Leg Cramps at Night: Finding the Cause and Treatments

Leg Cramps at Night: Finding the Cause and Treatments

Nocturnal leg cramps are sudden contractions of the lower leg and foot muscles. They often awaken you from sleep. The calf muscles are most often involved. The cramps are harmless. They do not mean that you have a serious disease.


The specific cause of nocturnal leg cramps is unknown. These cramps may be related to imbalances in local muscle chemistry. Many activities and diseases are associated with nocturnal leg cramps:

  • Overexertion of the muscles
  • Standing on hard surfaces
  • Prolonged sitting
  • Certain leg positions while inactive
  • Dehydration
  • Diseases
    • Diabetes
    • Parkinson’s disease
    • Hypoglycemia
    • Hormone disorders (eg, thyroid imbalance )
    • Chemical imbalances (eg, calcium, potassium, magnesium)
  • Certain medications
    • Blood pressure medicines
    • Statins (that lower cholesterol)
    • Morphine
    • Lithium

Risk Factors

The following factors increase your chance of developing nocturnal leg cramps:

  • Age over 50
  • Overexertion
  • Pregnancy
  • Staying in certain positions for a long time
  • Flat feet or other foot or ankle deformities
  • Alcoholism
  • Neurologic diseases
  • Certain medicines
  • Diabetes
  • Parkinson’s disease
  • Hypoglycemia
  • Hormone disorders (eg, thyroid imbalance )
  • Chemical imbalances (eg, calcium, potassium, magnesium)


  • Sudden nighttime calf (or foot) cramps


Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include the following:

  • Blood tests
  • Checking your foot pulses for good circulation


Talk with your doctor about the best plan for you. If no specific cause can be found, treatment options include the following:

  • When cramps occur, pull against them with your leg muscles. Also, grab your foot (feet) and pull up.
  • Standing on the affected leg often stops the cramping.
  • Massage and hot or cold treatments to help the muscles relax.


None of these medicines has earned full approval for either safety or efficacy. Quinine , while often effective for reducing the frequency and intensity of cramps, has a significant risk of major allergic reactions. The other prescription medications carry risks as well. So, they are not generally recommended. They are most often used in only severe cases.


  • Diphenhydramine hydrochloride (Benadryl)
  • Calcium


  • Quinine sulfate
  • Simple muscle relaxants (eg, meprobamate , Equanil, Robaxin )
  • Verapamil hydrochloride (Calan, Isoptin, Verelan)
  • Chloroquine phosphate (Aralen)
  • Hydroxychloroquine sulfate (Plaquenil)
  • Carbamazepine (Tegretol)
  • Phenytoin (Dilantin)


To reduce your chance of getting nocturnal leg cramps, take the following steps:

  • Stretch three times a day and just before going to bed.
    • Face a wall and put your hands on the wall and keep them there. Step backward. Keep your knees locked. Keep your heels on the floor until you feel a strong pull in your calves. Hold that position for 10 seconds. Repeat two or three times.
  • Exercise feet and legs regularly.
  • Drink plenty of liquids.
  • Eat plenty of potassium-rich foods. This includes bananas, tomatoes, potatoes, broccoli, cantaloupe, oranges, and grapefruit.
  • Wear comfortable, supportive shoes.
  • Sleep with toes up, not pointed downward.


American Academy of Family Physicians

Health Education | Illnesses, Diseases & Conditions

American Academy of Orthopaedic Surgeons


The College of Family Physicians of Canada

Women’s Health Matters


Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician . 2012 Aug 15;86(4):350-5.

Butler JV, Mulkerrin EC, O’Keeffe ST. Nocturnal leg cramps in older people. Postgrad Med J . 2002;78:596-598.

Garrison SR, et al. The effect of magnesium infusion on rest cramps: randomized controlled trial. J Gerontol A Biol Sci Med Sci . 2011;66(6):661-666.

Nocturnal leg cramps. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 23, 2012. Accessed October 24, 2012.

2/11/2011 DynaMed’s Systematic Literature Surveillance DynaMed’s Systematic Literature Surveillance : El-Tawil S, Musa T, Valli H, Lunn M, Tawil T, Weber M. Quinine for muscle cramps. Cochrane Database Syst Rev. 2010;(12):CD005044.

by Ricker Polsdorfer, MD

Leg Cramps: Causes and What to Do

Leg Cramps: Causes and What to Do

Leg Cramps: Causes and What to Do

There is nothing quite like having leg cramps. I can be sleeping soundly one minute and be wide awake and writhing in pain the next. It feels like someone has tied barbed wire around my calf muscle and then put a wrench on both ends. But what are some possible causes?

