Nightime Leg Cramps

Nighttime leg cramping is a common ailment especially in people over the age of 50.  As many as half report cramps at least three times per week, and 5-10 percent have them nightly.  Cramping usually occurs suddenly in the calf muscle resulting in significant pain and sleep disturbance.  Cramps can last from a few seconds to more than fifteen minutes. 

The cause of leg cramps is mostly unknown, although imbalances in electrolytes like sodium, calcium, magnesium and potassium have been implicated.  Circulation problems, dehydration, sedentary lifestyle and certain medications like diuretics (water pills), angiotensin receptor blockers (blood pressure medication), benzodiazepines (anxiety medication), statins (for high cholesterol), certain cancer treatment drugs and oral contraceptives also may cause leg cramps. Diseases associated with nighttime leg cramping include diabetes, hypothyroidism, hypoglycemia, alcoholism, muscle disorders, Parkinson's disease and other neurologic disorders. 

Leg cramps can often be relieved by flexing the toes upward to stretch the calf muscle or by getting up and walking around.  Gentle massage of the tensed muscle and warm compresses can be helpful.  In one study, passively stretching the calf muscles three times a day for several days successfully prevented cramps.  Subjects stood three feet from a wall, leaning against it with arms outstretched and gently tilting forward with the heels kept firmly in contact with the floor until a non-painful stretch was felt in the calves.  This position was held for 10 seconds and repeated after five second intervals for 3-4 repetitions.

Staying well hydrated and exercising regularly is recommended not only to prevent cramps, but to help maintain overall health. 

Medications may be used when cramps are persistent and severe.  Quinine was commonly used in the past with varying degrees of success but has been discontinued more recently due to potential side effects involving blood and heart problems.  Muscle relaxers, antihistamines, calcium channel blockers, and anti-seizure medications are other common treatments.

Persistent, painful leg cramping should be evaluated by your health care provider to determine if a disease process is involved and to develop a treatment plan specifically for you.