You don't have to sprint a marathon to get a painful leg cramp. Sometimes a muscle cramp - commonly called a "charley horse" - can wake you up from a sound sleep. Nighttime muscle cramps are more common with age, but younger people can get them too.
A muscle cramp is when a muscle involuntarily contracts and is not able to relax. The muscle may look and feel hard. Usually, the pain of night leg cramps comes on suddenly just after falling asleep, or wakes you up in the morning. The pain lingers for a few minutes, but eventually goes away. Night muscle cramps usually involve the calf muscles or those of the sole of the foot.
Night muscle cramps are not the same as restless legs syndrome, in which you get a creepy-crawly or burning feeling in your legs and feel the urge to move them. Nighttime leg cramps are not dangerous, but they are painful and often interfere with sleep. Frequent episodes are a reason to see your doctor.
What causes night leg cramps?
Any type of muscle cramp is an involuntary muscle contraction that causes pain. Exercise-related muscle cramps may be due to overuse of a certain muscle. But no one is sure what causes nighttime leg cramps, which come on while you are perfectly still. Underlying medical conditions may rarely play a role. Dehydration, an electrolyte imbalance or certain medications may also contribute. Diuretics (water pills), certain cholesterol-lowering medicines called statins, steroids and birth control pills are among the medicines linked to this condition. Pregnant woman are also more likely to have nighttime leg cramps.
What should I do when I get a nighttime leg cramp?
Studies are conflicting as to whether stretching is good for leg muscle cramps. But a lot of people find stretching helps end a painful leg cramp.
Try bending your foot up toward you until you feel a stretch in the calf muscle with pain. Then hold the stretch for a few seconds. Pulling your foot toward you using a towel also works well. Researchers believe that flexing the muscles opposite the calf (in the front of the leg) like this relaxes the calf muscles and may help relieve the pain.
You might also try:
- Massaging the painful muscles with your hand
- Taking a warm shower
What can I do to prevent nighttime leg cramps?
Some people recommend the following, though good studies are still needed to prove their effectiveness:
- Wear good shoes. Find a sturdy pair of shoes with good arch support, especially if you have flat feet, which can put extra strain the calf muscles.
- Use lighter blankets if you sleep on your back. The weight of heavy bedding can flex your feet down, pulling calf muscles and tiring them out. You can find lightweight bedding that's made of warm material. Try sleeping on your stomach with your feet just over the edge of the bed.
- Practice good sleep habits. Go to bed when you're sleepy. Avoid alcohol or caffeine before bed.
- Try preventive calf stretches three times a day. Stand three feet from a wall while leaning against it. Keep your arms outstretched with hands firmly contacting the wall. Gently press the heels down until you feel a non-painful stretch in both calves. Hold for 10 seconds then repeat after five-second intervals three or four times.
When should I call my doctor?
If your leg cramps occur frequently or are extremely painful, contact your doctor. Also contact your doctor if the pain persists. Persistent muscle aches or pain are not cramps. Muscle pain can be due to many causes, including a rare side effect of statins. These are certain medications that help lower cholesterol. Tell your doctor right away if you have muscle pain and are taking a statin (such as simvastatin, lovastatin, pravastatin and others).
As part of a visit for muscle cramps, your doctor:
- Will look for underlying conditions that cause muscle cramps. Peripheral vascular disease, chronic kidney failure, a thyroid condition or diabetes are some illnesses that can be related to muscle cramps. Involuntary muscle twitching and wasting may be signs of a possible serious underlying neuromuscular disease and should prompt you to seek medical attention.
- Will do blood work, including tests for potassium and calcium, which are important for nerve and muscle function. Low levels of these elements can contribute to muscle cramps.
- May consider alternative medications. If you are taking medications that can cause muscle cramps, your doctor may try you on a different drug.
- May prescribe medications that may help relax muscles. Treatments include a calcium-channel blocker called diltiazem (Cardizem) or vitamin B complex. However, more research is needed to see how effective these medications are at preventing painful leg cramps. In the past, quinine was sometimes used as a last resort. But due to safety concerns, the FDA is now warning against using it to treat or prevent leg cramps.
