Foot Pain and Leg Problems in Pregnancy

Changes in your feet during pregnancy are common and often treatable at home. You may have foot cramps and swelling, more noticeable veins, and even toenail problems. Resting often, stretching, staying hydrated, wearing shoes that fit, and using compression stockings can help treat most changes in your feet and legs while you're pregnant.

Most of these conditions are not serious, but there are times when changes in your legs and feet can be a sign of a pregnancy complication, like preeclampsia, that needs medical attention.

This article will cover the common causes of foot and leg changes during pregnancy and tips for relieving your symptoms. 

Man massaging pregnant womans feet
Tetra Images / Getty Images

Foot and Heel Problems During Pregnancy

The levels of hormones in your body increase during pregnancy. Some of these hormones relax ligaments and other structures to prepare the body for a vaginal birth. These same hormones also relax the ligaments in other parts of your body including your feet. Lax ligaments can lead to flat feet (fallen arches) and overpronation.

Loosening of ligaments can also increase your shoe size during pregnancy. After you give birth, you might find that your shoe size has increased by half or even a full size.

Your growing uterus, fetus, and breasts contribute to pregnancy weight gain that puts extra stress on your feet, especially the arches. It's common for pregnant people to have heel pain (plantar fasciitis) because of the extra weight and stress on the arches.

Your center of gravity and how you walk and stand are also affected by the changes in your body during pregnancy, and these changes may cause problems with your balance.

Prevention and Treatment

There are a few strategies you can use to manage foot and heel pain while you're pregnant, such as:

  • Rest often. Try to avoid standing for long periods of time and walking barefoot. Take a break when you can to sit down and elevate your feet.
  • Wear the right shoes. The extra weight, loose ligaments, and decreased balance in pregnancy mean you'll need extra support for your feet. Supportive, properly fitted shoes and over-the-counter (OTC) arch supports can be helpful. If you still have problems, you can ask a foot specialist (podiatrist) about getting custom orthotics for your shoes.

Foot and Ankle Swelling During Pregnancy

Swelling (edema) is an increase in fluid in the tissues of your body. Swelling in your feet and ankles during pregnancy is very common.

When you're pregnant, swelling is usually caused by an increase in blood volume that occurs to help your body carry extra oxygen and nutrients to the fetus. Pregnancy hormones can also cause changes in the blood vessels, which can lead to swelling.

All the extra fluid needs a place to go, and gravity usually pulls it down to your feet and ankles. You may notice that your shoes are getting too tight. Increases in your foot size from swelling are common, but also temporary.

Foot and ankle swelling during pregnancy is normal when it is the same on both sides of the body (symmetric) and painless. However, swelling that is painful or on just one side (asymmetric) can be a sign of a more serious medical problem like a blood clot.

When to See a Provider

If you have swelling in your face, around your eyes, or if the swelling comes on very suddenly, you should see a healthcare provider right away. These could be signs of a potentially life-threatening pregnancy complication called preeclampsia.

Prevention and Treatment

Here are a few ways you can manage foot and ankle swelling while you're pregnant:

  • Move around. Try not to stand still for long periods. Walking gets your calf muscles working, which helps pump some of the extra fluid out of your legs and feet. Rest several times a day, elevating your feet as much as possible when you're sitting down.
  • Use special socks and devices. Wear compression stockings to help decrease swelling. Knee-high stockings can help, but thigh-high stockings are even better because they ensure that the extra fluid will not collect around your knees. You may want to ask your provider about external pneumatic compression devices.
  • Check your footwear. Wear the correct shoe size for your foot (even if it means temporarily going up a shoe size).
  • Stay hydrated. Drink plenty of water throughout the day. Try to avoid foods that have a lot of salt in them, as they increase fluid retention.
  • Get in the water. Take a bath or go swimming. Water puts an outside force on the swelling and helps decrease it.
  • Use certain positions for rest. When you're in bed, lay on your left side to decrease the pressure on blood vessels and allow more fluid to move from your legs to your upper body.
  • Try alternative approaches. Consider reflexology or pregnancy massage. to help with the swelling.

