additional vitamins, and the reason for such women is a deficiency of calcium and magnesium. Secondary causes of seizures in the legs during pregnancy are less than 5%. Such data allow us to judge not only the possible causes, but also give grounds for conducting primary prevention of this pathology.
Causes of the leg cramps during pregnancy
Pregnancy is a period when, for the sake of small happiness, a woman has to endure many unpleasant moments that violate her general condition. One such condition is the sensation of paresthesias and muscle cramps.
Under normal conditions, the human body has a normal ratio of different electrolytes, which provide nerve conduction and good muscle stimulation. This process is controlled by the content of calcium, magnesium and potassium in the body. During pregnancy, these trace elements are redistributed in such a way as to ensure the development of the child, so for their mother may not be enough. Deficiency of vitamins and trace elements during pregnancy is a frequent phenomenon, but not all are concerned about the problems of leg cramps. Therefore, it is necessary to take into account also other factors.
To understand the pathogenesis of seizures in muscle tissue, you need to know about the role of certain electrolytes in the human body.
Calcium is a microelement that provides cardiac activity, the work of muscle and nerve fibers, as well as the structure of bone tissue. Calcium also takes part in the normal conductivity of the impulse and the contraction of muscle fibers. He is the main initiator of muscle contraction at the moment when he enters through the calcium channels inside the cell. During pregnancy, a large amount of calcium is necessary for the structure of the child's bone tissue, therefore, an increased intake of this element from the external environment is necessary. In conditions of calcium deficiency, the work of the channels is disrupted and the open calcium channels are replaced by sodium, which causes an increase in the level of sodium in the muscle cell. Increased calcium content inside the cell causes a huge inflow of water, which in turn promotes intracellular hyperhydration. The edema of the muscle fibers causes compression of the nervous 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 of the legs or their cramps.
Magnesium is an element that provides for the impulse to travel through nerve cells. The work of the nerve, which provides the innervation of one or another 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 conduction of the nerve impulse are settled. Calcium through slow channels goes inside the cell and there is a muscle contraction, and then magnesium provides relaxation of the muscle fiber by nerve impulse from the nerve fiber. When magnesium is not enough, the process of impulse to the nerve ganglion from the muscle fiber does not proceed properly, which can lead to numbness or excessive muscle contraction in the form of seizures of certain muscle groups. Thus, the combined deficiency of magnesium and calcium is the reason that it reduces the legs.
Given the shortage of trace elements, as the main reason for the development of the problem of numbness of the legs during pregnancy, do not forget about the possible other causes of such pathology. Very often women in the second half of pregnancy are concerned about the problem of fluid retention and the development of edema on the legs. This is due to the fact that an increase in the weight of the fetus disrupts the outflow of venous blood through the system of the inferior vena cava, and also the lymph drainage is disturbed. Therefore, the problem of edema of the extremities can be very pronounced. In this case, not only the innervation processes are violated, but the severity of the edema can be a cause of compression of the nerve channels, which causes a violation of innervation. This can be one of the reasons that reduces legs during pregnancy, especially in the evening, after long walks or loads on the limbs.
It should also be noted that in women with varicose veins of the lower extremities, the cause of numbness of the legs is very often due to the fact that the process of outflow of venous blood is disrupted, and the enlarged veins bring considerable discomfort.
Pregnancy is a risk factor for the development of gestational diabetes, even if the woman was not previously diabetic. Therefore, the reason that reduces legs during pregnancy, can also be diabetes. The pathogenesis of the development of such symptoms is that when insulin deficiency glucose does not go the full pathway of metabolism and form a huge amount of an intermediate metabolite - sorbitol. Sorbitol is a substance that can accumulate in blood vessels that supply blood to nerve fibers - vasa vasorum. This disrupts the trophism of nerve fibers and causes paresthesias, that is, sensations of numbness in the hands. Therefore, with this pathology, it is very important to exclude diabetes mellitus as a possible cause of paresthesias.
Another possible cause of seizures or numbness of the legs during pregnancy can be considered a neurological disease in the form of osteochondrosis or arthrosis of the lumbar spine. This results in the compression of the nerve endings, which causes a violation of the normal conductivity of the nerve impulse with a sensation of numbness. This pathology is more serious and requires correction, and is more common in older women.
