Get Some Sleep: Avoid frequent leg cramping
Leg cramps usually involve sudden, intense pain, unlike RLS, which is usually a steady, uncomfortable feeling that lasts for hours.
August 2nd, 2011
12:19 PM ET

Get Some Sleep: Avoid frequent leg cramping

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs regularly on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

It is frustrating, to both patients and doctors, that modern medical science often lacks understanding of or treatment for common, everyday ailments.

One such ailment, leg cramps, is very common and yet poorly understood. It often plagues people at night, and therefore “sleep-related leg cramps” is recognized as a bona fide sleep disorder by the International Classification of Sleep Disorders.

Most people have had a “charley horse” and know that leg cramps can be quite painful. Leg cramps result from the sudden, intense and involuntary contraction of a muscle or muscle group. They usually occur in the calf muscle or the small muscles of the feet.

If this happens once a year, few people think of this as a medical condition, but there are people who have leg cramps every night, sometimes several times a night. The cramps can prevent people from falling asleep or can awaken them many times during the night, and therefore leg cramps can lead to chronic sleep deprivation.

The painful sensation is usually relieved by strenuous stretching of the affected muscle. Often, people jump out of bed in their attempt to stop the searing pain. Both the prevalence and frequency increase as people age. There is research showing that approximately one-third of all people over the age of 60 and one-half of those over the age of 80 reported having sleep-related leg cramps once in the previous two months. Six percent of adults over the age of 60 have reported having leg cramps that disturb them every night.

Leg cramps are sometimes confused with restless legs syndrome (now known as Willis-Ekbom disease), but the two disorders are quite different, although patients can have both problems.

RLS is not commonly described as a sudden, intense pain. Also, people who suffer from RLS usually have a steady, uncomfortable feeling in the legs that lasts for hours, and this maddening feeling is only temporarily relieved for a few minutes while they move or rub their legs.

There are some medical conditions that seem to predispose people to leg cramps such as diabetes, peripheral vascular disease and neuromuscular disorders. Medications such as oral contraceptives have been associated with leg cramps. They occur in approximately 40% of pregnant women and usually resolve after birth.

If leg cramping is frequent and intense, people should not assume that they have benign, idiopathic (of unknown cause) leg cramps. It is advised to consult a physician in order to differentiate leg cramps from more serious medical conditions such as akathisia, myelopathy, peripheral neuropathy and disorders of calcium imbalance.

There are numerous theories about the cause of leg cramps but little evidence supporting the veracity of any given theory. One common notion is that they result from dehydration, but the little research done does not support this.

Also common is the idea that there is a relative electrolyte imbalance. Magnesium and potassium are popular culprits. Again, there is little research on this. One study attempted to treat leg cramps in a group of pregnant women and found that magnesium was no better than a placebo.

The same is true for potassium deficiency; there is no research showing that low potassium causes leg cramps or that taking extra potassium prevents them. That said, I have patients who swear that a banana before bed takes care of the leg cramping problem. I also know people who report that sitting in a bath of Epsom salts right before bed helps ward off  nocturnal leg cramps.

I have patients who think that the leg cramps come upon them only when they exercise strenuously, and then there are those who associate the cramps with lack of exercise. The best theory is the “squatting hypothesis,” which speculates that leg cramping is associated with the modern habit of sitting on chairs and on the toilet instead of squatting as our forebears would have done.

I believe that is just another way of saying that leg cramps could be caused by a lack of strengthening and stretching of the calf and feet muscles.

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Filed under: Pain • Sleep

soundoff (276 Responses)
  1. Farley

    My instinct tells me it's a calcium deficiency. I don't drink milk or eat dairy products and I have very little cheese I used to take the stuff called cal mag from Amazon and I never got the cramps when I took that so I'm starting to think that a combination of calcium and magnesium is going to help someone to order some more and start taking it again even though I was told that too much calcium clogs your arteries and raises your blood pressure. After reading all this thread and realizing what a curse upon humanity is cramping as I've come to the conclusion that most all of us are not absorbing calcium right even if you drink milk and eat dairy it's not enough so I'm going to try ordering some CalMag because that really did work and I'm also going to cut down on the soda water and drink regular water even though I hate the bottled water I'll drink it. Next to my bed I have tonic water craft 911 homeopathic leg cramp and spasm relief regular water mix and leg cramp cream including some kind of Hamish leg cramp remedy I'm telling you this is been driving me crazy for about 10 to 15 years. I'll sleep 2 or 3 hours sound as a baby I wear a breeze right nose strip on my nose so I won't snore or have sleep apnea and I've come to the conclusion after reading all your posts that this is definitely a calcium magnesium deficiency and that soda is not good for you of any kind. So I'm going to reorder the cal mag now from Amazon and try that. Best wishes and good luck to everyone that is experiencing these stupid leg cramps which really interrupt with our sleep patterns. Please forgive my speech to text I'm too lazy to type and I might have made some errors but you get my point it's CalMag from Amazon

