Avoid Pesky 'Charlie Horse' Cramps At Nighttime With This Hydration Hack
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Picture this: You’re lying in bed, *just* about to fall asleep, when your leg starts to cramp. The contractions, the twisting, the spasms, ugh! Naturally, you start to wonder, what causes leg cramps at night?
A leg cramp is an involuntary, often painful, contraction also referred to as a muscle spasm, or “Charlie horse,” says Arlesia Jones, DO, a primary care physician at Methodist Le Bonheur Healthcare. It typically feels like the muscle is twitching or quickly tightening, and you may be able to see the affected area contracting, she says.
Most people experience cramping in the calves, which usually lasts anywhere from a few seconds to several minutes, says James Chen, MD, an orthopedic surgeon at DISC Sports and Spine Center. “Since the muscle is under a sustained contraction, you may experience immobility and pain, and the muscle will feel firm.”
But why are leg cramps more common at night? “The simple answer is that most of us have been active throughout the day and have a higher likelihood of experiencing muscle fatigue at night,” says Dr. Chen. Plus, because you’re immobile at night, this may decrease circulation which increases your chances of cramping, he adds.
Ahead, doctors share the 10 most common causes of leg cramps at night, treatment options, and how to prevent the discomfort from happening in the first place.
Meet the experts: James Chen, MD, is an orthopedic surgeon at DISC Sports and Spine Center who specializes in hip and knee total joint replacement. Arlesia Jones, DO, is a primary care physician at Methodist Le Bonheur Healthcare. Laura Purdy, MD, is a family medicine physician and the medical director and founder of SMed.
What is muscle cramping a sign of?
The short answer to this question is “it depends” since there’s no single, universal cause of cramps, says Dr. Chen. For example, leg cramping may be a sign of dehydration, electrolyte imbalance, nutritional deficiencies, muscle fatigue, poor blood flow, nerve compression, and/or medication side effects, he says. Other conditions—like weight and hormone changes experienced during pregnancy, diabetes, kidney disease, and thyroid conditions—can also increase the risk of leg cramps, he adds.
It’s worth noting that leg cramps are *not* the same as restless leg syndrome (RLS), says Dr. Jones. “Restless leg syndrome is not painful, and it presents as an urge to move the legs, while leg cramps are painful and do not last as long as symptoms associated with restless leg,” she explains. RLS is also a neurological condition that feels like a tingling, crawling, itching, or twitching sensation that improves with movement, adds Laura Purdy, MD, a family medicine physician and the medical director and founder of SMed.
What causes leg cramps at night?
1. You're dehydrated.
Leg cramps may be caused by dehydration if you don’t drink enough fluids throughout the day, says Dr. Chen. The dehydrated-induced cramps are often caused due to inadequate electrolyte intake or reduced blood flow to the muscles, he explains. Other symptoms of dehydration include dark urine, dry mouth, and dizziness, so it’s crucial to drink about 11.5 cups (2.7 liters) of fluids a day, per Mayo Clinic.
2. You have poor circulation.
Conditions such as peripheral vascular disease can lead to leg cramping since it limits blood flow to the extremities and causes poor circulation, says Dr. Jones. Peripheral vascular disease can be a complication of diabetes, high blood pressure, and smoking, and other symptoms include cold feet, discoloration of the feet, slow wound healing in the legs, and a tingling sensation in the feet, adds Dr. Chen. If you suspect you have peripheral vascular disease and/or experience any of the associated symptoms, check in with your doc.
3. Your muscles are fatigued.
You may experience leg cramps at night due to overuse or high activity during the day, says Dr. Purdy. For example, crushing a workout or running a big race can lead to cramping in the overworked muscle fibers, per a study in Current Sports Medicine Reports. Other symptoms of muscle fatigue include muscle aching, soreness, and stiffness, but light stretching and adequate hydration can help limit the risk of cramping post-workout, adds Dr. Chen.
4. You're pregnant.
Pregnancy comes with a slew of bodily changes, but leg cramps are a common symptom, says Dr. Jones. The exact cause of your cramps may be due to related changes in blood circulation, weight gain, and hormonal fluctuations as your body adapts, she explains. That said, the fetus may also be placing pressure on your blood vessels and nerves which can cause cramping, according to the American Pregnancy Association. If cramping persists or worsens, talk with your ob-gyn.
