Nighttime leg cramps can happen to anyone, at any age. And they can occur at any time of the day or night. Calf muscles can suddenly become hard, tight, and painful at any time, such as during a run or when drifting off to sleep.
Almost everyone gets a muscle cramp that comes on without warning. Research finds as many as 60 percent of adults and seven percent of children have experienced nighttime leg cramps. The likelihood an adult will have a leg cramp increases as they age.
In This Article:
- What are Nighttime Leg Cramps?
- What Causes Nighttime Leg Cramps?
- What are the Symptoms of Nighttime Leg Cramps?
- How are Nighttime Leg Cramps Diagnosed?
- How are Nighttime Leg Cramps Treated?
- Is It Possible to Prevent Nighttime Leg Cramps?
- Novus Spine & Pain Center
- Nighttime Leg Cramp Resources
What are Nighttime Leg Cramps?
Nighttime leg cramps, nocturnal leg cramps, and a “Charley Horse” are all names for a painful, involuntary contraction or spasm in the muscles of the legs. The hard lump you feel at the point of pain is the contracted muscle. Leg cramps most commonly occur in the calves and hamstrings, though they can occur in the feet, thighs, and just about any other muscle. They tend to jolt a person awake in the middle of the night, but can also strike in the daytime during physical exertion such as running and cycling.
The tight, knotted sensation of a leg cramp can last a few seconds to several minutes. Sometimes the pain may linger; and if the cramp is especially severe, the muscle may be sore for days afterward. As painful as they feel, leg cramps are harmless.
Sometimes leg cramps seem to come out of nowhere, but they can also be related to movement. Fitness routines can put a strain on the leg muscles causing a cramp. Some leg muscle cramps may also be the result of a sedentary lifestyle, which is a normal occurrence as long as the pain isn’t prolonged or recurring.
Men and women are equally prone to leg cramps. While they can strike people of all ages, those over the age of 50 may get them more often.
What Causes Nighttime Leg Cramps?
The cause of nighttime leg cramps can be the result of many conditions ranging from vigorous exercise to something more serious, like kidney disease. If a person is suffering from a condition like kidney failure or diabetic nerve damage, they will have other symptoms in addition to leg cramps. Generally, nighttime leg cramps are not a sign of an underlying condition.
In most cases, there is no specific underlying cause of leg cramps, but they usually occur for a reason, like trauma to a muscle. Sometimes, the cause can be something as simple as maintaining an awkward leg position for an extended period of time, such as at a movie or in an airplane. Other causes can include medications such as diuretics (often used to help control high blood pressure) and steroids. A lack of minerals like potassium, magnesium, or calcium can also be the underlying cause, as well as cold weather.
Dehydration is often mentioned as a cause because athletes who exercise strenuously in hot weather often experience cramps. However, this theory is disputed as research shows athletes in cooler climates also get cramps.
Some doctors believe muscle fatigue and nerve dysfunction can cause leg cramps. It is suggested that during sleep the foot is stretched out and the calf muscles shortened, which could be a trigger for leg cramps. Some physicians also think the brain may mistakenly tell the leg to move while dreaming, causing them to contract and resulting in nighttime leg cramps. Another theory is that cramps are more likely nowadays because people no longer squat, which is a position that stretches the calf muscles.
Other conditions that may cause cramps include:
- Addison’s disease. A disorder in which the adrenal glands fail to produce enough hormones.
- Alcohol abuse.
- Blood pressure drugs.
- Cancer treatment.
- Chronic kidney failure.
- Cirrhosis. Late stage of scarring (fibrosis) of the liver.
- Diuretics (water retention relievers).
- Stressing or using a muscle for a long time may trigger a leg cramp during or after exertion. Cramps often affect anyone if the body is out of condition.
- Gastric bypass surgery.
- Hemodialysis (kidney dialysis).
- Hyperthyroidism (overactive thyroid).
- Hypothyroidism (underactive thyroid).
- Hypolalemia (decreased blood potassium levels).
- Inadequate blood flow to a muscle.
