Dear Doctor Column, June 13, 2005

Proactive Steps Helps Reduce Leg Cramps

Question:

I have bad nighttime leg cramps that extend to my feet. I can't get a good night's sleep because they wake me up so often. What causes this, and what can I do about it? I'm healthy otherwise.

Answer:

A cramp is a painful spasm in a muscle. Leg cramps involving the calf muscles and muscles in the foot are extremely common and everyone experiences them occasionally. But, when they occur at night, leg cramps often interfere with restful sleep, as you have discovered.

Nighttime, or nocturnal, leg cramps occur most often in individuals aged 50 years and older. Although researchers do not know why we suffer from more leg cramps as we get older, they have discovered these cramps are frequently brought on by too much exercise or by sitting, standing, or lying in an uncomfortable position for a prolonged period. Dehydration is another cause.

Additionally, stretching your toes downward when in bed or lying on your stomach with your feet pointed downwards toward the end of the bed can trigger a cramp. Certain medications, such as diuretics commonly taken for hypertension or fluid retention, deplete the body's potassium, which may result in cramps.

Although you may generally be healthy, it is always a good idea to have a thorough medical examination to rule out underlying problems that can cause nighttime cramps. If your leg pain persists during the day or occurs when you exercise or is associated with heat, swelling, or persistent tenderness in the calf, see your doctor as soon as possible. Leg pains during exercise can sometimes signal hardening of the arteries. Heat, tenderness, and swelling in the calf can signal inflammation of veins called thrombophlebitis.

To stop a routine nighttime cramp, stretch and massage the cramping muscle. For a calf cramp, grab your forefoot and pull it towards your knee. Try massaging the muscle with a kneading, up-and-down motion (since the muscle runs lengthwise), and take an analgesic, such as aspirin, acetaminophen, or ibuprofen, to reduce soreness. Walking the cramp off by placing your full weight on your heels is another good method. You also might try sitting in a hot bath or using a heating pad or cold pack on the affected muscles.

UAB physicians offer these additional steps you can take to reduce the likelihood of getting nocturnal leg cramps:

• Sleep on your side to avoid pointing your toes downward.
• Avoid tucking in blankets and sheets too tightly at the bottom of the bed.
• Consider an extra blanket over your legs to keep your muscles warm.

Also, try stretching your legs daily 5 to 10 times before bedtime. Stand facing the wall with your feet about 2 feet from the wall and slightly apart. Lean against the wall with your hands, keeping your heels on the floor. Stand far enough away from the wall to get a good stretch in the calf and arch of the foot. Do a steady stretch for about 1 minute.

If the problem persists, see your physician.