Leg cramps are common and usually fleeting and harmless. They can affect any part of your leg, including your feet and thighs, but calf cramps are the most common. Leg cramps while you’re sleeping at night account for three out of every four cases. However, leg cramps can occur at any time, usually when you’re resting.
After a leg cramp has passed, your leg may feel tender, sore or painful for a few hours.
In most cases, the cause of leg cramps is unclear, although certain medications and diseases can cause leg cramps. You can reduce your risk of leg cramps by performing regular exercises to stretch your leg muscles. If you regularly have leg cramps and all other treatment approaches are unsuccessful, you may be prescribed quinine tablets.
Leg cramps occur when a leg muscle spasms ie suddenly contracts too strongly. This causes muscle pain and can make your toes and feet stiffen and consequently make it difficult to move your leg. Leg cramps can last from several seconds to 10 minutes.
Calf muscle cramps are the most common type of leg cramps — they affect the muscle below your knee that runs along the back of your lower leg. However, thigh cramps and cramps in your feet can also occur. Thigh cramps usually last the longest.
Once your leg cramps have passed, you will be able to move your leg and control the affected muscle again. However, your muscle may feel tender, sore and painful for up to 24 hours, particularly if you have severe leg cramps.
What causes calf cramps or leg cramps varies but your risk increases with age. Straining your muscles during exercise, especially in hot humid weather, can cause leg cramps, as can drinking too much alcohol.
Certain health conditions can also cause leg cramps — these are called secondary leg cramps. In some cases, no cause can be identified — these are called idiopathic leg cramps.
The exact cause of idiopathic leg cramps is unknown, hence the name. However, there are several theories as to what causes them, including:
Other risk factors for idiopathic leg cramps include:
Secondary leg cramps are caused by another health condition or underlying issue. This includes lifestyle factors, such as:
Health conditions that can trigger secondary leg cramps include:
Other health conditions that can cause secondary leg cramps include:
If your kidneys are not working properly and you are being treated with renal dialysis (clearing waste products from your blood by passing your blood through a special machine), you are also at greater risk of leg cramps.
Pregnant women have an increased risk too due to the extra strain placed on their leg muscles as their weight increases.
Certain medications can cause leg cramps in a small minority of people who take them. These medications include:
If you’re concerned that your medication is causing leg cramps, speak to your doctor. They may be able to adjust your dosage or suggest alternative medications.
Leg cramps are common and if you only have them occasionally, you don’t need to see your GP for a diagnosis.
You should see your GP if:
They will perform a physical examination of your legs and ask you about your symptoms and medical history. If you have symptoms such as numbness or swelling, you may have an underlying condition that is causing your leg cramps. Your GP may, therefore, refer you for further tests (eg blood and urine tests) to rule out other conditions.
You should call your GP urgently or call 111 if:
The most effective remedy for leg cramps is usually to exercise your legs — this can both stop and help prevent leg cramps.
If you are pregnant you will likely stop having leg cramps after your baby is born.
If your leg cramps are caused by an underlying condition, treating that condition may resolve your leg cramps. For serious liver disease, this can be difficult, however, you may be prescribed muscle relaxants to help with your leg cramps.
If you have idiopathic leg cramps ie where the cause is unknown, exercise and painkillers can help.
Home remedies for leg cramps involve stretching and massaging your affected muscle and applying heat (eg a hot towel or hot water bottle, taking a warm bath or shower). These can all reduce your pain and discomfort during a cramp, although cramps will usually go away by themselves anyway.
To massage your leg muscles, use one or both hands to gently knead the muscles. This will help loosen them up.
To properly stretch your leg muscles, there are several exercises you can try:
Stand on a step with the front half of your feet on the step and the back half (your heels) hanging off it. Now, gradually lower your heels below the level of the step and hold this position for several seconds. Then lift your heels back up to the level of the step. Repeat this several times.
With your leg straight, bend your ankle so that your foot lifts upwards and your toes point towards your shin. Hold this position for several seconds and then bend your ankle back down so your foot is at 90 degrees to your lower leg. Repeat several times.
Walk around on your heels for several minutes to activate the muscle on the fronts of your lower legs (tibialis anterior), which will consequently relax your calf muscles. Make sure you have a clear path, free from any obstacles or trip hazards.
Stretching your leg muscles regularly can reduce how often you have leg cramps and/or how severe they are but may not completely stop them. It can take at least a week of daily exercises before your leg cramps lessen so try a two to four week exercise programme.
Make sure you stretch your leg muscles before bedtime and after exercise. You can try the exercises listed above (under ‘Treating leg cramps during a cramp’) as well as the following wall exercise.
Stand about one metre away from a wall, keep the soles of your feet flat on the floor and lean forward to touch the wall with outstretched arms. Hold this position for five seconds and then come away from the wall. Repeat this exercise for five minutes.
In addition to stretching out your leg muscles before bedtime, it helps to adjust your sleeping position.
