By Jon Johnson

Reviewed by Gregory Minnis, DPT

Leg cramps at night, or nocturnal leg cramps, are common and can occur due to inactivity during the day, tired muscles, or certain medical conditions.

Leg cramps, also called charley horses, are uncontrolled spasms in the muscles of the leg that may be painful. They typically occur in the calf muscles, though they may also appear in the thighs or feet.

Much of the time, simple stretches may help ease the cramped muscles. There are also other treatments and prevention methods to try. Anyone dealing with leg cramps regularly should see a doctor for a full diagnosis.

What are they?

Experiencing leg cramps at night is fairly common. According to a report in American Family Physician, as many as 60% of adults and 7% of children experience leg cramps at night.

Leg cramps are involuntary muscle spasms anywhere in the leg, though they are most common in the calf. The muscle tenses up, causing discomfort or moderate to severe pain and tightness in the area.

Nocturnal leg cramps may also lead to other issues. They can disrupt sleep and break up a person’s sleep cycle, which can make them feel tired or lethargic the next day. Leg cramps may make it very difficult to fall asleep, and this could lead to issues such as insomnia over time.

People may confuse nocturnal leg cramps with restless leg syndrome.

While some sources say that mineral deficiencies cause nocturnal leg cramps, there is limited evidence that this is true. Research suggests that taking mineral supplements, such as calcium, magnesium, or vitamin B-12, may not relieve leg cramps at night in most people.

Causes and risk factors

The following sections discuss possible causes of leg cramps at night and risk factors that make a person more likely to experience them.

Tired muscles

According to a review about nocturnal leg cramps, the research available suggests that muscle fatigue is a primary cause. Athletes are more likely to get leg cramps after doing higher than normal levels of activity.

Overexertion, such as exercising the muscles very intensely for a long time, may cause some people to experience more cramping later in the day.

Standing for long periods during the day, which is common in many jobs, may fatigue muscles. The muscles tire during the day and may be more likely to cramp later on during the night.

Inactivity during the day

A person may be more prone to leg cramps at night if they are inactive for extended periods during the day.

Another leading theory is that sitting for an extended period, such as while working at a desk, may cause the muscles to shorten over time.

This physical inactivity when a person has not stretched their muscles for a while may increase the risk of cramps, and these can commonly occur in bed at night.

Someone who does not stretch their muscles or exercise regularly may be more at risk of leg cramps at night. The muscles in people who are less physically active may be shorter, which may increase the risk of cramping or spasms.

Body position

Sitting or lying in a certain way that restricts movement or blood flow to the legs, such as resting one leg on the other or with the legs crossed, may lead to cramps.

People may wish to experiment with sleeping in more stretched out positions to see if this eases their nighttime leg cramps.

Older age

As people age, they may also be more likely to have leg cramps at night. As a review published in the journal BMC Family Practice notes, up to 33% of people over 50 years of age experience chronic nocturnal leg cramps.

Pregnancy

There may also be a link between pregnancy and leg cramps at night. This might be due to the increased nutritional demands or hormone changes in the body during pregnancy.

A side effect of medication

Many medications list muscle cramping as a side effect. Few of these are directly associated with leg cramps, but there are some, including:

• intravenous iron sucrose
• naproxen
• teriparatide (Forteo)
• raloxifene (Evista)
• levalbuterol (Xopenex)
• albuterol/ipratropium (Combivent)
• conjugated estrogens
• pregabalin (Lyrica)

Medical conditions

Some chronic medical conditions may also put a person at risk for chronic leg cramps, such as:

• cardiovascular disease
• diabetes
• alcohol use disorder
• kidney failure
• liver failure
• lumbar canal stenosis
• flat feet
• hypothyroidism
• osteoarthritis
• nerve damage
• nerve disorders

Anyone who thinks one of these conditions may be the cause of their leg cramps should talk to a doctor for further information or guidance.

Treatments

Treating leg cramps at night, in the moment they occur, may help a person get more rest.

Some possible home remedies to find relief in the moment include:

• gently stretching out the muscle
• massaging the area by hand
• using a foam roller to massage the leg
• flexing and unflexing the foot to help extend the leg muscles
• applying heat to the area

Taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin will not help ease cramps because cramps are not related to inflammation. It may help deal with the pain from a cramp but will not relieve the cramps.

In some cases, doctors will prescribe medications to treat chronic leg cramps, including:

• carisoprodol (Soma)
• gabipentin
• diltiazem
• verapamil
• orphenadrine

A person should talk with a doctor to discuss these drugs and any possible side effects.

Preventing leg cramps at night

Preventing leg cramps in the long term may be the best option for some people, though this is not always possible.

Mild exercise

Some people feel they do not experience as many cramps if they do some mild exercises at the end of the day. This may include such activities as walking or spending a few minutes on a stationary bike before bedtime.

Drinking plenty of water

Fluids help transport nutrients and waste to and from the muscles. Drinking fluids, especially water, throughout the day can help prevent cramps by keeping the muscles functioning well.

Changing shoes

Some people may notice they have less cramping when they wear more supportive shoes. Anyone uncertain about how supportive their footwear is can consult a podiatrist.

When to see a doctor

Nocturnal leg cramps can be very uncomfortable and cause sleep problems.

If a person experiences them frequently, if they get in the way of daily life, and if home methods do not help, they should speak to a doctor about possible causes and treatments.

Likewise, if the cramps spread to other muscles or become severe, people can see a doctor for a full diagnosis.

A doctor will want to rule out other disorders with similar symptoms first and then test for other possible causes.

Summary

Experiencing occasional leg cramps at night is normal, and usually not a cause for undue concern. Simple home remedies may help in the moment, such as flexing the foot, stretching the legs, or massaging the tense muscle.

Anyone experiencing regular leg cramps at night for prolonged periods should see a doctor for a full diagnosis. They may prescribe medication or other treatments to manage nocturnal leg cramps and help a person sleep better.