Sudden sharp pain in calf while sleeping

What Are Nocturnal Leg Cramps?

Nocturnal leg cramps are a tight, knotted feeling in your legs that happens at night. They can last several seconds to several minutes. If the cramp is severe, your muscle may be sore for days.

Leg cramps are different from restless legs syndrome. Both tend to happen at night, but restless legs syndrome causes discomfort and an urge to move instead of painful muscle cramps.

As much as they may hurt, leg cramps are harmless.

Nocturnal Leg Cramps Causes and Risk Factors

Experts don’t know the exact cause of nighttime leg cramps. They could happen because your nerves send the wrong signals to your muscles. For example, your brain might mistakenly tell your leg to move while you dream. That confuses your calf muscles and causes them to contract.

You’re more likely to have a leg cramp if you:

  • Are 50 or older
  • Work your muscles too much
  • Sit too long without moving
  • Don’t drink enough water
  • Stand too long on hard surfaces

Other health conditions can also raise your chances of leg cramps, including:

  • Diabetes
  • Neurological disorders like Parkinson’s disease
  • Alcohol abuse
  • Low blood sugar
  • Some hormone disorders, such as hypothyroidism
  • Too much or not enough of certain chemicals in your body, such as calcium, potassium, and magnesium
  • Flat feet
  • Pregnancy
  • Blood flow problems
  • Nerve damage

Some medications can cause leg cramps. These include:

  • High blood pressure drugs
  • Statins to treat high cholesterol
  • Drugs for chronic obstructive pulmonary disease (COPD)

Nocturnal Leg Cramp Diagnosis

If you often have severe leg cramps, talk to your doctor to be sure another problem isn’t causing them.

They’ll ask about your medical history and your symptoms. They’ll also do a physical exam to look for possible causes. You might have blood tests if your doctor suspects a hidden problem.

Treating Nocturnal Leg Cramps

The next time a leg cramp strikes, try some of these tips:

  • Stretch the muscle.
  • Get out of bed and stand with your foot flat on the floor. Press down firmly.
  • Massage the muscle.
  • Flex your foot.
  • Grab your toes and pull them toward you.
  • Ice the cramp.
  • Take a warm bath.

Your doctor might give you medications such as diltiazem (Cardizem), diphenhydramine (Benadryl), or verapamil (Calan, Verelan). But they don’t always work, and they can have harmful side effects. For example, experts used to use the anti-malaria drug quinine for leg cramps. Doctors and the FDA no longer recommend it because it can also cause severe bleeding and problems with your heart rhythm.

Nocturnal Leg Cramp Prevention

Some simple things you might keep you from getting cramps:

  • Stretch during the day and before bed. Focus on your calf and foot muscles.
  • Drink plenty of water.
  • Move around during the day to exercise your feet and legs.
  • Wear comfortable, supportive shoes.
  • Sleep under loose covers, especially if you sleep on your back.

More than just a break from the challenges of the day, sleep helps the body heal and better deal with life’s daily stresses. If you experience calf pain at night, a full measure of shut-eye may prove elusive. Here are some common causes of calf pain at night, along with suggestions to prevent and relieve it.

What are the different types of calf pain at night?

Lower leg pain at night is different for everyone who experiences it. Even if the causes are the same, the types of pain you feel may vary from person to person (and even from night to night!).

Three common types of calf pain at night include:

  • Leg cramps
  • Muscle soreness
  • Referred pain from other conditions

Leg cramps at night (a.k.a. charley horses)

You likely know how these cramps feel. They can last for a few seconds or stretch on for agonizing minutes.

Leg cramps occur when the gastrocnemius muscle of the calf spasms involuntarily. In addition to pain, this typically feels like your calf muscles are tight or knotted and can be so severe as to make it hard to flex your feet. About 60% of people experience nocturnal leg cramps at some point in their lives.

Muscle soreness

Muscle soreness is another very common type of lower leg pain at night.

We may not even realize it’s there until we turn out the light and lay down. Muscle soreness has many causes and can range from mild and fleeting to severe and debilitating.

Referred pain from other conditions

Referred pain is pain that does not necessarily originate from the calf itself but the calf is affected by it at night.