5. Your medications may be to blame.
Certain blood pressure medications like diuretics can cause leg cramping since they often lead to dehydration and electrolyte imbalances, which further increases the frequency of cramps, says Dr. Chen. Cramping may also be a side effect of chemotherapy and/or radiation, adds Dr. Jones. Stopping the medication may not be possible but talk with the prescribing doctor about your symptoms in case there is a lower dose or alternative drug.
6. You slept in an awkward position.
It happens to the best of us, but if you sleep with your legs twisted, crossed, or contorted, it may lead to leg cramps, says Dr. Purdy. These cramps are typically not a cause for concern, and sleeping in a different position or gentle stretching can squash the issue.
7. You didn't do a proper warm up.
You’ve likely heard it before, but warming up pre-workout is non-negotiable, says Dr. Jones. Why? An improper warm-up and poor stretching (or not stretching at all) can lead to tight muscles which may induce cramping, she explains. To keep your muscles long and limber, try a dynamic warm up before your next sweat sesh.
8. You live a sedentary lifestyle.
Sitting at a desk all day is sometimes unavoidable, but a sedentary lifestyle can lead to stiff and weak muscles which is a common culprit of leg cramping, says Dr. Jones. Plus, prolonged sitting can cause buildup of fluid in the legs which can cause an uncomfortable crampy sensation, adds Dr. Purdy. To counteract the negative impacts of sitting, go for a daily walk and incorporate resistance training into your routine at least three days a week.
9. You're dealing with nerve compression.
Leg cramps at night may be caused by a compressed nerve in the lumbar spine (the lower back) or along the peripheral nerve (the nerves branching out from the brain and spinal cord), says Dr. Chen. Other symptoms of nerve compression include a radiating tingling or burning sensation down the leg, muscle weakness, and a change of normal reflexes, so visit your doctor ASAP if you experience any associated symptoms, he adds.
10. You have a nutritional deficiency.
Believe it or not, leg cramps may be an indication of a nutritional deficiency, says Dr. Purdy. More specifically, a deficiency in vitamin B, potassium, and/or magnesium may be to blame, she adds. It’s always best to talk with your doctor before taking a nutritional supplement, but a diet rich in nuts, seeds, beans, leafy greens, sweet potatoes, fruit, and peas can help keep your levels in check.
How To Treat And Prevent Leg Cramps At Night
Need relief from leg cramps? Drink plain water, coconut water, or an electrolyte beverage such as Gatorade or Pedialyte, says Dr. Jones. Yellow mustard and pickle juice may also do the trick to calm contracting muscles thanks to the acetic acid, sodium, and potassium contents, she adds.
Gentle stretching and light massage can also resolve cramps to help relax the involuntary contractions, and applying heat to the affected area or taking a warm bath may alleviate some of the discomfort, says Dr. Purdy. It’s also best to avoid tight bedding that may restrict leg movement or keep your feet in a stationary position, she adds.
Magnesium supplements can prevent and ease leg cramps, but it’s always best to consult with your doctor before taking any supps since magnesium can negatively interact with existing medications, says Dr. Jones. The required daily dose of magnesium varies on age, gender, and size, but most people need roughly 200 to 400 mg per day, explains Dr. Chen. Just remember, too much of anything can be dangerous, so talk with a professional before self-dosing magnesium, he adds.
Lastly, do your best to get regular exercise throughout the day to boost circulation and condition the leg muscles to reduce the likelihood of fatigue and cramping at night, Dr. Chen says.
When To See A Doctor For Leg Cramps
Leg cramps aren’t always a cause for concern, but if your cramps become frequent, severe, and/or begin to disrupt your daily activities and ability to sleep, it’s time to visit your doctor, says Dr. Chen.
Additionally, if your cramps are accompanied by a radiating burning or tingling sensation down the legs, discoloration of the skin, cold feet, or swelling, talk with your healthcare provider, adds Dr. Chen. From there, they can determine the underlying cause and prescribe the appropriate treatment.
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