Why cramps legs during pregnancy and what to do?

Unfortunately, pregnancy is not only a joyful expectation of the birth of a baby, but also a number of unpleasant moments. For example, toxicosis, heaviness, leg cramps during pregnancy are not uncommon. Cramps can disturb both during the day and at night, and the muscles after that are able to maintain increased sensitivity for a long time. How to prevent seizures and can they be eliminated? What is the reason for their appearance?

Doctors say: leg cramps during pregnancy appear at any time. Sometimes they do not have a clear cause and are directly related to an "interesting" situation, but in some cases they can be a sign of a disease that requires immediate intervention by a medical specialist. Let's try to understand this issue in more detail. [1]

Epidemiology

According to statistics, leg cramps during pregnancy periodically disturb nine out of ten women. At the same time, 60% of the discomfort occurs after a long walk, or with a long stay in an upright position. And in 30% of women, seizures appear for no apparent reason.

Most often, the problem is detected in the second half of pregnancy - from about 20-22 weeks.

Causes of the leg cramps during pregnancy

In most pregnant women, the appearance of leg cramps is associated with such reasons:

• Trace element instability in the body, lack of magnesium, potassium or calcium, or vitamin B ₆. Here's what can cause such instability:
  • I trimester - frequent vomiting, toxicosis, inability to properly assimilate vitamins and trace elements or lack of sufficient intake (for example, with a complete lack of appetite);
  • II trimester - active intrauterine development of the baby and the associated high need of the mother's body for trace elements;
  • throughout pregnancy - malnutrition, taking certain medications (for example, diuretics).
• Anemia. When the level of hemoglobin decreases, the supply of oxygen to the muscles is disturbed, which causes its periodic convulsive contraction, which is especially disturbing in the legs (without a definite connection with the time of day).
• Hypodynamic stagnation of blood flow. Due to insufficient motor activity of a woman, stagnant processes occur in the circulatory system.
• Varicose veins. Convulsive muscle contractions are disturbing as a result of stagnation of venous blood - they are found mainly at night, or in the late afternoon.
• Drop in blood glucose levels. The state of energy hunger, when the flow of glucose into the blood is disrupted, can also cause leg cramps. Such troubles occur mainly at night or closer to the morning.
• Syndrome of compression of the inferior vena cava. Starting from the 20th week of pregnancy, the enlarged uterus begins to put pressure on the inferior vena cava. This causes a slowdown in blood flow in the legs, the appearance of edema and cramps. It is interesting that convulsions in such a situation disturb the pregnant woman if she is laid on her back or on her right side.
• Dehydration. Drinking small amounts of fluid throughout the day can cause leg cramps during pregnancy.
• Incorrectly selected shoes, hypothermia of the feet, prolonged standing or walking.

Risk factors

Risk factors that can increase the risk of leg cramps during pregnancy include:

• excessive thinness, or vice versa, overweight;
• a sharp change in the intensity of physical activity;
• malnutrition and non-compliance with water balance;
• diseases of the liver, thyroid gland, frequent nervous shocks and breakdowns, diabetes mellitus.

Pathogenesis

The pathogenetic mechanisms of the appearance of muscle contraction, as well as the processes of regulating this reaction by the nervous system, are very complex and depend on the different content of certain ions in the cell and outside it. Any failure and imbalance can cause seizures, and the main cause is considered to be a disorder of mineral metabolism.

Here is what is causing this disorder:

• with increased need for minerals during pregnancy;
• with toxicosis, frequent vomiting, diarrhea;
• with malnutrition, lack of appetite, the predominance of certain foods against the background of the absence of others, etc.;
• with medication (especially in the absence of control by a doctor).

