Pregnancy Leg, Foot and Hand Pain

Leg and foot pain in pregnancy can be categorised into three main areas: swelling or oedema, varicosities and leg pain / cramps.

Here are some of the common symptoms that women can suffer from:

• Painful feet – often first thing in morning when getting up
• Cramps in lower legs
• Swelling / oedema in lower limbs, especially lower legs, ankles and feet; and hands
• Carpel tunnel syndrome – swelling at site of wrist (carpels) causing pressure on carpel nerves making for ‘fat’ fingers
• Varicose veins in lower legs or vulva
• Restless Legs Syndrome
• Sciatica and piriformis pain

Sciatica and Piriformis Pain

Piriformis Pain

Piriformis syndrome occurs when your piriformis muscle compresses your sciatic nerve and results in inflammation. It can cause pain or numbness in your buttock and down the back of your leg. It can happen on one side of your body or both. The piriformis is a flat, narrow muscle.

How is Piriformis pain treated?

The choice of piriformis therapies depends on the length of symptoms and severity of your condition. These therapies include:

• special back care education
• rest
• physical therapies: massage, physio, chiropractic, acupuncture Book here
• medication treatment
• lifestyle changes
• Book here
• surgery

What are Varicose Veins

• These purplish dilated veins often develop primarily in the lower legs, upper legs and in the groin and vulva area – although they are less common in the last areas, and generally occur in late pregnancy.

They are primarily caused by the increased weight of your baby and your own physical changes in pregnancy. This can reduce the return of blood to the legs and result in aching legs and a degree of throbbing discomfort. Your blood volume is greatly increased by up to 45% more to cope with the extra demands of growing your baby and meeting your increased needs as well.

• Towards the end of your pregnancy, your various systems can be overwhelmed and less efficient in ‘taking care of business’. The extra blood volume can tax the vein walls causing them to stretch and bulge.
• Faulty valves made faulty by various pregnancy hormones, cause the blood to pool, creating the bulgy veins. When it occurs in the groin and vulva area, it is even more sensitive and uncomfortable. Fortunately, it is relieved by having your baby.

Meanwhile, see useful tips…

Swollen Feet and Fluid Retention

Swollen feet occur due to retained fluid in the feet and ankles and may extend into the lower and upper legs as well. Again it generally occurs in late pregnancy.

• The extra fluid is required to transport oxygen and nutrients to your baby and towards the end of your pregnancy, the increased weight gain and heavier uterus put extra pressure on the veins that carry blood back from your lower body, causing fluid retention to pool in the feet and lower extremities.
• The blood vessels in the feet and ankles are narrower and increased blood and fluid levels cause fluid retention to some degree in most pregnant women.

Again, most women experience some of these common discomforts, although in combination with other symptoms, they can be more serious.

See Pre-eclampsia…

Tips for Fluid Retention / Swelling / Oedema

• Elevation is generally recommended but often hard to achieve. The way to do it is to elevate your legs above the height of your heart (that’s where all the circulation is happening) – about 20-30 cms for 15-20 minutes. And as often as you can.
• Increase your fluids – your body needs more, not less. Dehydration increases swelling.
• Rotating your ankles – to stimulate circulation in your lower limbs.
• If the swelling hurts, particularly at night – elevate your feet and apply ice-packs around your ankles for about 15 minutes.
• Monitor your weight – particularly if you think you are gaining more than recommended.

What is the average weight gain for pregnancy?

• Average weight gain for pregnancy is about 12 kg plus.
• Some women gain more because they were underweight to begin with or gain more because of poor nutrition or exacerbated by other problems.
• Other women gain less because they may eat a vegan diet and less animal protein and dairy intake which increases weight gain.
• A woman’s weight gain also depends on her BMI (bodymass index factor). Meaning if it is between BMI 18.5-24.9 (the healthy weight range), you can expect to gain between 11 kg and 16 kg.
• However, if you are in the unhealthy weight range with a higher BMI above 25.9, you can expect to be cautioned by your health and caregivers to gain as little weight as humanly possible.Unfortunately, a woman who is to heavy can encounter difficulties in late pregnancy and may affect a satisfactory labour and birth experience.

Carpel Tunnel Syndrome

Carpel tunnel syndrome (CTS) is a painful condition of the hand and fingers caused by compression of the median nerve, where it passes over the carpel bones through a passage at the front of the wrist. It may be caused by repetitive strain movements or by fluid retention. During pregnancy women can be prone to CTS due to hormonal changes (high progesterone levels) and water retention (which swells the synovium – the specialised tissue that lines the joints in the wrist and other joints), which are common during pregnancy. In extreme or chronic cases, surgical intervention may be required. However, CTS is more likely to be pre-existing prior to pregnancy and is exacerbated by various hormonal changes. Overall women are more likely to develop CTS. Associated conditions such as obesity, rheumatoid arthritis and diabetes increase the risk of women developing CTS.

Symptoms of Carpel Tunnel Syndrome are: 

• Numbness and tingling
• Pain and discomfort
• Difficulty with gripping things re weak grip or inability to grip fully
• Discomfort may extend into arm

Tips for Carpel Tunnel Syndrome:

• Modify use of mouse activity with gel pad to support wrist
• Wrist splint worn at night
• Physiotherapy and / or specialised physical therapy (myofascial) to treat affected areas
• Self-exercises to do such as hand stretches