I only have two pain-related symptoms of multiple sclerosis, migraines and nocturnal leg cramps. I can usually nip the migraines in the bud with a large cup of strong coffee (I live in Starbucks land, so that’s not a problem, ever!), but leg cramps for me are a bit more tricky, especially because they interrupt my sleep.
It’s not just the pain that’s the problem
Granted, getting a strong charleyhorse in my calf at 2am is not going to make me a happy camper. There will be the leap out of bed, the awkward strut up and down the hallway as I try to work the knot out of my foot where it’s seized up, and it can take at least ten minutes before my foot relaxes enough to let go of my leg muscle.
But by then, my stress hormones have kicked in, leaving me with an elevated pulse and fully awake when I should be sleeping.
In the field of sleep medicine, nocturnal leg cramps are symptomatic of disordered sleep. For good reason, right? Anything that disrupts a night of sleep—such as a frequent need to use the bathroom, unsettling nightmares, or leg cramps—leads to disordered sleep.
Untreated sleep disorders, meanwhile, lead to sleep deprivation and the long list of other problems it sets off in its own chain of dominoes.
Causes for nighttime charleyhorses
Nocturnal leg cramps are common, even among people without neuromuscular disorders.
There are a ton of reasons why you might have these acute muscular pains, and not all of them are related to multiple sclerosis.
- You might have flat feet (fallen arches).
- You might spend too much time sitting every day.
- You might have something called Restless Legs Syndrome.
- You might have a blockage in a leg artery.
- You might be pregnant.
- You might be middle aged or older.
- You might have an electrolyte imbalance.
- You might have another condition that can cause cramping, such as diabetes.
- You might be taking a medication that has nighttime leg cramps as an adverse effect.
- You might be dehydrated.
- You might have overexerted yourself.
- You have multiple sclerosis (or other neuromuscular disorders).
See a doctor about regular problems with leg cramps at night
Those who routinely suffer through muscular cramping when they should be sleeping may be at risk for ignoring other conditions or changes that reflect their MS disease course.
For instance, Restless Leg Syndrome (RLS) is a condition that can lead to nocturnal leg cramps, though the two are not the same. However, RLS is very common and eminently treatable.
Also, aside from the fact they are so acutely painful, nocturnal leg cramps are also disruptive to the healing sleep that your brain and body so desperately need in order to keep your multiple sclerosis at bay.
If you miss sleep every night because of them, you are destined to become sleep deprived, which will increase your sensitivity to pain, worsen your problems with daytime fatigue, and compromise your immune system.
Whatever you do, don’t write these pains off as “part of MS.” They might be something else entirely, and there might be an easy treatment for them. You won’t really know for sure what is causing your nighttime leg cramps without seeing a medical professional.
A physician can run a number of tests to identify the root cause of your problem. From these results, an MS specialist can review things like medications and therapies and may even investigate the possibility of relapse.
If your nocturnal leg cramps are MS-related
Your doctor will likely offer treatment options which include drugs, supplements, or physical therapy.
Meanwhile, more research is being done to help evaluate new drugs that could help with treating the leg cramps and spasticity that are a hallmark of MS.
The pharmaceutical company, Flex Pharma, recently announced a Phase 1 clinical trial which will evaluate its product, FLX-787, for its effectiveness in modulating pain receptors through a therapy known as topical chemical neuro stimulation. They believe this new agent could provide relief from intense spasms and cramping in people with MS.
Their researchers say they have found FLX-787 to reduce cramp intensity in a way that is dose responsive, meaning that the more of it you take, the better the relief.
Flex Pharma’s chief medical officer, Thomas Wessell MD PhD, recently said in a press release, “By prioritizing our clinical programs to severe neurological diseases ahead of nocturnal leg cramps, we can focus on those patients with the greatest unmet need and accelerate our research efforts for cramps and spasticity.”
Rod MacKinnon, MD, Flex Pharma co-founder and a Nobel Prize winner, added, “Our approach has a broad range of applications that we believe will ultimately benefit the millions of people that suffer from frequent painful muscle cramps.”
For occasional leg cramps at night
You cannot fix chronic problems with nocturnal leg cramps by using over-the-counter treatments or tried-and-true home remedies. That is for a doctor to help you manage.
However, if you only have occasional nocturnal leg cramps, these approaches can offer some relief:
- Stretch the muscles in your feet, ankles, calves, and upper legs during the day and right before bed.
- Where shoes that have good heel support.
- Drink more water to avoid dehydration; for the same reason, avoid caffeine products and alcohol, which have a diuretic effect on the body.
- Make sure your diet has adequate amounts of calcium, magnesium, iron, and other minerals to ensure your electrolytes are in a working balance.
Remember, anything that chronically disrupts your sleep can have a negative long-term impact on your disease course. Your brain needs sleep to fight multiple sclerosis. If your sleep’s constantly being interrupted (for whatever reason), you’re destined to never get enough deep sleep, opening the door to future chronic health problems.