Most often, mineral metabolism disorders are associated with a lack of components such as potassium, calcium, magnesium and vit. B6. _{_}

• Potassium plays a special and important role in the processes of intracellular metabolism. With prolonged or frequent vomiting or diarrhea, with chaotic or prolonged treatment with diuretics, a deficiency of this microelement may develop. Abuse of coffee is also often the cause of potassium deficiency, however, during pregnancy this problem is most often irrelevant, since coffee consumption in this period is usually severely limited, or completely abandoned. Few people know, but the absorption of potassium worsens against the background of a lack of magnesium, another important trace element.

Potassium can be obtained from foods such as dried apricots, bananas, beans, broccoli, milk, melons. The average daily human requirement for potassium is approximately 4.5 g.

• Calcium is a microelement, the normal absorption of which is impossible without the presence of magnesium and vitamin D ₃. An increased need for calcium occurs during periods of stress and during pregnancy. Calcium absorption is disturbed by products containing oxalic acid (for example, sorrel and rhubarb, spinach, etc.) or phosphates (caviar and canned fish, egg yolks, hard cheese, cocoa and soda). Insufficient consumption of protein foods also disrupts the absorption of the trace element, but the normal intake of iron contributes to the good absorption of calcium in the gastrointestinal tract.

Where can the body get calcium? There is a lot of it in greens, beans, nuts, figs, cottage cheese, hard cheese.

• Magnesium during pregnancy is especially necessary, since the need for a trace element in this period increases many times over. Accelerate the excretion of magnesium from the body caffeine, an excess of potassium. A woman's body will require more magnesium on the background of a high-protein diet, taking hormonal drugs.

Magnesium deficiency can be replenished by adding seeds and seeds, nuts, beans, any greens, carrots, onion feathers to the diet.

• Vitamin B6 deficiency does not _in  itself cause seizures. However, a lack of the vitamin hinders the absorption and cellular absorption of magnesium. Pyridoxine acts as a kind of conductor that promotes the penetration and fixation of magnesium ions inside the cell.

Vitamin-rich foods include: meat and offal, brewer's yeast, nuts and beans, avocados. Alcoholic drinks and nicotine worsen the absorption of pyridoxine from food. [2]

Symptoms of the leg cramps during pregnancy

Most often, a convulsive problem during pregnancy appears precisely in the legs, and especially in the calf muscles. Cramps are painful muscle twitchings, and in some cases you can even see a strong tension of individual muscles under the skin. Zones of muscle spasm are found as painful seals, and it is absolutely impossible to independently resist such muscle contraction.

Convulsions occur mainly in the evening or at night, when a woman takes a horizontal position. Spasm occurs at the level of muscle cells, which are intensely excited and thereby contract.

During the entire period of pregnancy, the female body experiences a tremendous load. The volume of circulating blood increases, blood flow from the veins worsens, the water-electrolyte ratio changes, the consumption of vitamin substances and microelements increases - for example, calcium, magnesium, vitamin D and other components involved in metabolic processes and helping to assimilate each other.

The first signs of problems may appear already in the first weeks of pregnancy, especially if there was a violation of the water-salt balance, malnutrition, venous diseases, etc. A typical onset is the appearance of night cramps in certain muscle groups (most often in the calf muscles). The next morning, there may be a slight dull soreness in the calves caused by convulsive muscle strain, as well as general weakness, drowsiness, and a feeling of fatigue.

Leg cramps at night during pregnancy can manifest themselves in different ways. For example, in some women, this looks like a relatively long period of muscle tension, like a “leg cramped”. Other women point to a short series of gentle contractions, in which the muscles seem to "shudder".

The localization of cramps in the legs is different: from the fingers to the foot, ankle, calf muscles, popliteal region, etc. Depending on the duration and type of muscle spasms, cramps are divided into the following symptomatic varieties:

• Myoclonic contractions are rhythmic and arrhythmic twitches, shudders, not accompanied by pain.
• Clonic contractions are rhythmic spasms that can result in a "long-playing" attack, similar to muscle trembling.
• Tonic contractions are a well-known “leg cramped” condition, when the muscle spasms and does not let go for some time. Such cramps in the legs in the morning during pregnancy occur most often, and are accompanied by pain and extreme discomfort.
• The mixed type of tonic-clonic convulsions during pregnancy in the calves of the legs practically does not occur, since they are related to epileptic and epileptic-like pathologies.

