night cramps

They are muscle spasms that occur primarily in the calf muscles behind the lower leg and in the small foot muscles on the bottom of the foot. It seems out of nowhere the attack will occur with pain ranging from mild to moderately severe. In some cases just staying in bed and allowing the spasm to run its course is enough. Others find that when a cramp occurs it can be so painful that it forces them out of bed in order to stretch the muscle and relieve the pain.

The cramp can last for a few minutes or as long as up to ten minutes. Once it has finished it is not uncommon to have another. Thus this condition can make for a very restless sleep. Muscle cramps should not be mistaken for restless leg syndrome.

The cramps particularly in the leg can be so severe that the muscle is tender the next day.

Most muscle cramps occurring in the foot and leg are known as idiopathic, (unknown origin). The general principle of muscle is that if it is overstretched it will tend to go into spasm. So, sometimes if a patient has spent the day doing a lot of activity they be more prone to night cramps during the evening.

For most people, these types of cramps are an irregular occurring problem but there are some, especially older individuals who are more prone to regular bouts.

As stated, cause for leg-foot cramps have no origin other than from overstretching of the muscles during the day. There are however, some conditions which may cause muscle cramping:

• Some medicines can cause cramps as a side-effect, or make cramps occur more often. These include: diuretics (water pills), nifedipine, cimetidine, salbutamol, terbutaline, lithium, clofibrate, morphine (withdrawal), phenothiazines, and nicotinic acid.
• Dehydration
• Conditions that cause alterations in the balance of salts in the bloodstream (such as a high or low sodium or potassium level).
• Some people who have renal (kidney) dialysis get leg cramps.
• Pregnancy - usually in the later stages.
• An untreated under-active thyroid gland.
• peripheral vascular disease (narrowing of the leg arteries which causes poor circulation).
• Cirrhosis of the liver is a rare cause.
• Lead poisoning.
• Sarcoidosis.
• Rare disorders of nerves.
• Excess alcohol.

Avoiding night cramps may be possible by modifying life style or looking at other medical issues and better controlling them.

There are many simple treatments for this type of cramps, some work better than others, so some experimentation may be necessary. These include:

• Magnesium- this mineral helps your muscles relax. Take 500mg twice a day, just be careful because it may cause diarrhea in some people. Natural sources of magnesium include whole grains, wheat germ, nuts, seed, seafood and low-fat dairy products.
• Potassium- low levels of potassium will cause muscle cramping. Rather than take potassium supplements (too much potassium can cause heart problems) try getting your potassium from foods like grains, beans, fruits, vegetables, lean meat, fish and poultry.
• Stretching-for occasional simple night cramps, stretching and massaging the muscle is all you need.
• Quinine-taken either as a pill or as quinine water every evening has been proven to be very beneficial in the treatment of night cramps. This is contraindicated in women who are pregnant or contemplating pregnancy as quinine has been used over the years in abortion.
• Vitamin E- 800iu daily can be very effective in reducing night cramps. Note that vitamin E should not be taken by people who are on anti-coagulant therapy as vitamin E has a tendency to thin blood.

For those who like to try home remedies here are two for you:

1. Put a piece of silverware such as as spoon right on the cramp. The spoon does not have to be sterling; stainless steel is fine.

2. Pinch your philtrum, which is the area between your nose and upper lip, until the cramp is gone, which should take no more than a few seconds.

Children, especially prepubescent, are especially prone to night cramps in the legs. The problem here is that skeletal development is faster than muscle development so all of a sudden in a fast growing child, the muscles of the legs become too "short" for the legs and during the course of the day they are overstretched and then at night they will go into spasm. This is also commonly referred to as "growing pains". This seems to be more prevalent in children who pronate excessively. In an over-pronatory individual the leg muscles are forced to over-work during the gait cycle compared to someone who does not excessively pronate.

Typically the child will have spent the day either in the playground or at the mall doing a lot of walking, many times complaining to their parent that they want to sit down because their legs ache. Then at night the legs will go into spasm and generally can be a very uncomfortable experience.

If the child exhibits excessive pronation we generally put them in orthotics. By reducing the pronatory phase of their gait cycle we can keep the leg muscles from overworking and like magic, the pain goes away, including the night cramps. Children's orthotics are a great way to solve this common problem.

The remedies described for adults generally do not work very well in children.

More muscle strain information.

REFERENCES

Mayo Clinic

Harvard Health

Cleveland Clinic

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