What Causes Nocturnal Leg Cramps?

health wellness

Usually people associate leg cramps with the term "charley-horse," which are painful sensations of tightness and tension in the muscles of the leg. There are three primary areas where uncomfortable cramping may occur. These are the calf, the foot, and the thigh. Nocturnal leg cramps are muscle pains that occur during the night when a person is sleeping, causing sleep disturbances that may ultimately ruin a good night's sleep.

Although they may occur simultaneously with other sleep disorders, nocturnal leg cramps do not have a causal link to any known underlying medical disorders. They predominantly affect the elderly and pregnant women, two groups that tend to have relatively poor blood circulation in the limbs. Taking a step further back, nocturnal leg cramps are found in middle-aged and older populations, although they can afflict individuals of any age group.

A reason why a person may get nocturnal leg cramps is because he or she isn't drinking enough water. Water is important for transporting vitamins, minerals, and other substances throughout the body. Hydration is not the same when drinking caffeine or alcohol, since they are diuretics and end up dehydrating a person even further. Muscle needs hydration to function properly; without it cramping is more likely to occur. That is why athletes who do not replenish their water lost from sports and exercise end up with a charley-horse. Likewise, low water intake in an otherwise sedentary person can cause muscles twitches during sleep.

Another reason for nocturnal leg cramps is mineral deficiencies. Low levels of calcium, potassium, and magnesium are cited as causal factors of nocturnal leg cramps. While they can all be found in things we eat, some foods lose mineral levels when processed or refined. For example, nearly 85% of magnesium in grains is lost when finely milled.

Calcium deficiency is also responsible for muscle tremors and twitching at night and may lead to nocturnal leg cramps. However, milk and other dairy products do not make effective calcium replacement sources because of their phosphorus levels. A non-phosphorus containing calcium supplement is possibly the best alternative. Another mineral easily depleted is potassium, which is the most important mineral regarding muscle activity, serving as an electrolyte in the body and helping to balance body fluids. It also plays an essential role in muscle control and acts as a co-factor in muscle building.

To combat nocturnal leg cramps, there are several criteria to check. Make sure that your intake of calcium, potassium, and magnesium are at sufficient levels. Potassium-rich foods in your diet should include bananas, tomatoes, potatoes, broccoli, cantaloupe, and citrus fruits. Also, try to eliminate or reduce caffeine and sugar from your daily regimen. Check that you are properly hydrated by drinking up to the recommended eight glasses of water a day.

Finally, relieving any current discomfort with local massage, movement, or heat may help you avoid nocturnal leg cramps. For massage, rub the site of the tension in a circular rhythm to loosen the muscle tension beneath the skin. Stretch the calf muscles by holding your toes, pulling them up toward your knee and extending the leg straight out. This will exhaust the stretch reflex before you go to bed. If pain persists, apply a heat compress for about 10 minutes or take a warm bath or shower.

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54
The answers are all pretty much covered in the article above.

You need to hydrate and increase your sodium, potassium and calcium levels. Dairy is not a good source of calcium. You're much better to get it from green leafy vegetables (which also contain good levels of potassium and magnesium).

Everyone *thinks* they drink enough water. You don't. Admit it to yourself, get over it and drink more. I thought I had enough until I started to track what I had and I found it wasn't even close.

Count up what water (not soda, tea, coffee etc) you've had in the last three days. It won't be more than a litre a day.

This is my experience: the more sugars I take in, the more water I need. The more processed food I take in the more water I need. So consider upping your water above the 3l mark if you're eating a lot of foods which have their water cooked out of them.

I get wicked bad cramps when I don't follow these rules. They go away without fail when I change my water and electrolyte (sodium, potassium, magnesium) intake from natural sources.

