Night-time leg cramps are sudden, painful tightenings of a muscle, usually in the calf or foot, that come on at rest or during sleep. They last from a few seconds to several minutes and can leave the muscle sore the next day. They are very common in older adults and in the later months of pregnancy, they are usually harmless, and stretching is the simplest treatment with reasonable evidence behind it.
Also known as nocturnal leg cramps, calf cramps, charley horse
Anatomy: where the problem is
Side view of the lower leg. Highlighted in the diagram: calf muscle (gastrocnemius) and deep calf muscle (soleus).
Symptoms
- A sudden, painful tightening of the calf, foot or thigh muscle
- A hard, knotted feeling in the muscle
- Cramps that come on at rest or wake you from sleep
- Each cramp lasting seconds to about ten minutes
- Tenderness in the muscle for up to a day afterwards
Causes and risk factors
- Often no cause is found
- Increasing age
- Pregnancy, especially the last three months
- Hard or unaccustomed exercise
- Some medicines, including some water tablets, statins and inhalers
- Conditions such as kidney disease, thyroid problems, diabetes and nerve or circulation problems
What the evidence says helps
- Stretching helps. In a randomised trial in older adults, stretching the calves and hamstrings before bed for six weeks reduced both the number and the severity of night cramps.1
- Magnesium supplements are unlikely to help. A Cochrane review found they made little or no difference to cramps in older adults, and the evidence in pregnancy was unclear.2
- Quinine reduces cramps a little, but it can cause serious side effects. It is not recommended routinely and is only prescribed when cramps are severe and other measures have failed.3
- For cramps in pregnancy, a Cochrane review found it unclear whether any supplement works, so stretching and general measures are the first step.4
Things you can try at home
- During a cramp, straighten the leg and pull the toes up towards the shin, or stand and press the heel down
- Massage the muscle and walk around once the cramp eases
- Stretch the calves for a few minutes before bed each night
- Keep bedclothes loose at the foot of the bed so that your toes are not pushed down
- Stay active during the day and drink enough fluid
- Ask your GP or pharmacist whether any of your medicines could be contributing
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A swollen, warm, tender calf, especially in one leg only: get same-day medical help, as this can be a blood clot
- Leg pain or swelling with breathlessness or chest pain: call 999
- Cramps with muscle weakness, numbness or wasting: see your GP
- Cramps that are frequent, severe or disturbing your sleep despite stretching: see your GP
- Calf pain that comes on with walking and eases with rest: see your GP, as this can be a circulation problem
- Cramps in pregnancy with a swollen, painful leg: contact your midwife or GP the same day
How Apollo can help
Most cramps do not need treatment beyond stretching and simple changes, and we will tell you if that is all you need. If cramps are frequent, we look for things that may be contributing, such as calf tightness, foot and ankle mechanics, a change in activity or footwear, and we check for signs of a nerve or circulation problem that your GP should review. We can show you an effective stretching routine and, where appropriate, a calf strengthening programme.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
What causes leg cramps at night?
In most people no single cause is found. They become more common with age and in pregnancy, and can follow hard exercise. Occasionally they are linked to medicines or to conditions affecting the nerves, circulation, kidneys or thyroid.
Does magnesium help leg cramps?
Probably not. A Cochrane review found that magnesium made little or no difference to cramps in older adults. It is unclear whether it helps in pregnancy. Speak to a pharmacist, GP or midwife before taking supplements.
How do I stop a leg cramp quickly?
Stretch the cramping muscle. For a calf cramp, straighten the knee and pull your toes up towards your shin, or stand and push your heel into the floor. Gentle massage and walking around afterwards help the soreness.
References
- Hallegraeff JM, van der Schans CP, de Ruiter R, de Greef MHG (2012). Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. Journal of Physiotherapy 58:17-22. View source
- Garrison SR, et al. (2020). Magnesium for skeletal muscle cramps. Cochrane Database of Systematic Reviews 2020. View source
- El-Tawil S, et al. (2015). Quinine for muscle cramps. Cochrane Database of Systematic Reviews 2015. View source
- Luo L, Zhou K, Zhang J, Xu L, Yin W (2020). Interventions for leg cramps in pregnancy. Cochrane Database of Systematic Reviews 2020. View source
- NHS. Leg cramps. NHS website, accessed November 2026. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
