Rude Awakening: Nighttime Muscle Cramps

Painful muscle cramps in the calf, thigh or foot tend to jolt a person awake in the middle of the night. The strong muscle contraction or tightening, sometimes called a “charley horse,” comes on suddenly and can last a few seconds to several minutes.

 What Causes Nighttime Muscle Cramps?

Muscle cramps may be caused by many conditions or activities, including:

• Vigorous exercise, injury or overuse of muscles.
• Low levels of potassium, calcium, magnesium and other minerals.
• Medical conditions, such as peripheral arterial disease, kidney disease, thyroid disease and multiple sclerosis.
• Medications, such as antipsychotics, birth control pills, diuretics, statins and steroids.
• Exposure to cold temperatures or cold water.
• Standing on a hard surface or sitting for a long time.
• Keeping your legs in an awkward position while sleeping.
• Pregnancy, especially in the later months.

“Nighttime muscle cramps are more common in people over age 40,” said Rozan Razzouk, M.D., a primary care physician with Baptist Health Primary Care. “People in this age group are more likely to have an underlying condition or take medications that can lead to nighttime muscle cramps. In many cases, they also have experienced a decline in muscle strength and flexibility.”

How to Get Relief

When a nighttime muscle cramp strikes, the best method for relief involves movement, says Dr. Razzouk. She recommends walking around and pumping, jiggling and stretching the muscle. Other relief options include massaging the area and taking a warm shower or bath, or applying a heating pad to relax the muscle. Some people may find that using an ice pack numbs the pain or reduces soreness.

Be cautious about taking over-the-counter pain medications such as acetaminophen, ibuprofen or naproxen, Dr. Razzouk warns. Many people reach for these drugs to relieve pain, but they can have adverse effects if taken over a long period of time or combined with other medications.

When to See a Doctor

Dr. Razzouk advises consulting your physician if you have muscle cramps that occur multiple times a week or last for 5 to 10 minutes. “Muscle cramps may be a symptom of another problem, such as a thyroid problem, vascular condition, nutritional deficiency or medication reaction,” Dr. Razzouk said. “If a medication is suspected of causing your muscle cramps, that medication may be stopped or changed, or the dose may need to be adjusted.”

Since acute leg muscle cramps can be confused with restless leg syndrome, your doctor also will check for this condition. Restless leg syndrome is a neurological disorder characterized by throbbing, pulling or other unpleasant sensations in the legs and an uncontrollable urge to move them.

If there is no known cause for your muscle cramps and they keep coming back or interfere with your sleep, your doctor may prescribe medicine that relaxes your muscles.

How to Prevent Muscle Cramps

Experts like Dr. Razzouk recommend taking these steps to prevent nighttime muscle cramps:

• Eat a balanced, healthy diet that is rich in calcium, potassium and magnesium.
• Maintain an exercise program that focuses on stretching and strengthening the muscles.
• Drink plenty of water and other fluids, including sports drinks with electrolytes. Dr. Razzouk suggests choosing a sports drink that is low in sugar or diluting it with water.
• Limit or avoid drinks with alcohol.
• Partner with your doctor to determine if taking a daily multivitamin supplement is a good option.
• Review your medications with your doctor to identify those that may be causing muscle cramps.

“Implementing healthy lifestyle habits will help you maintain maximal health,” said Dr. Razzouk. “This includes strengthening your body as well as stretching your muscles every day, especially before and after exercise and at bedtime. If you’re beginning a new fitness regimen, be sure to start gradually to reduce the chances of muscle cramping.”