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
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.
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. 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.
Leg cramps can occur because of nutritional deficiency. Commonly thought to be lack of potassium, calcium and magnesium. However some women may be more prone to them as a pre-existing condition and exacerbated by the demands of pregnancy.
Common tips and remedies:
- Stretch your calves before going to bed in whatever way works for you. Hold the stretch for 15-30 seconds or until you feel a softening in your lower legs. A slow stretch will do more than a quickie.
- Mild exercise is useful. A a short walk around the block before going to bed might be helpful.
- If you get struck by one in the middle of the night, you may experience it in your foot or in the calf. Here’s what to do as best you can as a cramp can feel incredibly crippling and hard-core. Gently move your foot to stretch your muscles and to ease the cramp. If you can, press your fingers into the cramp site, whether arch of the foot of mid-calf and hold in the epicentre, until it starts to ease and soften. Take slow and deep breaths. No need to say to yourself that you are a wuss for carrying on about a leg or foot cramp as compared to what labour might bring! A sudden, unexpected cramp attack is not like labour at all which is more predictable and regular and expected.
- Take a magnesium supplement. Most pregnancy supplements will have this already but Mag Phos (a tissue salt) might be a useful addition if required on top of your existing supplements. Seek advise from your health or caregiver if appropriate.
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
What Causes Varicose Veins
- Pregnancy increases blood volume by up to 45% in pregnancy
- Standing for long periods on feet
- Subsequent pregnancies
- Increased weight gain, either prior to pregnancy or during
- Genetics – it’s true. If your mother had them, you are more likely to get them as well.
Tips for Varicose Veins
- Increasing circulation is the main thing to do with exercises such as – walking, swimming and light moving exercise. Sitting and moving about on a Swiss Ball is excellent for circulation and rotation of hips, especially if you do long computer hours at work or home. Make sure you are moving your legs back and forth to get circulation happening.
- Pressure stockings come in different grades and can be purchased from chemists /pharmacies. Discuss with your practitioner if need be. Best put on first thing in the morning before any pooling of blood in veins starts to happen.
- Ice-packs might be useful too, especially at the end of the day, and more so for vulva varicosities.
- Put your feet up when you sit or lie down, when possible and practical.
- Elevating the end of your bed with a couple of blocks can be helpful for bad varicosities and fluid retention both.
- Flexing calf (gastrocs) muscles and rotating ankles, especially prior to bed is useful for both varicose veins and leg cramps.
- Gentle massage using essential oils (e.g. lemon and lavender) or other recommended products or see recommended person.
Pre-eclampsia, formerly toxaemia, is a condition that can lead to eclampsia and cause fitting or seizures in pregnant women.
Symptoms of Pre-eclampsia are:
- increased protein in urine
- elevated blood pressure
- swelling in face, hands or eyes
- epigastric discomfort (rather like heartburn)
- blurred vision
- sudden weight gain caused by increased fluid
- vomiting and nausea
(the main symptoms are generally the first three with 2 out of 3 being a cause for concern)
Restless Legs Syndrome
Some women experience Restless Legs Syndrome, which like leg or foot cramps has no obvious causes, and may occur in other areas such as feet, thighs, arms and hands – in other words the extremities. The symptoms are not actual cramps, but more tingling, crawling and burning sensations. This can be worsened by staying still for periods of time, such as sitting for long periods as in car trips, watching movies in confined positions or lying on one side. If it was pre-existing before pregnancy, it may worsen during pregnancy. Again, a hereditary condition that can be passed on.
Tips for Restless Legs
- Take magnesium supplements or Mag Phos (a tissue salt) as an extra if required. Seek health or caregiver advice if appropriate
- Stretch the afflicted parts
- Have warm baths at end of day
- Cold packs might work for you best
- Massage can help your whole body or learn to massage the affected areas yourself for easy maintenance