Lower leg pain in this instance may be a result of injury to another part of the body that forces the calf to compensate all day, resulting in soreness at night. For example, sciatica is a common cause of referred calf pain at night.

Why does calf pain at night happen?

Calf pain at night may be fleeting, or it may occur regularly. For those who regularly experience lower leg pain at night, there are a few common calf pain at night causes to look for, including:

  • Dehydration
  • Pregnancy
  • Sciatica
  • Shin splints
  • Parkinson’s disease
  • Deep vein thrombosis (DVT)
  • Varicose veins
  • Diabetic neuropathy
  • Torn or strained Achilles tendon
  • Injuries

Note that you should always talk to your doctor if you’ve been experiencing calf pain at night for an extended length of time, or if it becomes severe enough to limit your overall quality of sleep.

Dehydration

The simplest cause to remedy and one that is often overlooked, dehydration can cause leg cramps at night (and at any other time of day).

If you’re dehydrated, you may feel tired and your urine may be dark yellow (instead of the pale straw color of proper hydration). Muscles in all parts of the body may cramp and feel tense.

Pregnancy

Add pain in the legs at night to the long list of ways that pregnancy can make you uncomfortable!

The additional weight of a growing baby causes the arches of the feet to flatten a bit, forcing your calf muscles to work harder. This can create muscles soreness that you notice at night when you lay down to rest. Many pregnant women also experience sciatica in the lower legs as the baby grows and compresses the sciatic nerve.

Sciatica

Sciatica is a common cause of pain in the legs at night. The sciatic nerve is the longest and widest nerve in the body, originating in the lumbar spine and traveling across the buttocks and down the hips to end in each foot.

Any injury along the length of this nerve can result in referred pain anywhere along its length (including the calf). In addition to pain, calf pain at night caused by sciatica may be accompanied by tight muscles and restricted movement and numbness or tingling.

Shin splints

Shin splints affect the front of the calf and occur when the muscles and the tendons on the shins are overworked. The resulting inflammation can be painful, especially at night.

Simple activities like walking on flat ground may be restricted by painful shin splints.

Parkinson’s disease

Parkinson’s disease is a neuromuscular disease that has, as a primary symptom, involuntary muscle contractions. These contractions can affect any muscle group in the body, including the lower legs.

Deep vein thrombosis (DVT)

Deep vein thrombosis is a serious medical condition that can be fatal.

If you have long periods of inactivity (i.e., during a long flight or car ride), blood clots can form in the lower leg and travel through the blood stream to the lungs. This could cause a fatal pulmonary embolism. Treat this as a serious medical emergency, especially if you’re feeling other pulmonary embolism symptoms.

Varicose veins

Varicose veins occur when the walls and valves of your veins weaken and expand, sometimes due to age and sometimes as a result of another condition.

You can see these larger veins clearly at the surface of the skin as twisted, sometimes raised, and deep purple. If you have varicose veins and are on your feet throughout the day, you may experience an aching soreness in your lower legs at night.

Diabetic neuropathy

Nerves all over the body are damaged by continually fluctuating blood sugar levels that come with diabetes.

Diabetic neuropathy is a common complication that causes pain in the lower legs at night, following by tingling sensations and finally numbness.

Torn or strained Achilles tendon

Often the first indication of an Achilles tendon tear or strain (tendinitis) is pain in the calf. This can feel like soreness and quickly change into a stabbing pain in the lower leg whenever the foot is moved.

Other injuries

Strains, sprains, and broken bones in the legs can all result in calf pain at night that ranges from a dull ache to a sharp pain.

Sudden sharp pain in calf while sleeping
people, health care and problem concept – unhappy senior man suffering from knee ache at home

When should I see a doctor about calf pain at night?

If you are experiencing calf pain at night that seems unrelated to minor muscle overuse or that changes over time, talk to your doctor.

While it may be easily related to an underlying medical condition, it is possible that lower leg pain at night could be a symptom of something serious. At a minimum, talking to your doctor about calf pain at night can set your mind at ease and help you get a good night’s sleep.

Note that new calf pain after long periods of inactivity or travel can be caused by a blood clot, and this is an emergency medical situation that requires immediate attention. If your regular doctor is not immediately available, go to the nearest emergency room for treatment.