If you reduce your legs during pregnancy, also do not forget about the syndrome of the inferior vena cava - compression of the fruit of this structure causes a violation of the outflow from the lower limbs. This can lead to impaired circulation of the pelvic organs, and the innervation of the organs and lower limbs is provided by the pelvic plexus, so these symptoms arise.
Risk factors
Given all of the above reasons for the development of pathology, it is necessary to identify the main risk factors that can lead to the fact that it reduces legs:
- pregnant women with insufficient food intake and micronutrient intake of food;
- varicose veins of the lower extremities in women;
- late gestosis of pregnant women with development of edema of the lower extremities;
- diabetes mellitus in pregnant women;
- overweight 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 to conduct an adequate correction of the condition.
Symptoms of the leg cramps during pregnancy
Cramps in the legs during pregnancy often occurs after a long working day, when a woman goes to rest. This is due to the fact that the conductivity of the nerve impulse after an intense load on the limbs deteriorates, because the edema and fatigue of the muscles are expressed, their contractility decreases. As for the period, often occurs numbness in the third trimester of pregnancy, when the weight of a woman significantly increases and the processes of release of metabolic products are violated. In this case, the outflow of blood from the lower extremities is also disturbed.
Very often reduces legs during pregnancy at night and this is associated in most cases with the inadequacy of trace elements - potassium, calcium and magnesium. The peculiarity of such numbness is their one-type character, that is, there is no severe pain or increased symptoms with different movements. In this case, the severity of the symptoms may be such that the convulsions of the extremities are felt, which leads to the fact that the woman wakes up, and for a long time can not fall asleep. It often reduces the calves of the legs, as these muscles are most developed and located most distally, which violates their innervation and blood circulation in a dream.
Often numbness of the legs can be combined with other symptoms. If you reduce your arms and legs during pregnancy, and this is accompanied by pain, then you need to pay attention to these symptoms, since this can be a manifestation of osteochondrosis. There may also be swelling and numbness. In this case, it is a violation of kidney function or the possibility of hypertension. If the numbness of the lower limbs is accompanied by their edema and edema is generalized, then it should be analyzed, perhaps it is just an excess of fluid in the body and you just need to remove it. If there is a concomitant headache, then it is necessary to exclude late preeclampsia, therefore it is necessary to control blood pressure.
If it reduces toes during pregnancy, then it is necessary to analyze and exclude the violation of peripheral circulation. Then such symptoms can be accompanied by cooling of the extremities and their white color - this must be taken into account when prescribing treatment.
If you reduce your legs during pregnancy at a later date and this is accompanied by swelling, then you need to pay special attention to this symptom and exclude late gestosis. If you reduce your legs during pregnancy in the early stages, then this may indicate a micronutrient deficiency. This can be observed with pronounced early toxicosis, which is accompanied by severe vomiting. As is known, during vomiting, a lot of water and useful electrolytes are excreted from the body, which disturbs the state of homeostasis. And one of the manifestations of this can be spasms in the muscles of the lower extremities, especially against the background of hypochloraemia. This must be taken into account in the diagnosis of causes and possible methods of treatment. It is necessary to take into account other symptoms, analyzing the general condition of the pregnant woman, in order to avoid possible complications.
Complications and consequences
Complications that can develop against the background of convulsions of the lower limbs, are reduced to a violation of the general condition of women. If micronutrient deficiencies increase, then it can disrupt the work of cardiac activity and circulation. In the future, this can cause violations of uteroplacental blood circulation and cause chronic fetal hypoxia. The consequence of untimely diagnosis of osteochondrosis can be a pronounced compression syndrome with impaired innervation of the pelvic organs. Then there is a violation of the function of the bladder.
Diagnostics of the leg cramps during pregnancy
Given the fact that more than 95% of cases of leg cramps during pregnancy are caused by a deficiency of calcium and magnesium, it is first necessary to determine the level of these microelements and to monitor them throughout the pregnancy for diagnosis. It is very important to take into account any details, with clarification of all complaints and other symptoms. It is necessary to find out how other pregnancies took place, whether such symptoms were earlier. It is necessary to find out the dynamics of the body weight of a pregnant woman and to detail the issue of the presence of edema and leg fatigue, soreness. Anamnestic data allow to exclude or confirm the presence of diabetes mellitus, varicose disease 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 a woman's flat feet, because such an innocuous reason, at first glance, can become a serious problem. After all, with an increase in the body weight of the child, the load on the legs and feet increases, so even if there were no manifestations of flatfoot earlier, during pregnancy this can be manifested by numbness of the legs.