There have been times when it’s easy to assume my leg cramps simply come from too much exercise. Roughly 10 years ago, I was an avid gym patron. Each morning, I got up at 5 a.m. and headed out. I had a pretty stringent routine.

First, I did my cardio exercises. I ran between 3.1 and 5 miles on the treadmill every morning. I started out at a modest 8 miles per hour, but as I went along, I increased my speed. By the end of my run, I was at a sprint.

Then I did strength training on both the weight machines and free weights. One morning, I would work on my upper body. On the following day, I would work on everything from the waist down.

One day, I noticed a growing pain in my hip. Before long, it was pretty clear to me I had injured a flexor muscle due to overuse. But at night ? when I had cramps in the back of my calf, too ? I assumed it also was due to my exercise routine.

I stopped using the treadmill for a while and used the ellipticals instead. This helped my hip to heal. However, I still continued to get leg cramps off and on.

In my experience, muscle injury due to overuse can certainly cause leg cramps. But one should not just assume that’s what it is.

The Mayo Clinic says that during periods of heavier exercise than normal you can become dehydrated, which can cause leg cramps as well. Simply replenishing your body’s water supply can alleviate leg cramps that result from dehydration.

But dehydration also can result from inadequate fluid intake even during normal daily activity.

Other Leg Cramps Causes

I’ve mentioned a few leg cramps causes. These were the causes I originally knew about. But there are many more.

According to the Mayo Clinic the depletion of calcium in your body is one of them. But Mayo also states that too little potassium and magnesium can play a role in leg cramps as well. And the depletion of these minerals in the body can be caused by several factors.

For example, the Mayo Clinic says people who take diuretics and blood pressure medications may find their levels of calcium, potassium and magnesium are still not up to par. These medications have a tendency to deplete mineral levels, in spite of efforts to eat foods rich in these minerals.

Leg cramps causes can come from much more serious issues as well. Harvard Medical School says about 30,000 people in America currently suffer with amyotrophic lateral sclerosis (otherwise known as ALS, or Lou Gehrig’s disease). About 5,600 people are newly diagnosed every year. Muscle cramps in the legs can be one of the symptoms.

The National Institute of Neurological Disorders and Stroke states that muscle pain, stiffness and cramping in the legs and toes are also symptoms of Parkinson’s disease.

Studies through the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) show that leg cramps can be the beginning signs of serious kidney malfunction. When kidneys don’t function properly, wastes aren’t being filtered from the blood in a sufficient manner. The resulting condition is called uremia.

Sometimes leg cramps causes are simply unknown. Although my leg cramps are terribly painful, at least they don’t happen on a frequent basis.

I’ve never consulted a doctor about my own leg cramps. So far, the ones I’ve experienced seem to be of this variety: infrequent, with no other symptoms that accompany them.

But if leg cramps should become frequent and persistent, you should not hesitate to see your doctor. There may be a serious underlying cause.

Remedies for Leg Cramps

There are many remedies for alleviating leg cramps causes, but you should do your homework and choose wisely.

One of the most common remedies doctors used to treat leg cramps was quinine, a chemical with medical uses. However, according to Johns Hopkins Health Alerts, quinine can have some serious side effects. It should only be used for its primary purpose: to treat malaria.

Johns Hopkins says that doctors are exploring the use of muscle relaxers, numbing agents and calcium channel blockers as other treatments for leg cramps causes. Johns Hopkins also says diazepam and naftidrofuryl (an antiseizure medication) may be effective, but patients are encouraged to try B-complex vitamins.

As I said earlier, I don’t know what causes my leg cramps. I haven’t consulted a doctor because they happen so rarely. So far, I have found relief with some very simple methods.

Most of my leg cramps tend to happen at night. Simply getting out of bed and walking around for a minute or two has made them go away.

I’ve also used eucalyptus-based salves or rubs. Between the massaging motion and the warmth that radiates to my muscle, the pain usually subsides within a few minutes.

But if my pain still persists, I find relief by applying a heating pad. However, other people I’ve talked to have preferred to use ice packs to soothe their leg cramps.

Some athletes I know swear by stretching exercises. One exercise I hear about often is placing your hands on each side of your foot with your fingers cupping the bottom right around the ball joint, just below the toes. Pull the foot gently toward the shin.

The Mayo Clinic suggests doing light activity for five to 10 minutes before stretching. For calf muscles, you can also try the downward dog pose exercise.

Keep yourself hydrated. Again, be sure to see your doctor if leg cramps become frequent and persistent or if you have any other concerns about their causes.

Source: Lifescripts