Leg Cramps and Alcohol: Is There a Connection?

According to the National Institute of Health (NIH), about 30 % of American adults report experiencing nocturnal leg cramps at least five times per month. Nocturnal or night leg cramps are characterized by sudden, painful, and involuntary muscle spasms. Leading causes of leg cramps include heavy exercise, muscle strain, overuse of muscles, pregnancy, dehydration, and alcohol misuse. Alcohol contributes to the buildup of lactic acid in the leg muscles, resulting in leg cramps. However, certain lifestyle changes and medications can help manage and prevent the condition.

Confidant Health is a virtual platform that provides Medication-Assisted Treatment (MAT) to help you cope with alcohol misuse and related disorders. If you’re struggling with alcohol misuse, Confidant Health’s virtual alcohol rehabilitation program can help you get back to a life without alcohol.

What are leg cramps?

Leg cramps refer to sudden, involuntary, and painful contractions of leg muscles, usually affecting the muscles of the thigh, feet, and calves. Sometimes, leg cramps can be extremely uncomfortable and painful; thus, they can affect an individual’s daily activities. Although they may last up to a few seconds, the average duration is about nine minutes per episode. 

Nocturnal leg cramps, also known as night or sleep-related leg cramps, are a common condition in which leg cramps predominantly occur at night. Nocturnal leg cramps can result in sleep disturbances and may lead to insomnia.

Common causes of leg cramps

Several factors can cause leg cramps or increase their risk. Some of those factors are discussed below.

Heavy exercise or Prolonged standing

Overexertion of muscles during heavy exercise or prolonged standing can cause microscopic damage in the leg muscle fibers. These damages result in muscle soreness and cramps.

Medications

Certain medications such as diuretics, antidepressants, cholesterol-lowering drugs, iron sucrose, and conjugate estrogens can cause nocturnal leg cramps. Generally, these medications produce electrolyte imbalance that may lead to leg cramps. 

Alcohol consumption

Alcohol use is strongly associated with nocturnal leg cramps, particularly in people aged 60 or more. Alcohol consumption can lead to muscle tissue damage and deficiencies of vitamin B, vitamin D, iron, zinc, and potassium. Moreover, alcohol contributes to the accumulation of lactic acid inside leg muscle tissues.

Pregnancy

Leg cramps commonly occur during the second and third trimesters of pregnancy. The probable reason behind pregnancy-related cramps is decreased calcium or increased phosphorus levels in the blood, although the exact mechanism is unknown.

Dehydration

Dehydration can also cause muscle cramps in the legs. Water intake is essential to maintain adequate blood volume, which is needed for an optimal supply of oxygen to muscle tissues. Lack of oxygen supply can cause ischemia of muscle fibers, leading to muscle cramps.

Why does alcohol cause leg cramps?

There’s strong evidence suggesting that alcohol use has a strong association with leg cramps, mainly nocturnal leg cramps. However, the exact mechanism is still unknown. Following are the currently accepted reasons behind alcohol-related leg cramps.

• Alcohol accelerates muscle wasting by decreasing protein synthesis and increasing protein degradation.
• Alcohol consumption can result in vitamin B, vitamin D, iron, and folate deficiencies in the body. These vitamin and mineral deficiencies are often related to muscle cramps and fatigue. For instance, vitamin B1 deficiency can cause leg cramps.
• It is a well-known fact that heavy use of alcohol can cause liver damage. On the other hand, lactic acid (a by-product produced during muscle activity) is metabolized by the liver. When the liver gets damaged by alcohol intake, it becomes challenging for the liver to metabolize lactic acid at the same pace. It results in the accumulation of lactic acid, which can exacerbate the symptoms.

Who is most likely to experience alcohol-induced leg cramps?

Alcohol-related nocturnal leg cramps are mostly experienced by older people aged 60 or more. A study revealed that almost one-half of patients aged 60 or older experience nocturnal leg cramps. Moreover, a strong link has been found between alcohol consumption and sleep-related leg cramps among the elderly.

How long do leg cramps last?

Leg cramps usually last from a few seconds to several minutes, while the average duration is about 9 minutes. During a cramp, leg muscles involuntarily contract and cause sudden pain. However, you may feel pain and tenderness in your leg for several hours, even if the cramp has passed.

How to deal with alcohol-related leg cramps?

The following measures can be useful in managing alcohol-induced leg cramps.