Analyzes are an important indicator for diagnosing changes in the level of basic electrolytes, as well as for monitoring the main indicators of the state of a pregnant woman. Conduct general tests and special - a general blood test, a general urine test, feces, a biochemical blood test with diagnostics of the basic electrolytes. As a rule, in case of a normal pregnancy, there are no specific changes that would indicate a pathology. In 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, but remains normal in the blood. The normal level of blood calcium is 2.25 - 2.75 mmol / l. If this indicator is significantly below the norm, then it is necessary to think about the serious shortage of this trace element, because in this case the leg cramps can be aggravated by the symptoms of osteoporosis and there is a pronounced pain in the joints and bones.
In biochemical blood analysis, you also need to determine the level of total protein.
To exclude the pathology of the venous system, it is also necessary to conduct a blood test with the definition of the main indicators of the coagulogram. If the indicators indicate a thickening of the blood, then you need to think about the pathology of the veins of the lower extremities, which can also cause pain and leg cramps.
To exclude gestational diabetes it is necessary to conduct an analysis of the determination of blood glucose, as well as a test for glucose tolerance. This will help in the differential diagnosis of pathology.
The general analysis of urine should include mandatory diagnostics of daily proteinuria, which allows eliminating late gestosis and the presence of latent limb edema as one of the possible causes of numbness in the legs.
Instrumental diagnostics is carried out with the purpose of excluding neurological pathology, pathology of pelvic organs, and also for monitoring the fetus. For this, ultrasound is usually performed with the determination of the fetal condition, and in the late stages of pregnancy - cardiotocography, which allows to determine the state of the fetal heartbeat and the tone of the uterus. Also with the help of ultrasound of the pelvic organs, one can determine the presence of circulatory disorders in the small pelvis and possible sources of compression.
Special instrumental studies can also be used for the purpose of differential diagnosis to eliminate osteochondrosis or other neurological symptoms. It is also necessary to consult specialists - therapist, neurologist, surgeon (with varicose veins).
Differential diagnosis
Differential diagnosis of cramps in the legs during pregnancy should first of all eliminate such serious problems that can harm a child - diabetic neuropathy, osteochondrosis, preeclampsia, arterial hypertension.
To exclude diabetes mellitus allows carrying out of the analysis of a level of a glucose in blood and the test with loading by glucose. Neurological problems in the form of an osteochondrosis can be differentiated at survey and consultation of the expert. In this case, soreness and violation of other types of sensitivity will be observed, as well as numbness will be not only local, but there will be other somatic pains or impaired pelvic organs.
If it reduces legs and this is accompanied by marked swelling, it is necessary to measure blood pressure for the purpose of differential diagnosis with late gestosis. Confirm or disprove it is possible by determining the level of protein and daily proteinuria.
In any case, the diagnosis should be as wide as possible to exclude pathological conditions that can disrupt the normal state and development of the fetus.
Treatment of the leg cramps during pregnancy
Treatment of this problem should consist not only in the effect on the cause, but also the principle of minimal harm for the child should be taken into account. Considering the fact that in most cases cramps in the legs are caused by a lack of trace elements, it is necessary to fill up this deficit not only at the expense of medicines, but also at the expense of rational nutrition. First, it is necessary to adhere to sufficient kallorazha and drinking regimen. If, in addition to cramps, there are also swelling of the legs, then you need to limit the amount of fluid used. This can reduce the severity of the symptoms. Also need to eliminate excessive static loads on the legs and increase the duration of rest and sleep.
As for food, it is necessary to use those ingredients that are rich in magnesium and calcium. Therefore, you need 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 it can be with whole milk during pregnancy.
