Nighttime Leg and Foot Cramps - Causes, Prevention and Treatment

November 06, 2022

man with a cramp in his calf

If you have ever been jolted from sleep by a painful cramp in your foot or calf, you are certainly not alone, as nearly half of all adults, as well as nearly ten percent of children report getting leg and foot cramps at some point. Also known as “charley horses,” these sudden, involuntary and intense muscle contractions are more frequent as you get older, affecting nearly one in three adults.

If experienced regularly, these unwelcome nighttime visitors can severely disrupt sleep, and can even cause anxiety about going to bed. So, what causes nighttime muscle cramping and why do they happen mainly at night? And even more importantly, what can you do to prevent them or calm them down when you do get them?

First, let’s look at some of the common causes of nighttime leg and foot cramps:

Overexertion and muscle fatigue - If you are not used to strenuous exercise and on a whim decide to go on a hike in the mountains, then you are a candidate for leg muscle cramping. All that activity can fatigue muscles, leading to a dysregulation of the nerve impulses which control muscle contraction. People who have jobs that require long intervals of standing and walking are often more susceptible to leg and foot cramps as well.

Low levels of magnesium - Significant deficiencies in magnesium can cause such symptoms as nausea, vomiting and even an irregular heartbeat, but more minor drops in magnesium can lead to foot and leg cramps.  Magnesium functions to help your muscles relax after contracting. If magnesium levels are low, muscles can’t relax fully and may “over-contract” causing painful cramps.

Low levels of potassium -Like magnesium, potassium is an essential nutrient that helps to regulate muscle contraction. When potassium is too low, normal contractions can be disrupted and cramping can develop.

Improper footgear - ill-fitting or tight shoes put too much pressure on the feet, leading to a restriction in blood flow that can cause cramping. Also, shoes that don’t have proper arch support as well as high heels force the foot into an unnatural and uncomfortable position. If worn for too long, cramping can occur later in the day or that night.

Medication side effects -Some prescriptions can cause leg and foot cramps. These include statins used to control high cholesterol, diuretics which can deplete potassium, and beta-agonists used to control some respiratory diseases such as asthma. In addition, people with kidney failure who must have dialysis can also suffer from muscular cramping.

Pregnancy -  Being pregnant is a common cause for foot and leg cramps. The exact cause is still unknown but is thought to be related to calcium metabolism.

To prevent foot and leg cramps, be sure your diet contains adequate amounts of potassium and magnesium. Good sources are beans, lentils, winter squash, bananas, avocado and broccoli. Magnesium rich foods include nuts, seeds, greens, beans, wheat germ, whole grains and wheat and oat bran. Some people find taking a magnesium supplement daily helps to prevent cramping.

Gentle stretching of your leg muscles both before and after exercise can help to reduce the frequency and intensity of cramps brought on by overexertion. Plus, comfortable supportive footwear is a must, especially for exercise and also if you are on your feet a lot.

If you think your prescription medications might be to blame, speak to your health care provider about this.

So, what can you do if a cramp strikes in the middle of the night? Most people will get some relief by getting up and out of the bed and carefully walking around on the affected limb. Stretching your foot and calf muscles by holding on to something for support and gradually raising yourself on your toes can help as well. You can also try applying a warm pack, or if that doesn’t help, a cold pack. If leg or foot cramps are frequent and severe, then it’s time to see your health care provider to make sure there is no underlying cause that needs attention.

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