If you’ve ever had a leg cramp, you’ll recognize the description: A sudden clenching of the muscle in your calf, foot or thigh. The cramp lasts for a few seconds to a few minutes, but the muscle can be sore for up to several hours after it relaxes.
And these annoying episodes tend to strike when you least expect them. “Leg cramps can occur while you’re awake, but most occur at night,” says family medicine doctor Matthew Goldman, MD.
What causes leg cramps at night?
There’s a long list of things that might be causing these cramps, Dr. Goldman says. Possible causes fall into several categories:
- Anatomical issues: Things like flat feet or abnormalities of the knee joint can lead to leg cramps.
- Activity and positioning: If you sit too much, spend too much time in an awkward position or stand all day on a concrete floor, your leg muscles might cramp at night. Overexertion of your muscles during exercise can also bring on nighttime cramping.
- Neurological conditions: Problems such as pinched nerves, Parkinson’s disease and amyotrophic lateral sclerosis (ALS) can lead to leg pain.
- Metabolic issues: A range of metabolic problems can cause leg cramps, including hypothyroidism, diabetes, low magnesium and even salt imbalances caused by excessive sweating.
- Medications: Certain prescription drugs are linked to leg cramps, including common medications like oral contraceptives and statins.
- Circulation disorders: Conditions such as anemia and peripheral artery disease can bring on nocturnal leg cramps, too.
- Idiopathic causes: Idiopathic is the medical term for “we don’t understand what’s causing this.” And unfortunately for people looking for answers, most nocturnal leg cramps are idiopathic, Dr. Goldman says.
When should you be concerned?
Nighttime leg cramps are common — as many as 50% to 60% of adults have experienced them, as well as 40% of pregnant women. If you wake up with a painful knot in your calf, it doesn’t automatically mean you have a serious underlying condition.
Occasional cramps are probably nothing to fret over. But Dr. Goldman recommends talking to a doctor if you notice these symptoms:
- Waking up several times a night with leg cramps.
- Leg cramps that prevent you from getting enough sleep.
- Muscle cramps in other parts of the body, besides the legs and feet.
- Leg cramps combined with a known electrolyte imbalance or fluid abnormality.
- Significant pain, leg swelling and/or skin changes.
When you talk to your doctor, include any details you can remember about when the leg cramps happen, how long they last and anything else you can note about them. And mention any medications you take and underlying conditions you may have.
Ease the pain: Leg cramp treatment
For many people, though, leg cramps aren’t a sign of an illness. Still, they can be a painful nuisance. Dr. Goldman recommends these tricks to help calm your angry muscle:
- Stretch: If your calf is clenched, for example, straighten your leg and pull your toes toward your shin.
- Stand: Get out of bed, stand flat on your foot and press it firmly into the floor.
- Walk: Move around and jiggle the sore leg.
- Warm: A hot shower or warm bath can ease the cramp and soothe lingering soreness.
- Ice: Some people find more relief from cold than hot. Try rubbing the sore muscle with ice wrapped in a towel.
- Elevate: After the cramp eases, prop up the affected leg.
How to prevent leg cramps
Better yet, prevent the cramp from striking in the first place. These strategies can reduce the risk of nocturnal leg cramps:
- Limit caffeine and alcohol.
- Drink plenty of water, especially if you’re taking diuretics.
- Gently stretch your legs before bed.
- Wear shoes that are supportive, especially around the heel. (Sorry, flip-flops won’t cut it.)
- Keep bedding loose at the foot of the bed so your feet can move freely.
If those strategies don’t work, your doctor may be able to prescribe medications to prevent leg pain from cramping your slumber.