Increase the amount of exogenous magnesium possible with products that are rich in this trace element. It includes black bread, bread with bran from coarse flour, buckwheat, millet, oatmeal, nuts, lentils and peas, chick peas, and dried fruits. Very useful teas, made from dried fruits, which also contain a lot of potassium.
It is good to increase the amount of other vitamins, so pregnant women are encouraged to use seasonal fruits and vegetables.
As for the medical treatment of a deficiency of magnesium and calcium, it is mandatory for the rapid correction of deficiency and regression of symptoms. Therefore, it is necessary to include in the treatment of magnesium and calcium preparations in the form of vitamin preparations.
- Kerkavit is a complex vitamin preparation, the composition of which allows to restore the deficiency of calcium and other vitamins. Given the rich composition, the drug replenishes stocks of not only vitamins and trace elements, but amino acids that allows using it as a vitamin preparation for the treatment of numbness and seizures, as well as for improving tissue trophism and muscle tone. The structure of Kerkavit includes vitamin B1, which improves blood flow in the broken muscle sites and relieves convulsions and numbness, increasing the tone of these muscles. Also, the composition of the drug includes calcium, cystine and keratin, which provide trophic nerve fibers. Due to the complex action of calcium and vitamin B1, numbness and cramps pass very quickly with the restoration of the normal level of electrolytes in the tissues. Kerkavit is available in the pharmacological form of gelatin capsules. Method of application - one capsule once a day, dissolving in a small amount of water. Side effects with respect to the dose are not detected, there may be a change in the color of urine due to the composition of the drug. Contraindications to taking the drug - this is an increased level of any hormones, serious violations of kidney and liver. Precautions - do not combine with other calcium preparations and do not use for more than thirty days.
- Magvit B6 - a vitamin remedy, which includes magnesium and vitamin B6, which complement the actions and effects of each other. Magnesium is the main microelement, which contributes to the improvement of nervous excitation and impulse conduction to the muscles. The drug is available in tablets. Dosage - one tablet twice a day, it is better to take an hour after eating, which improves the metabolism of the drug. The course of treatment is one month. Side effects can be in the form of allergic manifestations, as well as dyspepsia. Contraindications to the use of this remedy for treatment are an increased amount of magnesium in the body, malabsorption syndrome and congenital lactase insufficiency. The drug is approved for use during pregnancy. Precautions in the case of using this drug - you need to take care with the drug in the event of an impending driving.
- Berroca plus is a complex vitamin preparation that can be used as a therapeutic vitamin remedy. Given the rich composition, the drug replenishes stocks of not only vitamins, but also trace elements. The composition of the drug includes vitamins - A, B1, B2, B6, B12, C, D, E, as well as trace elements of magnesium and calcium. Due to the complex action of calcium and magnesium, numbness and cramps pass very quickly with the restoration of the normal level of electrolytes in the tissues. The drug is available in tablet form with a dosage - one tablet once a day, it is better to take it after fifteen minutes after eating, which improves the metabolism of the drug. Side effects are possible in the form of allergic manifestations, as well as dyspeptic phenomena in the form of constipation. Contraindications to taking the drug - a gastritis and a history of an ulcer, urolithiasis, stones of the gallbladder. Precautions in the case of using this drug - you should not take it in combination with other multivitamin complexes.
- Vitrum is a multivitamin complex that is recommended for pregnant women as a preventive and curative vitamin remedy. The composition of the drug includes vitamins A, B1, B2, B6, B12, C, D, E, as well as trace elements - magnesium, calcium, copper, manganese, zinc, phosphorus, biotin, nicotinamide and folic acid. Magnesium, which is contained in the drug, takes part in the metabolism of respiratory chain electrons in cells, which contributes to the synthesis of energy necessary for the cell. This restores neuromuscular conduction and reduces the cramps of individual muscles.
This product is available in the form of tablets in the amount of 30, 60 pieces. Dosage - one tablet once a day. Precautions in the case of using this drug - you should 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 state of nerve fibers. They use magnetotherapy, electrophoresis with ions, and also therapeutic massage. You can use self-massage of the affected muscles and during an attack of seizures, such a massage removes symptoms.
Alternative treatment of convulsions in the legs during pregnancy
The drugs and alternative methods that are used are mainly aimed at correcting the lack of trace elements and improving the nerve conduction. Such methods can be used in conjunction with vitamin medications. You can use, as well as medicinal infusions and teas, and grindings with herbs and biologically active substances.
