How to eliminate nocturnal leg cramps

@brucerocheleau
I am sorry to hear your condition. I am 75 yo male and do have occasional cramps. I am still play pickleball and walk frequently but not in the same day when playing pickleball. I hate taking medicine for everything. My condition appeared to be alleviated by changing my habits. I drink more during the day time, even in the evening. Cutting down on my alcohol consumption. Unfortunately, drink more in the evening caused me to waking up during the night to urinate. Also, I found it quite helpful after walking or any exercise is doing stretching, especially the lower extremities, legs and toes. My bad habit is watching night games on TV after supper for hours without moving. I am trying to break that. I believe try to stretch about an hour before going to bed may help. Hope this helps. Good Luck and Good Health!

Thanks for the ideas. I tend not to drink enough fluids during the day so I will endeavor to hydrate better. That is a possible contributing factor to my cramps.

Hi Bruce,

I used to get these cramps at night in my hamstrings mostly, sometimes extending to my calves so my legs are in very painful cramps.

I had an MRI, thinking this may be caused by sciatic nerve compression. My lumbar spine is a disaster area - stenosis, scoliosis, listhesis, severe disc degeneration and arthritis spurs. I am in the gym everyday and my strong core is protecting my lower back - well, so says my surgeon.

The MRI revealed something interesting - my lower back muscles were too tight and likely causing these sporadic cramps. I added in some lower back stretches and the problem is pretty much gone.

You can search for lower back stretches and try some if you'd like. A favorite of mine is to simply lie on my bed, or floor, and pull one leg at a time up to my chest, wrapping my arms around the lower leg.

I have also used "dry needling" to relieve tension in my lower back muscles. The procedure is nearly painless in spite of the name and, in my case, instantly effective.

Hope this helps Bruce!

Joe

@heyjoe415 thx Joe. This is interesting. I also have lower back trauma. I was crushed in a car accident in 1975 and my pelvis was broken in 7 places and I had hairline fractures in a number of vertebrae.
The left leg (hip knee and ankle) were also badly damaged and it that leg that gives me a lot of nocturnal grief.
I’ve wondered if it’s vascular (hydration), muscular (electrolytes) or nerve damage or maybe the perfect storm?
I will certainly try your suggestions and I thank you for taking the time to share your experience.

You're very welcome Lorry - and I'm so sorry for what you've been through.

Have you seen an orthopedic specialist or a neurologist? That's probably where I'd start.

Another suggestion - some Drs, usually as part of an orthopedic group, used to go by the name "Dr of Sports Medicine". That seems to have been replaced with the less specific but more useful "Dr of Physical Medicine". I have such a Dr, and she has helped me solve problems my PCP couldn't handle. She has referred me to other specialists, but I did get the help I needed.

Your injuries are complex, and so may require a knowledgeable "generalist" who can pinpoint problems and get you to the right specialist.

Hope that helps, and I hope you get some relief.

Joe

I know the feeling. We will try anything to relieve the pain or prevent it. I put salon pas patches where I usually get the leg cramps before going to bed. I know it only masks the pain but I’m fine with that as long as it prevents the midnight dance.

Here is some accurate information from a particular study about what is most probably happening with the information you have provided:

I’m really sorry you’ve been going through all of this — especially after already dealing with a staph infection and years of symptoms that must have been frightening and frustrating. What you described with the B6 toxicity is very real; B6-related nerve irritation can cause many of the symptoms you mentioned (tingling, burning, clumsiness, visual disturbances, tremor, “hot feet,” etc.), and unfortunately it can take months for the excess B6 to clear from the system and for the nerves to calm down.

What’s tricky is that once you stopped the magnesium supplement (which contained the B6), the original issue—nighttime cramps—came right back. Even with “normal” magnesium on blood tests, people can still get cramps because blood levels don’t always reflect what’s happening inside the muscles.

A few things that people with similar experiences have found helpful:

1. Try a magnesium form that contains no B6.
Some tolerate magnesium glycinate or magnesium citrate without any B6 added. Even 100–200 mg before bed can help if your body responds to magnesium.

2. Check ferritin (iron stores)
Not just hemoglobin. Low-normal ferritin can trigger severe nighttime cramps and restless legs–type symptoms.

3. Peripheral nerve irritation from the old B6 toxicity:

Even though your levels are dropping, irritated nerves can cause the muscles to “misfire” at night. That can take 3–12+ months to settle. Some people do physical therapy or gentle nerve-gliding exercises and notice improvement.

4. Try non-drug physical measures that help some people with stubborn cramps:

• Warm foot bath before bed.
• Heating pad to calves/feet.
• Gentle calf and hamstring stretching.
• Massage or foam rolling.
• Wearing loose socks (helps some by reducing nerve irritability).
• Trying a topical magnesium (no B6).

