The sensation of aching, tired, or heavy legs is characterized by a feeling of heaviness and fatigue in the legs, and is most often felt at the end of the day and during summer months. These circulatory impairments are particularly frequent during pregnancy and are due to weight gain and hormonal changes.
Although these unpleasant sensations most usually disappear on their own after delivery, they should not be taken lightly; heavy legs can evolve into vascular pathologies which can sometimes be disabling. They therefore require close monitoring and appropriate care from the very first signs so as to limit the risk of complications.
NORMAL BLOOD CIRCULATION IN THE LEGS
In their normal state, arteries supply the body’s tissues and organs with essential substances for their healthy functioning, such as oxygen. Veins, on the other hand, return blood to the heart.
Blood pressure and the firmness of vein walls allow blood to flow from the lower to the upper portion of the legs. This blood flow through the veins and back up to the heart is called venous return. Valves, acting as small flaps, are positioned every 2 to 5 centimeters (0.8 to 2 inches) in the veins. These valves ensure that blood always flows in the same direction without ever “falling” back down the other way. The calf muscles and compression of the instep also play a role in blood flow, particularly when walking.
SIGNS OF ACHING OR HEAVY LEGS
Aching or heavy legs first appear as a sensation of discomfort, fatigue, and heaviness in the legs. These sensations can be the first sign of an actual circulation impairment. The sensations also frequently occur alongside other characteristics:
- Pain is often localized in the interior and posterior area of the calf and radiates up the leg toward the inside of the knee.
- This pain is most often felt towards the end of the day.
- The pain increases if you remain standing for a long time or if you are in contact with heat (summer temperatures, hot baths, hot-wax treatments, etc.).
- This pain is felt increasingly often as the pregnancy progresses.
- The pain is relieved by cold temperatures, winter climates, rest, elevation of the legs, and walking.
- The pain can be accompanied by cramps at night, restlessness of the legs (painful discomfort that requires that one move one’s legs for relief), inflammation (edema of the ankles), varicosities, and even varicose veins.
If you are experiencing any of these symptoms, talk about it with your doctor at your next visit; your doctor may be able to prescribe a suitable treatment for you.
CAUSES OF ACHING OR HEAVY LEGS
The sensation of heavy or aching legs is related to a loss of firmness and elasticity of the vein walls, which causes a slowing of blood circulation in the veins. Because of this, the veins dilate and blood pressure increases. Valves, the small flaps that normally keep blood from flowing back down the leg veins, have difficulty maintaining this pressure and progressively become deficient. Resistance to leaks weakens and blood stagnates in the lower portion of the veins, which further impairs vein walls. A vicious circle takes hold.
HEAVY LEGS DURING PREGNANCY
Pregnancy is a period during which the risk of circulatory disruptions emerging becomes particularly high; these disruptions are the consequence of the related increase in body weight and hormonal changes.
- As early as the first trimester, the increase in hormones creates circumstances in which the blood in the veins can easily stagnate, weakening vein walls and the firmness of blood vessels. Estrogen levels can lead to inflammation (edema) and progesterone modifies the vein walls and vessel dilation.
- Throughout pregnancy, the increased volume of the uterus leads to increased pressure on the main vein responsible for returning blood to the heart.
- Finally, an increase in blood weight and volume (of 20% to 30%) contributes to increased pressure on the leg veins, which is doubled or tripled. The valves are separated further from each other by distension of the veins, and no longer play their role of impeding blood return.
Blood circulation in the leg veins can therefore be considerably impeded. The symptoms vary significantly from woman to woman and pregnancy to pregnancy, ranging from simple discomfort to disabling pain. After delivery, these impairments most often wane on their own within a few weeks.
Several factors can increase the risk of vascular insufficiency during pregnancy:
- Heredity: if your mom has had circulatory issues, you run a higher risk of experiencing them yourself
- Working in a standing position and shuffling. Prolonged sitting can also disrupt venous return.
- A sedentary lifestyle and lack of physical exercise.
- Excess body weight prior to pregnancy, or significant weight gain during pregnancy.
- Previous pregnancies: the risk of venous insufficiency increases with the number of previous pregnancies carried to term: 23% for the first pregnancy and 31% for the fourth.
GOOD HABITS TO GET INTO
To avoid circulatory impairments during pregnancy, prevention is essential:
If you need to, try to lose weight before getting pregnant and then limit your weight gain during pregnancy.
- Take walks or do light exercise, which boosts blood flow.
- Wear shoes with a small heel that is neither too high nor too flat (3 to 4 cm or 1 to 1.5 inches).
- Avoid tight-fitting clothes and constricting socks.
- If you suffer from any plantar arch problems, wear corrective insoles.
- In certain cases, wearing compression stockings and taking venotonics may be recommended during pregnancy, starting in the second month; ask your doctor.
If you experience the sensation of heavy legs despite these measures, try some of these tips to help ease the discomfort:
- Raise your feet from the foot of your bed.
- At the end of each shower, spray cold water over your legs in an upward motion from the ankles to the thighs.
- Avoid sources of heat (prolonged exposure to the sun, high-temperature baths, underfloor heating, etc.).
- Massage your legs every day, from the ankles to the knees, using a specific treatment cream to increase blood return and stimulate blood flow.
If your legs are painful and you see no improvement after adopting the recommended measures outlined in the previous section, do not hesitate to see a doctor. They can prescribe suitable treatment for your condition. Various methods - from medicinal to physical to surgical - may be considered, depending on the severity of your circulatory impairments:
- Compression via pantyhose, stockings, or socks is the basic treatment for anyone experiencing venous insufficiency. Different models are available depending on the strength of compression necessary. Significant progress has been made in improving the esthetics of these garments. The cost of some of these compression methods may be eligible for Social Security reimbursement.
- Venotonics have anti-inflammatory properties, stimulating muscle tone and protecting the elasticity of the vein walls. They must be taken for an extended period of time in order to be effective.
- Kinesitherapy and exercises to build up the leg muscle also have a role to play. Walking, swimming and biking are the best types of activity. Spa treatments, massages, and manual lymphatic drainage can also provide valuable relief.
- If varicose veins developed during your pregnancy and are still present after delivery, vein sclerotherapy or surgery may be considered. These techniques can be performed under local anesthesia, requiring neither an epidural nor general anesthesia, and the patient can go home the same day as treatment, or the following day.