Nocturnal Leg Cramps

• The true causes of nocturnal leg cramps remain unknown, but studies have found that they may be associated with structural disorders, neurological disorders and peripheral artery disease.
• Those suffering with nocturnal leg cramps should try to stretch and massage the affected muscle softly. A cold compression massage has also been found to be effective. Should the pain associated with cramping continue, pain relief medication may be taken, and pain relief cream applied to the affected area to alleviate the discomfort.
• Those suffering from common nocturnal leg cramps that disrupt sleep should consult a specialist, who can perform a diagnosis and advise on the necessary steps required to treat the condition effectively.

There are bound to be many of you out there who have experienced nocturnal muscle cramps. This means you will understand just how painful they can be, often causing the sufferer to wake suddenly due to the severe discomfort. Have you ever wondered why these occur and what is causing them? And what treatment and prevention options are available for this strange and usually unexplainable occurrence?

Muscle cramps refer to the phenomenon of a muscle contracting acutely and being unable to relax again as usual. The muscles affected can often feel hard to the touch, and can cause severe pain and discomfort to the person experiencing them. Generally, cramping occurs in the calves, hamstrings, and groins. When they occur at night, these types of cramps are referred to as nocturnal leg cramps, and they tend to affect those of middle to old age as well as pregnant women more than other groups.

The true causes of nocturnal leg cramps are not yet fully understood, but there is evidence to suggest that the causes are more likely associated with muscular fatigue, flexibility, irregular central nervous system function, or inhibited circulation rather than the common misconception that a lack of minerals or other factors play a part. Indeed, there are a number of factors that are believed to impact cramp occurrence, as follows:

• A lack of muscular flexibility, and irregular contraction of muscles and tendons
• Irregular central nervous system function
• Peripheral artery disease or venous insufficiency
• Lack of daytime hydration
• Sitting cross-legged or flexing the feet
• Standing or working on a hard surface for extended periods
• Overuse of muscles, such as during strenuous exercise
• Laying, sitting, or standing in the same position or in an uncomfortable posture for an extended period

• Pregnancy
• Thyroid disorders
• Nervous system disorders, such as Parkinson’s disease
• Central nervous system disorders, such as peripheral neuropathy or motor neuron disease
• Metabolic conditions, such as diabetes
• Coronary artery disorders, such as heart disease or peripheral vascular disease
• Physical disorders, such as flat footedness or spinal stenosis
• Drugs used to treat certain conditions, such as statins, cholesterol reduction medication, COPD drugs, diuretics, and blood pressure medication

Those who suffer from repeated nocturnal leg cramps that disrupt sleep and do not improve with self-care, thus leading to symptoms including redness, skin changes, or severe muscle weakness, are advised to seek medical attention. This will enable a doctor to perform a diagnosis that can rule out other disorders to ensure they provide the appropriate treatment. Such a diagnosis will involve reviewing the patient’s medical history and prior medication use, conducting a detailed physical examination, and taking a blood test where hematological issues are suspected.

Doctors will consider pain relief drugs to treat nocturnal leg cramps, including oral muscle relaxants and paracetamol or ibuprofen-based drugs. They may also look to magnesium supplements for adults and pregnant women as there is evidence to suggest this substance can be beneficial to the health of these groups. However, quinine is not recommended as a suitable form of treatment for nocturnal leg cramps as its drawbacks outweigh its potential benefits.

• Rest the affected muscle immediately.
• Attempt to stretch the affected muscle slowly and gently as doing so can help to reduce the muscular tension, thus alleviating the cramp. Should the cramp occur in the calf muscle, sit up and stretch the leg out in front of you. Then, slowly flex your feet, hold for 10–15 seconds, release, and repeat 5 –10 times.
• Gently massage the affected muscle to help relax the muscle.
• A cold compress can be used to massage the affected muscle and relieve the pain.
• Should the pain continue despite the cramp subsiding, some pain relief drugs such as paracetamol and muscle relaxants may be taken.

• Try stretching frequently. For instance, you can stretch your calves by facing a wall, stepping one foot back behind you while the other is placed out in front. Then, bend slightly forwards onto the front foot and keep both feet flat on the ground as you hold the position for 5–10 seconds on each side. Do this 10 times for one set and attempt to do 3 sets of these stretches per day for the best results.
• Be sure to stretch properly before playing sports or exercising.
• Stay hydrated throughout the day, drinking between 8–10 glasses of water and avoiding dehydration, especially when exercising.
• Perform regular calf raises to ensure effective circulation and to prevent the muscles from cramping.
• Always bathe or shower in warm water.
• Avoid drinking alcohol.
• Reduce your intake of caffeine from drinks containing the substance, such as hot chocolate and coffee.
• Pregnant women should make sure they have a diet plentiful in calcium (yogurt, cheese, soy milk), potassium (cocoa, prunes, sunflower seeds), and magnesium (bananas, green peas, spinach, sweetcorn, pumpkin seeds, and sesame seeds).

While the true causes of nocturnal leg cramps remain unknown, there are several symptoms that can signal an increased risk of occurrence, such as diabetes, kidney disease, and peripheral artery disease. For this reason, should you experience frequent nocturnal leg cramps, it is best to seek medical attention, so that a doctor can perform a diagnosis and advise you on the most effective forms of treatment in a timely manner.