Calf Wrestling: Nighttime Leg Cramps

I've been meaning to ask you this but keep forgetting. I got a strong reminder late last night when a muscle cramp in my calf made me cry out so loud all four cats leapt off the bed and were promptly chased all over the house by my confused dog. My leg cramps are not usually as bad as this, but I do get them quite often. Am I lacking a vitamin or something, or are they genetic (my dad gets them too)?
--Stephanie A.

Include the charley horse along with all the other animals in the room, and your house is a regular nocturnal petting zoo. I'm actually surprised that your question isn't about allergies. Regardless, I'm glad something finally reminded you to ask about your leg cramps before the four cats got together and e-mailed the newspaper veterinary columnist to complain about you and the dog.

These sudden, agonizing leg attacks are caused by an involuntary contraction of the hamstring muscle, sole of the foot and toes, or most commonly, the calf muscle. Nocturnal leg cramps seem to come from nowhere and can last for just a few seconds or up to an excruciating 15 minutes--the higher end serving as a little reminder for men what childbirth is probably like. Depending on severity, the resulting muscle soreness can actually cause difficulty walking for a day or two. The effect on bedroom animals, however, is strictly psychological.

A common notion that nocturnal leg cramps only affect the elderly does not take into account the abundance of pregnant women and athletes who suffer the same misery. Smokers, diabetics and those on certain drugs are also prone to these nighttime torments. Two interrelated causes, separate from health conditions or medications, are dehydration and/or electrolyte disturbance. Loss of fluids (from heat, exercise, alcohol or lackadaisical liquid consumption) can result in an imbalance of minerals salts like calcium, magnesium, sodium and potassium. These minerals are necessary for proper muscle function. Put too simply: calcium contracts muscle, magnesium relaxes it, and sodium and potassium set the trigger.

All very interesting, you say, but not much help during the midnight ordeal. Well, until I researched your question, my technique had always been to completely relax and let the charley horse progress from spike-studded tourniquet to eventual throbbing release. But proving me out-of-date once again, current medical advice now recommends you to follow your natural urge to fight: In the case of a calf spasm, pointing your toes and foot upward toward your knee--even grabbing them--and holding until you feel the muscle loosen, is said to more efficiently break the cramp and reduce next-day soreness.

Avoiding leg cramps all together is a better plan, albeit one more difficult to achieve. The traditional drug of choice, a muscle relaxant called quinine, has fallen out of favor. Research has not only shown the drug to be ineffective (despite years of anecdotal evidence), but the FDA has banned its use in over-the-counter medications due to side effects and concerns over birth defects and miscarriages. However, small amounts of quinine continue to be used as a flavoring for tonic water, but self-treating leg cramps with several gin and tonics before bedtime will likely fail to impress your doctor.

A non-alcoholic strategy for the cramp prone is a combination of proper hydration, diet and brief stretching. The most important of the three is to make certain you've had plenty of liquids during the day. Eating fruits and vegetables like bananas, tomatoes and potatoes, as well as drinking orange juice, can help maintain the proper electrolyte balance required for undisturbed sleep. Prior to bedtime, exhausting the muscle's stretch reflex with a quick exercise can also reduce the frequency and severity of the cramps. For calves and feet, stand (without shoes) with your toes on a stair or block and steady yourself with the banister or wall. Simply lower, and then raise, your heels to stretch your calf and foot muscles, holding a few moments at each extreme position. Additionally, loosening sheets and blankets at the foot of your bed helps keep your toes from pointing all night--another factor known to encourage a cramp ambush.

As far as genetics, there is no evidence that one gets the abrupt, tormenting early morning awakenings from their parents--that is, of course, unless you're 11 years old and late again for the school bus. With my own mom, it wasn't so much a leg cramp as leg clamp. I suppose if you have similar memories, that would account for sleeping with the watchdog in the room. But it still doesn't explain the cats.

Dr. Ed Rabin is a chiropractor practicing at Life Chiropractic Center in Boise. Send warm milk and health-related questions to theantidote@edrabin.com (on the Web at www.edrabin.com).