Restless Leg Syndrome in Pregnancy: An Overview

What Is Restless Leg Syndrome?

Restless legs syndrome, or Willis-Ekbom disease, is the overwhelming urge to move legs uncontrollably. Restless leg syndrome is a condition affecting the nervous system causing an unpleasant sensation that makes the person unable to control the leg movements. Due to the nature of restless activity, the person may experience disturbed sleep. The risk of restless leg syndrome is higher in pregnant women, and studies are still ongoing to confirm the reason for this increased incidence.

What Are the Symptoms of Restless Leg Syndrome While Pregnant?

As the name indicates, the main symptom of restless leg syndrome is an uncontrollable urge to move the legs due to a strange sensation on the legs. The movements may be mild, powerful, or vigorous and usually develop when the person has a prolonged inactive period. The discomfort gets better when the person moves and worsens in the evening or night. This may affect the quantity and quality of sleep, making pregnant mothers tired throughout the day. Some people may experience the following types of unpleasant or strange sensations on the legs:

• Itching.

• Burning.

• Tingling.

• Throbbing.

• Pulling.

• A creepy-crawl feeling, just like an ant crawling up and down the legs.

• A sensation of the presence of fizzy liquid within the veins.

• Pain, especially below the knees.

Since the chances of developing restless leg syndrome are higher in the third trimester of pregnancy, the affected mothers may get fatigued, adding to the discomforts already developed during the trimester.

What Causes Restless Leg Syndrome During Pregnancy?

The exact reasons for restless leg syndrome during pregnancy are unclear. But it is believed to be due to the following reasons:

• Hormonal Variation: During pregnancy, hormones may alter the average circulation, leading to restless leg syndrome.

• Iron Deficiency Anemia: The blood volume in the body increases during pregnancy. This increases the requirement for more iron to make more blood to supply oxygen and nutrients to the mother and the baby. Iron deficiency anemia is common to occur during pregnancy. This leads to an impairment in circulation, especially to the legs, causing restless leg syndrome.

• Folate Deficiency Anemia: Folate is a kind of vitamin B. A decreased red blood cells due to folate deficiency is called folate deficiency anemia. Folate or folic acid is required to form and grow red blood cells.

• Diet: Some studies have shown that excessive intake of coffee (caffeine), alcohol, or chocolate during pregnancy may lead to restless legs syndrome.

• Genetic: Some women may experience restless leg syndrome due to genetic inheritance. Such women may develop the symptoms of the condition even without getting pregnant. In cases where pregnancy is the cause of restless leg syndrome, the condition is called secondary restless leg syndrome (restless leg syndrome developing secondary to pregnancy).

• Medications: Restless leg syndrome during pregnancy may worsen if the woman consumes certain medicines like beta blockers, antihistamines, antidepressants, antipsychotics, dopamine receptor blocking agents, and antiepileptics.

• Other Causes: Restless leg syndrome may also be due to other underlying conditions like hypothyroidism (decreased secretion of thyroid hormones by the underactive thyroid gland), diabetes (high blood glucose or sugar levels), high BMI or body mass index (a high body mass index may be due to overweight or obesity), rheumatoid arthritis (an autoimmune condition causing swelling and pain in the joints), or neurological problems like multiple sclerosis (a condition where the protective covering of the nerves get attacked by the immune system) or Parkinson’s disease (a central nervous system disorder causing tremors).

How to Treat Restless Leg Syndrome During Pregnancy?

It will be challenging for pregnant women with restless leg syndrome, as no medications can be consumed during pregnancy or breastfeeding. It is recommended to modify the lifestyle accordingly to reduce the discomforts caused by the condition. The following changes can be adapted during pregnancy:

• Stopping alcohol consumption as immediately as possible will help reduce the complications for the mother and the baby.

• Chocolate and caffeine consumption should be limited. Caffeine is contained in coffee, chocolates, tea, and certain cold beverages. Before choosing bottled drinks, it should be ensured that it has no caffeine.

• Doing moderate exercises consistently during pregnancy helps manage weight, decreases fat percentage, and improves blood circulation. The pregnant woman should consult a doctor before starting a workout routine. Relaxation exercises, slow-paced walking, and stretching can also be done.

• Massaging the legs improves blood circulation and decreases discomfort and unpleasant sensations. It can be accompanied by a warm bath or applying heat pads.

• Adjusting the sleeping position, especially in the third trimester, is mandatory. It will be challenging to sleep on the back or front. Tilting towards the left is the best option that enhances blood circulation. A pillow can be used to get more support and assistance while sleeping.

• A consistent sleep schedule will help pregnant women organize their nighttime routine. This includes staying away from scree, reading a few pages from a book, doing a relaxing massage, stretching, a warm bath, or listening to relaxing music. Meditation, aromatherapy, and maintaining a clean sleep environment will also benefit building the habit.

• Consuming a balanced and nutrient-rich diet is essential to decrease the risks of nutritional deficiencies. The doctors may usually prescribe folic acid and iron supplements during the initial trimester of pregnancy.

• The doctor may prescribe mild pain relievers and topical counter irritants to relieve discomfort and leg pain. They may not prescribe other medications as they would be unsafe to take during pregnancy.

Will Restless Leg Syndrome Go Away After Delivery?

Secondary restless leg syndrome or restless leg syndrome due to pregnancy will go away within a few weeks after delivering the baby. However, there are chances that the women could develop the condition later after pregnancy or breastfeeding. In such cases, they can consult the doctor and take the required medications, as there is no need to worry about the drug's safety if the woman is no longer pregnant or breastfeeding. If the symptoms persist after delivery, the woman should check for underlying conditions after getting assistance from the doctor.

In the case of primary restless leg syndrome or restless leg syndrome that arises independently due to other causes other than pregnancy, the symptoms may persist after delivery. The woman should stick to lifestyle modifications that could manage the symptoms. They can take medicines when they are no longer breastfeeding the baby.

Conclusion:

The uncontrollable urge to move the legs due to some underlying discomforts is called restless leg syndrome. Pregnant women are more likely to experience the symptoms, especially in the third trimester. Since taking medicines for the condition may be unsafe, adapting to certain lifestyle modifications will be the only choice to manage the condition.