There is a bit of debate on the exact number of people who struggle with Restless Leg Syndrome (RLS) during pregnancy but it is thought that around 1 out of 5 experience it, generally in the third trimester.
WHAT IS RLS?
Restless Leg Syndrome also known as Willis-Ekbom disease is a condition of the nervous system which causes an overwhelming urge to move your legs. It can also be accompanied by sensations of “itching/ pulling/ burning/ creepy crawling” over the legs. There are other symptoms that confirm it as RLS and not another condition apart from the overwhelming urge to move the legs; the urge is worsened at night or with rest and is eased with movement.
The exact cause is unknown but it is hypothesised that it could be: an iron or folate deficiency; a hormonal imbalance potentially of dopamine and or rising oestrogen or possibly the progesterone that rises in the third trimester and diminishes after birth; insufficient sleep; diet – vitamin D deficiency or consumption of caffeine and or lack of exercise.
Treatments for RLS differ when you are pregnant as the medications generally prescribed are not always suitable for use during pregnancy.
Iron: It is likely that the initial assessment will include an Iron deficiency check & if found to be deficient then the first course of treatment is to treat that with supplements and or an IV infusion of Iron as well as dietary changes to include more iron rich foods.
Diet: if there are any other mineral or vitamin deficiencies discovered then supplements may be advised and dietary changes to include foods with those which are lacking. It is generally advised to limit the amount off caffeine consumed during pregnancy to about 200mg or less per day. However cutting out caffeine entirely may help with RLS. Alcohol is also not advised during pregnancy and may be a contributing to RLS if being consumed.
Sleep: even though one of the most frustrating components of RLS is being woken or kept awake, fatigue and lack of sleep also contribute to it worsening. Set up a sleep routine by going to sleep and waking up at roughly the same time. And practice good sleep hygiene by keeping the room dark and cool and avoiding screens for a few hours before going to sleep.
Exercise: taking moderate exercise on a regular basis has been found to be helpful but try and keep it to earlier in the day. Brisk walks, cycling or swimming as well as some strength work. Just before going to sleep, try simple ankle pumps up and down 10 times and in and out 10 times.
Heat: having a warm bath or using a heat pack can help alleviate the symptoms.
Massage: massage is helpful to reduce the symptoms when the arise, either self massage or from someone else.
Compression socks: some people have found it useful to use compression socks at night to help alleviate symptoms.
Generally if RLS has developed during pregnancy then shortly after giving birth it should resolve, however it may put you at risk of developing it later in life.
There are other conditions that need to be ruled out:
- a blood clot (DVT) usually in one leg only
- meralgia paraesthetica – a condition caused by a trapped nerve in the thigh