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Leg Cramps at Night: Causes and Remedies

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Charley Horse Causes and Remedies

Written By: Margaret Boyles Contributor

Eeow! Startled from a deep sleep, you suddenly come to with a shriek, as your calf, thigh, or maybe the arch of your foot contracts in violent pain. Commonly called a “Charley horse,” this is a common and painful occurrence. Discover what causes leg cramps at night, as well as how you can prevent and relieve them.

Usually, a leg cramp strikes during the night or when you’re resting. Groggily, 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:

  • Dehydration
  • Sitting all day in a cramped position
  • Standing for long periods on concrete floors
  • Electrolyte imbalance 
  • Hard exercise during the day
  • Neurological, neuromuscular, or endocrine disorders
  • Lumbar stenosis
  • 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, get up or roll out of your reclined position, 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.I’ve had good luck using a towel or a woven stretching strap to help straighten out especially vicious hamstring cramps.
  4. When the acut e 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. Drink water! Don’t overdo it. Keep a water bottle with you throughout the day. If you’re serious about addressing leg cramps, simply set an alarm or reminder on your phone to drink water throughout your day. Monitor caffeine and alcohol intake. Tea, coffee, smoothies, fruit, and vegetables all contribute to your daily fluid needs.
  2. Loosen the bedcovers so that they don’t press your feet down and shorten the muscles of your arches, encouraging them to cramp.
  3. Start putting potassium- and magnesium-rich foods on your list to eat every day. Good choices: black beans, kidney beans, nuts and seeds, potatoes, sweet potatoes, leafy greens (especially beet greens), bananas, and other fruit.
  4. 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.
  5. 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, especially after exercise.
  6. Stay flexible with a regular stretching. Here are two common stretches:

Basic calf stretch

Just stretching the affected muscles three times a week will help immensely. 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

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.

Sleep

About The Author

Margaret Boyles

Margaret Boyles

Contributor

Margaret Boyles is a longtime contributor to The Old Farmer’s Almanac. She wrote for UNH Cooperative Extension, managed NH Outside, and contributes to various media covering environmental and human health issues.

