Up to 60 percent of adult’s report that they have had nocturnal leg cramps. The exact mechanism is unknown, but the cramps are probably caused by muscle fatigue and nerve dysfunction rather than electrolyte or other abnormalities.
Nocturnal leg cramps are associated with vascular disease, lumbar canal stenosis, cirrhosis, hemodialysis, pregnancy, and other medical conditions. Medications that are strongly associated with leg cramps include intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide.
A history and physical examination are usually sufficient to differentiate nocturnal leg cramps from other conditions, such as restless legs syndrome, claudication, myositis, and peripheral neuropathy. Laboratory evaluation and specialized testing usually are unnecessary to confirm the diagnosis
Leg cramps charley horses are a common nocturnal symptom that can be difficult to manage because of uncertainties about etiology, appropriate diagnostic evaluation, and optimal treatment.
Various Causes of Nocturnal Leg cramps
Experts don’t know exactly what causes leg cramps at night. There are, however, known factors that can increase your risk. In most cases, nocturnal leg cramps are idiopathic, which means their exact cause isn’t known.
Night time leg cramps may be related to foot position. We often sleep with our feet and toes extending away from the rest of our bodies, a position called plantar flexion. This shortens the calf muscles, making them more susceptible to cramping.
The following sections discuss possible causes of leg cramps at night and risk factors that make a person more likely to experience them.
Tired muscles
Muscles need to be stretched regularly to function properly. Sitting for long periods of time could make leg muscles more susceptible to cramping.
According to a review about nocturnal leg cramps, the research available suggests that muscle fatigue is a primary cause. Athletes are more likely to get leg cramps after doing higher than normal levels of activity.
Overexertion, such as exercising the muscles very intensely for a long time, may cause some people to experience more cramping later in the day.
Standing for long periods during the day, which is common in many jobs, may fatigue muscles. The muscles tire during the day and may be more likely to cramp later on during the night.
Inactivity during the day
Share on Pinterest A person may be more prone to leg cramps at night if they are inactive for extended periods during the day.
Another leading theory is that sitting for an extended period, such as while working at a desk, may cause the muscles to shorten over time.
This physical inactivity when a person has not stretched their muscles for a while may increase the risk of cramps, and these can commonly occur in bed at night.
Someone who does not stretch their muscles or exercise regularly may be more at risk of leg cramps at night. The muscles in people who are less physically active may be shorter, which may increase the risk of cramping or spasms.
Body position
Improper sitting position: Sitting with your legs crossed or your toes pointed for long periods of time shortens the calf muscles, which could lead to cramping.
Prolonged standing: Research suggests that people who stand for long periods of time at work are more likely to experience nocturnal leg cramps.
Sitting or lying in a certain way that restricts movement or blood flow to the legs, such as resting one leg on the other or with the legs crossed, may lead to cramps.
People may wish to experiment with sleeping in more stretched out positions to see if this eases their night time leg cramps.
Older age
As people age, they may also be more likely to have leg cramps at night. As a review published in the journal BMC Family Practice notes, up to 33% of people over 50 years of age experience chronic nocturnal leg cramps.
Pregnancy
There may also be a link between pregnancy and leg cramps at night. This might be due to the increased nutritional demands or hormone changes in the body during pregnancy.
Nocturnal Leg Cramp Diagnosis
If you often have severe leg cramps, talk to your Podiatrist to be sure another problem isn’t causing them.
The diagnosis of nocturnal leg cramps is based on a careful history and on the absence of physical signs or disease. Conditions that may mimic cramps includes simple muscle strain, dystonias, ischaemic or neuropathic claudication, nerve root disease, restless leg syndrome, and nocturnal myoclonus.
Muscle cramps are a feature of many myopathic and neuropathic conditions. Cramps due to myopathy or neuropathy diseases are not usually restricted to the night time or necessarily to the legs.
Nevertheless, a careful examination of the neuromuscular system is essential in patients with troublesome cramps, and investigations such as creatine phosphokinase, aldolase, electromyography, and nerve conduction studies may be indicated in selected patients.
They’ll ask about your medical history and your symptoms. They’ll also do a physical exam to look for possible causes. You might have blood tests if your Podiatrist suspects a hidden problem.
Treatments of Nocturnal Leg cramps
Treating leg cramps at night, in the moment they occur, may help a person get more rest.
Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin will not help ease cramps because cramps are not related to inflammation. It may help deal with the pain from a cramp but will not relieve the cramps.
Though leg cramps at night can be intensely painful, they aren’t typically serious. Most people who experience them don’t need medical treatment.
You can try the following at home to try to relieve a cramp:
- Massage your leg. Rubbing the affected muscle may help it relax. Use one or both hands to gently knead and loosen the muscle.
- Stretch. If the cramp is in your calf, straighten your leg. Flex your foot so that it’s lifted to face you and your toes are pointing towards you.
- Walk on your heels. This will activate the muscles opposite your calf, allowing it to relax.
- Apply heat. Heat can soothe tight muscles. Apply a hot towel, hot water bottle, or heating pad to the affected area. Taking a warm bath or shower may also help.
- Drink pickle juice. Some evidence suggests that drinking a small amount of pickle juice may help relieve muscle cramps.
In some cases, Podiatrists will prescribe medications to treat chronic leg cramps, including:
· carisoprodol (Soma)
· gabipentin
· diltiazem
· verapamil
· orphenadrine
A person should talk with a Podiatrist to discuss these drugs and any possible side effects.
If frequent cramps are disrupting your sleep, make an appointment with your Podiatrist. They might prescribe a muscle relaxant to prevent cramps. If your cramps are related to another medical condition, they can help manage that too.
