There are so many things that keep a pregnant mama up at night—heartburn, insomnia, stress, even the anticipation of a wonderful new life with your newborn. Add restless leg syndrome to the mix, and you can fuggedabout sleeping! And unfortunately, restless leg syndrome (RLS) is common during pregnancy.

So what’s a sleepy mama to do? We’ll break it all down for you, including:

  • What causes restless legs syndrome
  • What it means for your pregnancy
  • Natural remedies to ease symptoms of RLS

What is Restless Leg Syndrome?

Restless leg syndrome (RLS) affects the nerves in the leg and causes sensations like itching, burning, or a “creepy crawly” feeling. The symptoms can be difficult to describe, since they stem from the nerves, not the muscles.

Unlike leg cramps that are generally sharp and seize the muscle, restless leg syndrome causes an allover uncomfortable feeling that gives you a strong urge to move the legs, especially at night.

How Common is Restless Leg Syndrome

RLS affects approximately 1 in 10 people (source), but is much more common in pregnant women.

Restless leg syndrome during pregnancy affects nearly one-third of women by their third trimester.

What Causes RLS During Pregnancy?

Experts haven’t agreed on a singular cause of pregnancy restless leg syndrome, however there are several factors to consider:

Dopamine Imbalance

Our brain’s produce dopamine, a neurotransmitter that helps muscle movements stay smooth and even. Some research suggests that a dopamine imbalance that occurs during pregnancy can cause restless leg syndrome symptoms. Low magnesium, vitamin D, folate, or iron can all cause lack of adequate dopamine in the body.

Hormone Levels

During pregnancy, the hormones estrogen and progesterone naturally increase. Some research indicates this excess of hormones, specifically estrogen, contributes to restless leg syndrome.

The good news? Though all women have elevated levels of estrogen during pregnancy, not all pregnant mamas get restless leg syndrome. And those who do? Since estrogen levels decline and return to normal levels after delivery, symptoms of RLS also decline.

Genetics and Lifestyle Factors

  • Genetics: About half of those with RLS also have a family member with RLS, so genetics are a likely factor. (source)
  • Lower socio-economic status: Those with a lower socio-economic status are more prone to RLS. Researchers aren’t sure why, though it likely has to do with access to nutrient-rich foods that can help prevent restless leg syndrome.
  • Obesity and weight gain. Excess weight gain in pregnancy increases the chance of developing restless leg syndrome. (source)

Nutrient Deficiencies

During pregnancy, the body funnels nutrients to the baby to foster development, making adequate nutrition vital. When a pregnant mama is deficient in vitamins D, E and B12, magnesium, and/or iron, it ups her chances of having restless leg syndrome. (source, source, source, source,)

Studies also suggest low folate levels prior to conception can cause restless leg syndrome during pregnancy. Another great reason to take those prenatals even before trying to conceive!

Restless Leg Syndrome Symptoms

The symptoms of restless leg syndrome can be hard to describe, since they’re triggered by the nerves, not muscles. The most obvious and prominent symptom, though, is the strong urge to move the legs. (source)

Other symptoms include:

  • Discomfort when sitting or lying down for long periods of time
  • Uncontrollable urge to move the legs
  • Crawling, aching, itchy, or electric sensations in the legs
  • Increased discomfort at night
  • Twitching in the legs and feet while sleeping
  • Lethargy during the day, caused by sleepless nights
  • Temporary relief with movement

How Do You Test For Restless Leg Syndrome?

There is no test for restless leg syndrome.

That said, your healthcare provider may want to do tests to rule out other conditions. RLS can also be caused by things like kidney or brain disorders, so tests to measure the function of other organs may be suggested.

If you’re pregnant, though, it’s generally assumed pregnancy is the cause.

Your provider will likely go over the following questions with you to confirm an RLS diagnosis:

  • Do you have a strong urge to move your legs along with uncomfortable sensations?
  • Are symptoms worse at rest and at night?
  • Are symptoms relieved by movement?
  • Do you have any known medical conditions that could cause these symptoms?

Is Restless Leg Syndrome During Pregnancy Dangerous?

RLS doesn’t directly put baby in jeopardy, but can indirectly make for a more complicated labor and uncomfortable pregnancy.

If your RLS is caused by nutrient deficiencies, this can lead to issues like anemia, mood disorders, and low energy. And sleeping can be difficult with RLS, which can lead to a whole host of health problems for you and baby. Some studies have found that pregnant women who get less than 8 hours of sleep are at greater risk of having a longer labor and Caesarean section.

