Pregnancy Leg and Foot Pain

 What causes pregnancy leg and foot pain?

While morning sickness, fatigue, and back pain are frequent complaints during pregnancy, leg and foot problems are just as common, particularly during the last trimester. Fortunately, chances are these ailments will disappear after you deliver. In the meantime, there are some things you can do to alleviate discomfort.
Beginning early in your pregnancy, alternate circulation-boosting exercise with the proper amount of rest (prop those feet and legs up!). This can prevent foot and leg problems from developing in the first place. But if those aches have already begun, here's the scoop on what's causing them and what you can do about it.

Swelling & Edema

Raised hormone levels cause you to retain water during pregnancy, making you feel swollen and bloated. Your body needs this extra fluid so it can do the work of carrying nutrients and oxygen to your baby, explains David S. Levine, MD, an orthopedist at the Hospital for Special Surgery in New York City.

Although swelling is not a huge concern, consult your doctor if you notice swelling of your face and hands along with blurred vision, severe or constant headaches, and weight gain of more than a pound a day. These can be signs of preeclampsia, a serious condition.
Typically, fluid retention is particularly pronounced in your feet, ankles, and calves because your growing uterus puts pressure on the veins that carry blood back from your lower body. This partially blocks blood flow, keeping fluid in your legs and feet.
Blood vessels are also smallest in your foot and ankle, adds Dr. Levine, so your body has difficulty accommodating the extra fluid pouring in there.
Jane Anderson, a podiatrist at the Food and Ankle Center in Durham, North Carolina, offers some ideas for relief:

• Elevate your feet as often as you can. Try to raise your legs 6 to 12 inches above your heart for 15 to 20 minutes to help the blood flow back to your heart and lungs.
• Sleep on your side, not your back. This relieves pressure on the vena cava, the largest vein leading to the heart. Otherwise, the pressure slows the blood returning from your lower body.
• Consume a lot of fluids. Dehydration worsens swelling.
• Monitor your weight. Women of normal weight should gain 25 to 35 pounds during pregnancy. Excessive weight gain exacerbates swelling and can lead to other problems.
• Improve the circulation in your ankles with rotation exercises. Try sitting, with one leg raised. Rotate your ankle 10 times to the right, then to the left. Switch legs. Repeat 10 times.
• Ice your ankles. With your feet up, apply ice to the inside of your ankles for 15 to 20 minutes every half hour to an hour.

Leg Cramps

Some women can't escape leg cramps (commonly called charley horses) during pregnancy. These painful muscle contractions usually occur in the calf. It's believed that leg cramps occur because of a calcium deficiency and too much phosphorous (found in diet sodas and processed meats, so go easy on those foods), says Enid Leikin, MD, an ob-gyn at Westchester Medical Center in Valhalla, New York. Cramps are common at night when legs and feet are tired. Dr. Leikin suggests eating more dairy products or asking your doctor about calcium supplements. Women who get leg cramps may also have a potassium deficiency. Some expectant mothers report that snacking on potassium-rich bananas or dried apricots nips those cramps in the bud.
Besides dietary changes, you can prevent leg cramps by revving up your circulation -- take a 15- to 20-minute walk in the evening. Also avoid standing or sitting in one position for too long; both cause fluid to accumulate, making your legs feel heavy or full of pressure.

If you find yourself in the middle of a leg cramp, try to ease the pain by resting your calf on a hot-water bottle or flexing your foot to stretch the calf. The best way to ease the pain of a foot cramp is to walk it out. But if it's the middle of the night and you don't feel like getting out of bed, try grasping your foot with both hands and gently pressing your thumbs into the arch, pushing toward your toes.

Varicose Veins

As if tired, aching legs aren't enough, about 20 percent of women develop varicose veins -- those ugly, blue, swollen, ropelike veins -- during pregnancy. Pregnant women have up to 40 percent more blood in their circulatory system and this extra blood increases the amount of pressure on the veins walls, causing veins to stretch so much that their valves don't close properly. Faulty valves allow blood to pool in the veins, causing them to become varicose. You're more likely to get varicose veins if you gain too much weight, stand for long periods during the day, or if your mother had them (they're hereditary).
With varicose veins, many women complain of aching in the legs, as well as heaviness, fatigue, and pressure. Although these symptoms usually subside after pregnancy, they tend to worsen with each new baby.
As with other leg problems, increasing circulation can help relieve discomfort -- and even prevent varicose veins in the first place. Ronald Dee, MD, a vein specialist in Stamford, Connecticut, recommends taking a walk every day or doing other low-impact exercises such as swimming or bicycling. If you can't exercise, try sitting in a rocking chair several times a day; use your legs to gently rock back and forth to encourage better blood flow.
The gentle pressure of stockings can relieve achiness, too. Put them on before you get out of bed so blood doesn't have a chance to pool at your ankles. Also ask your doctor about prescription-strength hose.
Once you've had the baby, you may choose laser therapy or surgery to remove the veins.

Swollen Feet

Besides the discomforts of pregnancy, all that swelling may make it tough to squeeze your feet into your usual heels or boots. It's not unusual for an expectant mom to go up a half to a full size in shoes, says Dr. Anderson. In addition to fluid retention, the hormone relaxin, released primarily during the third trimester to relax your pelvic ligaments for childbirth, flattens and lengthens foot ligaments.
In addition to needing larger shoes, your feet also need extra support and comfort. Since your center of gravity is constantly shifting as you gain weight, you need to wear shoes that actually balance you, and that means it's best to avoid high heels. Choose shoes with a broad-based one- to two-inch stacked heel. For a dressy or office shoe, try an Aerosoles style with a crepe sole for shock absorption. If you're looking for a walking or athletic shoe, buy a running sneaker, which also offers more shock absorption. If width is an issue for you, buy men's shoes in an equivalent size -- they're cut wider.
Here are some more shoe-buying tips from Dr. Anderson:

• Shop late in the day. Feet tend to swell as the day goes on.
• Be sure shoes fit before you leave the store. It's a myth that you can "break them in."
• Choose shoes with a square or round toe. Avoid pointy-toed shoes.
• Buy boots with room in the calf area, because your calves may swell. Also choose a boot with a side zipper -- they're easier to get on and off than a pull-on style.
• Replace worn heels often. Uneven heels can throw you off balance.