- Lead poisoning.
- Motor neuron problems.
- Muscle fatigue.
- Nerve damage, as from cancer treatments.
- Parkinson’s disease (a disorder of the central nervous system that affects movement).
- Peripheral artery disease (PAD).
- Pregnancy (especially later stages).
- Sarcoidosis. A disease in which small growths or lumps produce tissue inflammation (swelling) in any part of the body.
- Some medications, including oral birth control, intravenous iron sucrose, conjugated estrogens, naproxen, raloxifene, teriparatide, and cholesterol-lowering drugs (statins).
- Spinal stenosis, a spinal cord injury or pinched nerve in the neck or back.
- Vascular disease and venous insufficiency.
Older people are more likely to experience leg cramps. Muscle loss, which begins about the mid-40s and increases in people who are less active, have a higher likelihood of having night leg cramps.
Some activities can make a person more prone to leg cramps. These include exercises that rely heavily on the leg muscles, such as recreational running, leg weight training, or sports that require a lot of running resulting in muscle fatigue. It is possible to reduce the chances of activity-related leg cramps by drinking plenty of water and stopping exercise when fatigued.
Restless legs syndrome (RLS) is sometimes confused with nighttime leg cramps, but is a different condition. In general, pain is not a primary feature of RLS, although some people describe their RLS as being painful.
What are the Symptoms of Nighttime Leg Cramps?
Nighttime leg cramps are sudden, painful involuntary contractions of muscles in the feet, calves, and thigh. These leg cramps are quite painful, causing affected muscles to feel tight or knotted. They can occur while a person is sleeping or just resting.
The cramp can last a few seconds to several minutes. The average duration is about 9 minutes. The muscle may remain tender for as long as 24 hours after the episode. The cramps happen mostly in the calf muscles, but can also commonly occur in the thighs or feet.
How are Nighttime Leg Cramps Diagnosed?
The occasional nighttime leg cramp doesn’t require an official medical diagnosis. However, it is important to consult a doctor if there are recurrent muscle spasms, especially if they occur more than once a week without an adequate explanation.
A diagnosis is generally obtained by going over the patient’s medical history, and a physical examination. The medical history is important to identify the possible cause of leg cramps. During a leg cramp, visible muscle tightening, and sudden, intense pain are typical. The patient’s description of the symptoms will help differentiate leg cramps from other common conditions.
In some cases, MRI scans are helpful in determining whether nerve compression is the cause of the leg cramps. An MRI utilizes a magnetic field and radio waves to create a detailed image of the body’s internal structures. Laboratory work may also be necessary to rule out low potassium, calcium, or magnesium levels.
How are Nighttime Leg Cramps Treated?
In most cases, it is possible to take care of a leg cramp at home. Forcefully stretching the contracted muscle will help relieve the pain. However, frequent muscle spasms are often linked to underlying health conditions that need medical treatment.
Currently there are no medications specifically designed to treat recurring muscle cramps, but if the cramping is a sign of another problem, addressing the underlying issue could provide relief. If leg cramps occur often, and for no apparent reason, it is important to see a doctor.
If there is no underlying cause, the leg cramps will probably get better without treatment. Often, self-massage of the affected muscle, followed by the application of ice, is helpful. Other home treatments during and after a leg cramp include:
- Get Moving. When experiencing leg cramps, the best thing to do is walk around. Walking tells the muscle it needs to contract and relax.
- OTC Pain Relief. Analgesic balms or patches, available over-the-counter at most pharmacies, can provide further relief. Painkillers usually are too slow acting to be useful for a leg cramp; however, when a severe cramp leaves a muscle feeling tender, an over-the-counter (OTC) painkiller may help after the cramp has ended. OTC pain relief medications that are formulated to treat menstrual cramps, such a Pamprin and Midol, can be an effective treatment for severe leg cramps.
- Stretching. Stop any activity that may have induced the cramp, and lightly stretch the muscle. Gently hold the stretch for a few seconds while massaging the area.
- Tip Toes. Stretch the calf muscles by standing and walking on the tips of your toes for a few seconds may help.