    September 23, 2015 at 17:32 | Report abuse | Reply
    • Vincevac

      I to have a bottle of cramp 911, mag. spray, bottle of water, and a homemade pickle juice. I have terrible leg and foot cramps for over a year. My wife and I bought a travel trailer, it's been sitting for just about a year. I can't drive too far and I'm worried about sleeping in the trailer. I'm 64 yrs. old and I feel like 90.

      July 13, 2016 at 10:23 | Report abuse |
  2. Cclby

    Very effective and simplest solution I've found is to take the homeopathic tablets dissolved under the tongue called Leg Cramps, found at Pharmaca and other resources for homeopathy. I swear by these. Not sure what's in them. But they definitely work for me. My situation is that I've noticed I mostly get the leg and foot cramps when I eat ice-cream before bed (I know the simple solution is to not do that, duh.). And occasionally get them at other times, too. However, at those times when I want my little reward for a busy day, this solution makes it possible.

    October 11, 2015 at 12:08 | Report abuse | Reply
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  4. Lyle

    I get bad cramps in my thigh or lower leg if I eat sweets. only Mustard or pickle juice will relieve them. this may be
    bad to take but I pass up a lot of pie and such. Any studies on sugar causing them????

    November 27, 2015 at 18:34 | Report abuse | Reply
    • cjsbequus

      I've wondered that, too! Last night I had one of the worst episodes ever...one inner thigh and both shins and front of feet. Could barely hobble. Husband helped me while listening to me scream...he said neighbors probably thought he was killing me! He tried massaging which sometimes helps but I had to get in bathtub with extremely hot water to ever get relief. Took awhile. Went back to bed with warm compresses. Legs very sore this morning. So yesterday was Christmas and I ate lots of sweets including 5 chocolate covered cherries before bed! When I go on a sugar fast in Jan it will be interesting to see if the episodes stop. Years ago I stopped my statin drug...cramps completely stopped. But in recent months they have started again. Now after seeing a few comments I wonder about my BP med. Sometimes I get them after a day of hard yard work or hiking but not always. Hard to figure how it is all connected and why one thing works for some but not for others. I can't help but believe there is an imbalance or a depleted nutrient that occurs to produce such pain. The body is such a complex system and so much isn't fully understood about how it all works together. Trial and error I guess to see what works for each of us!

      December 26, 2015 at 16:13 | Report abuse |
  5. bobspez

    This happens a couple of times a month to my wife and myself. It happens to her while watching TV at night and falling to sleep in the chair. It happens to me while I am sleeping. When it happens they are incredibly painful and I have had them in my shins, my calf, my inner thigh, and my foot. The contraction causes my toes to arch upward towards my shins. It's too painful to move, let alone walk them off or stretch them out.
    My wife and I have discovered how to stop the cramp within a few minutes. Rink about 7 ounces of pickle juice. I'm not kidding. Tonic water has also worked, but not as well as pickle juice. We keep a large jar of kosher garlic pickles in the fridege and if we get a cramp the other one pours a 7 oz glass full of the pickle juice and the one with the cramp drinks it down. It stops the cramp in about 5 minutes. This has also worked for our friends and relatives. The other day I was woken up with a painful shin cramp and hopped on one foot into the kitchen to get my pickle juice. I drank it down fast and the cramp lessened in a couple of minutes and was gone in less than 5. Just as the first cramp was stopping the other calf started to cramp up. I downed a 7 oz glass of tonic water and within a few more minutes both cramps were gone.

    December 5, 2015 at 16:01 | Report abuse | Reply
  6. Keith B. Rosenberg

    I would not call night time leg cramps benign if you are not getting enough sleep and have an injurious accident because you are tired.

    March 25, 2016 at 13:56 | Report abuse | Reply
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  16. Roger

    Been on a ketogenic diet (low carb) for a few months now, and could not find any way to keep from getting awakened by calf cramps. Now that I've reached my target weight, I've added 1/2 banana a day, and that's enough to be able to sleep through the night without being awakened by calf cramps. This makes me happy!

    May 26, 2017 at 19:24 | Report abuse | Reply
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    I was talking about this one day, and my uncle said, "Do you sleep with a fan on?" Sure enough, that was the reason. I still cannot figure out why, but when I don't sleep with a fan on, I never get them. Would like to know why.

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