- anon52983
52
Well at night I start kicking and then I'm like what the heck is going on. I'm like really hurting in the calf of my leg. And it lasts for about three or four minutes. Then when I woke up in the morning I tried to walk on it and it hurts really bad. It's been going on for about months now. Tell me what's wrong.
- anon50834
51
I am posting #42 below. Forgot to add that I totally stopped using anything with artificial sweeteners and cut down on packaged/processed foods. I still have not had a significant leg cramp in at least three or four months. We have well water and I think a lot of the improvement is related to bottled water and the calcium, sodium and magnesium and less artificial things in my food.
- anon50727
50
I suffer from nocturnal leg cramps(NLC) ranging from moderate to severe. They hit my right inner thigh, calves and both ankles, sometimes all at the same time. When my ankles are affected I look like I have polio. Standing helps to realign the feet. I have increased calcium-no change; hydration is not a problem; increased potassium-no change. What I did not know about was the magnesium and quinine tips. I will try those one at a time. Also, from the Mayo clinic I found, re: nocturnal leg cramps that in some cases (not all), nocturnal leg cramps may be associated with underlying medical conditions. A few of these are: Addison's disease, alcoholism, blood pressure medications, cirrhosis, dehydration, Type 2 Diabetes. There are more but I will not list all. Remember, that just because NLC are present, does not mean you definitely have an underlying medical condition. We all know to get things checked first.

I am diabetic so perhaps being more diligent in treating the diabetes will reduce the amount or severity of my NLC. I hope we all find relief. ~M~

- anon49943
49
I work 12 hour shifts. At night if I eat dessert or indulge in something sweet before bed I get cramps in my legs. What makes this happen? What is the fastest relief so I can get back to sleep? (Okay, I'll give up the sweets at night.)
- anon49663
48
Im 15 and I get these all the time. I wake up at night and involuntarily kick my leg, then I'm like "crap here it comes." they can get pretty long; I've screamed out loud on numerous occasions. I'll try the advice here. Otherwise I'm a very healthy child.
- anon48615
47
Although I am searching causes for leg cramps on google there is about a four- minute cure someone shared several years ago. I chew one or two (depending how bad the cramp) zinc tablets and leave it under my tounge for a couple of minutes. Zinc can be purchased at most health foods dtores, or a local pharmacy. They have been 100 percent effective for me. However, I do not like the taste and during an episode I become anxious and wonder if the zinc will work this time. Again, so far chewing zinc tablets has been my 100 percent effective cure. Is that a good thing to do? I do not know. Hope it helps someone. BB
- anon48301
46
In addition to consuming enough water during the day and night, I find that running a small vaporizer/humidifier helps. The air gets a little too dry at home when the seasons change. The extra moisture keeps my skin hydrated and my voice ready to sing.
- anon47459
45
I have been having charlie horses or leg cramps, specifically in my calves for years! It started when I was pregnant and then returned later in my years. I am 46. I eat at least 1 banana a day and take a multi-vitamin. That doesn't help, but I could be not drinking enough water. I have slacked in the water department lately, and will try drinking more. They are so painful when I try to stretch it out. But it passes, but what a nightmare. Sometimes I can still feel the soreness as if I worked my calves out at the gym. But after reading all the above posts, I have nothing to lose by adding magnesium. With me it is always how many mg's do you actually take?
- anon45650
44
Thanks for all the info about leg cramps. I have noticed that if I walk a lot during the day and don't drink enough water I get leg cramps.
- anon44980
43
I have had charley horses since I was 17 years old. I am now 30. My doctor put me on a 400 milligram magnesium supplement. Since going on the magnesium the cramps have really slowed down to maybe one a year. I notice that I get them after eating bananas. Not just one banana every now and then but when I eat one a day for a couple of days. Just had one last week. They are so awful. My husband jumps up in the middle of the night to massage it for me. I find that if he helps me massage it that I can actually walk the next day.
- anon44619
42
Website helped a lot. Have had bad cramps for about a year at night. Due to info on site I'm drinking bottled water, drinking the juice of one full lemon or lime daily, magnesium supplement and calcium in morning and again right before bed, lots of water, untucked bed sheets at bottom so they can't pull on my legs, drank pickle juice and increased sodium. Better. Only got one cramp this week. I too had none on vacation which means stress might play a part also. LPK
- anon42523
41
I just started having leg cramps at night. The first time I had it since I was pregnant. I thought I dreamed it. I must have been exhausted.

When I was pregnant the doctor told me I was drinking too much milk and to cut back. I was only drinking 1 cup a day. I cut this out and the leg cramps disappeared.