Severe leg cramps during pregnancy can be triggered by various factors, from malfunctions in the functioning of the nervous system and blood vessels to a banal vitamin and mineral deficiency. Depending on the clinical manifestations, the doctor prescribes the appropriate diagnosis and only after that proceeds to correct the pathological condition.

Complications and consequences

Leg cramps during pregnancy are not always a harmless symptom. Even the lack of any vitamin or microelement in the body of a pregnant woman can result in violations of the functions of individual organs, including vital ones.

Not always during pregnancy, a woman manages to eat qualitatively and fully, to eat greens, fruits and vegetables. The reason for this is hormonal changes, stress, toxicosis, and digestive disorders. In addition, the load on the vascular network is significantly increased - for example, everyone knows that the first signs of varicose veins often occur precisely during the bearing of a baby.

In order to prevent the development of adverse consequences and pathological complications, it is impossible to treat seizures on your own. Any drugs and procedures during pregnancy should be prescribed only by a doctor, after conducting the necessary diagnostics. For example, if a woman's body additionally needs vitamins, then the doctor will help you choose a vitamin-mineral complex that will help get rid of leg cramps, and at the same time will not harm the intrauterine growth and development of the baby.

Diagnostics of the leg cramps during pregnancy

Finding the cause of leg cramps during pregnancy is most often not difficult, but this will require a number of diagnostic measures. In particular, it is necessary to evaluate blood parameters - such as hemoglobin level, color index, levels of serum iron and basic trace elements. If the doctor suspects varicose veins of the lower extremities, he may prescribe Doppler ultrasound followed by a consultation with a vascular surgeon or phlebologist.

Tests that the doctor may recommend:

• a general clinical blood test (it will help to recognize inflammatory processes, anemia, get a general idea of \u200b\u200bthe health of the body);
• determination of the level of glucose in the blood;
• general urinalysis, analysis according to Nechiporenko (to assess the performance of the kidneys, which are directly involved in the regulation of water and electrolyte balance);
• blood biochemistry (an analysis that allows you to evaluate the work of the liver and kidneys).

Instrumental diagnostics may include Dopplerography, or ultrasound examination of the venous vessels. This is necessary in order to assess the quality of blood circulation and diagnose possible venous insufficiency.

Probably, in each individual case, other diagnostic studies may be needed. This issue is resolved by the gynecologist: if necessary, the patient will be referred to a highly specialized specialist who will prescribe other diagnostic procedures.

Differential diagnosis

Differential diagnosis should be carried out with such diseases and conditions:

• violations of water and electrolyte balance;
• beriberi, violations of mineral metabolism, anemia;
• digestive disorders;
• toxicosis, vascular spasms;
• SARS;
• a prolonged state of hypodynamia, or vice versa, a sharp excessive muscle load;
• Varicose veins.

Treatment of the leg cramps during pregnancy

The first thing that a pregnant woman should do when cramps appear in her legs is to consult a doctor. It is advisable to first consult with your gynecologist, or sign up for a consultation with a therapist, phlebologist, nutritionist - depending on the alleged cause of the disease.

It is impossible to self-medicate categorically, because during pregnancy there is a high risk of harming a growing child. It is better to consult a doctor, undergo the necessary diagnostics, consult with narrow specialists (neurologist, endocrinologist, etc.).

As a rule, after the examination, the doctor prescribes medication, taking vitamin complexes to compensate for the deficiency of substances. Sometimes the problem can be eliminated without the use of drugs, simply by adjusting the diet, adjusting the rest regimen. Additionally, you can conduct a course of massage sessions or reflexology, at the discretion of the doctor.

What to do?

