Leg cramps are nasty whenever they occur. Leg cramps at night are even worse. That’s because they can strike without any notice. You can be fast asleep one moment and the next be writhing in agony. Sadly, neither health professionals nor the Food and Drug Administration have come up with effective treatments. Maybe that’s because nocturnal leg cramps have not been perceived as worthy of research dollars.
Leg Cramps At Night Are Serious!
On a scale of 1 to 10 of health problems, leg cramps may not seem like such a big deal. They’re certainly not as dangerous as heart disease or diabetes. But nighttime leg cramps can be extremely painful and disruptive.
Many people get them so often that they can’t get a good night’s sleep. Lack of sleep often leads to next-day drowsiness. Sleep deprivation can also impact concentration, memory and mood. Immune function can be affected increasing susceptibility to infection.
When you can’t get a good night’s sleep on a regular basis there are even more serious consequences. A recent review noted (Nature Medicine, Dec. 2017):
Sleep deprivation is a major source of morbidity with widespread health effects, including increased risk of hypertension, diabetes, obesity, heart attack, and stroke. Moreover, sleep deprivation brings about vehicle accidents and medical errors and is therefore an urgent topic of investigation.”
All of a sudden leg cramps at night are a big deal. Doctors have no FDA-approved medications to treat this painful condition that can have such serious long-term health ramifications.
Stories from Readers About Leg Cramps At Night:
Here are just a few stories from readers to illustrate how serious this problem can be and the lengths people go to for relief. One reader wrote:
I have a history of severe leg cramps that could last up to two hours. Both my husband and I lost a lot of sleep when I woke us both, screaming in pain.
“The first solution was a ‘karate chop’ my chiropractor taught my husband to do on the calf because nothing else would stop it at the time. The alternative was crying and screaming for hours. I’ve had primary care doctors tell me, ‘It’s just a cramp. It will go away.’ They have never had such severe pain as I experienced.
“Later, I took quinine and that was a good solution for me for years. The FDA banned it, so I had to switch to tonic water. It is probably the bitterness of the tonic water that stopped the cramps.
“Neither soap nor mustard worked for me, but pickle juice gave relief in less than a minute. I tried those after reading your newsletters.
“I almost never have cramps as severe as I had thirty years ago because I am very proactive. I don’t allow myself to become dehydrated. I make sure I don’t strain my calves by standing on tip-toe. I also take action at the least hint of an impending cramp, any tiny pain or twinge so I can head off a painful wakening in the night.
“With all this, I usually avoid most cramps. Recently, though, I had cramps threaten every night for over a week. My primary care doctor has me taking potassium gluconate and magnesium glycinate. That solved the problem quickly. The pickle juice I prefer is natural Bubbie’s Pickles with a cloudy ‘mother’ floating around in it, made the old-fashioned way.”
Another reader shared this painful story:
I too have suffered severe leg cramps off and on for over 15 years now. I have them 4 to 5 times a night for a week straight. Then, all of a sudden they go away, only to come back weeks or a month later.
“I have never felt such pain as when the cramping begins in my inner thighs and radiates to my hamstrings. I cannot walk when this happens, but I certainly cannot stay still in bed. Somehow, I get up and try stretching, only to cry out loud with the pain. I have had them in toes, feet, ankles and thighs.”
What Causes Leg Cramps At Night?
Health professionals have come up with some interesting explanations for nocturnal leg cramps. Here are just a few of the purported triggers:
Over-exertion of leg muscles is frequently trotted out as a reason for nighttime cramping. In our opinion this is nonsensical. Most of our readers report that they are lying in bed peacefully sleeping when out of the blue a leg cramp strikes. Many of these folks are older individuals who have not been running marathons or climbing mountains during the day.
Standing or Sitting Too Long:
Other common explanations blame daytime activities or lack thereof. Some health professionals say that if you stand too long on hard floors you will get leg cramps. Others say too much sitting is the cause. If these reasons were true, why do the cramps come on at night when people are sleeping instead of during the day when people are sitting or standing?
Dehydration and/or Electrolyte Imbalances:
We suspect that dehydration and electrolyte imbalances are the most often cited contributors to leg cramps at night. Health professionals and victims of exercise associated muscle cramps (EAMC) frequently blame cramps on not enough fluids or a lack of potassium or magnesium or both.
Athletes and Muscle Cramps:
It seems logical to blame muscle cramps on dehydration and electrolyte imbalances. The only trouble with these explanations is that the data don’t support them. Elite athletes are like canaries in the coal mines. That’s because they exercise much harder than the rest of us. They also have been carefully studied.
Over two decades ago exercise physiologists from South Africa challenged traditional theories about muscle cramps (Journal of Sports Sciences, June, 1997):
Scientific evidence in support of the ‘electrolyte depletion’ and ‘dehydration’ hypotheses’ for the aetiology of EAMC [Exercise Associated Muscle Cramps] comes mainly from anecdotal clinical observations, case series totalling 18 cases, and one small (n = 10) case-control study. Results from four prospective cohort studies do not support these hypotheses. In addition, the ‘electrolyte depletion’ and ‘dehydration’ hypotheses do not offer plausible pathophysiological mechanisms with supporting scientific evidence that could adequately explain the clinical presentation and management of EAMC.”
