Pain in Pregnancy Part 4: Leg Cramps and Leg Pain

Leg cramps are extremely common, with up to around 60% of pregnant women experiencing them, especially in the third trimester. Most commonly reported at night, they can disrupt sleep, make your leg sore, and they really hurt! If you are dealing with leg cramps or leg pain during your pregnancy - this guide will be helpful!

What causes leg cramps?

In general, a lack of hydration and electrolyte imbalances are the most likely cause of cramps. For cramps related specifically to pregnancy, there are a few other factors:

1. Circulation changes: During pregnancy, there is increased blood volume which will impact how blood flows to different areas of the body. Additionally, the growing uterus can also impact blood flow going to the legs.

2. Changes to demand on legs: with weight gain AND the changes to your center of gravity and posture, there will be different demands on your leg muscles. Generalized fatigue of the muscles and increased demand can be a factor in cramping.

What should I do when my leg is cramping?

When the leg is actively cramping, the best thing is to contract the opposite muscle group. If your calf (the gastrocsoleus if we are getting technical) is cramping, you need to contract your shin muscle (tbiialis anterior). You will aggressively pull your foot and toes towards your head. This should stop the cramp fairly quickly (this works via “reciprocal inhibition”). 

How do I prevent leg cramps?

The current research unfortunately doesn’t have any magic bullets for preventing cramps.

Here are a few simple, non-invasive suggestions:

1. Stretch your calves before bed. This has limited evidence…but the worst that can happen is you spend a few minutes stretching! No harm to mom or baby.

2. Stay hydrated! Drink plenty of water.

3. Stay active, if you are having an otherwise normal, uncomplicated pregnancy, staying active has tons of benefits. Always discuss activity with your doctor.

It's worth discussing with your doctor if electrolytes might be helpful. Some research shows some improvement in frequency of cramping with taking a magnesium supplement…but not definitive enough to give a blanket suggestion. Supplementing salt is not advised in pregnancy, mostly for concerns about increasing blood pressure and very limited evidence it actually does anything for cramping. Again, discuss supplements with your doc before you take anything!

When should I be worried about leg cramps during pregnancy?

First - always report the symptoms you are experiencing to your doctor!

Leg cramps are usually harmless, HOWEVER leg pain can be a sign of a more serious condition like a Deep Vein Thrombosis (DVT), which is a blood clot in the leg.

Call your doctor immediately if you experience:

• Severe or constant leg pain that doesn't ease up with stretching or massage.

• Swelling, redness, or warmth in one leg (especially the calf).

• Tenderness in the leg.

• Trouble walking.

Contact your health care provided right away if you have symptoms like:

• Vaginal bleeding or fluid leakage

• Fever

• Burning sensation when urinating

• Numbness, tingling, or weakness in the legs, buttocks, or genitals

• Intense, sudden, or cyclical pain (which could indicate contractions)

If you aren’t able to figure out how to relieve your pain, a PT can absolutely help! Physical therapists are experts in how the human body moves and functions, we can get to the root cause of your pain, and prescribe a specific program for you to work on. Additionally, we can actually work on you - improving muscle tone, joint mobility, and decreasing pain. 

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About the author: Dr. Caitlyn Hauswirth-Varis, PT, DPT, OCS, CFMT, CF-L1

Caitlyn is an expert in pelvic floor physical therapy, pregnancy and postpartum, and is board certified in orthopedic physical therapy. She has helped countless soon-to-be moms get out of pain during their pregnancy, and actually feel good throughout the process.

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.