Sleep-related movement disorders
Nocturnal Leg Cramps
Sudden, painful tightening of calf or foot muscles that wakes you from sleep. They are common, especially with age and in pregnancy.
Overview
Nocturnal leg cramps are sudden, involuntary and painful contractions of a muscle, most often in the calf or foot, that occur at night and can wake you up. The muscle feels hard and knotted, and the pain may last seconds to minutes, sometimes leaving soreness afterward.
They are common in older adults and during pregnancy. In most cases no specific cause is found, although some medicines and medical conditions increase the risk.
Stretching the muscle usually relieves a cramp. Quinine was once widely used, but the FDA has warned against using it for leg cramps because of serious side effects, so it should not be used for this purpose.
Common symptoms
- Sudden, intense pain in the calf, foot or thigh at night
- A hard, visibly tight muscle
- Toes curling or pointing involuntarily
- Soreness that lasts after the cramp
- Waking from sleep because of pain
Causes and risk factors
- Older age
- Pregnancy
- Prolonged sitting or standing, or muscle overuse
- Medicines such as some diuretics and certain other drugs
- Peripheral vascular disease, nerve damage or diabetes
- Kidney disease and electrolyte imbalances
- Often no identifiable cause
How it is diagnosed
A clinician diagnoses leg cramps from your description and an examination, and distinguishes them from restless legs syndrome, periodic limb movements and circulation problems. Blood tests may check kidney function, electrolytes, glucose and thyroid if a cause is suspected. A medication review is an important part of the assessment.
Treatment options
Stretching
Calf and hamstring stretches before bed may reduce how often cramps occur in some people.
Stretching during a cramp
Pulling your toes toward you or standing on the affected leg can relieve the spasm.
Treating underlying causes
Addressing medication effects or medical conditions where present.
Avoiding quinine
The FDA has warned that quinine is not approved for leg cramps and can cause serious blood and heart problems.
What you can do yourself
- Stretch your calves before bed
- Keep your bedding loose so your feet are not pointed downward
- Walk or jiggle your leg when a cramp starts
- Use warmth on tight muscles and gentle massage
- Stay active during the day
When to see a doctor
- Cramps are frequent, severe or interfere with sleep
- There is leg swelling, redness or warmth (possible blood clot, seek urgent care)
- You have muscle weakness or numbness
- Cramps started after a new medicine
Frequently asked questions
What is the difference between leg cramps and restless legs?
Leg cramps are painful, visible muscle tightening. Restless legs syndrome is an urge to move with uncomfortable sensations, without the muscle locking up, and it is relieved by movement.
Should I take quinine for leg cramps?
No. The FDA has warned against using quinine for leg cramps because of serious, sometimes fatal side effects, and it is approved only for malaria.
Does magnesium help night cramps?
For most older adults, reviews have not found magnesium helpful for typical leg cramps. Evidence in pregnancy is mixed, so ask your clinician before taking supplements.
Are leg cramps a sign of something serious?
Usually not. But frequent cramps with weakness, numbness, swelling or other symptoms should be checked by a clinician.
Sources
This page is general information, not a diagnosis or medical advice. Read our medical disclaimer.