- For a leg cramp in the calf or the back of the thigh (hamstring): Stand arm-distance away from a wall with your feet flat on the ground. Lean forward against the wall with your arms outstretched and your hands flat on the wall. Keep the heels on the ground. Hold for 10 seconds, then gently return to an upright position. Repeat five to ten times. Alternatively, sit or lie with the leg out straight, pull the top of your foot toward the head.
- For a cramp in the front of the thigh (quadriceps): While holding to a chair for stability, pull the foot back toward the buttocks.
- Massage. If the cramp is exercise-induced, simple stretches and a massage can help relax the muscle and stop it from contracting.
- Hot Soak. Many athletes and physical therapists recommend magnesium in the form of Epsom salts. This old-school remedy can be applied to a wet cloth and pressed onto a cramped muscle. Alternately, add some Epsom salts to hot bath water and soak for a few minutes. Heat provides relief for many people, with or without Epsom salts. The dry heat of a heating pad may also help.
- Ice Pack. While heating pads accelerate the relaxation process, an ice pack will help numb the pain.
Quinine as a treatment for leg cramps is no longer recommended. A 2010 warning by the FDA about quinine detailed the potentially dangerous interactions and side effects of quinine that outweigh the modest benefits.
Is It Possible to Prevent Nighttime Leg Cramps?
There are several things you can do at home to help alleviate nighttime leg cramps. Anyone who regularly suffers leg cramps should work to strengthen their muscles, which will help make leg cramps less frequent. Some other simple things that can help prevent leg cramps include:
- Diet. Eat a healthy diet with plenty of fresh fruits and vegetables, and foods high in vitamins, potassium, magnesium, and calcium. The advice about eating bananas for leg cramps is correct, because the potassium in bananas can help.
- Vitamins and Minerals: Potassium and Magnesium. Increasing magnesium intake can lessen the frequency of nighttime leg cramps, especially for pregnant women. Health experts recommend getting at least 300 milligrams of magnesium each day. Likewise, Potassium is an important electrolyte, a substance that conducts electricity in the body (along with magnesium), for nerve and muscle cell functioning. Potassium plays a key role in smooth muscle contraction, making it important for proper muscle function. A nutritional supplement can help you reach your daily allowance of both. However, the best way to get these nutrients is in eating foods rich in potassium (sweet potatoes, white beans, and bananas) and magnesium (nuts, lentils, and quinoa).
- Hydration. Drink plenty of water. Being properly hydrated can help the body better process the minerals from foods and supplements.
- Stretch properly before exercise. Focus on the calf and foot muscles.
- Exercise. If unable to find a program that is suitable for your age and ability, move around during the day to exercise your feet and legs.
- Footwear. Wear suitable, comfortable, supportive shoes, especially if you have flat feet or other foot problems.
- Stretch before bedtime. Before going to bed, stretch.
- Sleep under loose covers. Loose covers are important for people that sleep on their back. Loose bedding help prevent the feet and toes from pointing downward during sleep.
If you suffer frequent and severe leg cramps, talk to a doctor to make sure there’s not an underlying health problem causing the cramps.
Novus Spine & Pain Center
Novus Spine & Pain Center vein center in Lakeland, Florida specializes in treating nighttime leg cramps. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.
Nighttime Leg Cramps Resources
Why is My Leg Cramping? What Can Help? (WebMD)
Leg Cramps (WebMD)
Leg Cramps at Night (Cleveland Clinic)
Causes and Treatment for Leg Cramps (Medical News Today)
Night Leg Cramps (Mayo Clinic)
What Causes Leg Cramps and How Can You Stop Them? (Everyday Health)
How to Stop Leg Muscle Cramps (Healthline)
Charley Horse (Healthline)
What Causes Leg Cramps? (Healthline)
Nocturnal Leg Cramps (American Family Physician)
Exercise-Associated Muscle Cramps (PubMed)
Muscle Cramps (American Academy of Orthopaedic Surgeons)
Muscle Cramp (Mayo Clinic)