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Leg cramps in pregnancy

Dr Sanjay Agrawal
Wednesday, September 24, 2014, 08:00 Hrs  [IST]

Cramps as we understand from the word itself are irregular pain attacks which can occur in anyone but occur mostly in pregnancy. During the second and third trimesters, you may have painful leg cramps, particularly at night or while sleeping. You may also have a jumpy feeling in your legs. Leg cramps tend to occur more often during the last months of pregnancy. One research shows that as many as 50-55 per cent pregnant women suffer from  nocturnal pain attacks which in itself presents a huge figure. Another research also seconds this fact that about half of pregnant women attending an antenatal clinic have had leg cramps within one month of their visit. Thus reading about these not only provides us with information but also gives a simple cure for such a common but neglected suffering.

What are these?
These are sudden and sharp gripping kind of pain cramps attacking calf muscles during second and third trimester of pregnancy. These cramps are mostly nocturnal and thus disturb necessary sleep.

Why do they occur?
No one really knows why pregnant women get more leg cramps. It's possible that your leg muscles are tired from carrying around all of your extra weight. Or they may be aggravated by the pressure your expanding uterus puts on the blood vessels that return blood from your legs to your heart and the nerves that lead from your trunk to your legs.

Leg cramps are a sudden tightening of muscles, which can cause intense pain. The muscles may tighten for a variety of reasons, such as:

  • Lack of fluids
  • Injury
  • Muscle strain
  • Staying in the same position for a long period of time
  • Blood circulation problems or pressure on the nerves in the spine
The reasons for increased leg cramps during pregnancy aren't clear. They may be caused by:
  • Changes in blood circulation during pregnancy
  • The stress on your leg muscles of carrying the extra weight of pregnancy
  • The pressure of the growing baby on the nerves and blood vessels that go to your legs
There have been many hypothesis regarding these, some of which have been mentioned here:

1) Of course, the most certain and predictable cause  is the increasing weight of the mother and baby which produces strain on calf muscles and thus cause their undue stretching.
2) The constantly increasing abdominal pressure causes decreased blood flow to lower limb muscles producing nutritional deficiency to muscles and thus pain.
3) Next can be deficiencies of certain mineral elements like Calcium and Magnesium which create spasm in muscles as these minerals are necessary for muscle relaxation.
4) New theory which has been proposed in this context is hormonal.
 It states that progesterone being necessary for uterine homeostasis and for maintenance of foetus gets diverted from the calf muscles to uterus. This hormone is necessary for muscle relaxation and thus its deficiency in calf muscles leads to their contraction producing cramps.

Why mostly nocturnal?
The most apt answer to this lies in the lying down at night i.e. postural difference is the culprit here. During night, patient lies down which eliminates gravitational pull causing blood to move away from legs and towards heart thus aggravating the above effects which results in so called ‘charley horse’ more at night.

What to do for relief?
 Home remedy: Immediately stretch your legs and slowly flex your toes. This can be a little painful earlier but then gradually pain will go off. Don’t point your toe.
Medical consultation: If exercise doesn’t give enough relief, then one can try the latest formulation Crampfort which contains the necessary vitamins, minerals and amino acids after your doctor’s consultation.

How to prevent cramps?
Try these tips for keeping leg cramps at bay:
  • Avoid standing or sitting with your legs crossed for long periods of time.
  • Stretch your calf muscles regularly during the day and several times before you go to bed.
  • Rotate your ankles and wiggle your toes when you sit, eat dinner, or watching TV.
  • Take a walk every day, unless your midwife or doctor has advised you not to exercise.
  • Avoid getting too tired. Lie down on your left side to improve circulation to and from your legs.
  • Stay hydrated during the day by drinking water regularly.
  • Try a warm bath before bed to relax your muscles.
To stop leg cramps - usually in your calf muscles - from stealing your sleep at night, do a few gentle leg stretches before you turn in. Try this simple calf stretch:
1. Stand about arm's length from a wall; place your hands on the wall for support.
2. Keep your left knee slightly bent and move your right foot back a foot or two, keeping it flat on the floor.
3. Feel the stretch in your right calf as you lean forward. Hold the stretch for 10 to 30 seconds, then switch legs to stretch your other calf.

Drink plenty of water during the day; staying well-hydrated help muscles contract and relax properly. Resting with your legs elevated (up on a wall or propped on pillows), wearing support stockings, and keeping your legs warm (try a bath right before bedtime) may all help ward off muscle spasms.

Some research suggests that taking a magnesium supplement in addition to a prenatal vitamin may help some women avoid leg cramps. An adequate supply of calcium is necessary to support your bones and muscles, along with those of your developing baby. It's smart to take a calcium supplement and include plenty of calcium-rich food in your diet.

What do if the pain persists?
Call your practitioner if your muscle pain is constant and not just an occasional cramp or if you notice swelling, redness, or tenderness in your leg, or the area feels warm to your touch. These may be signs of a blood clot, which requires immediate medical attention. Blood clots are relatively rare, but they're more common during pregnancy.

So, readers this presents most of the information regarding pregnancy leg cramps. I just hope that in coming times, if anyone suffers from these, this article may prove helpful.

(Author is a medical consultant and editor in chief of IJMToday)


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