How to avoid leg cramps during pregnancy

By Kathleen Kennedy, MD | July 01, 2021

Did you know around half of pregnant patients get leg cramps by their third trimester? Leg cramps tend to strike at night when you’re about to fall asleep. You might feel a sudden tightening of your muscle followed by a sharp pain.

Usually, leg cramps in pregnancy are nothing to worry about, however, sometimes they can be a sign of a more serious health problem. Let’s take a look at the common causes of leg cramps, how you can handle them at home and when to call the doctor.

Common Causes of Leg Cramps

There are many potential causes for leg cramps during pregnancy. They tend to show up in the second and third trimesters as your body is rapidly changing.

Low Vitamin or Mineral Levels

Why: During pregnancy, hormone and diet changes can decrease your calcium and magnesium levels.

Try This:

• Taking a prenatal vitamin can help. Get tips to find the best prenatal vitamins.
• Vitamin B complex supplements might also help with leg cramps.
• Eat food high in potassium, such as bananas, kiwi and spinach.
• Eat food high in magnesium, such as dark chocolate, avocados and nuts.
• Eat food high in calcium, such as seeds, cheese and salmon.

Circulation Changes

Why: Your blood volume will almost double during pregnancy. That can cause slower circulation, leading to swelling and cramping.

Try This: Here are a few tips for improving circulation during pregnancy:

• Sleep on your left side: This position takes pressure off your liver, which is on the right side of your body and helps improve circulation.
• Elevate your legs: Not only does putting your feet up reduce swelling, it also pushes blood flow back to your heart and lungs. 
• Sleep with a pillow between your knees: This position helps facilitate blood flow through a major vein carrying blood to the heart and back. This position may also relieve stress.
• Stay active: If you sit a lot during the day, get up and walk around every couple of hours. Movement helps increase overall blood flow.

Dehydration

Why: Do you remember to drink enough water? Leg cramps are a common symptom of dehydration. Water keeps your body hydrated, making the heart’s job of pumping blood easier. The heart sends oxygen to your organs and muscles, reducing the likelihood of cramps and circulation problems.

Try This: While pregnant, you should drink 8-12 cups of water per day. Try adding a slice of fruit or low-sugar flavoring if plain water is too boring.

Muscle Fatigue and Weight Gain

Why: During pregnancy, you might already feel tired. That goes for your muscles, too. Some of that weak, heavy or tired feeling might be coming from the added weight of the baby. Some may be from gaining additional weight during pregnancy.                        

Your uterus is also putting extra pressure on your blood vessels. When the blood vessels in your legs and feet are strained, it can lead to increased leg cramps.

Try This: For this type of cramp, we recommend stretching before exercise and bed. Wearing compression socks also helps move the valves in your blood vessels closer together, keeping blood flowing better in the legs.

Staying active during pregnancy can help relieve and prevent leg cramps caused by weight gain. Work with your doctor or midwife to eat a healthy diet during pregnancy. The goal is to gain enough weight to nourish the baby, but not so much that it negatively affects your health.

Tips to Treat Leg Cramps at Home

Cramping muscles are no fun. Here are some safe at-home treatments you can try to reduce pain:

• Massage the cramping muscle and nearby muscle groups to release the tightened muscles to restore proper blood flow, oxygen and nutrients to the muscle.
• Gently hold your leg in a stretched position until the cramp stops. This lengthens your muscle fibers so they can properly contract and tighten, allowing your muscle’s oxygen supply to be restored.
• Rotate applying ice, to ease the pain of the cramp, and heat, to relax your muscle and increase blood flow.
• Soak in Epsom salt bath. When Epsom salt dissolves in water, it releases magnesium which plays a big role in muscle contraction.

Exercises to reduce leg pain:

• Ankle Pumps: Lie on your back with your feet slightly elevated. Point and flex your feet.
• Calf Stretches: Put one foot against the wall with your toes pointing up, brace yourself with your arms and lean toward your foot, keeping your leg straight.
• Good Mornings: Feet hip width apart, put your hands behind your head, with a slight bend in your knee, bend at your hips until you’re parallel to the floor or feeling a good hamstring stretch

When to See a Doctor

If leg cramps are keeping you awake at night and at-home treatments aren't working, talk with your doctor or midwife. They can prescribe safe medication to ease the pain and help you sleep.