Reduce or stop alcohol

Reduction in the amount of alcohol consumption is the main line of treatment for alcohol-related leg cramps. After stopping or reducing alcohol intake, the muscles may initiate their recovery process and take a few days to months to get the repair. If you or one of your close one is struggling with alcohol misuse, you can consult with Confidant Health’s professionals, who provide counseling sessions and medication to help you overcome this problem.

Hydration

Proper hydration can prevent alcohol-related cramps; hence, you should drink at least 16 ounces of water for each drink you have. Furthermore, you can also try to drink water before going to drink. It can prevent you from alcohol-related leg cramps to some extent.

Supplement Therapy

Supplement therapy with vitamins B, D, C, and magnesium can improve the symptoms of nocturnal leg cramps. For example, vitamin C helps in energy production at a cellular level in muscle fibers. Similarly, vitamin B12 improves the function of nerve-muscle junctions in patients experiencing leg cramps.

Medications

Although no drug is currently recommended for routine treatment of nocturnal leg cramps, some medicines, such as diltiazem, gabapentin, verapamil, and carisoprodol, can be used in severe cases. 

Massage Therapy

Massage treatment can also help stretch the tight muscles of the thigh, calf, and feet, making them relaxed. Moreover, calf massage also increases the blood flow to the leg muscles, helping them repair quickly.

Epsom salt baths

Bath with Epsom salt can also help relieve the symptoms of leg cramps. Epsom contains magnesium that helps in transporting glucose to the leg muscles. Muscles use glucose to produce energy and perform their functions. Furthermore, magnesium also slows the accumulation of lactic acid inside the muscle tissue, decreasing the chances of leg cramps.

Contraindications to Epsom salt bath: One should avoid Epsom salt bath if they have high blood pressure, cardiovascular disease, or open sores. Pregnant women should also avoid Epsom salt baths. 

Stretch exercises

During an episode of leg cramps, the stretching exercise of the affected muscle can relieve the symptoms. For instance, if you experience cramps in the calf region, you can do the stretch exercise by straightening the leg and lifting the foot upwards while the toes point towards the shin.

Other Frequently Asked Questions (FAQs)

Can alcohol use disorder (AUD) cause muscle cramps?

Alcohol use disorder can cause several muscle-related problems, including muscle cramps and soreness. Alcohol consumption can cause deficiencies of electrolytes and oxidative stress. In oxidative stress, large amounts of free radicals are formed that can interfere with the lipid and glycogen storage of muscles. Lipid and glycogen stores are responsible for energy production in muscles. Thus, muscles may get cramps and soreness if one misuses alcohol for longer, as in alcohol use disorder.

How can you prevent leg cramps after drinking?

The following measures can help reduce the risk of leg cramps after drinking.

• Keep yourself hydrated by drinking at least 6 to 8 glasses of plain water daily.
• Monitor and regularize your sleep cycle.
• Stretch your leg muscles before going to sleep daily.
• Use comfortable shoes to support your feet during daily activities.
• Avoid alcohol intake, and if you’re struggling with alcohol misuse, you can seek professional help to overcome this issue.

What can you drink for leg cramps?

Oral rehydration solutions containing specific proportions of electrolytes such as sodium, potassium, magnesium, and chloride can help relieve leg cramps. These electrolytes increase the absorption of water and are necessary for muscle health.

Can you use quinine for leg cramps?

Quinine, an antimalarial drug, has often been used to treat leg cramps; however, studies have revealed that quinine doesn’t reduce nocturnal leg cramps' frequency, intensity, or duration. The U.S. Food and Drug Administration (FDA) has also advised not to use quinine for leg cramps due to its ineffectiveness and side effects.

When to ask for professional help

You must seek professional help if you struggle with alcohol misuse, recurrent nocturnal leg cramps, or night cramps disrupting sleep. A healthcare professional usually rules out the other causes of leg cramps and discusses different ways to help you cope with alcohol misuse.

Consult online with Confidant Health’s Professionals

Confidant Health provides online Medication-Assisted Treatment (MAT) that involves certain medications and behavioral therapy sessions to help you overcome alcohol misuse. Moreover, Confidant Health’s virtual alcohol rehabilitation programs provide an opportunity to improve consequences  related to alcohol misuse, including alcohol use disorder and nocturnal leg cramps. You can download Confidant Health’s app to consult with their consultants.