I love cappuccino, and I know it has milk I think I'm going to drink more water and cut back on that. I will also try some of the other suggestions here.

When I woke up this morning again with leg cramps, I knew I wasn't dreaming. It's very painful and nothing seems to help relieve the pain.

I know if I keep my legs covered at night it helps a little. My husband thinks I'm crazy for wanting a cover over my legs even in the summer, but what can you do?

- anon40409
40
I have had leg and foot cramps for over 20 years. I'm 52 and otherwise healthy. I am a nurse and have read extensively on the subject. I take Mg each day, along with eating a banana, and water, water, water. I stretch. I put the soap under the sheet. You name it, I've tried it. Nothing has worked. I am getting 1-3 spasms a night that leave my poor calves and feet feeling like I worked out all night. Need I say, I don't sleep much. One thing I forgot about was sodium. I eat hardly *any* salt. Once, when I had a few good weeks, I noticed I was eating more salt. I'm gonna try it again. It might explain the pickle juice that worked for another writer. Anyway, good luck. These things are awful. I also have the twitching.
- anon40090
39
While it's probably caused by excess coffee drinking, the solution is simple: take 1 - 2 magnesium tablets per day. this works and addresses the cause: mineral deficiency. (you should be taking calcium too, like Tums or equivalent). Taking potassium is dangerous. So eat bananas if you wish, but be very careful with the potassium. Magnesium will solve the problem.
- anon38551
38
If your sugars are high, the more chance for leg cramps. Be sure to keep your lower extremeties warm at night or they will cramp

ksgoode

- anon36869
37
I have been a diabetic for 22 years and noticed the leg and foot cramps soon after diagnosis. I was originally taking quinine but after they removed it from the US markets I now take 2 595mg of potassium gluconate a day plus 1 calcium and magnesium.

The most important advice for you is not to drink carbonated drinks! That is most of the problem or was for me. Drink plenty of water as recommended above. The lack of accessibility to quinine has not been a problem for me.

- anon36868
36
As long as I drink three glasses of milk a day I do not get leg cramps.
- anon36484
35
How much tonic water do you take? I havent looked it up to find out exactly what it is, but how much Mag gx do you take? My doctor put me on a pill to pull fluids. When I told him what was happening, he didnt take me off that med. He was trying to get my blood pressure down. I'm a non-insulin diabetic and have read where diuretics screws up your electrolytes. He should've known that.Can someone help?
- anon35227
34
i don't like the idea of taking quinine everyday, but i can get it easily at my local health food store. it is Highlands leg cramp medicine with quinine. you dissolve the tablets under your tongue and my husband says it works within minutes. hope it helps some of you.
- anon34840
33
Garden: I have been reading a ton about nocturnal leg cramps as I had them quite often during high school. My family was not well off and relied on Medicaid for insurance-due to the government's effort to not spend much on health care the doctor's I saw always treated symptoms I had growing up as separate things not willing to do the more expensive tests which in the long run would have cost them tons!

Basically since I can remember I often passed out, had migraines, was always cold and had "exercised induced asthma." All symptoms were treated separately and nothing worked. Once I passed out on my grandmother as an adult in college and she sent me to her doctor, covering all expenses and finally a proper diagnosis was made which has changed my life- Mitral Valve Prolapse. All symptoms, including leg cramps while sleeping are gone--I feel normal.

As I was researching nocturnal leg cramps I wanted to make sure to prevent them as a teen I was an avid distance runner and injury followed by surgery took me out for a few years. All the causes listed that I've found do not apply to my lifestyle: I get enough of the proper minerals, always eat organic, constantly drink water, and never stay still for long. I'm 24 and never had a child yet. The leg cramps plagued me for years. Keep on with the research as I'm proof there may be a link to an unknown heart condition.

- misskandas
32
One of the best cures for leg cramps is tonic water. I have used this for years and it does the job. You also can add a little gin for relaxation. I keep several bottles on hand at all times. A glass even before bed time will work. Try it.
- steadyed
31
To: Defunkedkaraoke

Sounds like Restless Leg Syndrome to me. Mag Phos 6X is at any health food store that carries Homeopathic Remedies. Don't know if it helps RLS, but the health food staff should be able to recommend something specific to that condition. They're promoting drugs for RLS on TV, but that would personally be my last ditch choice.

