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Foot pain

Night Time Leg Cramps

The legs are undoubtedly the hardest working part of the body. It has to bear the weight of most of the body and contend with impact during walking. Naturally there are many symptoms that will arise in the legs. One such condition is night time leg cramps. In the strict sense it is a symptom but since most of the time the cause is unknown, it is often considered as a condition on its own.

Night time leg cramps mainly involve the calf muscles of the lower leg. However, the feet and even the thigh muscles may sometimes be affected as well. Muscles of the legs contract and relax at will but with cramps, the contraction is involuntary, painful and sustained. It is more correctly known as muscle spasm.

Although spasm of any muscle is not uncommon, with night time leg cramps it can be very painful and affect normal sleep patterns.


Most cases of night time leg cramps occur for no clearly identifiable reason. It is believed that muscle strain during the day inevitably leads to symptoms such as pain and spasm during periods of rest, like at night while asleep. However, night time leg cramps have also been seen as a symptom in people with known circulatory and nerve disorders of the legs, as well as with hormonal changes in women.

With regards to circulatory problems, night time leg cramps may occur in a condition known as peripheral arterial disease (PAD). In this condition the blood supply to the legs by the way of the arteries is impaired.

The artery is abnormally narrowed usually due to the build up of fatty plaques in its wall, known as atherosclerosis.

The reduction in blood flow is not so much of a problem when a person is standing. Gravity allows for the blood to be pulled downwards. However, when a person walks, climbs stairs or runs, the blood supply is insufficient to meet the higher metabolic demand of the muscles. When lying flat, the benefit of gravity is negated. Therefore a person may experience pain and cramps at night.

Hormonal changes particularly in pregnancy and with menopause may in some way contribute to night time leg cramps. This has also been noted in women who take oestrogen medication. However, the exact mechanism is not fully understood.


Night time leg cramps is a symptom on its own and is not a disease. In most instances there are no other symptoms present. When the cramping is severe the calf muscles may feel like a hard ball.

Since these muscles control the movement of the feet, there may also be abnormal alignment of the feet during the cramping.

However, when night time leg cramps occurs with conditions like peripheral arterial disease (PAD) then other symptoms may also be present. The ankles and feet may have a paler colour, hair on the legs may fall off and the feet may feel colder to touch. Skin ulcers may form in severe cases and even muscle weakness may arise over time.


Since night time leg cramps is a symptom and not a disease, the treatment depends on the underlying cause. However, in the majority of cases the cause cannot be identified. Common measures that help with any muscle spasm in general may therefore be useful. Apart from rest and stretching exercises, heat can be very effective in not only treating but also preventing cramps.

Heat applications are available in various different forms. Heat therapy eases muscle spasm and improves blood circulation the area. Any external source of heat may be used but it is most effective when it is placed against the skin. Given the dangers of sleeping with a hot water bottle and power utilisation with an electric blanket, a wheat bag or heat pad may be the safer and more cost effective option. It can be placed directly under the calf muscles to treat existing cramps or prevent night time leg cramps.

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