Danielle BSN

If you have ever experienced pesky painful cramping in the muscles of your thighs, calves, or feet, then you can lend some empathy to your patients if they report this agonizing sensation. As a nurse using sound clinical judgment to prioritize patient care, irritating muscle cramps may be low on your totem pole of symptoms or issues to address; however, there are still some clinical considerations to make, as well as some interventions that you might be able to use to help your patients. What Are Nocturnal Muscle Cramps? Nocturnal muscle cramps usually occur in leg muscles from the sudden, unintentional tightening or contracting of these muscles. One cramping incident can last up to ten minutes, and the discomfort from this incident can sometimes be felt long after it has ended. According to the Cleveland Clinic, about 75% of people who experience muscle cramps reported getting them at night. These cramps can seriously interrupt a person's sleep pattern and affect daily function. Who is at Risk? Nurses can expect that some patients with the following medical conditions might report experiencing nocturnal muscle cramps: Lumbar Spinal Stenosis and other neuromuscular diseases Pregnancy Renal failure and dialysis Liver failure Diabetics Cardiovascular diseases and peripheral vascular disease (PVD) Dehydration The following types of medications have nocturnal muscle cramps as a side effect, so be sure to check your patient's medication list: Statins Certain blood pressure medications Diuretics Certain sleep aids Nurses should also consider these other factors when identifying nocturnal muscle cramps: Aging adults are more likely to experience nocturnal muscle cramps as tendons shorten as a person ages. Patients facing prolonged bed rest may report these cramps as sedentary activity is a factor. Certain sleeping positions and tucked-in bed linens can place a person's feet in a non-neutral position which causes cramping at night. Certain electrolyte imbalances could cause muscle cramping, so be sure to review the patient's lab work and report any out-of-range values You should ask the patient these assessment questions and consider the information mentioned above: Can you describe what they feel like, when they happen, and how long they last? Do you have any medical problems that might be related? What medications and OTC medications are you taking? What are the Possible Interventions? After reporting to the patient's doctor, you can anticipate applying these interventions and should offer to assist the patient as needed: Ask your patient to flex their foot to stretch the muscle Have your patient massage the area Offer the patient a warm cloth to place over the affected area Offer to untuck the patient's bed linens near their feet and suggest a change in sleep position Offer to assist the patient with walking in their room or hallway to stretch the muscles if the patient is able Obtain an order for pain relieving medication for the patient, such as an NSAID (if applicable) for discomfort that may continue after the initial cramping episode Encourage oral hydration, but first, be sure to check the patient's orders for fluid restrictions or NPO status Each patient and situation is unique, so this information will not apply to every patient experiencing nocturnal muscle cramps. You should always use your nursing judgment and report the patient's symptoms to their doctor. Furthermore, you may consider assessing the patient's legs for warmth, redness, and swelling in addition to the painful sensation. These other symptoms may be a sign of a different, more severe health problem that requires further assessment and testing. You can use the information you gained in this article to advocate for your patients, provide comfort, and continue expanding your ever-evolving nursing practice. References/Resources Leg Cramps: Cleveland Clinic Criteria in diagnosing nocturnal leg cramps: a systematic review: BioMed Central Primary Care Nocturnal Leg Cramps and Lumbar Spinal Stenosis: A Cross-Sectional Study in the Community: International Journal of General Medicine Night leg cramps: Mayo Clinic