Less commonly, some leg cramp symptoms are signs of deep vein thrombosis (DVT). This is a serious medical condition that can cause blood clots. Pregnant women are 50 percent more likely to get blood clots than non-pregnant women.

Call for help right away if you have any of these symptoms:

• Extreme leg pain when you stand up
• Severe, persistent or worsening leg cramps
• Very swollen legs
• Red spots that are warm to the touch
• Enlarged veins in the legs

If you are struggling with leg cramps during pregnancy, help is available. Talk to your doctor or midwife to discuss your options.

Reviewed by: Larissa Hirsch, MD

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Now that I'm in my third trimester, I keep getting these painful cramps in my calves. Sometimes they even wake me up at night. What can I do to make them stop?
– Emelia

You're not alone — many pregnant women get these lower leg cramps, often in the middle of the night in their second and third trimesters.

Experts aren't sure what causes "charley horses" (the nonclinical name for painful cramps in your calf muscles). Although they can be extremely painful, charley horses are — luckily! — usually brief.

What might help:

• Do calf stretches before bed to prevent the cramping. But make sure not to point your toes while stretching.
• Straighten your leg and flex your foot when you get a cramp. A gentle massage of the calf may help relax the muscle.
• Make sure you are drinking enough fluids during the day.
• If cleared by your doctor, get regular exercise, which can help reduce cramps.

Talk to your doctor to see if extra calcium or magnesium could help you. But don’t take supplements without checking with the doctor first.

If the leg pain doesn't ease; is severe; or is accompanied by swelling, warmth, or redness in the leg or trouble walking, talk with your doctor right away.

Reviewed by: Larissa Hirsch, MD

Date reviewed: January 2021

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Along with swelling and varicose veins, leg cramps are a normal but sometimes uncomfortable part of pregnancy. Knowing what to do when you get a cramp and how to prevent cramps from happening can make your pregnancy a bit more comfortable.

This article is about leg cramps only. To find out more about pelvic cramps, check out our article on pelvic pain in pregnancy, or speak with your doctor or midwife.

What are cramps and why are they common during pregnancy?

Cramps are a sudden, sharp pain, usually in your calf muscles or feet. A cramp is a sign that your muscles are contracting very tightly when they shouldn’t be. They usually happen at night and are more common late in your pregnancy. They can be very uncomfortable and it can be hard to know what to do.

There are many suggested reasons for cramps while you’re pregnant – carrying extra weight, changes to your metabolism, having a vitamin deficiency, being too active or not being active enough. The truth is that nobody really knows.

Can leg cramps be prevented?

Certain exercises might help you to prevent cramps.

Gentle exercises, such as walking or swimming, and specific exercises, including calf raises and walking on the spot, are good for helping blood flow in the legs and might help to prevent cramping.

In fact, regular, moderate exercise during pregnancy is a good idea, because it helps your body get used to the physical changes that happen throughout pregnancy.

You could try specific foot and leg muscle exercises such as:

• bending and stretching your foot vigorously up and down 30 times
• rotating your foot 8 times one way and 8 times the other
• repeating with the other foot

Stretching your calf muscles before you go to bed might help to prevent cramps at night.

A magnesium supplement might also help. Talk to your doctor about whether this could work for you.

How to get rid of cramps

To ease a leg cramp, it usually helps if you stretch the muscle by pulling your toes hard up towards your ankle. You can also rub the muscle firmly or walk around for a while. If you have a partner, ask them to help.

Calcium is sometimes suggested as a treatment for cramps, but there isn't any evidence that this works.

When to talk to your doctor or midwife about your cramps

You should talk to your doctor or midwife about your cramps if:

If you're not sure what to do when you get a cramp, or don't know the best way to deal with them, talk to your doctor or midwife.

You can also call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.

Last reviewed: February 2020