Dear Dr. Roach: I am a very healthy 74-year-old male. I am not on any medications and enjoy normal blood pressure and great stats from my regular bloodwork. I weigh 140 pounds and have been exercising every day faithfully for decades.
A couple of years ago, I started getting cramps in both legs throughout the night. My toes would curl down and my entire leg would get stiff; the pain was horrible. I had a terrible time walking it off, and very often when I finally got it to pass, as soon as I got back in bed the whole thing would start all over again. Sometimes I would go a few nights without having a problem, but there was always the fear that I would have another episode.
I read online advice to get the weight of the sheet and covers off the feet. I took a strong cardboard box and sleep with my feet in the open end of the box. The first time I got in bed with this rigged up, it felt very strange not having anything on my bare feet, but eventually I got used to it. The remarkable news is that I have not had a single episode since fabricating the box over six months ago. G.K.
Answer: I appreciate your writing in. I have had many patients use a box during sleep for acute gout, where even a sheet on top of the affected toe can be exquisitely painful, but I had not heard this used for nocturnal leg cramps. Some patients have noticed that the symptoms do seem to be started or exacerbated by the weight of blankets.
Before resorting to that, I recommend regular exercise, even a few minutes of riding a stationary bicycle before bed can help. Couple that with regular stretching of the calf and hamstring muscles and adequate hydration. Although many people ask about it, I do not recommend quinine for most people, and its quite rare for the cause to be disturbances of sodium, potassium, calcium or other electrolytes. B complex vitamins and magnesium are helpful in some people, but I restrict iron to people with proven iron deficiency.
If all else fails, prescription medications such as verapamil may be helpful.