What can you do on your own to relieve leg cramps during pregnancy?

• Eliminate the possible cause of the cramp (for example, take off your shoes).

• Give the legs an elevated position (above the level of the head), try to pull the entire plane of the foot towards you.
• Breathe deeply with full breasts, do not be nervous.
• Make a small massage of the calves (you can do it with your hands, or with the help of a small massager).
• Apply a warm heating pad to your feet, or take a warm shower.
• Relax, drink a cup of warm tea or water.

If the cramps do not go away, or even turn into pain, then it is necessary to consult a doctor.

Medications that a doctor may prescribe

Treatment for leg cramps during pregnancy can vary greatly, depending on the cause of the condition. For example, with varicose veins, the doctor may recommend the use of such medications:

• Venotonics, or phlebotropes, or phleboprotective agents are a number of drugs that can increase the tone of the veins, reduce specific venous manifestations and syndromes. Treatment with venotonics is effective if varicose veins are just beginning to develop. Typical representatives of venotonics are Detralex, Troxevasin, Venoruton.
• Venotonic external preparations are ointment, cream or gel products, such as Heparin ointment, Venoruton gel, etc.

Most often, leg cramps during pregnancy are a complex problem, so mineral and multivitamin preparations are almost always prescribed. Particularly popular are drugs such as Magne B ₆  (Magnicum), Calcium D ₃  Nycomed, as well as combined vitamin and mineral complexes. We will talk about vitamins separately below.

Detralex	Diosmin, hesperidin. It has venotonic and angioprotective properties, reduces vein extensibility, eliminates venostasis, increases capillary resistance, improves lymphatic drainage. Detralex for convulsions during pregnancy is taken under the supervision of a doctor, 2 tablets per day (morning and night, with food). Possible side effects are dyspepsia.
Troxevasin capsules	Troxerutin preparation, capillary-stabilizing and venotonic agent with anti-inflammatory and antioxidant activity. Take 2 capsules per day, with food. The duration of therapy is about a month.
Venoruton capsules	The drug strengthens capillaries and stabilizes their permeability, eliminates edema, leg cramps, and trophic disorders. Usually taken in the amount of one capsule three times a day, for two weeks. Possible side effects are dyspepsia, headache.
Heparin ointment	The preparation is external, is an anticoagulant of direct action, has anti-inflammatory and local analgesic properties. During pregnancy, the ointment is used extremely carefully, in very small quantities under the supervision of a physician. Side effects: redness of the skin, local irritation, allergies.
Magnicum	Preparation with magnesium lactate and pyridoxine hydrochloride. For convulsions, take one tablet twice a day, with water. Adverse reactions are rare and are expressed in allergies or digestive disorders.
Calcium D 3  Nycomed	A combination drug that is prescribed for the prevention and treatment of calcium and vitamin D deficiency. For convulsions during pregnancy, one tablet of the drug is usually prescribed twice a day. Rare side effects can be expressed in minor digestive disorders.

Vitamins for cramps during pregnancy

Vitamins during pregnancy play the role of the most important regulator of intracellular biochemical processes. At the same time, a woman receives most of the vitamins from food, therefore, before pregnancy and during the gestation period, it is necessary to diversify the diet as much as possible, introduce, if possible, a sufficient amount of plant foods: vegetables, fruit juices, berries, herbs, etc.

In some cases, it is necessary to compensate for the deficiency of vitamins using special vitamin-mineral complexes. Most often, they not only help get rid of leg cramps during pregnancy, but also improve the condition of the body as a whole, and even prevent the development of toxicosis. Synthetic vitamin preparations are not much different from those vitamin substances that are present in foods. Sometimes they are even better perceived by the body and easier to digest.

What vitamins are especially needed for a pregnant woman to eliminate leg cramps? Of course, it is better to take a special analysis and check what specific substance is missing in the body. But in most cases, no one wants to waste time identifying the problem, so you have to immediately take a complex of vitamins recommended for expectant mothers. Be sure to include folic acid, vitamin D, magnesium, iron, calcium and potassium in the composition of such a complex.