- Garden
30
Need help...mine is not leg cramps

(charlie horses). I *cannot* explain how it feels, but mainly at night my legs feel heavy with pains from groin to toes, up & down hips. Just everything. You know how an hour glass shifts the sand? Well that is how they feel & very heavy. Anything touching my leg area they move & jerk. What is up with me??? But when I am up all day I am great.

Can anyone help out? Now I have noticed mag. phos 6x. Can that only be bought online or through a health food store? Walmart & walgreens do not carry it. Thank you...relief would be nice.

- defunkaraoke
29
I also have the twitching in my calves which drives me crazy. The only thing I have found that seems to cause it is the local drinking water. I have reached this conclusion as I never get the cramps or the twitching when I am away on holiday. Doesn't help though when I am not away! Would love to find a cure as I can be up 3 to 4 times a night and nearly pass out with the pain, plus am very tired!!
- pitmanl
28
I wish to post a warning about using a heating pad to alleviate cramps. I've had severe cramps for 20 years. One night a cramp in my inner thigh was severe, so I put a heating pad on it, thinking I would take it off in a few minutes. Unfortunately, I did not, I fell asleep. The next day, I had a red irritation which developed into a 3rd degree burn, which took 5 weeks to heal, and I still have an ugly scar.

I am willing to try anything that will work!!

- anon29705
27
I've never had nocturnal cramps until recently. I was out of town and had terrible cramping in my feet and hands...kept me from sleeping. I called my doctor and he called in a prescription for a quinine sulfate capsule. I'm lucky I have insurance, but I haven't had a problem since I began taking the quinine capsule.

The literature says it is used to treat malaria. I don't care, as I have had no problem since I began the medicine.

- anon29437
26
I have just looked up quinine... see below. Maybe these cramps are caused by some parasite that lives in our bodies? Or is that too far fetched - I mean it's probably something a doctor wouldn't look for?

Since quinine is medication used to treat malaria (a disease caused by a parasite that lives part of its life in humans and part in mosquitoes) couldn't this be true?

jibz

- anon29336
25
i have nasty leg cramps for at least three years. if i eat a couple of bananas a week that eliminates the problem as it increases the potassium level. i get the cramps two to three times a week and i must stretch my legs to eliminate the pain.

knowing that it would occur again later i drink about a half of a cup of pickle juice. sounds crazy but it works from a minute or two to a maximum of 5 minutes. there never has been a recurrence during the same night.

the pickle juice must be very high in one of the minerals, but i have not researched it to find out which minerals. i use the juice from kosher pickles but i suppose it may not make a difference. david