Restless Leg Syndrome Home Remedies

There is no one-size-fits all treatment plan for restless leg syndrome during pregnancy. What works for one woman may not work for another, so you may need to experiment to see what brings you the most relief. Try:

Gentle Exercise

These gentle pregnancy exercises help soothe tight muscles and relieve restless leg symptoms by increasing circulation.

You can also try:

  • walking
  • pregnancy yoga
  • swimming

Avoid exercise that is too strenuous or stimulating, as this can make symptoms worse.

Warmth

Heat can calm the overactive nerves that cause restless leg syndrome symptoms. Try:

  • A warm water bottle or compress
  • A soothing warm bath

Note: Health experts say pregnant women should avoid very warm temps that will raise the core temperature to 102 degrees or higher. According to a recent review, a moderately warm bath is safe for up to 20 minutes during pregnancy. Talk to your provider about the safest way for you to enjoy a warm bath to relieve restless leg syndrome symptoms.

Prenatal Massage

The hormone relaxin causes the pelvis and lower back to shift during pregnancy, allowing room for baby. This movement can bring the body out of alignment, compressing nerves in the lower back and legs. A prenatal massage relaxes the muscles, opening nerve pathways.

Bodywork

Along with massage, other types of bodywork help ease restless leg syndrome. Myofascial release, trigger point therapy, and deep tissue massage have all been successfully used to relieve RLS symptoms. It’s important to work with a practitioner who is also certified in treating pregnant mamas. Pressure points that stimulate contractions should be avoided. (source)

“Careful application of deep tissue massage is still safe (during pregnancy) in many areas of the body, including the shoulders, upper chest, back, glutes, outer legs, and feet.” – Sheila Resari LMT

Chiropractic

As baby grows, they put pressure on the nerve roots in the lower back that can cause RLS. A chiropractor trained in the Webster technique can help keep the pelvis aligned during pregnancy, which relieves subluxations, or nerve compression, in the spine that trigger RLS symptoms.

“Pelvic instability can place additional stress on the sacral base and cause anterior (forward) pressure from the spine toward the abdomen. The result here is an increased… forward curvature of the spine toward the abdomen. The resulting symptoms are synonymous with RLS. (source)

Chiropractic brings the body back in balance so the nerves are no longer compressed or blocked (source).

Note: You can find a local pregnant-friendly chiropractor trained in the Webster-technique through this database.

Magnesium Supplements

Most of us are magnesium deficient, and pregnancy can further deplete magnesium stores. Because magnesium is necessary for proper nerve function, a deficiency can cause restless leg syndrome symptoms. Magnesium also helps relax muscle fibers to calm the legs.

Best magnesium sources for restless leg syndrome:

  • Magnesium lotion: Because it’s readily absorbed into the body, this is one of the most effective ways to boost magnesium levels. This study showed positive results with 56mg of magnesium applied two times a day, especially before bed. This product delivers 66mg of magnesium in roughly 1/2 teaspoon of lotion.
  • Foods high in magnesium: Try pumpkin seeds, dark leafy greens, almonds, beans, salmon, and dark chocolate. Read more about the best foods for magnesium here.
  • Magnesium glycinate: This form of magnesium is great for relieving nerve pain.
  • Magnesium malate: This helps produce energy in the body and reduce muscle pain. Get it here.

Read more about the best magnesium supplements here.

Iron

Mild anemia (when your body can’t produce as much iron as it needs) is common in pregnancy, due to increased blood volume. (source) And low iron levels can sometimes cause problems with muscle and nerve function, resulting in restless leg syndrome symptoms. Researchers are divided on the role low iron plays in causing RLS, but its still an important nutrient during pregnancy.

Best iron-rich foods: 

  • Grass-fed beef liver
  • Clams and mussels
  • Oysters
  • Grass-fed beef
  • Sardines
  • Beans (especially lima, kidney beans, and chickpeas)

Consume with vitamin C rich foods to aid absorption. Note: Too much iron can cause vitamin E deficiency, so it’s important to have balance here.

Vitamin E

There’s some evidence that vitamin E helps ease restless leg syndrome by supporting healthy circulation and blood vessel function.

The World Health Organization doesn’t recommend vitamin E supplementation during pregnancy. However, it’s still important to get the recommended 3 mg of vitamin E a day through food (like wheat germ, sunflower seeds, and almonds) or a prenatal.

