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What are nocturnal leg cramps?

Nocturnal leg cramps are pains that usually occur in the legs, especially in the calf (gastrocnemius muscle) during the night while sleeping. They usually cause awakenings from sleep, but they may also occur while awake at night during periods of inactivity.  These cramps are most often present in the calf muscles but can also occur in the thighs or feet.  Nocturnal leg cramps are quite painful and cause the affected muscles to feel tight or knotted.  Symptoms may last from several seconds up to several minutes.  There might also be muscle soreness after the cramp goes away, lasting for the rest of the night or even until the following day.

What causes nocturnal leg cramps?

The cause of nocturnal leg cramps is often times unknown, but some cases have been linked to:

  • Sitting for long periods of time
  • Over-exertion of the muscles in the leg
  • Standing or working on concrete or other hard surfaced floors
  • Sitting improperly

Nocturnal leg cramps have also been linked to certain medical conditions and medications. These include:

  • Pregnancy
  • Alcoholism
  • Dehydration/electrolyte imbalances
  • Parkinson’s disease
  • Neuromuscular disorders (neuropathy, myopathy, motor neuron disease)
  • Structural disorders (flat feet)
  • Endocrine disorders (diabetes, hypothyroidism)
  • Diuretics, statins, beta agonists

Who gets nocturnal leg cramps?

Nocturnal leg cramps are more common in adults over age 50, but they also do occur in younger adults and children. Both men and women seem to be equally affected.

Do I need to have any testing done to evaluate my leg cramps?

If leg cramps are frequent and severe, your medical physician may order lab work to ensure that there are no electrolyte imbalances.

What can I do to help prevent these cramps from happening?

  • Make sure that you stay hydrated... drink six to eight glasses of water each day.
  • Gently stretch your leg muscles before you go to sleep.
  • Keep blankets and sheets loose around your feet so that toes are not distorted.
  • Wear properly fitted shoes.
  • Spend a few minutes riding a stationary bicycle before going to bed.

What can I do to make nocturnal leg cramps go away if they happen?

When a nocturnal muscle cramp strikes it can nearly leave you paralyzed. Knowing how to properly handle an attack will offer you relief and leave you less sore afterwards. Here are some tips to better handle nocturnal leg cramps.

  • While sitting on the floor extend both legs out in front of you. Now flex your feet at the ankles and point your toes toward your knees – you may want to tug on your feet to offer an even better stretch.
  • Get up slowly and walk around a bit – shaking your legs can also improve blood flow.
  • Gently massage the area in a circular motion.

Treatment for nocturnal leg cramps depend on the cause. For example, if the cause of your nocturnal leg cramps is due to dehydration, ensure you stay well hydrated throughout the day. Other treatment and preventative methods for nocturnal leg cramps include:

  • stretch your legs prior to bed
  • forcefully stretching the affected muscle cramp is usually the most effective way to relieve the cramp itself
  • relieve the cramp by walking around, jiggling your leg or massaging the leg or the affected area in a circular motion
  • take a relaxing warm bath or shower prior to sleep to ease any muscle tightness may be helpful
  • applying a heating pad to the affected area. Alternatively, applying ice has also shown some benefit
  • use horse chestnut, which has been shown to increase blood flow to the legs
  • take a tablespoon of yellow mustard to relieve discomfort.
  • try chiropractic care which may include electophysiotherapy or acupuncture treatment to relax and loosen tight leg muscles
  • ensure you are not deficient in magnesium or potassium – deficiencies in both minerals have been linked to muscle cramping
  • partake in water exercises to build leg muscles
  • wear ergonomic shoes and avoid high heels.
  • ensure blankets and sheets are not tight enough to make the leg muscle contract.

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Are nocturnal leg cramps the same as restless leg syndrome (RLS)?

No. While both types of leg disturbances tend to happen at night while sleeping, or at rest, restless leg syndrome:

  • RLS does not cause pain or cramping
  • RLS is more of a discomfort or a crawling sensation in the  legs that results in a desire to move the legs to relieve it. While moving, the restlessness is relieved but the discomfort returns when movement stops. This does not happen with nocturnal leg cramps where the tightened muscle needs to be actively stretched out for relief.

Are there any medications that will treat nocturnal leg cramps?

If known, always try to treat the underlying cause first. Vitamin E supplements or Vitamin B complex may helpful.  Magnesium supplements have also shown some benefit, mostly in pregnant women. Diphenhydramine and calcium channel blockers may be suggested by your doctor.  Quinine was previously used for the treatment of nocturnal leg cramps. However, due to its potential for serious and life-threatening adverse effects (cardiac arrhythmias, thrombocytopenia, and hypersensitivity reactions), it is no longer recommended as a treatment option.

Source: belmarrahealth.comtheheartysoul.com
 

References:

  1. http://www.mayoclinic.org/diseases-conditions/muscle-cramp/basics/causes/con-20014594
  2. http://www.nhs.uk/CONDITIONS/LEGCRAMPSUNKNOWNCAUSE/Pages/Causes.aspx
  3. http://patient.info/health/Cramps-in-the-Leg
  4. The American Chiropractic Association
  5. https://en.wikipedia.org/wiki/Cramp
  6. http://www.aafp.org/afp/2012/0815/p350.html
  7. http://pmj.bmj.com/content/78/924/596.full
  8. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445088/
  9. American Academy of Orthopaedic Surgeons. Muscle Cramp. Accessed 11/5/2014.
  10. Vinetz JM, Clain J, Bounkeua V, Eastman RT, Fidock D. Chapter 49. Chemotherapy of Malaria. In: Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw-Hill; 2011.
  11. American Academy of Family Physicians. Nocturnal Leg Cramps. Accessed 11/5/2014.
  12. https://my.clevelandclinic.org/health/diseases_conditions/hic_Nocturnal_Leg_Cramps
  13. http://emedicine.medscape.com/article/1188327-differential
  14. http://www.mayoclinic.org/symptoms/night-leg-cramps/basics/causes/sym
  15. http://www.mountsinai.org/patient-care/health-library/diseases-and-conditions/nocturnal-leg-cramps
  16. http://www.healthguidance.org/entry/15660/1/Nocturnal-Leg-Cramps-Treatment
  17. http://www.everydayhealth.com/pain-management/what-causes-leg-cramps-and-how-can-you-stop-them
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