It happens when you least expect it. You are in a deep, restful sleep hoping the night never ends, and then out of the clear blue sky of your blissful dream it hits you. The worst possible pain you have ever felt in your life hits you like a ton of bricks in the back of your calf and you sit bolt upright in bed stifling a scream. You don’t know what to do and you don’t want to wake the person next to you but the pain is scaring you to death and you feel as if your leg is going to rip right off your body. Leg cramps in the middle of the night affect about two-thirds of people over the age of 65 and create a long period of guess work trying to figure out why they came on and what to do to treat them. A gentleman who brings his wife to our office thanked me last week for the hernia column and asked if I would please look into the issue of leg cramps at night and I promised I would.
There are not very many true “experts” on the issue of nocturnal leg cramps. Information available ranges from “we don’t really know what causes them” to “advanced chemical testing to determine the deficiencies or disease processes in the body are required to make a definitive diagnosis”. I sifted through the fine sand and came up with a few interesting points.
There are many possible causes of nighttime leg cramps. As a chiropractor, I would be remiss if I did not suggest that the first stop along your journey to finding the cause of the cramps for you should be to make sure that you have no nerves being pinched. Having a nerve being interfered with will certainly make your muscles do strange things and nocturnal leg cramps is one of those things. Once you have made sure that your nervous system is in proper working order, check your prescription medications. Many medications cause an imbalance in chemicals in your body which regulate muscle contraction; potassium, sodium, magnesium and calcium, for example. If these chemicals are unbalanced your muscles might very well contract involuntarily. Some medications have among their possible side-effects “nocturnal leg cramps”. If this is true for you, consult the doctor who prescribed the medication and ask if there might be an alternative to that particular prescription. Your diet might not be providing good sources of the minerals that I mentioned before. If that is the case, find some foods that are rich in calcium and potassium and eat those foods. If you can tolerate dairy it is a good source of calcium. If you cannot, dark green leafy vegetables can provide it. Bananas provide a rich source of potassium. If you have a deficiency of these minerals and that is the cause of the leg cramps, your solution might be as simple as eating more mineral-rich foods. Another possible cause of nocturnal leg cramps is dehydration. If you are not taking in enough water for your body to be completely hydrated, your muscles will let you know it. Enough water is one half ounce per day per pound of your body weight. In other words, if you weigh 150 pounds, you need 75 ounces of water every day in order to be completely hydrated. Intake of caffeine and alcohol encourage tissue dehydration, so if you drink beverages that contain either of these you should add more water to compensate for it. Less commonly some diseases cause nocturnal leg cramps. Diabetes, anemia, and hypoglycemia (low blood sugar) are among some of the maladies which might be to blame.
Treatment is as varied as the causes seem to be for the problem. If the problem is caused by a mineral or vitamin deficiency, you must figure out a way to put what is missing back into your body. Eating foods that are mineral-rich or supplementing with the missing pieces will usually handle the problem easily. If a prescription medicine is causing the cramps, either stopping the medication or substituting another one will be beneficial. Never stop taking a prescribed medication without the advice of a medical professional, however. In some cases not getting enough exercise can cause the muscles to cramp, so exercise will help. If you are already exercising, you might not be stretching properly before and after you do. Be sure to stretch enough to warm up your muscles before you put demands on them. If you wake up and are in the middle of a horrible cramp, straighten out the leg that hurts and point your toes as far back toward your head as possible. You can also straighten the leg, loop a towel around your toes and pull them toward you. This will maximally stretch the calf muscle and offer some relief.
There are no simple answers to finding the cause of your nocturnal leg cramps. One source suggests that you make a list of all of the possible causes and eliminate them one at a time. This will at least help you to narrow the field of choices and you can take action on the remaining possible causes to get to the bottom of it. It will be a worthwhile effort for you and the person who sleeps next to you will be eternally grateful to you for it. Treat your body well.