Leg Cramp Causes … and What You Can Do

Cramps of any kind are annoying, at best, but they can be downright painful, especially when they happen at night when you’re trying to sleep. Leg cramps are particularly bothersome, and when they occur, they can indicate a range of possibilities, from something as simple as not drinking enough fluids to more serious issues such as neuropathy. Read on to learn more about leg cramps and how you can stop them in their tracks!

What causes leg cramps?

Leg cramps can happen for a number of reasons.

Charley horse (muscle spasm)

A charley horse is another name for a muscle spasm, and it most commonly occurs in the legs (but it can occur in any muscle in the body). Muscle spasms in the legs, which can affect the thigh, calf, and feet muscles, can trigger all of a sudden and can be incredibly painful. Muscle spasms can occur when you overuse or injure a muscle. Things that might bring these on include

• Exercising when you haven’t had enough fluids (dehydration)
• Having low levels of potassium or calcium

Spasms in the calf can occur while kicking during swimming or running. Upper leg spasms are more common with running or jumping activities. Charley horses tend to happen when you’re sleeping, and the pain and discomfort wake you up.

Symptoms of a charley horse include muscle tightness, or a knot. Severe pain is also a symptom.


Stretches and massage can help relax the muscle. Try using your thumbs to apply pressure to the site of the spasm; standing up and standing on your tip-toes may help, too. Using a heating pad can also help relax the muscle, followed by an ice pack to help lessen the pain. If charley horses keep happening, talk with your health care provider about using an antispasmodic medication and/or physical therapy.

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Make sure to address the underlying cause of your charley horses so that they don’t keep happening. Staying hydrated, stretching before you exercise, and addressing certain medicines such as diuretics and statins with your provider can prevent or at least lessen the frequency of these spasms. What about taking potassium, magnesium, or calcium supplements? Talk with your provider before taking any supplements. But making sure to include food sources of these nutrients is certainly a good idea. Foods that might help prevent cramps include avocado, bananas, beans and lentils, milk and yogurt, leafy greens, and nuts and seeds.

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Peripheral neuropathy

Diabetes is a leading cause of neuropathy, which is damage or dysfunction of nerves, resulting in numbness, tingling, muscle weakness, and pain. Peripheral neuropathy (PN) is when nerves outside of the brain and spinal cord are damaged, and this type of neuropathy frequently affects nerves in the arms or legs. Long-term high blood sugars can lead to PN.

About 60% to 70% of people with diabetes have neuropathy, but this condition can also result from injury, kidney and liver disorders, autoimmune disorders, infections, medications, vascular problems, and alcoholism.

When PN occurs in the legs and feet, it can cause burning, tingling, pain, cramping, and spasms, and these symptoms can act up at night.


Pain and spasms from PN may require medication. Over-the-counter medicines, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDS), can treat mild to moderate pain. Prescription medicines may be needed. Antidepressants, such as nortriptyline and serotonin-norepinephrine reuptake inhibitors, work to help block pain signals in the brain. Other effective medications are those used for epilepsy, such as gabapentin, pregabalin, and topiramate. Topical creams and skin patches that contain lidocaine or capsaicin can be helpful, too.

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Non-medicine approaches that might be helpful include physical therapy, transcutaneous electrical nerve stimulation (TENS), which uses a low-level electrical current to disrupt pain signals, acupuncture, yoga, behavioral therapy, and medication. Some dietary supplements are thought to help with neuropathic pain, too, including alpha-lipoic acid, acetyl-L-carnitine, and vitamin B 12, but there isn’t a lot of evidence to support their use, and some supplements can lead to potentially serious side effects. Talk with your provider about what treatments would be best for you.


Aiming to keep your blood sugars and A1C levels as close to target as possible is the best way to prevent PN, along with other chronic diabetes complications. In addition, good foot care, not smoking, eating healthfully, and staying active may help, as well. For more information on PN, visit The Foundation for Peripheral Neuropathy’s website.

Peripheral artery disease

Peripheral artery disease (PAD) in the legs is the narrowing or blockage of arteries that carry blood from the heart to the legs, says the CDC (Centers for Disease Control and Prevention). PAD is primarily caused by the buildup of fatty deposits (plaque) in the arteries, called atherosclerosis. PAD can happen in any blood vessel, but it’s most common in the legs. Between 8 and 12 million Americans are affected by PAD.

Risk factors for PAD include:

  • High blood pressure
  • High cholesterol
  • Older age
  • Smoking
  • Diabetes

The main symptom of PAD is pain in the legs during physical activity, such as walking. Pain can occur in the thighs, hips, buttocks, or calves, and it generally goes away with rest. Other signs of PAD include muscle weakness, lack of hair on the legs, shiny skin, decreased or absent pulses in the feet, sores or ulcers on the legs or feet that don’t heal, and cold or numb toes. Left untreated, PAD can lead to a heart attack, heart disease, stroke, and amputation (especially in people who have diabetes).

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Early on, lifestyle changes can help treat PAD. These include regular exercise and controlling blood pressure and cholesterol. Also, an eating plan that is high in fiber and low in saturated fat and sodium can help. Stopping smoking is a must. Your provider may prescribe aspirin or other types of blood-thinning medication, and you may need medication to manage high blood pressure and high cholesterol. In some instances, procedures such as balloon angioplasty, atherectomy, or stents can help; surgery may be required to bypass blocked arteries.


Managing your blood sugars, blood pressure, and cholesterol levels is a key step in preventing PAD. Taking medication as prescribed, as well as eating healthfully, getting regular physical activity, and managing stress are important. Since tobacco is a major risk factor for PAD (and heart disease), seeking help for how to quit is a priority. Work with your provider and diabetes educator to come up with a treatment plan that’s best for you. For more information about PAD, visit the American Heart Association’s website.

Finally, be aware that leg cramps can include for reasons other than those listed above, including:

  • Older age, due to loss of muscle mass
  • Pregnancy
  • Other medical conditions, such as thyroid, kidney or liver disorders, spinal stenosis, osteoarthritis, and Parkinson’s disease

Let your provider know if you continue to have leg cramps so that they can help diagnose the cause. Also, keep in mind that stretching and strengthening the leg muscles can go a long way to prevent leg cramps.

Want to learn more about painful conditions of the legs? Read “Diabetic Leg Pain and Peripheral Arterial Disease” and “Controlling Neuropathic Pain.”


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About the Author: Tung Chi