Written by Dr.M.D.Mazumdar, MD
Many women complain of cramping pain in the legs, more so in the calf muscles, when they are pregnant. The toes may also be affected.
Sometimes this pain occurs all through pregnancy, but it is usually more common in the later 3 months.
The pain may be less during the day when you are busy with your daily chores and thus getting at least some exercise.
But, at night, or during the day when you are lying down, the cramps can be excruciatingly painful.
In most women, the pain may be mild or moderate with some amount of discomfort, but occasionally it may be severe enough for the muscles in your calf to become as hard as a rock or for your toes to curl uncomfortably under your soles.
Causes of Leg Cramps
Deficiency of calcium : This is believed to be the main reason for calf muscle cramps. Much of the calcium that you get in your normal diet is used by your body to help develop your baby's bone, teeth and other organs. This decreases your own body's share of calcium, making your bones and muscles weak.
Calcium helps the muscles of the whole body to contract and relax properly. Deficiency can cause abnormalities in the uptake of calcium by the muscles leading to painful cramps.
Dehydration : Dehydration is a very common cause of leg cramps, even in women who are not pregnant. It causes increases in leg cramps when the woman is pregnant and needs more fluids than otherwise.
Deficiency of other salts and minerals: Deficiency of potassium, iron, and the Vitamin B group can cause cramps.
Excessive weight gain: The extra weight that you carry in pregnancy puts more pressure on the legs especially the calves. The heavier you are, the more is the pressure. The muscles of the leg have to work more to carry this weight. This extra work leads to collection of lactic acid in the calf muscles, leading to pain.
Restriction of Blood Circulation: The growing baby and the enlarging uterus presses on the blood vessels of your legs. These blood vessels carry blood, rich in oxygen, from your heart to your legs. Pressure on the blood vessels of the lower body can cause a mild oxygen deficiency in the legs. The pressure can also decrease blood flow back from the legs, leading to pooling of fluid around the ankles with swelling . This can cause cramping pain in the legs.
Lack of Exercise: Exercise increases blood flow to and from your legs and can prevent cramps. Lack of exercise can hamper blood circulation and can also cause you to put on too much weight - both are causes of leg cramps.
What You can do to Control Leg Cramps
Take more Calcium : Increase the amount of calcium-rich food like milk and milk products in your diet. The normal daily requirement in a pregnant woman's diet is 1000 mg of calcium per day. And 1500 mg in a woman who is breastfeeding.
200 ml of whole milk (a standard water glass ) contains about 300 to 350 mg of calcium. Other food that contains calcium are meat and fish, eggs, and vegetables like broccoli and okra (also called ladiesfinger).
Supplements : If necessary, take a calcium supplement like pills of calcium carbonate. Talk to your gynaecologist about the cramps and ask for a prescription for calcium salts. Do remember to tell her if you are taking any antacids as most antacids contain calcium.
Avoid calcium supplements that contain bone meal or dolomite as they may contain dangerous levels of lead.
Other Deficiencies : Deficiency of other salts like magnesium, potassium, and vitamins like vitamin C and vitamin B can cause cramps. Improve your diet to get enough of these essential nutrients in your food. Snack on citrus food like lemons and oranges, increase green leafy vegetables in your diet.
Take a glass of lime juice everyday - Squeeze a slice of lime into a glass of water and add a pinch of salt and a tablespoon of sugar. It will provide you with adequate electrolytes, sodium, potassium and vitamin C. Alternately, take oral rehydrating salts (ORS) that are generally available at the pharmacies. Depending on your body weight, the amount of ORS you need may vary. Ask your doctor how much you can take.
Avoid Dehydration : Drink at least 8 - 10 glasses of water a day. Dehydration can cause cramps.
If you feel a cramp in the middle of the night, get up and walk around slowly till it goes away, get up and walk around slowly till it goes away.
Exercise : Stretch your calf muscles right before you go to bed and as soon as you get up in the morning. Flex your feet by straightening your leg and gently flexing your ankle and toes back toward your shins several times. You can do this in bed or while standing up.
Massage: squeeze your muscles gently with your hand, release and squeeze again. Alternately, rub your legs from the knee to your heel with long firm strokes. Ask your partner to massage your calves for more comfort.
Heat: A heated pad or towel (you can place one in the oven) placed on your muscles will usually relieve the pain.
Do not cross your legs for long periods of time while sitting. The crimp at your knees will hamper blood circulation and can lead to cramps. While sitting, whether in front of the TV or anywhere, stretch your legs in front of you. Wriggle your toes, rotate your ankles clockwise and then anticlockwise and stretch your calf muscles.
Walk : A short walk daily will stretch your muscles and give you plenty of fresh air, helping your circulation and oxygenating your blood.
Elevate your Legs : When lying down, put your legs up on a small pillow or cushion to help return of blood from your legs to your heart. It will help to decrease swelling of the ankle (edema) which also contribute to leg cramps.
Wear Supportive Stockings to prevent pooling of blood in your lower limbs.
Posture : Lie on your left side while sleeping. This will draw the enlarged uterus away from the large vein (the inferior vena cava) carrying blood from the lower limbs to the heart and help in blood circulation.
A word of caution : If your cramps are very severe, or if you notice any localized pain or swelling anywhere in your legs, contact your doctor. In some women, a blood clot can lodge in the veins preventing blood flow and causing severe pain. Do not mistake this pain for cramps. Pain due to a blood clot is constant and very severe, while cramps usually decrease after some time.