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What Causes Severe Leg Cramps At Night While Sleeping?
Question: I get severe leg cramps only at night while trying to sleep. They are mostly in the feet but often in the calf. I'm 75, exercise regularly and drink plenty of water during the day. I have recently been prescribed Gabapentin for a neurological problem. Anything I can do.
Thank you,
XXXXX
Thank you,
XXXXX
Brief Answer:
Read below.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
It might have been useful if you could have said something on other conditions you might have and other tests, you mention to have been recently prescribed Gabapentin for a neurological condition, but not what condition and how was it diagnosed, as it might well be the cause of the cramps, or the tests (like EMG and blood tests) might exclude some cramp causes as well.
Nocturnal leg cramps can occur in the setting of other diseases such as vascular disease, liver or kidney failure, stenosis of lumbar canal, peripheral neuropathy.
When they occur while going to sleep at times they are difficult to separate from restless legs syndrome in which predominates an irresistible urge to move or shake the legs, relieved by movement, so if you have such symptoms as well it could well be the cause.
In cases in which no other cause is found several treatments have been tried, but their success has been mixed. One treatment is Gabapentin which you have started, so you will see if that works for you.
Other alternatives if it doesn't are calcium channel blocking drugs like verapamil or diltiazem (but should consult your doctor because they influence your heart rate and blood pressure as well), muscle relaxing drugs like Carisoprodol, vitamin B12, magnesium.
Staying hydrated, exercising and stretching which you already mention to do are helpful as well.
I remain at your disposal for further questions.
Read below.
Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.
It might have been useful if you could have said something on other conditions you might have and other tests, you mention to have been recently prescribed Gabapentin for a neurological condition, but not what condition and how was it diagnosed, as it might well be the cause of the cramps, or the tests (like EMG and blood tests) might exclude some cramp causes as well.
Nocturnal leg cramps can occur in the setting of other diseases such as vascular disease, liver or kidney failure, stenosis of lumbar canal, peripheral neuropathy.
When they occur while going to sleep at times they are difficult to separate from restless legs syndrome in which predominates an irresistible urge to move or shake the legs, relieved by movement, so if you have such symptoms as well it could well be the cause.
In cases in which no other cause is found several treatments have been tried, but their success has been mixed. One treatment is Gabapentin which you have started, so you will see if that works for you.
Other alternatives if it doesn't are calcium channel blocking drugs like verapamil or diltiazem (but should consult your doctor because they influence your heart rate and blood pressure as well), muscle relaxing drugs like Carisoprodol, vitamin B12, magnesium.
Staying hydrated, exercising and stretching which you already mention to do are helpful as well.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry for not mentioning my other conditions:
2 years ago a triple by-pass;
Psoriatic arthritis;
Diabetes;
My meds are:
400 MG Gabapentin for CFS Cramp fasciculation syndrome and 100 mg Tegretol
Enbril, Celebrex and methotrexate for arthritis
Metformin and Victoza for diabetes.
As mentioned I am 75 but still try to keep as active as possible however the arthritis will sometimes get in the way.
Any additional comments will be greatly appreciated
2 years ago a triple by-pass;
Psoriatic arthritis;
Diabetes;
My meds are:
400 MG Gabapentin for CFS Cramp fasciculation syndrome and 100 mg Tegretol
Enbril, Celebrex and methotrexate for arthritis
Metformin and Victoza for diabetes.
As mentioned I am 75 but still try to keep as active as possible however the arthritis will sometimes get in the way.
Any additional comments will be greatly appreciated
Brief Answer:
Read below.
Detailed Answer:
Thank you for bringing some more information.
So I am assuming considering your by-pass history and diabetes your doctors must have considered the possibility of vascular disease and excluded it. Also an EMG must have been done to exclude other causes of cramps and fasciculations like ALS.
Cramp and fasciculation syndrome is a very rare condition and as a result there are very few studies on its treatment. You seem to be taking the two most common medications in Gabapentin and Carbamazepine (Tegretol). The dosage you are taking is low especially for Tegretol and if you aren't experiencing any side effects from it, it could be raised if not effective, Gabapentine can be used at higher dosage as well.
Actually I would have preferred to use either one or the other and increase the dosage as tolerated, because when used together it's hard to assess possible individual side effects and efficacy. So before adding Gabapentine I would have raised Tegretol to at least 800mg.
If their use is not effective Prednisone is also tried, but considering your history of diabetes and its many side effects I wouldn't start it.
I hope you'll get better soon.
Read below.
Detailed Answer:
Thank you for bringing some more information.
So I am assuming considering your by-pass history and diabetes your doctors must have considered the possibility of vascular disease and excluded it. Also an EMG must have been done to exclude other causes of cramps and fasciculations like ALS.
Cramp and fasciculation syndrome is a very rare condition and as a result there are very few studies on its treatment. You seem to be taking the two most common medications in Gabapentin and Carbamazepine (Tegretol). The dosage you are taking is low especially for Tegretol and if you aren't experiencing any side effects from it, it could be raised if not effective, Gabapentine can be used at higher dosage as well.
Actually I would have preferred to use either one or the other and increase the dosage as tolerated, because when used together it's hard to assess possible individual side effects and efficacy. So before adding Gabapentine I would have raised Tegretol to at least 800mg.
If their use is not effective Prednisone is also tried, but considering your history of diabetes and its many side effects I wouldn't start it.
I hope you'll get better soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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