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What are Nocturnal Leg Cramps?

Nocturnal leg cramps are pains that occur in the legs during the night. 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. 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.

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
  • Standing or working on concrete 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?

Anyone can get these types of cramps. However, they tend to be found more often in people who are middle-aged or older.

Do I Need to Have any Testing Done to Evaluate my Leg Cramps?

If leg cramps are frequent and severe, your doctor 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?

Forcefully stretching the affected muscle is usually the most effective way to relieve the cramp. You might be able to relieve the cramp by walking around, jiggling your leg, or massaging the leg. Warm baths or showers may be helpful. Alternatively, applying ice has also shown some benefit.

Are Nocturnal Leg Cramps the Same as Restless Legs Syndrome?

No. While both types of leg disturbances tend to happen at night, or at rest, restless leg syndrome does not cause pain or cramping. Restless legs syndrome is more of a discomfort, or a crawling sensation, that results in a desire to move the legs. 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.


  • American Academy of Orthopaedic Surgeons. Muscle Cramp.  Accessed 9/6/2012
  • 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. . Accessed 9/6/2012
  • U.S. Food & Drug Administration. Drug Safety Newsletter, Vol. 2, No. 2, 2009. “Quinine Marketed as Qualaquin. Overview of off-label use and serious adverse effects. Accessed 9/6/2012.
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