Have you ever woken at night to the debilitating, piercing pain of a leg cramp? If so, you are not alone. It’s been shown that 33.6% of the general public experience night-time muscle cramps, and as high as 50% among those with chronic venous insufficiency.1

Across the nation, the same scenario occurs each night. A calf muscle suddenly seizes. The stricken individual jolts awake and screams. The disoriented spouse frantically begins to massage the muscle, as the pained individual finds a way to get up and walk around, begging the cramp to subside. Sometimes they find themselves standing on the cold tile of the bathroom as the cold sensation on the feet can sometimes coax the pain away. This nightmare occurs more than three times a week for 40% of vascular patients (occurring every night for 6%), according to one study.2

Night-time muscle cramps are not only common; they are complicated. There are several different causes: such as vascular diseases, over-excitable neurons, irregular endocrine or metabolic function, genetic disorders, and nutrition deficiencies. For this reason, a myriad of treatments exist, ranging from the robustly-studied neuron-stabilizing quinone, to the more holistic “spoonful of mustard” before bedtime. This complexity unfortunately means that sleep-deprived individuals with muscle cramps do not know where to turn.

One fact is clear. If you experience leg cramps and also have varicose veins, spider veins or other signs of venous insufficiency, your first step should be to seek consultation from a vein specialist.

In the past 10 years, I have performed more than 10,000 venous procedures for patients with a diagnosis of venous insufficiency. My patients are often afflicted with night-time leg cramps, which reflects the established knowledge that venous disease places individuals at risk for night-time leg cramps.3 While very few diseases in the field of medicine can be fully “cured,” the occurrence of leg cramps almost always improves significantly, or goes away entirely when the underlying venous insufficiency is treated.

In fact, the reduction of nocturnal leg cramps following treatment is so reliable in my experience that it can be used as a measure for post-operative evaluation. For instance, a patient may come to me with both joint pain and venous pain. They will describe symptoms of a whole array of leg and joint symptoms. If after the venous treatment, their leg cramps have disappeared while the other less obvious pain symptoms remain, it becomes clear that the treatments have effectively addressed the venous condition and what remain are symptoms associated with other causes, such as arthritis, fibromyalgia, or neuropathy.

As we become increasingly aware of the role chronic pain can play in our lives, it is important to be aware of the relationship between leg cramps at night and chronic venous insuffiency. If you have ever experienced leg cramps at night, ask yourself a simple question: do you have any varicose veins, spider veins or other venous problems? If so, your leg cramps may be treatable, even curable. It is among the most satisfying things in my daily life—to hear my patients say afterward, “I haven’t had any cramps since I last saw you.” Sometimes, it’s the spouse who thanks me more, because they’re not awoken by their loved one’s scream at night.


[1] Ruckley CV, Evans CJ, Allan PL, Lee AJ, Fowkes FG. Chronic venous insufficiency: clinical and duplex correlations. The Edinburgh Vein Study of venous disorders in the general population. J Vasc Surg. 2002 Sep;36(3):520-5. PubMed PMID: 12218976.

[2] Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010 Jan;10(1):53-9. doi: 10.1007/s11910-009-0079-5. Review. PubMed PMID: 20425227.

[3] Hirai M. Prevalence and characteristics of muscle cramps in patients with varicose veins. Vasa. 2000 Nov;29(4):269-73. PubMed PMID: 11141650.