By Lim Ju-won
Nocturnal leg cramps are sudden involuntary contractions of the lower leg and foot muscles. Leg cramps commonly occur in the foot, thigh, or calf at night or during rest, and last from a few seconds to a few minutes. They are characterized by sudden muscle tightness and pain. Besides being painful, leg cramps disrupt sleep and can cause distress and anxiety. The risk of night leg cramps increases with age. Pregnant women also experience leg cramps at night more frequently.
What can cause nocturnal leg cramps?
There are many different possible causes of leg cramps. Overuse of leg muscles, prolonged standing or sitting in one position, and wearing uncomfortable shoes are risk factors for developing leg cramps.
The cause of legs cramps is unclear in most cases. These cramps can be related to dehydration and electrolyte disturbances such as magnesium, calcium, potassium and sodium. Reduced blood flow through muscles can be associated with leg cramps. Medications that may cause cramps include inhaled long-acting beta agonists (LABA), diuretics, and beta blockers. If cramps develop after taking medicine, you should contact your doctor.
How can I make the leg cramp go away?
Cramps often resolve spontaneously and can be relieved without any medications.
The following treatment options may be helpful if a cramp occurs.
― Forceful stretching of the affected muscles
― Leg elevation
― Putting some pressure on the affected leg or standing on the affected leg for a while
― Walking some distance
― A hot shower on the leg with cramps, usually for 5 to 10 minutes
― A warm tub bath
― An ice massage
― Use mineral and vitamin supplements: Vitamin B complex, Vitamin E, calcium and magnesium may be effective for legs cramps. The use of magnesium is limited to patients with pregnancy-related cramps. For patients who have iron-deficient anemia, iron supplements can be tried.
What can I do to possibly prevent nocturnal leg cramps?
The following suggestions may be helpful:
― Ride an exercise bike for a few minutes before sleep
― Stretch leg muscles regularly, in the evening and again before sleep. Stretching can be performed in the weight bearing position
― Wear comfortable shoes and other proper foot gear
― Keep the bed covers at the foot of the bed loose
― Apply a heating pad for 10 to 20 minutes before sleep
― Remain adequately hydrated. Drink 6 to 8 glasses of water daily. It is more important particularly for the elderly and patients on diuretics.
― Avoid alcohol and caffeine
― Avoid exercising in extreme heat
When should I see a doctor?
In most cases, night leg cramps are harmless and are merely a bothersome symptom. It does not mean that you have a serious disease. But some people may need to see a doctor if the leg cramps are severe and persistent. In this case, you should contact your doctor immediately. If muscle weakness and atrophy develop with leg cramps, you need to seek medical care. Benign nocturnal leg cramps can begin with non-pharmacologic therapy. But if cramps continue after trying the above suggestions, contact your doctor.
The writer is an Assistant Professor at Seoul National University Hospital International Healthcare Center (SNUH―IHC).