If you sleep on your back, ensure your toes are pointed upwards. You can prop the soles of your feet up against a pillow at the end of your bed to help with this. Alternatively, you can place a pillow under your knees, which will bend them up slightly and help keep your toes pointing upwards. If you sleep on your belly, dangle your feet over the edge of the bed to help prevent your calf muscles from contracting and tensing.
Make sure your bed sheets and blankets are loose so you can move freely at night.
Stay hydrated by drinking lots of fluids and adjusting how much you drink depending on your activity levels, the weather and whether or not you are taking certain medications.
Try some gentle exercise on a stationary bike before bedtime — pedalling can loosen up your leg muscles.
Wear supportive footwear especially if you have flat feet — this will help avoid aggravating any nerve or muscle issues in your legs.
Medication is usually only needed for leg cramps that do not get better with exercise. Painkillers can be taken to reduce tenderness and soreness after a cramp but won’t provide any relief during a cramp as the painkillers won’t start working until after the cramp has passed.
Quinine for leg cramps
Quinine is the main medication prescribed for persistent leg cramps that don’t resolve with exercise. However, it’s not suitable for everyone and your GP will therefore assess whether it is safe and appropriate for you, as well as explain the risks.
Quinine was first used to treat malaria but also can reduce how often leg cramps occur. Side effects of quinine include:
If you are prescribed quinine by your doctor, always follow the dosage recommended and never take more than this. Overdosing on quinine can cause blindness and death.
Given the risks associated with quinine, your doctor will only prescribe it for your leg cramps if there are significant benefits for your life that outweigh the risks. They will, therefore, only prescribe quinine if:
You will receive a four-week prescription of quinine. If your leg cramps do not improve in those four weeks, you will no longer be treated with quinine.
Other medications for leg cramps
Although magnesium for leg cramps and other medications, such as diltiazem, naftidrofuryl, orphenadrine, verapamil, vitamin B complex and vitamin E, have been tried to treat leg cramps, they are not recommended. This is because studies show they are not effective in most people.
However, if quinine doesn’t work to resolve your leg cramps or you experience serious side effects, your doctor may suggest trying one of these medications.
How do you stop leg cramps fast?
Leg cramps usually don’t last any longer than 10 minutes. However, during this time you can ease your leg cramps by exercising, specifically stretching out your leg muscles. You can also try massaging your leg muscles and/or applying heat using a hot towel or water bottle, or by taking a warm bath or shower.
What causes leg cramps in bed?
You may have leg cramps in bed at night if you sleep with your knees slightly bent and your toes pointing downwards. This shortens your calf muscles and makes cramps more likely. You may also have nighttime leg cramps if you spend the day standing up for a long time.
Can leg cramps be a sign of something serious?
Leg cramps are not usually a sign of something more serious. However, if you have persistent leg cramps, leg cramps that last longer than 10 minutes, leg cramps alongside swelling or numbness, or your leg cramps are affecting your quality of life, you should see a doctor. Blood poisoning, tetanus infection and certain diseases (eg liver disease, thyroid disease) can all cause leg cramps.
What is the best vitamin for leg cramps?
There is currently no clear evidence that vitamin deficiencies cause leg cramps. However, some people find taking vitamin B1 or vitamin B12 helps. Speak to your doctor before taking any vitamin supplements to make sure you don’t take more than the recommended daily allowance.
What is your body lacking when you have leg cramps?
Leg cramps are usually caused by strained or tense leg muscles. However, in some cases dehydration, which lowers your salt levels (eg low sodium and potassium levels), can cause leg cramps.
What can I drink for leg cramps?
Staying hydrated is important as dehydration can cause leg cramps. So make sure you drink enough fluids, such as water or juice. Do not drink alcohol to hydrate yourself as alcohol will dehydrate your body. Similarly don’t drink too much coffee, as caffeine can, in excess, cause dehydration.
How can I stop my legs from cramping at night?
Make sure you stretch your leg muscles before bedtime and try to sleep in a position that does not tense up your leg muscles. If you sleep on your back, keep your toes pointed upwards by either placing a pillow under your knees or placing the soles of your feet flat against a pillow at the end of your bed. If you sleep on your front, dangle your feet over the edge of the bed.
Can too much sugar cause leg cramps?
In people with type 2 diabetes, muscle cramps are more common both when blood sugar levels drop too low or rise too high. High blood sugar levels trigger the body to get rid of the excess glucose, which is removed via urine alongside water and other salts. This results in dehydration which causes muscle cramps.
Can leg cramps be a sign of blood clots?
Throbbing or cramping pain in your leg can be a sign of a blood clot if it occurs alongside redness, swelling and warmth in your leg. If you experience these symptoms call 111.
Does drinking water before bed prevent leg cramps?
If the cause of your leg cramps is dehydration, drinking water before bedtime can help.
Can B12 deficiency cause leg cramps?
Some people with a vitamin B12 deficiency sometimes have muscle cramps, including leg cramps.
Does magnesium help leg cramps?
Magnesium has been tried to treat leg cramps but studies show it is not effective for most people. However, in persistent or severe cases of leg cramps where exercise and quinine treatment are ineffective, your doctor may suggest trying magnesium.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.
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