Read more from Margaret Boyles

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Comments

<span>Wise Wombat</span> Sun, 08/20/2017 - 15:06
A lot of great ideas here, you just need to find the one that works for you. There are numerous studies published on this and even the experts cannot point to a single cause. The posts below that refer to the balance between Magnesium, Calcium, and/or Potassium are in line with the study results. Of course, unless you know what your deficiency is, taking the wrong supplement could make it worse. For example, there is research supporting the benefit of Magnesium supplements*, but ONLY in individuals with a magenesium deficiency. (* Magnesium Citrate, not Magnesium Oxide which is not easily absored) If the cramps appear after a day of heavy exercise and/or sweating, the salt water is likely to help, especially as a preventative measure. Pickle juice is loaded with salt so the results should be similar in these individuals, as would Gatorade or the equivalent. It is obvious from the posts that the placebo affect is also a factor here. This is understandable because anything that causes to to relax and not worry about it as much will help. Anyone who has had these knows that there is that moment just before it happens where you can feel it coming and your brain is like "Nooo!", followed by some degree of panic. I have had some success with actually being able to stop it in it's track at this point by taking a huge deep breath, grabbing the mucle and squeezing quite hard, while continuing to breath as slowly as possible and telling myself I can control this. This works best when you are not completely asleep when it starts. The above is also most effective if you take the time in advance to learn where the trigger point(s) are that relate to the muscle in spasm. Usually it is the trigger point in the upper lateral part of the gastrocnemius (main calf) muscle. In my case, managing this trigger point in advance has been the bast way to prevent the spasms in the first place. I have come to be able to sense when an episode is coming, about 6-12 hours in advance, and if I ignore the signs I am in trouble that night. Learn how to release the trigger point using a tennis ball or your hands. Also check for trigger points in the tibialis anterior and extensor digitorum longus (muscles on the front of your shin between the two bones). Your calf muscles work against these muscles and if they are constantly fired up, your calf muscles may be just be "hanging on for dear life" to keep your foot aligned. To find/release anterior (front) shin trigger points, the tennis ball may be too large to go between the bones. A lacross ball or even golf ball may work better, but watch out with the latter, if you have issues there it may be quite alarming. Good advice here on ensuring your sheets blankets are not tight around your feet. You do not want anything holding the calf muscles in a shortened position. This applies all day as well. In your normal sitting position, are your feet pointed down, up, or neutral? The best is actually none of the above for any long period. Switch it up, move around, and change your position. One poistion you should always avoid is with your legs extended on a footrest and your feet hanging off the end of the footrest. Make sure your heels are supported. In some cases, a night splint may be helpful (either posterior or anterior). You can get these devices at walmart or any drug store. They are intended for use at night when sleeping and hold your foot at an angle (toes pointing up toward your head) such that calf muscles are in a stretched position. Seems like a good idea, UNLESS your anterior (front/shin) muscles are tight and inderectly causing the problem (as above). SLEEP. Getting enough sleep is essential to muscle rebuilding and repairing. Not just any sleep, but deep sleep (REM/dreaming cycle). This is when your voluntary muscles go limp, so to speak, allowing blood to circulate and provide the needed nutrients to repair the muscle fibers. The amount of deep sleep required is directly related to amount of exercise/stress on the muscle during the day. You need more every night during a week when you are hiking or playing sports every day than a week where you are mostly resting (however not moving around causes other issues, as above). Professional athletes in intense traning often average 10 hours of sleep a night, or otherwise become injury prone. I know someone who suffered frequency night leg cramps throughout college and early medical career, a time in which he was not sleeping much and under significant stress. Upon taking a much less stressful position (teaching), and increasing hours of sleep, he has not suffered a single leg cramp. Be wary of posts that imply a single solution is right for everyone. The person posting is not "wrong" or posting in bad faith. Their solution did work for them and they are trying to help. There is no harm in trying any of these remedies (within reason and common sense) but it should not be claimed that just because something worked for one person, that everyone should do that and ignore all the other advice and solutions.
<span>Coral</span> Wed, 10/23/2019 - 11:48
Did you know that a good dark chocolate has potassium, magnesium, manganese and phosphorous in it? I only eat two small squares on most days...but no leg cramps anymore
<span>Mari Polding</span> Sat, 08/05/2017 - 12:26
Other solutions which can help leg cramps are: Make a tea from onion shells. Put full, left over or bits of soap under mattress cover near feet where the bumps will not bother you
<span>Tina Boyd</span> Thu, 12/07/2017 - 09:36
I saw this on the internet and thought it was crazy, but my leg cramps were getting more and more severe, sometimes twisting around my leg, so what the heck, let's give it a try. It worked So of course then I wondered if it was all in my head, but I was okay with that. Then my husband removed the soap one day while making the bed. I wasn't aware of it and my leg cramps came back. Also, if the soap gets old it becomes less effective. If we cut it in half it works again. Don't know what the tie-in is, but it works for this girl.
<span>Tom</span> Thu, 08/03/2017 - 15:18
I have started taking magnesium supplements between 30-100% of DV. Night time cramps are gone.
<span>Sussie Due</span> Thu, 08/03/2017 - 13:38
My friend swore by drinking a glass of tonic water every day for stopping leg cramps. I thought she was nuts but I tried it anyway. And by golly...it works!
<span>Fran Zimmerman</span> Mon, 07/09/2018 - 13:30
Quinine water (as in gin-and tonic) works instantaneously for me. Buy diet tonic water and keep it in the frig. A small glass provides immediate relief from cramps.
<span>Dfm</span> Wed, 08/02/2017 - 22:27
I get these now and them in the arch of my foot, calf and once deep in my thigh. I found the best remedy was to drink a lot of water and walk it off. Usually takes about 10 minutes but always works for me.
<span>Susan</span> Wed, 08/02/2017 - 14:30
This may sound very silly, but it seems to work 85-90% of the time. Put a bar of scented soap (remove its packaging) between your sheets, by your feet. It makes your sheets smell nice and it works. If a cramp arises, pull the soap near the cramp. My friends and family have been amazed at the results, too.
<span>Hannah Lloyd</span> Wed, 08/02/2017 - 12:15
Magnesium oil spray every couple of days prevents this problem altogether.