Of all of the causes of calf pain at night, there is one that is very simple to treat: dehydration. Ensuring that you get adequate amounts of water during the day for your body and activity level is crucial and is an easy treatment for pain caused by an electrolyte imbalance.

For all other conditions that can cause calf pain at night, here are some treatment options, broken down by each cause.

Pregnancy

In many cases, leg cramps at night will resolve themselves shortly after the baby is born. As long as there is no threat of blood clot, sometimes leg and foot massages can help relieve muscle soreness.

Some expectant mothers report good pain relief (and better sleep) when they use a transdermal magnesium spray, stretch regularly, and use a heating pad to relax tight, sore muscles.

Sciatica

The best way to treat calf pain at night caused by sciatica is to treat the underlying condition.

If a herniated disc is causing sciatic pain that extends into your calf, treating that may immediately relieve your pain. Otherwise, physical therapy and stretching can relieve pain, as can regular exercise.

Shin splints

Shin splints are best treated with a period of rest and ice, as well as the proper use of NSAIDs for pain and inflammation.

To prevent shin splints from occurring, proper stretching and warm-ups are important. Additionally, wearing supportive, properly fitted shoes can help exercise safely and in comfort.

Finally, you may need to reevaluate your training program. Shin splints often occur after you increase your mileage or distance when running or walking. If you’re suffering from severe pain, you may need to decrease your training program or switch to a few weeks of low impact exercise instead.

Parkinson’s disease

Treating lower leg pain in Parkinson’s patients is all about managing this progressive disease while making patients as comfortable as possible.

For lower leg pain at night, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium can go a long way to relieve inflammation and pain. Other treatments like soaking in an Epsom-salts bath and gentle massage and stretching can also help to prevent calf pain at night.

Deep vein thrombosis

Deep vein thrombosis is more likely in patients who are inactive and overweight. Important treatments for this include losing weight and increasing activity. If you need to be sitting for long periods of time, compression socks can help prevent clots.

Additionally, for those who are particularly at risk, medications like blood thinners may be in order. Talk to your doctor before travel or other long periods of inactivity if you have risk factors for this serious condition.

Varicose veins

Calf pain at night from varicose veins can be prevented with the use of support stockings during the day.

Additionally, alternating between standing and sitting can help to give your legs a rest. If the pain of your varicose veins becomes unbearable, talk to your doctor to explore other treatment options.

Diabetic neuropathy

The key to preventing calf pain at night caused by diabetes is to work hard to get your blood sugar under control.

The cause of diabetic neuropathy is nerve damage caused by fluctuating blood sugar levels. It makes sense that finding a balance in diet and medication can help prevent further damage. Work with your doctor to find that balance, and then follow your treatment recommendations going forward.

Torn or strained Achilles tendon (and other injuries)

For active people with tendinitis, torn Achilles tendon, or other injuries that lead to calf pain at night, the recommended treatment may be the hardest for them: rest. Activity can cause further inflammation and irritation to an already-inflamed and irritated muscle or tendon. Taking time off from vigorous activity gives the injury time to heal properly.

During the acute phase of injury, applying ice in a 20-minutes-on, 20-minutes-off schedule can provide relief and decrease inflammation. NSAIDs can provide temporary relief of pain and inflammation as well, but take care to follow directions for use. Long-term use of even over-the-counter NSAIDs can cause serious side effects. Depending on the severity of your injury, you may also need to consider physical therapy, braces, or surgery with your doctor.

Each cause of calf pain at night is as unique as the person experiencing it. If lower leg pain at night is keeping you up, it may be time to talk to a pain specialist. If you’re in Arizona, contact the team at Arizona Pain for more help with your calf pain at night. 

Why do I get a sharp pain in my calf at night?

A calf cramp is often called a “charley horse.” Cramps can be the result of dehydration or overexertion. A cramp might last for just a few seconds, but your muscle can feel sore for hours afterward. Leg cramps and calf muscle pain at night are very common.

When should I be concerned about calf pain?

See your doctor as soon as possible if you have: Signs of infection, such as redness, warmth or tenderness, or you have a fever greater than100 F (37.8 C) A leg that is swollen, pale or unusually cool. Calf pain, particularly after prolonged sitting, such as on a long car trip or plane ride.