Leg cramps can feel like a recurrent, painful tightening that typically occurs in your calf muscles but can also involve your feet or thighs.
Sometimes, leg cramps are called “muscle spasms” or a “charley horse.”
They often occur during sleep at night (this explains why they are also called nocturnal leg cramps). They can be painful and even incapacitating.
If you’ve experienced these cramps, you’re not alone.
About half of adults over the age of 65 have occasional nighttime leg cramps, and they’re more common among the female gender.
The exact causes of leg cramps at night are not fully known. As much as they can hurt, they’re normally harmless.
What Are Leg Cramps?
Leg cramp, also called muscle spasm, is pain felt due to the tightening of the calf, thigh, or foot muscles.
The pain is usually intense, sudden, and involuntary.
What They Feel Like
Leg cramps at night can happen whether you’re awake or asleep.
They can feel like a spasm, tightening or straining the muscles of your calf, thigh, or foot.
The most common muscle affected is your calf, but any muscle of the leg can have cramps.
Cramps can be intense enough to cause your legs or feet to move or forcefully tense up or contract.
They can even be so intense and painful that you can’t do anything else.
How Long They Last
For most people, leg cramps at night last for just a few minutes.
The average is about nine minutes per episode. Afterward, you may experience cramps again in the same night, or you could have residual pain or discomfort that lasts for hours.
Leg Cramps at Night
You’re more likely to have leg cramps at night or while you’re resting.
People with leg cramps often have problems with sleep because the cramps can wake you up and disturb a good night’s rest.
Leg Cramps vs. Restless Leg Syndrome
What’s the difference between leg cramps and restless legs syndrome?
Both tend to happen at night, but restless leg syndrome feels like a crawling sensation and comes with an urge to move or shake the legs. The syndrome doesn’t cause pain or tight muscles.
Although it’s uncomfortable, restless leg syndrome is not associated with the severe pain of leg cramps.
Symptoms and Causes
Below are some of the symptoms and causes of muscle cramps.
Experts don’t know the exact mechanism of nighttime leg cramps.
But in most cases, the cramps are most likely caused by muscle fatigue, anatomical issues, and nerve problems.
People who have nerve conditions like Parkinson’s disease tend to have more leg cramps at night. Other nerve problems could also cause an increased risk of having leg cramps.
Lumbar canal stenosis, a condition where the spinal canal in the lower part of your back is narrower, can cause pressure on your spinal cord or nerves.
People with lumbar canal stenosis tend to have more leg cramps at night.
Medications and Procedures
Other medications may specifically increase your chances of leg cramps, but the risk is low. Here are some examples of medications that may cause leg cramps at night:
- Intravenous (I.V.) iron sucrose
- Conjugated estrogens
Some medical procedures and therapies are linked to an increased risk of leg cramps, such as cancer treatment and dialysis.
Certain metabolic problems, or medical conditions that affect the metabolism of food and nutrients, may increase your risk of leg cramps at night. Examples include:
Muscle fatigue or too much exercise can increase your risk of nighttime leg cramps.
Inactivity During the Day
If you sit too long during the day, such as when working at a desk for long periods of time, you’re more likely to have leg cramps at night.
Body Position While Sleeping
When laying down to sleep, your toes tend to point downward and away from your body, which flexes your calf muscles.
A pointed foot position may make you more likely to have leg cramps at night.
Leg cramps are more common as we get older. Approximately one out of two people over the age of 60 have nighttime leg cramps.
If you’re pregnant, you’re more likely to have leg cramps at night, and they may occur more frequently later in pregnancy.
The reason for the increase in leg cramps may be due to hormonal changes, increased nutritional demands, changes in blood flow, or a combination of these factors.
Other conditions that might increase your risk of nighttime leg cramps are:
- Heart disease
- Problems with veins and poor circulation
- Nervous system disorders
Management and Treatment
Even though leg cramps can be painful, they’re usually harmless.
There are different ways that healthcare professionals can help you manage and treat nighttime leg cramps.
You won’t necessarily need a blood test because there is no evidence that cramps are related to electrolyte imbalances.
However, depending on your individual medical history and associated medical conditions, your doctor may want to perform certain blood tests to evaluate for other medical-related problems.
Your doctor may also use diagnostic tests and imaging to look for problems with nerves or blood vessels that might be related to cramping.
There is no specific medication prescribed for leg cramps at night. In the past, doctors sometimes prescribed a medication called quinine, but this is no longer recommended.
Historically, quinine didn’t work well in reducing cramps, and it sometimes had severe side effects, such as bleeding and heart rhythm problems.
Depending on your other medical issues and the suspected causes of your leg cramps, your doctor might prescribe another medication.
Stretching and massaging your legs may also give you relief. Some people find that applying ice, hot packs, or taking a warm bath reduces the discomfort.
Mild exercise, rest, or sleeping in a different position may help with symptoms.
Good hydration is also very important because dehydration is associated with worsening cramping.
A small study of 28 people found that taking a vitamin B complex supplement helped with leg cramps at night.
Vitamin B complex is relatively safe for most people and may be worth trying, but there isn’t enough evidence yet to know how much it helps with cramping.
When to Seek Medical Care
Leg cramps can be painful, disturbing your sleep.
They’ll usually go away on their own after a few minutes.
If you notice you’re having more frequent or intense leg cramps at night, or if it’s happening at the same time as another health problem is getting worse, you should see a healthcare professional.
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Frequently Asked Questions
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A review of nocturnal leg cramps in older people. (2016).
Association between physical activity and Nocturnal Leg Cramps in patients over 60 years old: a case-control study. (2020).
Criteria in diagnosing nocturnal leg cramps: a systematic review. (2017).
Exercise-Associated Muscle Cramps. (2010).
Interventions for leg cramps in pregnancy. (2020).
Leg cramps in the elderly: prevalence, drug and disease associations (1999)
Nocturnal leg cramps. (2012).
Randomized, double-blind, placebo-controlled study of the safety and efficacy of vitamin B complex in the treatment of nocturnal leg cramps in elderly patients with hypertension. (1998).
Treatment of nocturnal leg cramps by primary care patients over the age of 60. (2018).
Vitamin D for Painful Nocturnal Leg Cramps. (2008).