Leg cramps are involuntary muscle contractions affecting the calves, feet and sometimes the upper leg. The painful sensation is quite normal during pregnancy, often occurring at night . Although most common during the third trimester , you may experience occasional cramps early in the first and second trimesters as well.
What causes leg cramps in pregnancy?
The exact causes leading to this symptom are still unclear as it may result from a number of factors. The strenuous job of bearing all the extra baby weight might be the cause behind leg cramps towards late pregnancy . The growing uterus puts direct pressure on the main vein in your legs. The rising progesterone level, affecting your leg muscle tone, is often the principal factor responsible for the problem in early pregnancy. Other possible risk factors include:
- Lack of nutrients like calcium and magnesium
- Dehydration in pregnancy 
- A past leg injury
- Changes in blood circulation from your legs to your heart due to the growing uterus 
- Carrying twins
Why are pregnancy leg cramps more common at night?
Most women complain of intense cramping at night that wakes them up even from a deep sleep. It is quite difficult to pinpoint any specific factor behind such severe cramps at night. Extreme fatigue and high body fluid levels are believed to be responsible for these nighttime leg cramps .
How to prevent leg cramps in pregnancy?
- Avoiding standing for extended periods of time
- Avoiding sitting or standing for long periods, keeping your legs crossed 
- Drinking lots of fluids to stay hydrated
- Rotating the ankles and wiggling the toes while sitting down
- Stretching the calf muscles several times throughout the day, especially before going to bed 
- Going for a short walk every day or following a light prenatal exercise routine 
- Wearing comfortable shoes with proper ankle and heel support
- Avoiding sleeping positions that leave the toes pointing downward
- Following a diet containing plenty of calcium, potassium and magnesium rich foods such as leafy vegetables, bananas and dairy products 
Nutrition deficiency causes a number of pain and complications while pregnant. You need extra nutrition during pregnancy for the wellbeing of your baby as well as your own. So, magnesium and vitamin B supplements may be recommended for preventing cramping; however, experts are still not sure about their effectiveness .
Pregnancy leg cramps treatment
- Applying a hot compress or a heating pad (consult your doctor before opting for heat treatment) 
- Standing on a cold surface or getting an ice massage to relieve the muscles 
- Gently massaging the calves
- Lying down on your bed with a few pillows under your legs to keep them elevated
- Wearing supportive stockings 
- Walking around in your room for some time to flex the leg muscles 
- Taking a warm bath can ease the pain by relaxing the muscles 
According to some, sleeping with a bar of soap under your feet helps to avert the pain. But, there is no scientific proof for this home remedy.
Stretching exercise for leg cramp relief
Doing some pregnancy-safe stretching exercises whenever you feel your leg muscles cramping can help to get rid of the pain. Straighten both your legs, keeping the heels in contact with the floor. Then, gently bend the toes back toward the shins as far as you can. Hold in this position for about 10 seconds before releasing the pressure. It might hurt a bit in the beginning, but will gradually lessen the pain by easing the muscle spasm .
Drugs and medicines like quinine (tonic water) are not recommended for treating the symptom in pregnant women . Some recommend taking acetaminophen for relieving severe pain . But, it is advisable to avoid taking any medicines during this time to keep your baby safe.
When to call the doctor?
- Constant muscle cramping that refuses to go away with exercise or any of the above remedies
- Leg cramps accompanied by symptoms like swelling, tenderness and redness in the legs (might indicate blood clotting disorders) 
- Persistent leg cramps during the last months of pregnancy (might be a sign of labor) 
- Leg cramps with ankle and foot swelling (might indicate varicose vein)
- Cramping accompanied by symptoms like extreme headache and diarrhea
ICD-9 and ICD-10 Codes for Leg Cramps
The ICD-9 code used for indicating cramp is 729.82 , while its ICD-10 code is R25.2 .
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