Night Cramps

Leg Cramps, Night Cramps:

Many people suffer greatly from night cramps.....the pain disturbs their sleep, they cry out at night and awaken the household, their toes curl and they cannot even 'walk it out'. Their doctors have tried all the usual approaches such as checking for and treating sodium, potassium, calcium and magnesium deficiencies and attempting low dose quinine and a variety of other drugs. We have had a number of patients with terrible cramping almost nightly. When their veins with failed valves are closed they no long have any cramping! Often, these patients continue to suffer if venous valvular insufficiency is not considered as a possible etiology. Many patients have failure of vein valves with no visible clues on the surface of their legs. A simple 'venous insufficiency' ultrasound will reveal this condition of failed valves if it is present.

Explanation on a cellular level:
In patients with venous valvular insufficiency extracellular, 'edema' fluid accumulates during the day and it returns to the vascular system at night when these patients are recumbent. Some suggest that this return of extracellular fluids that causes cramping by altering the osmotic balance at the cell membrane, activating the calcium pump and causing fibrin contraction.

Explanation on a macro level:
The only pump for venous blood is movement of the leg muscles. At night, the brain sends messages to the legs to keep moving to pump out the venous congestion and edema fluid that has accumulated all day. The brain sends messages to both legs to move. Flexor and extensor muscles get the same message and, working against each other, cramp.

When the 'truncal' veins with failed valves are treated, the veins distal to them are no longer under the pressure of a column of blood unsupported by valves. The capillaries of these vein systems no longer 'leak' fluid throughout the day. Edema accumulation throughout the day is stopped and the problem of nocturnal cramping is cured.

Patients with nocturnal cramping should have a simple venous insufficiency ultrasound included in their workup to exclude this problem of failed vein valves. If this problem is found, treatment will very often provide dramatic relief of cramping.

Palm Harbor
(US-19 & Alderman Road)
Serving the cities of:
Dunedin, Palm Harbor,
New Port Richey, Odessa
34918 US-19 N
Palm Harbor, FL 34684

Largo
(at the HCA Largo Medical Center Campus)
Serving the cities of:
Belleair, Seminole,
Clearwater
168 14th St. S.W.
Largo, FL 33770

Largo
(Brian Dairy)
Serving the cities of:
Seminole, Pinellas Park,
Clearwater
7241 Bryan Dairy Road
Largo, FL 33777

St. Petersburg
(Isla del Sol)
Serving the cities of:
St. Pete Beach, Tierra Verde,
Maximo, Gulfport
5901 Sun Boulevard, Suite #113A
St. Petersburg, FL 33715

Sun City Center
(Upper Creek Drive)
Serving the cities of:
Tampa, Wimauma,
Ruskin, Apollo Beach
4040 Upper Creek Drive, Suite #105
Sun City Center, FL 33573

Call (727) 865-6941 in Pinellas County.

Call (813) 634-1333 in Hillsborough County.

Toll free 888-875-6941

Daniel J. Mountcastle, MD, FAAEM, Director
Board Certified
Ohio State University College of Medicine,
Class of 1974
Specialty Practice for Leg Veins,
Member of American College of Phlebology