Nocturnal Leg Cramps

Medically Reviewed by Melinda Ratini, MS, DO on March 03, 2022
3 min read

Nocturnal leg cramps are a tight, knotted feeling in your legs that happens at night. They can last several seconds to several minutes. If the cramp is severe, your muscle may be sore for days.

Leg cramps are different from restless legs syndrome. Both tend to happen at night, but restless legs syndrome causes discomfort and an urge to move instead of painful muscle cramps.

As much as they may hurt, leg cramps are harmless.

Experts don’t know the exact cause of nighttime leg cramps. They could happen because your nerves send the wrong signals to your muscles. For example, your brain might mistakenly tell your leg to move while you dream. That confuses your calf muscles and causes them to contract.

You’re more likely to have a leg cramp if you:

  • Are 50 or older
  • Work your muscles too much
  • Sit too long without moving
  • Don’t drink enough water
  • Stand too long on hard surfaces

Other health conditions can also raise your chances of leg cramps, including:

Some medications can cause leg cramps. These include:

If you often have severe leg cramps, talk to your doctor to be sure another problem isn’t causing them.

They’ll ask about your medical history and your symptoms. They’ll also do a physical exam to look for possible causes. You might have blood tests if your doctor suspects a hidden problem.

The next time a leg cramp strikes, try some of these tips:

  • Stretch the muscle.
  • Get out of bed and stand with your foot flat on the floor. Press down firmly.
  • Massage the muscle.
  • Flex your foot.
  • Grab your toes and pull them toward you.
  • Ice the cramp.
  • Take a warm bath.

Your doctor might give you medications such as diltiazem (Cardizem), diphenhydramine (Benadryl), or verapamil (Calan, Verelan). But they don’t always work, and they can have harmful side effects. For example, experts used to use the anti-malaria drug quinine for leg cramps. Doctors and the FDA no longer recommend it because it can also cause severe bleeding and problems with your heart rhythm.

Some simple things might keep you from getting cramps:

  • Stretch during the day and before bed. Focus on your calf and foot muscles.
  • Drink plenty of water.
  • Move around during the day to exercise your feet and legs.
  • Wear comfortable, supportive shoes.
  • Sleep under loose covers, especially if you sleep on your back.

 

Show Sources

SOURCES:

NYU Langone Medical Center: "Nocturnal Leg Cramps."

American Academy of Family Physicians: "Nocturnal Leg Cramps."

Cleveland Clinic: "Nocturnal Leg Cramps," “Leg Cramps at Night.”

Ohio University College of Osteopathic Medicine: "Leg Cramps at Night."

UC San Diego Health System: "Medicines Used to Treat COPD."

Lancaster General Health: "Leg Cramps, Nocturnal."

Mount Sinai Hospital: "Nocturnal Leg Cramps."

Harvard Medical School Family Health Guide: "Leg Cramps."

Allen, R. American Family Physician, August 2012.

Kolata, G. “A Long-Running Mystery, the Common Cramp.” The New York Times, Feb. 14, 2008.

Maugh II, T. “The FDA warns against using quinine for leg cramps.” Los Angeles Times, July 8, 2010.

UpToDate: “Nocturnal leg cramps.”

Harvard Health Publishing: “Is there hope for leg cramp sufferers?”

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