Pregnancy causes a range of complications for the lower extremities. The weight gain experienced during pregnancy places an enormous amount of unexpected pressure on the feet. It’s common for pregnant women to suffer from foot pain, swelling, leg cramps and varicose veins. In addition to weight gain, stretched ligaments in the feet and ankles cause stability problems and flat feet can cause irreparable damage. A podiatrist may be able to relieve these symptoms through proper foot care and advice during pregnancy.
Treatment options for foot pain during pregnancy are often overlooked as other medical aspects of the pregnancy are prioritised. However, many of treatments chosen by podiatrists do not use pharmacological interventions, so they are very safe and effective during pregnancy. The following five podiatric complications are common during pregnancy and should be observed as part of an overall pregnancy support plan:
- Weight gain can have a biomechanical impact on the feet and occurs as the centre of gravity shifts as a pregnancy progresses. Weight gain can cause or exacerbate foot pain, bursitis and neuromas, along with corns and calluses. Patients should be advised to avoid wearing high heels or any shoes without adequate support.
- Production of the hormone relaxin during pregnancy will also relax ligaments of the feet and ankles. This can cause instability and discomfort through overuse of the muscles in the foot to maintain support and may lead to long-term, irreversible changes to the feet. Some women will also continue to have these issues whilst breastfeeding.
- Increased force to knees and ankles can cause injury and pain. Added force on the feet combined with biomechanical changes cause over-pronation and can result in irreparable arch collapse. Arch height is usually reduced during pregnancy and may become worse with future pregnancies.
- Oedema is common in the feet and, as well as causing discomfort, may result in problems getting into shoes and shoe sizes will probably need to be larger than what the patient is used to. Professional fitting is recommended. Patients should be advised to keep feet elevated while sitting down, to avoid crossing the legs, and to avoid sitting or standing for long periods of time, recommend short walks to improve circulation. Compressions garments should be considered to aid in the reduction of oedema.
- Foot and leg cramps are common during pregnancy due to altered calcium levels, muscle fatigue and increased pressure on nerves and blood vessels. Massage and exercises are recommended to alleviate symptoms.
Patient education should include advice on appropriate footwear during pregnancy, avoidance of socks or shoes that restrict blood flow and patients should be encouraged to exercise regularly and eat a healthy, balanced diet.
Consider referring to a podiatrist for pain relieving interventions for conditions that are easily treated such as corns, calluses and ingrown toenails.
Severe pain and discomfort can be treated with the fitting of orthotics, which are proven to realign unstable gait, relieve pressure on tendons, ligaments and muscles and reduce pain in the knees, hips and lower back. Orthotics can be custom fitted via referral to a podiatrist.
This resource has been provided by an Australian Podiatry Association (APodA) member podiatrist as part of Foot Health Month 2014