Cramps and leg pain in pregnancy: varicose veins and clot warning signs

A calf that suddenly tightens and wakes you from sleep is one of the most often described pregnancy experiences. Cramps are annoying but usually harmless. This article will help you tell usual cramps and leg pain from signs that need attention.

Why do cramps happen?

The exact cause is not known. Pressure from the growing womb on leg vessels and nerves, extra weight, muscle tiredness, fluid balance and levels of certain minerals may all play a role. They usually appear from the second trimester onward, at night, in the calf and foot. They can last from a few seconds to a few minutes.

What can you do when a cramp strikes?

• Flex the foot: Gently pull your toes and foot towards your knee, keeping the leg straight.
• Stand and press: Getting up and pressing your foot onto a cool floor helps some people.
• Massage: Gently rub the calf.
• Warmth: A warm compress or warm shower relaxes the muscle.
• After a cramp the leg may stay a little tender; this is usual.

Things that may reduce cramps

• Walk during the day and avoid staying in one position for long.
• Do calf and ankle stretches before bed.
• Drink enough water.
• Eat a balanced diet; dairy, leafy greens, nuts and pulses are sources of minerals.
• Wear comfortable, supportive shoes and avoid high heels.
• Let your legs rest relaxed in bed; pointing the toes down can make cramps easier to trigger.
• Ask your doctor before using a mineral supplement (for example magnesium).

Heavy, tired legs and varicose veins

The veins in the legs can widen in pregnancy. Hormones relax vessel walls and pressure from the womb makes return flow harder. As a result you may feel heaviness, mild swelling and sometimes visible bluish veins (varicose veins). Although uncomfortable, they are usually not dangerous in themselves and often improve after birth.

• Raise your legs above heart level several times a day.
• Avoid crossing your legs.
• With your doctor's approval you can use support stockings; they are easier to put on before getting out of bed.
• Walking and ankle movements support circulation.
• Choose a cool shower over hot baths and saunas.

Know the signs of a blood clot

The chance of a blood clot rises slightly in pregnancy. It is rare, but knowing the signs is important. It usually develops in one leg.

When to contact your doctor

• If one leg (especially the calf) has swelling, marked pain, tenderness, redness or warmth
• If the pain gets worse on walking or when you bend the ankle
• If there is a clear difference between the two legs
• If a varicose vein is painful, hard, red or hot
• If cramps are very frequent, severe and clearly disturb your sleep
• If you have leg weakness or numbness
• If you have sudden shortness of breath, chest pain, coughing up blood or a racing heart, call 112 (or your local emergency number) or go to the nearest emergency room

What you can do

Adding a short calf stretch to your evening routine, resting your legs during the day and drinking water helps most people. You might also add comfortable, supportive slippers and socks to your hospital bag checklist.

This article is for information only; your doctor's or midwife's advice for your own situation always comes first.