Why are complex vitamin preparations considered the best option for convulsions during pregnancy? The fact is that in the vast majority of metabolic mechanisms, vitamins and minerals are involved, interacting with each other. For example, magnesium should always come with B vitamins, and calcium with vitamin D.

Complex preparations are recommended to be taken before conception and throughout the entire period of pregnancy: this often allows you to prevent the occurrence of leg cramps in advance. If convulsions have already appeared, then in most women they disappear within a few days of taking the complex remedy. What drugs are we talking about?

• Doppelherz asset - vitamins for mom;
• Now Foods prenatal vitamins;
• Prenatabs Solgar;
• Alphabet Mom;
• Vitrum prenatal (or Vitrum prenatal forte);
• Elevit pronatal.

These drugs are most often used by women during pregnancy, but only a doctor can recommend their use (there are contraindications).

Physiotherapy treatment

Physiotherapy for leg cramps during pregnancy is relatively rare. The usual contrast dousing of the lower extremities, alternate application of ice and external heat, light massage help and alleviate the condition well. They practice special exercise therapy exercises, and with severe convulsions - bed rest. In addition, the wearing of medical underwear, bandages, etc. Is shown.

Actually, from physiotherapeutic methods, procedures such as ultraviolet irradiation, transcutaneous electrical nerve stimulation, and acupuncture are especially popular. There are cases of successful use of low-frequency non-thermal magnetotherapy: this method perfectly relieves tissue swelling and pain, restores a healthy balance of sodium and potassium ions, and alleviates muscle-tonic manifestations.

Ultraviolet exposure in the wave range of 320-280 nm is considered one of the most preferred procedures, since it does not lead to hypervitaminosis D ₃  (the risk of its development is present with the internal administration of appropriate drugs). With painful convulsions, UVR is performed in erythemal dosages: they start with 2-3 biodoses with a further increase to 5-8 biodoses.

Recommended sessions of electrophoresis with calcium and phosphorus in combination with total ultraviolet irradiation.

Alternative Treatment

Alternative prescriptions for leg cramps do exist, but should be discussed with your doctor if you are pregnant. In general, such methods are approved by official medicine and help to significantly improve the condition of women in such an important period for them.

• If convulsions are caused by a lack of calcium in the body of a pregnant woman, then it can be replenished with the help of eggshells. The shell should be fresh and well washed: it is calcined for 10 minutes in the oven or microwave, after which it is ground in a mortar to a powder state. This powder is taken daily, in the morning, in the amount of 1-2 g. Immediately before use, you need to add a few drops of lemon juice to it. You can eat a dose separately from other products, or add to cottage cheese, yogurt, salad.
• An excellent remedy for leg cramps is lemon juice. In the morning and at night, calves and feet are lubricated with it, both for prevention and for treatment. After applying the juice, you can not wipe it off or wash it off: it must be absorbed into the skin itself.
• Take 20 g of dry crushed bay leaf, pour unrefined vegetable oil in the amount of 250 ml, leave to infuse for 12 days. Sometimes the drug needs to be shaken and mixed. When the medicine is ready, it must be filtered and used to rub the legs with convulsions.

Herbal treatment

• Improves nutrition of the muscles of the lower extremities licorice rhizome. This plant is able to normalize the tone and nerve conduction of muscle tissue. To prepare the drug, take 100 g of dry rhizome and insist in 500 ml of boiling water - until cool. Take 1 tsp. Three times a day.
• An excellent anticonvulsant effect has a decoction of hawthorn fruits: 3 tbsp. L. Fruits are poured with 500 ml of boiling water, kept on low heat for five minutes, after which they insist under the lid for about three hours. Take 2 tbsp. L. Decoction 5 times a day for 20 days.
• For leg cramps during pregnancy, take one serving of fresh celandine plant juice and combine it with two servings of liquid petroleum jelly. The resulting remedy is rubbed on the legs in places where convulsions appear. If rubbing is repeated daily, then the cramps will stop bothering you within two weeks.

