Few things are more frustrating than being woken up in the middle of the night by a sudden, painful cramp in your calf or foot. These involuntary muscle contractions—often called “charley horses”—are surprisingly common, especially in adults over 40. While the pain usually subsides after a few minutes, nighttime leg cramps can interfere with sleep and leave soreness the next day.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we see many patients who deal with this recurring problem. Understanding why leg cramps happen at night is the first step toward finding relief.

What Are Nighttime Leg Cramps?

Nighttime leg cramps are sudden, intense tightening of the muscles—most commonly in the calves, feet, or thighs. Unlike restless legs syndrome (which causes an urge to move but not pain), leg cramps are painful spasms that can last from seconds to minutes. Afterward, the muscle often feels tender or tight.

Common Causes of Nighttime Leg Cramps

1. Dehydration

When the body doesn’t have enough fluid, electrolytes like sodium, potassium, and magnesium become imbalanced. This disrupts normal muscle function and increases the likelihood of cramps, particularly at night when circulation slows.

2. Electrolyte Deficiencies

• Magnesium: Critical for muscle relaxation. Low magnesium levels are strongly linked to cramping.
• Potassium: Helps regulate nerve signals to muscles. Deficiency can trigger spasms.
• Calcium: Plays a role in muscle contraction and relaxation; imbalances may contribute to cramping.

Through our functional medicine evaluations, we often uncover nutrient deficiencies that explain why cramps keep occurring.

3. Poor Circulation and Vein Disease

Leg cramps can sometimes be a sign of chronic venous insufficiency, where blood has trouble returning from the legs to the heart. This condition also causes leg swelling, heaviness, and varicose veins. At Sheen Vein, we frequently perform vascular testing to determine if circulation problems are contributing. Learn more about our vein treatments.

4. Medications

Some medications can increase the risk of leg cramps, including:

• Diuretics (water pills)
• Statins (cholesterol-lowering drugs)
• Certain blood pressure medications
• Asthma medications

5. Prolonged Sitting or Standing

Muscles that are overused during the day, or that remain in one position too long, are more prone to cramping at night.

6. Nerve Compression

Back problems like a pinched nerve or spinal stenosis can irritate nerves that supply the legs, leading to cramping.

7. Underlying Medical Conditions

Conditions such as diabetes, thyroid disease, and liver or kidney issues may increase the likelihood of cramps.

How to Prevent Nighttime Leg Cramps

At Sheen Vein (Aesthetics and Functional Medicine), we recommend a multifaceted approach:

Stay Hydrated

Drinking enough water throughout the day helps prevent fluid and electrolyte imbalances that trigger cramps.

Stretch Before Bed

Gentle calf and hamstring stretches before bedtime can reduce nighttime spasms. A simple stretch: stand facing a wall, place one foot behind the other, and lean forward to stretch the calf.

Support Nutrient Balance

• Magnesium supplements or magnesium-rich foods (leafy greens, nuts, seeds) can help.
• Potassium from bananas, sweet potatoes, and avocados supports muscle health.
• Adequate calcium intake strengthens both bones and muscle function.

Improve Circulation

• Elevate your legs for 10–15 minutes in the evening.
• Regular exercise improves blood flow.
• If vein disease is present, treatments such as sclerotherapy or laser vein therapy can address the underlying issue.

Adjust Medications if Needed

If cramps began after starting a new medication, speak with your provider about alternatives or dosage adjustments.

Optimize Sleep Position

Sleeping with slightly bent knees or avoiding prolonged pointing of the toes can reduce calf cramp frequency.

Functional and Regenerative Medicine Options

Beyond lifestyle measures, we also use advanced therapies to support muscle and vascular health:

• Red light therapy with PEMF: Improves circulation, reduces inflammation, and supports cellular recovery in muscles.
• PRP/PRF treatments: Enhance tissue repair and recovery in patients with chronic cramping linked to injury or poor circulation.
• Hormone optimization: Balancing thyroid or sex hormones can sometimes reduce muscle symptoms.

When to Seek Medical Evaluation

Occasional leg cramps are common and usually harmless. However, you should seek professional care if you experience:

• Frequent or severe cramps disrupting sleep
• Cramping associated with swelling, redness, or warmth in the leg
• Muscle weakness or numbness
• Signs of vein disease, such as varicose veins or chronic leg heaviness

These may point to a deeper vascular, neurological, or metabolic condition that needs treatment.

Final Thoughts

Nighttime leg cramps can feel like a minor annoyance, but for many patients, they are a signal that the body needs attention—whether that’s hydration, nutrients, circulation support, or medical evaluation.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we take a root-cause approach to leg cramps, combining vascular expertise with functional medicine to provide lasting relief.

👉 If leg cramps are disrupting your sleep, call our office today to schedule a consultation and find a personalized solution.

‍