Vitamin D

Research has found that some people with RLS are more likely to have low vitamin D levels. Vitamin D is necessary for dopamine function, which helps keep muscle movements smooth and even. (source).

Daily sunshine is the best way to boost vitamin D levels, but it can also be taken as a D3 and K2 supplement (source).

Foods to Avoid With Restless Leg Syndrome

These foods aren’t great for any pregnant mama, but they can also worsen RLS symptoms.

  • Caffeine: This stimulant can worsen restless leg syndrome symptoms. (source)
  • Refined sugar: Sugar depletes minerals in the body, especially magnesium. Without adequate nutrients, muscles and nerves can’t function properly which can contribute to RLS.

If symptoms are severe, strategically consuming calcium can also help. Too much calcium can block iron absorption (and low iron has been linked with RLS), so it’s best to avoid eating calcium and iron rich foods together.

When All Else Fails…

If RLS symptoms are severe and majorly disrupt quality of life, some providers recommend dopamine antagonist drugs and opiates. But proceed with caution. Dopamine and opiate drugs are classified as Pregnancy Category C, and according to the FDA:

“Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well controlled studies in humans.” (source)

If you’ve exhausted the other options and your day-to-day is severely affected, it may be worth talking with your doctor about other options.

How to Prevent Restless Leg Syndrome

Some factors we can’t control, like genetics and increasing pelvis pressure from baby’s growth. Fortunately there are plenty of ways to minimize symptoms of restless leg syndrome during pregnancy.

Manage weight gain

Eating a healthy, nutrient dense diet low in sugar and refined foods is best for mama and baby. Proper nutrition can prevent excessive weight gain, which impedes circulation and nerve function in the legs.

Reduce water weight

It’s common to have water weight, or water retention, during pregnancy, but too much can worsen RLS. Water weight (edema) prevents proper vein function in the legs and has been linked with RLS.

Dandelion root tea is a gentle liver tonic that reduces edema and is generally considered safe during pregnancy. Eating enough protein, at least 80 grams a day, can also help with swelling. (source, source)

Take a prenatal supplement

A folate-rich prenatal vitamin is necessary for preventing certain birth defects in baby, but it may also help RLS symptoms. Folate and iron help the body produce the hormone dopamine, which then helps muscles and nerves function right.

To make sure baby gets the nutrition they need, take a vitamin with folate, not folic acid. Here’s a list of my favorite prenatal vitamins.

Eat a balanced diet

A nutrient-rich diet (and supplements when necessary) will give the body what it needs to function properly. To minimize or prevent RLS, focus on food rich in:

  • Folate: Dark green veggies (like kale and spinach), asparagus, and brussel sprouts
  • Vitamin B12: Clams, grass-fed beef liver, wild trout, and salmon
  • Iron: Grass-fed beef, oysters, white beans, and dark chocolate
  • Vitamin E: Wheat germ, sunflower seeds, almonds, hazelnuts, and broccoli
  • Magnesium: Almonds, spinach, cashews, peanuts, black beans, and dark chocolate
  • Vitamin D: Cod liver oil, salmon, and egg yolks (sunshine is the best source!)

Read more about which foods are good sources of these nutrients here.

Exercise

Mild to moderate exercise increases circulation and eases RLS symptoms.

Try:

  • Walking
  • Pregnancy yoga
  • Swimming

Note: Intense exercise and cardio is generally not recommended during pregnancy and can further irritate RLS symptoms.

Sleep

Enough sleep is vital to a healthy, happy mama (and baby!). Lack of sleep has been linked with prolonged labor, increased C-section risk, and worsened RLS symptoms.

Since RLS can make it difficult to catch some Zz’s at night, a daily nap can help fill in the gaps.

When Does RLS During Pregnancy End?

Thankfully RLS usually resolves itself within a few days of giving birth, though in some cases it may take longer.

The hormone relaxin is still in the body up to 5 months after delivery, and this can cause the pelvis to be out of alignment. As outlined above, this can cause RLS. If symptoms persist, a Webster-trained chiropractor can adjust the pelvis, decreasing pressure on nerves in the leg.

Check in with your provider if the RLS hasn’t gone away within 3 months after baby’s arrival. This could indicate an underlying cause for the RLS that’s unrelated to pregnancy.

How About You?

Did you experience restless leg syndrome during pregnancy? What natural remedies helped you find relief? And when did it go away?