How Nocturnal Leg Cramps Are Keeping Me Awake

Some painful facts about nocturnal cramps

Photo by Clem Onojeghuo on Unsplash

It is 3 a.m. I suddenly get up with severe pain and knotting up of muscles on the outer part of my right lower leg, below the knees. I clutch my legs, not knowing what to do. Next, I try everything possible to release this spasm of the muscles. I hop out of bed, still groggy from sleep 😴 , and start jumping around like a jackrabbit. Hearing the commotion, my wife gets up and asks,

“ What’s wrong, dear?”. “ I think I got severe cramps,” I say and tell her to continue her sleep.

After walking a bit, the cramp is released, and I try to catch up on my lost sleep. But I don’t get any more quality sleep. I keep on shifting positions. Finally, I get out of the bed and start thinking about writing something- something on cramps and get up. I put the kettle on the stove and brew a glass of strong coffee. Later, while sipping coffee, I start writing…

I am sure many of you reading this article may have experienced this sort of cramps some time or the other. What causes these leg muscles to knot up? And what should you do about it? Let’s dig into the theory and reality of Nocturnal Cramps.

Common Causes of Cramps

Photo by Bulkan Evcimen on Unsplash

Note the above picture- you can see the calf muscle in the right 🦵leg bulking up. This is what happens in cramps, all of a sudden. So much so that you double up with severe pain. Now, in a simple cramp like that of the calf muscle, you can stretch your muscle as shown above- flex your toes upwards. And lo, your cramps disappear! But other cramps are not so easy to release.

Now let’s try and understand how and why cramps occur. For this, we will have to know what muscles are there in the whole leg. Here is the picture showing the whole anatomy of the leg

Source- Pinterest-https://pin.it/31gmK7w

If you observe carefully, there are some muscles in the legs, such as the -

• The biceps femoris
• The soleus
• The gastrocnemius
• The semitendinosus

These muscles are more prone to having cramps. Because they are used extensively for walking, running, squatting, kicking, etc.

What happens in these muscles to cause cramps?

Many theories are going around regarding the cramping of muscles. These are-

• Dehydration- this occurs mostly in those who exercise without drinking water. Marathon runners 🏃‍♂️ are the most to suffer. I used to get this while playing cricket 🏏. Also, when I was working on my farm in broad sunlight where I used to lift and carry crates of vegetables for more than 50 meters, weighing 20 kgs each, and I used to get cramps in both legs at night. Takeaways- drink water before starting and after exercise.
• After exercise, when you do not stretch while cooling off. Stretching your muscles is an important part of exercise after you finish it.
• Accumulation of lactic acid in your leg muscles.
• Lack of minerals like magnesium, potassium, and calcium in your diet.

Does getting cramps suggest you have some underlying illness?

Image by rawpixel.com

Yes, there are some chronic diseases like kidney failure, heart failure, etc. In chronic kidney disease [CKD], this occurs after dialysis.

I had seen my mother crying out with pain and cramps in the legs at night whenever she used to undergo dialysis.

In CKD, patients lack potassium and many more nutrients as their diets are restricted. The same goes for Heart Failure [ not heart attack].

Treatment of leg cramps

1.Stretching leg muscles.

According to an article in The Harvard Medical Education, proper warming up before exercising and stretching out after exercise can prevent cramps of the calf and other muscles of the legs.

2.Raise your legs

as shown below for few minutes to drain out the lactic acid accumulation in your muscles after a workout.

Photo by Artem Beliaikin from Pexels

If you observe in the picture above, the young lady is relaxing by keeping legs raised. This removes the accumulated lactic acid in the calves and the whole leg, too. Pictured above is also a tender coconut which the lady has been sipping. Tender coconut water contains lots of potassium- drinking this can also relieve cramps.

3. Stretch your leg muscles

As shown below, stretching legs are known to relax the muscles used in walking. Do it at the end of your walking/ jogging/ exercise session.

Photo by Allan Mas from Pexels

4. Stand up and walk when you get cramps of legs

According to Dr. Hope Ricciotti, a doctor from Harvard Medical Education-

Once a cramp starts, getting out of bed and standing on the affected leg may abort it. Using ice or heat and gently massaging the affected muscle may provide some relief.
— by Hope Ricciotti, M.D., and Hye-Chun Hur, M.D., M.P.H.

This is exactly what I do when I get a cramp. This gives me almost instant relief.

5. Avoid caffeine and alcohol

According to Dr. Hope, having coffee or alcohol can also cause dehydration. I have experienced this too. But this is limited to some people only. The majority may not experience this sort of dehydration.

6. Medicines 💊 and supplements-

• Having a muscle relaxant like Chlorzoxazone, thiocolchicoside before going to bed can help relax calf muscles.
• Adding a pain killer like ketoprofen and tramadol can get you a sound sleep. This is my personal experience.
• Having tonic water that contains Quinine Sulfate is known to help prevent cramps. Those having heart disease should avoid this drink.
• Vitamins and mineral tablets containing calcium pantothenate, magnesium sulfate, potassium are known to help prevent cramps.
• Liniments and rubefacient ointments to rub and massage the calf muscles will help to relax them. Soak your legs in warm water before applying these medicines. Here is an interesting article by author Kate Green Tripp to drive home this point.

Finally, I suggest that you should consult your family physician for procuring these medicines and not use it on your own unless you are a doctor yourself. Here is one interesting article from Harvard Medical education on how to prevent cramps.

Conclusion-

In this article, I have shared all I know about nocturnal cramps. If you have any more suggestions, kindly share them with me and others reading this article.