Homeopathy for cramps during pregnancy

Homeopathic remedies are safe and can be used during pregnancy under medical supervision. Most often, leg cramps are eliminated by such homeopathic remedies:

• Zincum 6 alternates with Belladonna 3, at first every half an hour, then less often, bringing up to 2 times a day;
• Sulfur 3, Veratrum 3, Sekale cornutum 3, Strontian carbonica;
• Causticum 6 twice a day, 5 drops;
• Ignacy 6, Stramonium 6, Platinum 6.

The dosage and selection of drugs is carried out by a homeopathic doctor during an individual appointment.

Surgery

The surgeon's help is mainly sought in cases where leg cramps during pregnancy are associated with varicose veins. Deterioration of the condition requiring surgical intervention may be accompanied by:

• pronounced swelling of the legs;
• the formation of ulcers;
• multiple hematomas on the legs;
• dryness and constant itching of the skin;
• thrombosis in the vascular lumen.

If possible, radical methods of eliminating seizures are transferred to the period after the birth of the child. During pregnancy, operations are carried out only in especially extreme cases.

To eliminate convulsions with varicose veins, you can use the following surgical methods of treatment:

• Sclerotherapy - is prescribed to eliminate the visible vascular network or medium-sized venous vessels. Using a microneedle, a sclerosing solution is injected into the vascular lumen, causing a gradual resorption of the vein. For a full course of treatment, several procedures are usually required, after which the progression of the pathology usually stops.
• Miniphlebectomy is the surgical removal of varicose vessels through skin punctures. Pain relief is usually local and the procedure is relatively simple. Can be used as an adjunct to other basic therapeutic methods:
  • endovasal laser coagulation;
  • CHIVA;
  • ASVAL.
• Phlebectomy is a full-fledged surgical intervention, usually used for advanced varicose veins, or in the presence of contraindications to other laser treatments.

Prevention

If you follow certain preventive rules, you can try to avoid unpleasant leg cramps during pregnancy:

• Eat properly and fully, often and little by little, without overeating. Instead of sugar, eat complex carbohydrates (cereals, durum wheat pasta), fruits. Focus on foods rich in calcium, potassium and magnesium: we are talking about bananas, herbs, dairy products, nuts and seeds, dried fruits, citrus fruits.
• Drink enough liquid daily. If swelling occurs in the legs, consult your doctor - you may have to limit the amount of salt you eat.
• Load your body wisely: both excessive physical activity and its complete absence are equally dangerous.
• Choose the right shoes and clothes: they should be comfortable, not tight, light, made from natural materials. You should not wear high heels, tight synthetic trousers (for example, leggings), socks and stockings with a tight elastic band.
• Periodically try to rest by lifting the “foot” end of the bed. If there are clear signs of fatigue in the legs, then you can do a contrast bath or light massage.
• In the cold season or with a tendency to constant "chilliness" you need to wear warm socks - for example, during sleep.

If you follow these tips, then leg cramps during pregnancy will not bother you.

Forecast

As a rule, after childbirth, convulsions pass and do not return. If there is any pathological cause of this discomfort, then it is advisable to take action and carry out treatment. To do this, you must definitely consult a doctor and, possibly, undergo a diagnosis.

You should never "prescribe" your own medications. Without knowing the true cause of the problem, such self-treatment can only harm and even aggravate the problem.

With a question about leg cramps during pregnancy, you should first of all contact a gynecologist who observes a woman in a antenatal clinic. If he considers it necessary, he will appoint a consultation with a narrower specialist - for example, a neuropathologist, surgeon, endocrinologist, phlebologist. Treatment and prognosis in this case is determined strictly individually, according to the results of clinical and laboratory studies.