Leg Cramps at Night: Causes and Remedies

Emerging groggily from the edge of sleep or from a deep sleep, you struggle to straighten your leg, pull your toes forward, perhaps kneading the knotted muscles with your thumbs. After the spasms subside, you may get up and try to hobble around a bit to loosen up the painful area a little more.

By now you’re completely awake, and you may not return to sleep. The cramped muscles may remain tender for hours or even days.*

The nighttime "Charley horse" is an age-old, global problem. Other languages use terms that translate into phrases like muscle hangover, wooden leg, thigh hen, thigh cookie, donkey bite, old woman, and water buffalo.

What Causes Leg Cramps at Night?

Sixty percent of adults say they’ve experienced nocturnal leg or foot cramps at some time in their lives.

Pregnant women and older people tend to suffer nighttime leg cramps more often than other groups, but medical experts say there’s often no clear explanation of why these nighttime leg cramps occur, listing many conditions that might bring one on, including:

• Hard exercise during the day
• Electrolyte imbalance 
• Dehydration
• Neurological, neuromuscular, or endocrine disorders
• Lumbar stenosis
• Standing for long periods on concrete floors
• Sitting all day in a cramped position
• A side effect of some drugs

Leg Cramp Remedies

When a cramp startles you from sleep, here are 5 tips to manage the problem:

1. Take a few breaths and try to stay calm. Panicking may cause you to tighten the affected muscles even further and prolong or intensify the cramp.
2. If the cramp is in your arch or calf muscles, forcefully extend your toes toward your head and hold the stretch until the cramp subsides. This will release the tension so that the muscles can relax. You may need to sit up, bend over, and pull your toes forward with your hands.
3. If the cramp is in the back of your thigh, roll out of bed, bend at the waist, supporting yourself on your forearms, and keep bending forward until you feel the cramped muscles stretching out. Hold the stretch until the cramp abates.
4. I’ve had good luck using a towel or a woven stretching strap to help straighten out especially vicious hamstring cramps.
5. When the acute pain subsides, get up and walk around a bit to bring oxygen to the cramped muscles. A cold pack or hot pack may help. I like the long, rectangular “beanbags” (cloth sheaths filled with beans or other seeds) heated for a couple of minutes in the microwave and wrapped around sore muscles. (Great for arthritic joints, too.)

How to Prevent Leg Cramps

If you’re prone to leg cramps at night, these 6 tips can help to stop cramps from happening again:

1. A lot of uphill walking/running or stair-climbing shortens the back muscles and the muscles and tendons at the back of the legs, making them more likely to cramp later. Focus attention on stretching these muscle groups after a hilly workout.
2. Go for a deep-tissue therapeutic massage with an experienced practitioner. Ask her/him to teach you the techniques for the muscle groups in the legs and feet, so that you can work the knots out before they become disabling cramps.
3. Loosen the bedcovers so that they don’t press your feet down and shorten the muscles of your arches, encouraging them to cramp.
4. Drink when you feel thirsty, especially after exercise. Don’t overdo it. Tea, coffee, smoothies, fruit, and vegetables all contribute to your daily fluid needs.
5. Eat a variety of potassium- and magnesium-rich foods every day. Good choices: black beans, kidney beans, nuts and seeds, potatoes, sweet potatoes, leafy greens (especially beet greens), bananas, and other fruit.
6. Stay flexible with a regular stretching. Here are two common stretches:

Basic calf stretch

Here’s how to do it:

• Stand with your palms placed against a wall, with arms stretched out
• Step back with leg of affected calf
• Lean forward on the other leg and push against the wall

• You should feel a stretch in your calf muscle and the back of the leg.

Towel stretch

Do this stretch while you sit:

• Keep legs outstretched in front of you
• Point the toes of your affected foot at the ceiling so that the leg is engaged
• Take a towel or neck tie and wrap it around your foot, holding it with both hands
• Lift the leg slightly until you feel a good stretch

Just stretching the affected muscles three times a week will help immensely. Hold stretch for at least 10 seconds, working up to 30 seconds. And perform each stretch 3 to 5 times. 

(Find more stretches here. Clicking the "Exercise Search" box on the right side.)

The drug quinine, once prescribed to prevent night cramps, is now rarely prescribed for this use, because the possibility of severe adverse reactions outweighs the benefits of its use.

If you start having far more frequent or severe attacks of night cramps, see your doctor for an evaluation to rule out a more serious medical condition.

Restless Leg Syndrome

Don’t confuse nighttime leg cramps with restless leg syndrome (RLS). RLS is annoying and may cause an aching sensation, but it's not usually painful and doesn't cause cramping. See home remedies for restless leg syndrome.

*Note: If your calf or thigh is swollen, warm to the touch, or discolored; if your pain gets worse when you get up and walk around and doesn't subside after a minute or two, seek immediate medical help. Don't knead or massage a swollen muscle. These symptoms could signal a serious, potentially life-threatening condition called a deep vein thrombosis, a blood clot in a deep vein that can travel to a lung, where it can block blood flow.