- anon26906
24
i have that about 2-3 times a month...but i never knew how to relieve them...i do now
- anon24311
23
Hopefully this will bring relief to those suffering from severe muscle spasms. This is what has worked for me. I had charley horses for years. The condition finally got to where I dreaded going to sleep at night, because my legs convulsed all night long. It was usually so bad that I had to try to sleep sitting up in a chair. I had this chronic problem for many years. The cramping would hit both of my legs at the same time, and every square inch of my legs were cramped -- from my toes to my groin -- such pain and suffering. Doctors could not tell me why I had this chronic problem. I finally looked at my diet and removed the following items from it. I stopped using carbonated beverages. I threw out every product in the house that contained artificial sweetener and especially aspartame. My chiropractor has a detox setup, so I did twelve sessions of drawing toxins out of my body, and I changed my diet to organic foods. Our food supply is robbed of the nutrients it once had and one can only find wholesome nourishment these days in organic foods that are specially grown and actually nourish the body. I started taking 200 mg of magnesium three times a day: morning, afternoon, and evening, along with 1800mg of calcium, 600mg three times a day. It is the magnesium, however, that helps leg cramping. I also have stopped snacking after 8:00 p.m. When we eat a large flow of blood rushes to our stomach to help digest our food, thus leaving our extremities and muscles -- in my case -- without the necessary blood flow to cleanse my muscles. Thus, I had severe leg cramping. I still get leg cramping from time to time, but it is within the realm of "normal" cramping. It never fails, however, if I break my rule and eat even the slightest snack after 8:00 p.m., assuming I'm not allowing three to four hours for my food to digest before going to bed, I most certainly will be struck with one or more leg cramps in the evening hours as I sleep. I hope you find this helpful. Ann
- anon19713
Editor's reply: Thanks for all the advice! Our articles, "How can I Relieve a Charley Horse?", "What are some Home Remedies for a Charley Horse?", and "What is Restless Leg Syndrome?" have more information on the topic.
22
I too have suffered calf and foot cramps. I used to take quine and since my episodes are realls unpredictable a script lasts me almost a year. Recently they have stopped selling quinine in the US and have replaced it with a much more expensive and "safer" medication. I get all of my prescriptions through Canada (I pay for all mine) and that may help you. A word of warning to those that "walk" them off. I have always thought that passing out from pure pain was a hypochondriacs mantra, however I am here to say it is not. In an effort to walk of a severe cramp I passed out and broke my ankle. Im lucky I didnt hit my head on something or worse. I am 53 ant that is the only bone I have ever broken and omg was I a baby about that cast! I hated it. I only stand by my bed now. Be careful with that walking!
- anon19313
21
Along with the Homeopathic remedy MAG PHos 6X I now keep a bottle of diet tonic water next to my bed (within easy reach)! When a cramp wakes me, I take both the Homeopathic remedy and the tonic water. Been working really good.

I heard that tonic water also works for restless leg syndrome, and other twitching leg problems. It's the quinine, but since it's on the prescription list the tonic water is readily available and much less expensive. Let me know if this helps you.

- Garden
20
I haven't drank milk for 6 months and have cut out the other dairy products also. Since then, I have not had any "cramps".

Every once in a while I get a pain in my thigh like a nail is going through it ....but other than that, I have been sleeping great.

- lori0213
19
I have suffered with nocturnal leg cramps for years...foot, calf, occasionally thigh. I have tried quinine, soap in the bed (will try something other than Ivory, LOL) calcium with oyster shell, potassium, stretching, and have a mini massager by the bed. If I can catch the cramp early I may be able to stop it by walking/massaging. If not, it's hit the hot shower massage for a few minutes. I get them more often in winter and always keep my feet and legs warm. The cold seems to bring on the cramps. I have had ultrasounds and other tests to rule out clots, etc. My doctor says I have "Old Lady Legs". I am 58.
- anon18879
18
I have stumbled onto something worth sharing. Ever since I started taking Cod Liver Oil, I've noticed the leg cramps have diminished. Not the reason I take the oil, but a wonderful "side effect" Worth a try. The Norwegian orange flavored - not too bad tasting. Liquid works better than gel caps. Hope it helps you too.
- anon15597
17
In the year 1978 I was given anecdotal information that some people had used quinine in the treatment of leg cramps, which I had suffered from approximately all my walking life. I proceeded to try some vile pills, that if swallowed gave me a pain free nights sleep. Then I found capsules and the world was good!

When the U. S. Government made them a prescription med. I convinced my regular physician to prescribe and on my occasional visit to my Canadian Grandsons where I could still buy over the counter. The cost of travel did increase and the Canadian government also made them prescription, so this plan was abandoned and I was forced back into the system. All went fairly well until I was notified my pharmacy would only give me a seven (7) day supply at the same cost as my previous 30 day supply. That meant that my co-pay instead of being $20 a month is $20 a week, plus 3 more trips to the pharmacy! and the cost of fuel really adds up. I know that at my age (78) I won't need them much longer, but I'd really like to live out my life pain free and out of debtors prison. OldJack

- OldJack
16
Re: Garden. Thank you so much. My doctor in Canada mentioned that there is still no known cause but the low magnesium/phosphate can sometimes be a factor and also mentioned that quinine works. I would prefer to try the homeopathic remedy before resorting to anything else. I also find that setting my watch to chime every hour to drink a 1/2 cup of water helps me to stay hydrated and lessens the cramps.

For the person who asked what Homeopathic Mag Phos 6X is, run a google search and you should find out what it is.... Apparently its a nerve stabilizer.

