Foot Pain During Pregnancy: Safe Management for Expecting Mothers

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Why Pregnancy Changes Your Feet

Pregnancy produces a cascade of physiological changes that affect the feet in predictable and sometimes dramatic ways. Understanding what’s happening and what can be done safely helps expecting mothers maintain foot comfort throughout pregnancy and beyond. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, we provide pregnancy-safe foot care with an understanding of what treatments are appropriate at each trimester.

Foot Swelling (Edema)

Fluid retention increases throughout pregnancy as blood volume expands and the growing uterus partially obstructs venous return from the lower extremities. Foot and ankle swelling is nearly universal in the third trimester and is normal physiological change, not pathology, when bilateral and without associated symptoms. Management: elevation (feet above heart level when resting), compression socks (15-20 mmHg if cleared by OB), side-sleeping (left side preferred — reduces uterine pressure on the inferior vena cava), and adequate hydration. Unilateral swelling with calf pain and warmth requires immediate evaluation for DVT — pregnancy is a prothrombotic state with significantly elevated DVT risk.

Arch Changes and New Flat Feet

Relaxin — the pregnancy hormone that loosens pelvic ligaments for delivery — also affects foot and ankle ligaments, reducing their stiffness and allowing the arch to progressively flatten. This arch collapse causes plantar fasciitis and arch pain, often beginning in the second trimester. Supportive footwear with firm arch support (avoiding ballet flats, flip-flops, and unsupportive sneakers) is the first intervention. Over-the-counter arch support insoles are safe throughout pregnancy. Custom orthotics are also safe if needed for significant symptoms.

Plantar Fasciitis in Pregnancy

Plantar fasciitis is common in pregnancy from the combined effects of weight gain (increased plantar fascia tensile load), arch flattening from relaxin, and altered gait mechanics. Management follows standard plantar fasciitis treatment with modifications: physical therapy, stretching, supportive footwear, and orthotics are all safe. NSAIDs (ibuprofen, naproxen) are not recommended after 20 weeks gestation; acetaminophen for pain relief as approved by OB. Corticosteroid injections are generally avoided in pregnancy — discuss with your OB and podiatrist if symptoms are severe.

Foot Size Changes That Persist

Permanent foot size changes — particularly foot lengthening and widening — occur in a significant percentage of women with each pregnancy. This results from permanent ligamentous laxity and arch flattening that doesn’t fully revert postpartum. Many women need to size up their shoes permanently after pregnancy. Continuing in pre-pregnancy footwear that no longer fits correctly contributes to ongoing foot pain postpartum. Contact Balance Foot & Ankle at (810) 206-1402 for pregnancy-safe foot care evaluation and management.

Foot or Ankle Pain? We Can Help.

Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.