Calf cramps are never fun. But they're especially unpleasant when they wake you up and disrupt your sleep.
Muscle cramps are sudden, uncontrollable muscle spasms that cause intense pain. Cramps that occur in the leg — often in the calf, foot or thigh — are sometimes called charley horses. And though they can hit any time, a whopping 75 percent of leg cramps strike at night, according to the Cleveland Clinic.
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So, why are the wee hours often prime cramping time? "It's not clear why leg cramping occurs more often at night," says Elana Clar, MD, a neurologist and movement disorders specialist at New Jersey Brain and Spine in Oradell, New Jersey.
But often, it's possible to pinpoint your tension trigger. Here are some of the most common causes of calf cramps at night and what you can do to cope.
1. You're Stressed
Yep, emotional tension can affect your muscles.
"Muscles reflexively tighten during stress, and the underlying problem with muscle cramps, including calf cramps, is sudden involuntary contractions that are often painful," Dr. Clar explains.
As a result, taking steps to manage your stress during the day may help minimize cramping at night. (These strategies from therapists can help.)
2. You're Dehydrated or Have an Electrolyte Imbalance
Too little water or not getting enough of minerals like potassium, calcium or magnesium can both affect muscle function, which can up the odds for cramping, Dr. Clar says.
Just one more reason to drink up throughout the day and make sure you're eating a balanced, nutrient-dense diet.
Tip
For a good general guideline on how much water you should drink each day, divide your body weight (in pounds) by 2. That will give you the number of ounces to aim for. So, for example, if you weigh 180 pounds, you should aim to drink about 90 ounces (or 11 cups) of water each day.
3. You've Been Working Out Too Hard
Regular physical activity is good for so many reasons. But pushing yourself to the limit can tire out your muscles, which can lead to cramping, Dr. Clar says.
Heavy exercise can also up the risk for dehydration or electrolyte imbalances if you're sweating buckets and not replenishing lost fluids, and that can also contribute to cramps.
4. You're Pregnant
Crampy calves probably won't be the first sign that you're pregnant. But as the baby grows and your weight increases, the extra strain on your muscles can lead to cramps.
In fact, up to 40 percent of pregnant people get leg cramps at night, per the Cleveland Clinic.
5. You've Been Spending Too Much Time on Your Feet
More time than usual spent on your feet or walking around might make your legs cramp up at night.
Excessive walking or standing (especially in unsupportive shoes) can lead to cramping for myriad reasons, according to the Mayo Clinic, especially if you're doing so in hot weather, which can be dehydrating.
6. It's a Medication Side Effect
Diuretics, which are often prescribed for high blood pressure, can cause the body to excrete excess potassium, calcium or magnesium and lead to calf cramping, the Mayo Clinic notes.
Other prescription meds list increased muscle cramps as a side effect too, including:
- Albuterol, used to treat lung diseases like asthma or bronchitis
- Estrogen therapy, often used to treat menopausal symptoms
- Gabapentin, which treats seizures and nerve pain caused by shingles
- Naproxen (Aleve)
- Statins, which treat high cholesterol
- Sleep aids like zolpidem (aka Ambien)
If you notice a new drug is making you cramp up, your doctor may be able to adjust your dose or switch you to a different prescription.
7. You Have Flat Feet
Having a low or nonexistent arch can cause foot pain and swelling that gets worse when you're active. And in some cases, that could lead to leg cramps, per Harvard Health Publishing.
Wearing the right shoes or orthotic inserts can give your arches more support and reduce your discomfort.
How to Stop a Calf Cramp at Night
Gentle stretching can help you find relief when a leg cramp strikes, says Dr. Clar.
Harvard Health Publishing recommends a simple calf stretch: Try sitting up and leaning forward toward your toes for a minute or two, or lean forward while standing against a wall and raising your heels off the ground.
If that's not enough, try massaging the area or applying a warm compress, Dr. Clar recommends.
Related Reading
Preventing Nocturnal Calf Cramps
Nighttime leg cramps can usually be managed with simple lifestyle changes, unless you have an underlying condition that needs to be addressed (more on those later).
Dr. Clar recommends doing the following:
- Stretch and move regularly. Stretching helps keep your leg muscles limber, so they're less prone to tensing up. A few minutes of gentle leg stretching before bed can make a difference, notes the Cleveland Clinic. And even gentle movement (think: walking, changing from sitting to standing and vice versa) will help keep your blood moving and your muscles more relaxed.
- Stay hydrated. Sip throughout the day to make sure you're meeting your fluid needs. When your muscles are hydrated, they're less likely to cramp.
- Reduce your caffeine and alcohol intake. Both can act as diuretics, which may contribute to dehydration.
- Avoid exercising in extreme heat. Heavy sweating can up the risk for dehydration and cause you to lose electrolyte minerals like potassium, calcium and magnesium. If you sweat heavily while working out, replenish your lost electrolytes with a sports drink.
- Wear comfortable shoes. Supportive, well-fitting footwear will keep you comfortable while you're on your feet and help minimize nerve compression in the spine, which can reduce the chance for cramping later on.
When to See a Doctor
Consistent leg cramps could be a sign of vascular problems, neurological disorders, poorly controlled diabetes or other serious health problems.
If your calf pains aren't easing up with at-home measures, or they're getting worse, call your doctor for an appointment, recommends Dr. Clar.
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Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.