- anon14313
15
Re the post by Garden: What is Homeopathic Mag Phos 6X? Please elaborate, as I have tried everything else mentioned in these postings and would be interested in a further explanation.
- anon13349
14
I only get cramps in the calf when I'm in bed and try to stretch my legs, usually in the early hours of the morning.

I'm 62 years old.

- jcgcscgc
13
I have been getting calf pain in the middle of the night since I was 5yrs old. I am now 42 and now I get pains in the top of my foot also (mostly left side). The pains are more severe now and almost causing me to pass out.

I have had several tests done and all come back fine. It doesn't seem to matter what I do throughout the day either. I just want them to stop.

- lori0213
12

Leg and foot cramps: Quinine works good, but makes my ears ring. Homeopathic Mag. Phos 6X has worked best for me. Had years of foot and leg cramps with no relief until Mag. Phos. 6X. Hope it works for you too. Can sleep through the night now with no cramps. Let me know if it works for you.

- Garden
11
I have found that when I get a twitching sensation all day in my body, it is from some kind of food or medicine allergy. I would get those crawling sensations every time I took Tylenol, not realizing I was allergic to it. Maybe keep a diary of what you are eating, (taking) and see if there is any correlation as to what you eat and when you get those unpleasant sensations. Hope this helps!

D.B.

- anon12171
10
I am researching the possibility that nocturnal leg cramps may be a warning symptom of heart problems. Anyone have information that either supports or discredits that theory?
- Garden
9
I have severe leg cramps. I'm on muscle relaxers..don't help..I drink two quarts of water per day..I apply heat, ice..I was diagnosed with polyneuropathy. I also have charcot marie tooth disease. I don't know if that's why they are so bad. Please help if anyone has suggestions.

Tamara

- anon7875
8
Hi guys sorry just popped on this site by accident, I'm a medical student in the UK. It sounds to me like the chaps with the nocturnal cramps could be suffering from a variety of problems. However there is substantial literature to suggest that nearly all forms of nocturnal cramp can be helped greatly by increasing your quinine intake, this acts as a mild vasodilator and seems to do the trick for most folk. So I'd recommend taking some tonic water just before bed, it will take a week or two for you to start seeing the benefits but I'm sure it will at least reduce the duration of the cramps.

Matt

- anon4195
7
i get really bad leg and foot cramps at night too. if you put a bar of soap(anything but ivory) in bed with you by your feet, it WILL help. if you start to get a cramp, put that part of your leg against the bar of soap. you will feel the soap draw out the cramp! it doesn't work every time, some cramps are too severe and come on too fast.

thanks for the tip to try more calcium and potassium. i will try that.

- anon3980
6
I have suffered with nocturnal leg cramps for more than 20 years. Rarely are they in the calf. They are in the shin, foot and/or toes. The only thing that has ever helped is quinine sulfate which is no longer available for leg cramps. My cramps are major cramps. I would very much like to find some other help to alleviate this painful occurrence most every night.
- anon3816
5
It may be probable that what you describe as something crawling beneath the skin is "Muscle Fasciculations." Let your doctor know and they can proceed from there. There is plenty of information on the web that you can check out. Hope this helps.
- anon3743
4
Does night cramp may sometime follow with the pain in hands also starting from elbow till palm.
- anon2582
3
I endure, thats all I can say, I endure. nobody can figure it out. no doctor I have been to has any clue.
- Dragonwind
2
You have my Complete Understanding ! I have NON-STOP leg twitching....it's not painful, but it appears like little aliens popping around my calves all the time now. It was primarily in my left leg...no it's moved to my right leg as well. I have only been told that it is a mystery neuropathy...I cannot stand it....What do you do?
- anon2269
1
While I do occasionally get some nasty leg cramps at night, I have another issues I can't find help for. The muscles in both of my calves (and only my calves) Twitch constantly, 24 hours a day, non stop.

One doctor told me it was restless leg syndrome but I have none of the symptoms listed for that problem. It's so bad, you can sit and literally see my calves moving like there is some creature under the skin crawling around.

Anyone else have something like this and gotten a diagnosis I could look at?

- Dragonwind

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Last Modified: 18 November 2009

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