- The licorice root has a tropism to the bone tissue and the muscular system, that's why it helps perfectly with limb spasms. For medicinal infusion of licorice, take one hundred grams of licorice leaves and pour half a liter of boiled water. Method of application - one teaspoon of infusion three times a day. Such a tool helps normalize the increased excitability of muscle structures, and also has a tonic effect on nerve fibers.
- The most important source of calcium is the egg shell. In order to get the medicine it is necessary to wash the shell of the raw egg, then to shred in a mortar finely to a powdery state, add five drops of lemon juice there, then when the reaction takes place, take it minimally once a day.
- Very good help rubbing the muscles of the lower extremities to relieve fatigue in the legs. To do this, use alcoholic tincture of Kalgan. In this tincture, add a few drops of olive oil and rub it overnight.
The main herbs that are used to treat this pathology are:
- Hawthorn is a plant that helps normalize the function of muscle cells and restore the normal structure of nerve fibers. For medical infusion it is necessary to take three tablespoons of herbs, pour boiling water and boil over low heat for another five minutes, this infusion should be covered and insisted for three hours. Take in warm form five times a day for two tablespoons. The course of treatment is not less than three weeks.
- Valerian root and nettle leaves reduce nervous excitability and improve the conduction of a nerve impulse along the fibers to the muscles and internal organs. To prepare medicinal tea, you need to take the leaves of nettle and the root of valerian pour them with water and insist for ten minutes. Such a solution should be drunk in a glass twice a day.
- The root of burdock and plants of the golden mustache are also used in this case. For this, use the infusion of these herbs and consume them half a glass twice a day. It is important to monitor the amount of fluid in the presence of edema.
Homeopathic remedies are based on the restoration of the level of microelements, as well as on the toning effect on the impulse on the fibers. Property, plant and equipment:
- Magnumum iodate is a one-component homeopathic preparation, the main active substance of which is the inorganic substance magnesium. The drug is recommended for the treatment of muscle cramps as a substitute mechanism of action. The drug is released in the form of standard homeopathic granules and dosage of it - ten pellets three times a day. The way of application - under the tongue after eating after half an hour. Precautions - do not apply for allergies to iodine. Side effects are in the form of redness of the face and a sensation of heat.
- Kalkohel is a complex homeopathic remedy, which is the main source of calcium. This drug is used in a dosage of three homeopathic grains. The course of treatment is three months with daily use of the drug twice a day. Side effects can be in the form of difficulty swallowing, but this is rare.
- Stramonium is a homeopathic remedy of natural origin. The drug is released in the pharmacological form of the homeopathic solution in ampoules and is dispensed on the third part of the 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, and there may also be allergic manifestations of varying severity.
- Graphite is a homeopathic remedy of inorganic origin. The drug is used in the form of homeopathic granules and drops. Dosage - six pellets three times a day or two drops under the tongue. It is necessary to dissolve the granules to complete dissolution and not take food for an hour. Side effects are rare, but there may be diarrheal syndrome. Precautions - it is impossible to use the drug for women asthenic physique and depressed mood.
Prevention
Measures to prevent the development of this pathology are nonspecific and consist in preventing the development of deficiencies in essential vitamins and microelements. This is the proper nutrition of the pregnant woman, its balance, a sufficient number of vegetables and fruits, vitamins. It is recommended to start a preventive intake of vitamins before pregnancy, and also take vitamin complexes throughout pregnancy. For the prevention of complications of pathology with the appearance of other symptoms - headache, swelling of the hands, violation of sensitivity - it is necessary to be examined. You need to monitor your health, especially during pregnancy.
Forecast
The prognosis of this pathology for recovery is favorable.
Cramps in the legs during pregnancy are a very common problem that must be addressed to improve the condition. Most symptoms occur at night and disturb the sleep of a pregnant woman, while you can use self-massage, which removes all symptoms. But in the future we need to find out the reason for this, and given the frequency of micronutrient deficiencies, we need to adjust the diet and substitutive vitamin therapy.
Medical expert editor
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, Specialty - "General Medicine"
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