You have no doubt seen elite athletes fall down in extreme pain brought on by muscle cramps. It could be a basketball player paid millions of dollars to win a championship game or a sprinter in the Olympics. These incredibly fit individuals have high-priced trainers who are diligent about preventing both dehydration and electrolyte imbalances.
An experiment conducted on ultra-marathoners who ran a 56 km race demonstrated that neither dehydration nor electrolyte imbalance accounted for muscle cramping (British Journal of Sports Medicine, Aug. 2004).
The results of our study do not support the common hypotheses that EAMC [exercise associated muscle cramping] is associated with either changes in serum electrolyte concentrations or changes in hydration status following ultra-distance running. An alternative hypothesis to explain the aetiology of EAMC must therefore be sought.”
An Alternative Explanation for Leg Cramps at Night:
Exercise physiologists and sports medicine experts have come up with a completely different explanation for muscle cramps. We think it is much more plausible (British Journal of Sports Medicine, June, 2009).
There is a growing body of evidence to suggest that the mechanism for muscle cramping has a neuromuscular basis. Firstly, as has been discussed, voluntary muscle contraction or stimulation of the motor nerve can reliably cause muscle cramping. Secondly, there is evidence from experimental work in human subjects that stimulation of the 1a afferents through electrical stimulation or using the tendon tap (activating the 1a afferents) can induce cramping”
OK, that’s complicated. But it boils down to “altered neuromuscular control.” That means problems with the connections between nerves and muscles. When muscles are fatigued and/or nerves are overstimulated or damaged, cramping can occur. This would explain why people with type 1 diabetes who experience nerve dysfunction are also very susceptible to muscle cramps (Clinical Neurophysiology, Jan. 2018).
Why Home Remedies Work for Leg Cramps at Night:
Why have we bored you with all this scientific gobbledygook? Because we think it explains how so many home remedies work so fast to end muscle cramps.
A study published in Medicine and Science in Sports and Exercise (May 2010) proved that swallowing a little pickle juice could terminate muscle cramps. The effect was so fast that it could not be explained by restoration of body fluids or electrolytes.
We now know that strong flavors like pickle juice, mustard, quinine, capsaicin (the hot stuff in hot chili peppers), ginger and cinnamon stimulate specialized nerve TRP (transient receptor potential) channels in the mouth, throat and stomach.
Stimulating these TRP channels can stop muscle cramps in their tracks (Muscle & Nerve, Sept. 2017). We suspect that this works whether the muscle cramp is brought on by fatigue due to exercise, electrical stimulation, medications or nerve damage caused by diabetes (Muscle & Nerve, Sept. 2017). Some people may just be more susceptible to problems with the nerve-muscle connections.
Don’t Believe Us? How About A Harvard Professor:
We had an opportunity to interview a world class neuroscientist at Harvard University. Bruce Bean, PhD, is a professor of neurobiology. He and his Nobel-Prize-winning colleague, Rod MacKinnon, MD, figured out the underlying cause of muscle cramps and came up a surprising treatment. You can listen to Dr. Bean’s interview at this link. The streaming audio (green arrow) and mp3 downloadable file are free:
Read the scientific explanation behind yellow mustard for leg cramps at night at this link:
Remedies for Leg Cramps at Night:
Remedies that people have used with varying success include swallowing a teaspoon of yellow mustard, drinking a few sips of pickle juice or tonic water and holding a bar of soap next to the cramping muscle. Read some stories from readers:
Blanche in Greensboro, N.C. found a cheap way to counteract cramps:
I keep the small packets of mustard that you get with take out sandwiches on my bed stand. I don’t relish the thought of swallowing mustard in the middle of the night, but it’s easier than trying to get to the kitchen and the cramp is gone in about a minute.”
Jackie and her brother use different strategies:
My brother and I have both suffered from painful night cramps in our feet, calves, and inner thighs. He drinks pickle juice to stop the cramping.
“I take another approach: I prevent the cramps from starting in the first place by drinking tonic water. I used to get cramps all the time, but now I never do. About 4 to 6 ounces of diet tonic per day does the trick for me. Perhaps there’s a neurological effect. Whatever the mechanism, this is an approach that other cramp sufferers might want to try.”
Lyn in Waxhaw uses soap:
Rather than experience the unpleasantness of swallowing pickle juice or mustard, I much prefer holding a bar of soap where the cramp is. It works in about two seconds for me. I keep the soap on my bedside table. It’s wonderful.
“From what I’ve read on People’s Pharmacy before, it’s the fragrance of the soap that makes it work. So if I think it’s not working as well as before, I replace it with a fresh bar, which I’m guessing may be every 6-12 months.
Read about the soap remedy at this link:
You can learn more about remedies for muscle cramps in our book, Quick & Handy Home Remedies. This book is filled with kitchen table wisdom that offers simple solutions for common ailments.
Share your own experience for leg cramps at night in the comment section below.