5. Ask the doctor about prescription options for severe nighttime cramps
If it is disrupting sleep every night, some physicians consider:

• Gabapentin or pregabalin (for nerve hypersensitivity after B6 toxicity).
• Quinine alternatives (quinine itself is rarely used now).*
• Low-dose muscle relaxants at bedtime.
These are not for everyone, but you don’t have to suffer night after night.

6. Consider getting an EMG/nerve conduction study.
Since you had real B6 toxicity and ongoing neurological symptoms, testing can help confirm whether the nerves are still irritated and guide treatment.

You are not imagining this, and you're not alone — B6 toxicity can absolutely cause lingering neurological effects that make cramping much worse, even long after you stop it. The good news is that many people do improve over time once levels normalize, but it can be slow and they sometimes need help managing symptoms during recovery.

I really hope you get some relief soon. You’ve been dealing with more than enough.

@tommy901 thank you for taking the time to record all of this relevant and useful information.

It’s 11 months now since I stopped taking the magnesium with 25mg of B6 and my B6 blood levels have dropped from a frightening 1670 back to within normal range (at 60).

I avoid pharmaceutical ‘solutions’ wherever possible as my experience is that they often solve one problem and create another.

Our bodies are amazing if given good food, fresh air and regular exercise.

It was necessary to resume magnesium (with nothing added) to relieve the nighttime cramps. The fact that it predominantly affected my damaged foot and calf makes me suspect inflammation and vascular issues are also contributing factors.

I did notice that low heart rate severely affected leg cramps. Possibly why they are nocturnal as that is when heart rate usually drops. I took medication to slow my heart in preparation for an angiogram and spent most of the night dancing around with severe leg cramps (both legs!). So low blood pressure - caused by low heart rate or dehydration or vasodilation due to use of a muscle relaxant (such as Valium) which I thought would relax cramps but made them worse (which I attribute to their vasodilation effect) - is also a factor.

Exercise is a tricky balance of getting enough movement without creating inflammation.

My ataxia (unsteadiness) has improved but many peripheral neuropathy symptoms persist. Eyesight and slow memory retrieval (once something I could do at lightening speed) is particularly frustrating. I continue to read and research to stimulate neural pathways (and keep myself busy and satisfied that breathing is not a waste of time).

I do feel I am trending in the right direction despite the fact that time itself is a negative factor.

Kind and informative support from people like yourself, and others in this group, have supported and added to my own ideas, observations and solutions.

We are creating our own valuable, wide ranging case study here.

I sincerely thank you for being part of it.

Australian
Age 73
Normal BMI
Healthy resting heart rate
Healthy blood pressure
Average fitness (not an athlete nor gym user)
Lifetime non-smoker

@lorry Thank you so much for taking the time to write all of this so clearly. Your observations, reasoning, and the way you’ve tracked your symptoms over time are incredibly valuable — not just for yourself but for everyone reading along. It’s encouraging to hear that your B6 levels have come down so dramatically and that you’re finding a balance with magnesium that actually helps the cramps without causing new problems.

You’ve pieced together a very sensible understanding of the factors at play: vascular changes, the effects of heart rate and blood pressure, the timing of cramps, and how medications like beta-blockers or muscle relaxants can sometimes have the opposite effect of what we’d expect. Your experience with the heart-rate-lowering medication causing a night of severe cramping is especially insightful — it’s the kind of detail that rarely shows up in textbook explanations but means a lot in real life.

Your comments on inflammation, movement, and the delicate balance of exercise are spot-on. It’s clear you’ve learned your own body very well, and that’s something many people struggle to do. The fact that some symptoms have improved while others persist is understandably frustrating, but it truly does sound like you’re moving in the right direction, even if the trajectory isn’t as fast as anyone would wish.

I’m really glad to hear your ataxia has eased, and I completely understand how difficult the memory and vision changes can be. Your determination to keep reading, researching, and engaging your mind says so much about your resilience. Those efforts absolutely matter.

Thank you as well for your kind words. Being able to share ideas back and forth — and to support each other with what we’ve learned — is exactly what makes these communities meaningful. You’re contributing just as much as you think others are contributing to you.

Wishing you continued improvement, steadier days, and fewer long nights with cramps. And thank you again for sharing your story so generously.

Hi crn,

I don't know what is causing your nighttime leg cramps. I used to get those in my hamstrings, and the cause was extremely tight, knotted low back muscles.

I've tried stretching with some relief. Recently I tried dry needling (some sessions are approved by Medicare for the lower back). Dry needling provided significant relief for lower back stiffness, and allows me to get a better stretch for my lower back. And despite the name, dry needling isn't painful. There is slight discomfort when the therapist gets a twitch response out of a muscle, but that's what is supposed to happen.

Not sure if this would help you. Just a suggestion. Be well!

Joe