Treatment of Leg Cramps at Night

Relief Possible by Avoiding Triggers and Stretching at Night

Exercise, especially stretching, may relieve leg cramps
A couple is active in the evening to reduce leg cramps. John Fedele/Blend Images/Getty Images

Leg cramps at night can be intensely painful and may lead you in search of an effective treatment. Beyond considering the most likely causes, it can be helpful to identify other effective therapies that may relieve the discomfort. Learn about some of the treatment options available for leg cramps, even for the elderly and pregnant, including a few you may wish to avoid.

Understanding the Cause of Leg Cramps

Leg cramps are characterized by an intensely painful sensation in the leg or foot that is associated with a sudden, involuntary contraction of the muscles.

There are many potential causes, though the exact mechanism behind the phenomenon is not fully understood.

There seems to be an association with dehydration and electrolyte imbalances, including low potassium, calcium, and magnesium. There is a possible association with changes in peripheral oxygen levels, linking it to diabetes and peripheral vascular disease. It may be exacerbated by vigorous exercise or prolonged standing. Certain medication may also play a role.

Importantly, leg cramps become increasingly common as part of aging. Though rare among children and adolescents, the majority of older adults experience leg cramps at least occasionally. It is estimated that 6% of people beyond the age of 60 years experience them nightly. This may be due to muscle and tendon shortening that occurs as a normal part of aging or due to a lack of stretching exercises.

Treatment and Relief of Leg Cramps

What can be done to relieve the painful contractions of leg cramps?

First, try to identify a contributing cause or trigger and, if possible, eliminate it. It may be important to ensure adequate hydration and replenish electrolytes with proper nutrition or vitamin supplementation.

In the midst of a leg cramp, relief can be obtained by forcefully stretching the affected muscles, thus releasing the contraction.

Stretching prior to bed may be effective in helping to prevent or reduce the occurrence of sleep-related leg cramps. It may also be helpful to be more active during the day, including regular walking, without overdoing it.

Once the cramp has passed, massage of the affected area or the application of heat may relieve any persisting discomfort.

In the past, quinine has been reported to be effective in relieving leg cramps. Unfortunately, it is associated with cardiac arrhythmias that can be fatal. Though it can be obtained in tonic water or as a supplement, the U.S. Food and Drug Administration has acted to limit its sale. Extreme caution is advised and consultation with your physician is recommended before using it to treat leg cramps.

There is also an old wives’ tale about putting a bar of soap in the bed to relieve leg cramps. Though anecdotally this has occasionally proven to be useful, there is little scientific evidence or rationale to support such an action. Unlike quinine use, however, it is harmless.

If you are experiencing recurrent leg cramps that are disruptive to your sleep, start by speaking with your doctor about your potential risk factors and the most effective treatment options in your situation. Regular nighttime stretching may be your best way to avoid painful muscle contractions, but a careful consideration of your medical history may highlight other possible remedies.

Sources:

Allen RE, Kirby KA. “Nocturnal leg cramps.” Am Fam Physician. 2012; 86:350-5.

American Academy of Sleep Medicine. “International classification of sleep disorders,” 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014, pp. 299-303.

Butler J, et al. “Nocturnal leg cramps in older people.” Postgrad Med J. 2002; 78:596-8.

Hawke F, et al. “Impact of nocturnal calf cramping on quality of sleep and health-related quality of life.” Qual Life Res. 2013; 22:1281-6.

Questions and Answers about FDA’s Enforcement Action Against Unapproved Quinine Products.” U.S. Food and Drug Administration. Last accessed: August 30, 2015.

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