Why do feet hurt and swell during pregnancy?

Multiple factors cause foot problems during pregnancy: increased body weight puts more stress on feet, hormones (relaxin) loosen foot ligaments causing arch collapse and flattening, blood volume increases by 50% causing fluid retention and swelling (edema), reduced venous return from the growing uterus increases lower leg swelling, and center of gravity shifts changing gait mechanics. Up to 70% of pregnant women experience significant foot pain.

Are custom orthotics safe during pregnancy?

Yes — custom orthotics are completely safe during pregnancy and often essential for managing pregnancy-related foot pain. They support the flattening arch, reduce plantar fasciitis pain, provide stability as ligaments loosen, and reduce foot fatigue. Many women find orthotics are the single most effective intervention for pregnancy foot pain. Post-delivery, orthotics remain valuable as the relaxin effects persist for several months after birth.

When should a pregnant woman see a podiatrist?

See a podiatrist if: foot pain limits your activity, you develop plantar fasciitis (heel pain with first steps), swelling is severe or asymmetric (one foot much more swollen than the other), you have skin changes on feet, you develop ingrown toenails that become infected, or you have diabetes and develop any foot change. Sudden severe swelling, especially with headache or vision changes, may indicate pre-eclampsia — contact your OB immediately.

Why do feet hurt and swell during pregnancy?

Pregnancy causes foot pain and swelling through several mechanisms: weight gain increases load on the arch and heel, relaxin hormone loosens ligaments causing arch flattening, increased blood volume produces swelling, and positional changes from the growing belly alter gait mechanics. Balance Foot & Ankle helps pregnant patients manage these changes comfortably. Call (810) 206-1402.

Can custom orthotics help with pregnancy-related foot pain?

Yes. Custom orthotics from Balance Foot & Ankle are particularly valuable during pregnancy because they support the flattening arch and compensate for the ligamentous laxity caused by relaxin hormone. Many pregnant women experience dramatic reduction in heel pain, arch pain, and foot fatigue with properly prescribed orthotics. Foot changes during pregnancy are real and treatable.

Will my feet return to normal after pregnancy?

For most women, feet partially or fully return to their pre-pregnancy state after delivery. However, arch flattening from relaxin's effects sometimes persists permanently, especially after multiple pregnancies. Balance Foot & Ankle recommends supportive footwear and orthotics during pregnancy to minimize permanent arch changes and provide comfort throughout gestation.

What can pregnant women do to reduce foot swelling?

Balance Foot & Ankle recommends: elevating feet when resting, wearing compression socks approved for pregnancy, staying hydrated, reducing sodium intake, gentle walking for circulation, avoiding prolonged standing, and sleeping on the left side which improves venous return. Sudden dramatic swelling especially in one leg warrants immediate medical evaluation to rule out blood clots.

Is it safe to see a podiatrist while pregnant?

Absolutely. Balance Foot & Ankle provides safe, effective care for pregnant patients. All treatments are selected with pregnancy safety in mind. X-rays are avoided unless absolutely medically necessary. Custom orthotics, footwear recommendations, stretching guidance, and conservative treatments are all safe during pregnancy. Call (810) 206-1402 to schedule a prenatal foot evaluation.

When should I see a podiatrist?

For persistent foot/ankle pain, difficulty walking, numbness, non-healing wounds, skin changes, or deformities. Dr. Biernacki offers same-day appointments. Call 810-206-1402.

Does Dr. Biernacki accept insurance?

Balance Foot & Ankle accepts most major plans including BCBS, Aetna, United, Cigna & Medicare. Call 810-206-1402 to verify coverage. Affordable self-pay options available.

What to expect at your first podiatry visit?

Comprehensive evaluation including history, exam, biomechanical assessment, and in-office X-rays. Same-day diagnosis and treatment when possible. Most visits take 30-45 minutes.

Why do feet swell during pregnancy?

Pregnancy increases blood volume by 50% and the growing uterus puts pressure on pelvic veins, reducing blood return from the legs. Hormonal changes also cause fluid retention. These factors combine to cause edema (swelling) in the feet and ankles, particularly in the third trimester and during warm weather.

Do feet permanently change size after pregnancy?

Research shows that pregnancy can permanently flatten the arch and increase foot length by 2-10mm. This is caused by the hormone relaxin loosening ligaments throughout the body, including those supporting the foot arch. These changes are most significant during a first pregnancy and may require new shoes or orthotics.

Is it safe to see a podiatrist during pregnancy?

Yes, podiatric care is safe during pregnancy. Treatments like custom orthotics, compression stockings, stretching programs, and footwear recommendations are all pregnancy-safe. Your podiatrist will avoid X-rays and certain medications during pregnancy and can coordinate with your OB/GYN if needed.

✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Pregnancy Foot Pain: Why It Happens & What Actually Helps

Pregnancy and Foot Pain: You’re Not Imagining It

Foot problems during pregnancy are incredibly common — and incredibly under-addressed. Most women assume foot pain and swelling are just unavoidable parts of pregnancy. While some degree of change is normal, there’s a lot you can do to manage these symptoms and protect your feet from lasting damage. Here’s what’s actually happening and what genuinely helps.