Leg Cramps During Pregnancy

Leg cramps usually involve painful spasms of the calf. It is not clear why pregnant people are more prone to getting them but it might be caused by changes in calcium concentration, tired muscles (from weight gain), or pressure from a growing uterus on the blood vessels and nerves.

Leg cramps are most common during the second trimester of pregnancy. They can happen both day and night but are more common at night.

Prevention and Treatment

There are a few steps you can take to manage leg cramps while you're pregnant, such as:

  • Stretch. Massaging the muscles in your legs and feet feels nice and can also help with tense muscles.
  • Stretch. If your leg or foot cramps up, stretch your calf muscle by making your knee straight and pulling/moving your foot back toward your nose. This will help relieve the spasm in the calf muscle.
  • Get some exercise. Taking an easy walk gets the blood moving in your legs and feet and stretches the muscles.
  • Use heat. Take a warm shower or bath to relax your muscles.
  • Take supplements. Ask your provider about taking calcium, magnesium, or vitamin B supplements.
  • Hydrate. Muscle cramps can also happen or get worse if you're dehydrated, so drink plenty of water throughout the day.

Varicose Veins During Pregnancy

Varicose veins are veins that have become enlarged and usually stick out above the surface of the skin. They can look like twisted, purple cords or strings. Increased blood volume and pregnancy hormones cause changes in the blood vessels that can lead to varicose veins.

Varicose veins can also be caused by the weight of your growing uterus and fetus putting pressure on blood vessels. Varicose veins are common in the legs, but can also occur in the vulva and rectum (hemorrhoids).

Prevention and Treatment

There are a few strategies that can help with varicose veins during pregnancy:

  • Keep moving. Try not to stand for a long time without taking a break. Walking helps keep the blood moving to your muscles, which gets the blood flowing back to your heart.
  • Take breaks. If you'll be driving a long distance, stop frequently to stretch and exercise your legs. This will also help prevent a serious type of blood clot (deep venous thrombosis).
  • Straighten out. Try not to cross your legs when you're seated, as this can put pressure on the blood vessels and nerves.
  • Ask about supplements. Talk with your provider about taking Rutoside (rutin) in your last trimester.

Toenail Changes During Pregnancy

Your toenails tend to grow faster while you're pregnant due to the increased blood volume and circulation of hormones. Prenatal vitamins can also help to improve the overall health of your hair and nails.

On the other hand, since your body is providing nutrition to a growing fetus, the cells in your toenails may not get enough nutrients.

As a result, you may notice nail changes such as brittleness, ridges or grooves that go across your nail, or dark, discolored lines/streaks (melanonychia) in the nail bed. A nail might even become loose and fall off.

Nail changes will usually go away after you give birth.

Prevention and Treatment

If you're noticing nail changes during pregnancy, here are a few tips that can help:

  • Check your shoes. Do not wear shoes or socks that are too tight. The extra pressure they put on the skin around the nails can cause ingrown toenails.
  • Make sure you're eating enough (and getting all your vitamins). Eat a nutritious diet to ensure that your body can keep you and the growing fetus properly nourished. If you're concerned that you're not getting all the nutrients you need through your diet, ask your provider about vitamin supplements.
  • Trim your nails—but not too much. Do not clip your toenails too short. Swollen skin can overlap the corners of short toenails, leading to ingrown toenails. Have someone else trim your toenails or get a pedicure if you are not able to see/reach your feet.

Summary

It’s normal to notice some changes in your feet and legs while you’re pregnant. Swelling, cramps, and varicose veins are common in pregnancy and can usually be managed with at-home treatments and recommendations from your provider. 

However, changes in your body while you’re pregnant can sometimes be a sign of a problem. If you have swelling in your face or any swelling that comes on fast, call your provider right away. This can be a sign of a potentially serious condition called preeclampsia.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Terence Vanderheiden, DPM
Terence Vanderheiden, DPM, is a podiatrist in Massachusetts with a subspecialty in the area of podiatric sports medicine.