Why Pregnancy Causes Foot Pain and Changes

Relaxin Hormone

During pregnancy, the body produces relaxin — a hormone that loosens the ligaments in the pelvis to allow childbirth. Unfortunately, relaxin isn’t targeted only to pelvic ligaments — it affects all ligaments, including those supporting the foot arch. This is why many women develop flat feet during pregnancy, and why foot size often increases by a half size or more (sometimes permanently). The arch collapses, the foot widens and lengthens, and suddenly your pre-pregnancy shoes don’t fit.

Edema (Swelling)

Blood volume increases by 30-50% during pregnancy. The growing uterus puts pressure on pelvic veins, reducing venous return from the legs. The result: fluid accumulates in the ankles and feet, especially in the third trimester. Some degree of bilateral ankle edema is normal in the last trimester — it typically peaks by evening and improves with rest.

Weight Distribution Changes

The growing belly shifts the center of gravity forward, causing compensatory gait changes that load the foot differently. Combined with the ligament laxity from relaxin, this significantly increases plantar fascia stress — which is why pregnancy is a major trigger for plantar fasciitis.

What Actually Helps

Footwear Modifications

The most impactful change: buy shoes that fit your pregnant feet, not your pre-pregnancy feet. Wearing shoes that are too narrow causes forefoot pain, bunion pressure, and nerve compression. Look for: wide toe box, adjustable closure (velcro or lace-up to accommodate swelling changes throughout the day), low heel (under 1 inch), and good arch support. Many women need a half to full size larger during pregnancy.

Compression Socks

Graduated compression socks (15-20 mmHg) worn from morning to evening dramatically reduce pregnancy edema by assisting venous return. Put them on before getting out of bed when swelling is at its minimum. This is one of the highest-impact, completely safe interventions for pregnancy foot and ankle swelling.

Elevation and Movement

Elevate feet whenever resting — ideally above heart level. Avoid sitting or standing in one position for extended periods (both worsen edema). Short walks activate the calf muscle pump and reduce swelling more effectively than complete rest.

Arch Support and Orthotics

OTC arch support insoles address the arch collapse from relaxin and can significantly reduce plantar fasciitis pain during pregnancy. Powerstep Pinnacle or PowerStep Pinnacle fit in most maternity-appropriate shoes. Custom orthotics are an option for severe cases.

When to Be Concerned

Normal pregnancy edema: bilateral, gradual, worse in the evening, better after rest. See your OB immediately if: swelling is sudden and severe, one leg is significantly more swollen than the other (possible DVT), swelling is accompanied by headache, visual disturbances, or upper abdominal pain (possible preeclampsia), or swelling extends significantly above the ankle and isn’t improving with rest.

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Significant foot pain during pregnancy? We see many expecting patients and can safely provide orthotics, recommendations, and treatment during pregnancy.

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Frequently Asked Questions

Will my feet go back to normal after pregnancy?

Swelling: yes, typically resolving within weeks of delivery. Arch changes: possibly not completely. Many women experience permanent arch flattening and foot size increase — particularly after multiple pregnancies. Starting with good arch support early in pregnancy may help minimize permanent changes.

Are foot massages safe during pregnancy?

Gentle foot massage is generally safe and beneficial during pregnancy. Some massage therapists avoid specific acupressure points on the feet that are traditionally associated with inducing contractions — though the clinical evidence for this concern is very limited. Gentle relaxing massage is considered safe throughout pregnancy.

Can I use Epsom salt soaks during pregnancy?

Warm (not hot) Epsom salt foot soaks are generally safe during pregnancy. Avoid hot water soaks that raise core body temperature. Check with your OB if you have any pregnancy complications before starting any new home treatment.

Why are my feet burning during pregnancy?

Burning feet during pregnancy can have several causes: meralgia paresthetica (nerve compression from weight gain), peripheral edema compressing superficial nerves, or in some cases, gestational diabetes causing early neuropathic symptoms. New burning or tingling in your feet during pregnancy warrants mentioning to your OB.

Is plantar fasciitis normal during pregnancy?

Yes — plantar fasciitis is very common during pregnancy due to arch collapse from relaxin, weight gain, and gait changes. It’s manageable with proper footwear, arch supports, and the stretching routine described above. It typically improves significantly after delivery, especially with continued use of supportive footwear.

About the Author: Dr. Tom Biernacki, DPM is a board-certified podiatric surgeon and founder of Balance Foot & Ankle Specialists, with locations in Howell and Bloomfield Hills, Michigan. He has treated over 5,000 patients.

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Medical References & Sources

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Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

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Clinical References

Ponnapula P, Boberg JS. “Lower extremity changes experienced during pregnancy.” Journal of Foot and Ankle Surgery. 2010;49(5):452-458.
Vullo VJ, et al. “Postpartum recovery of lower extremity changes during pregnancy.” Journal of the American Podiatric Medical Association. 1996;86(6):257-261.
Segal NA, et al. “Pregnancy leads to lasting changes in foot structure.” American Journal of Physical Medicine & Rehabilitation. 2013;92(3):232-240.

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