If you’re living with systemic lupus erythematosus (SLE), you likely deal with a range of symptoms like joint pain, fatigue, and inflammation. A less common symptom of lupus is leg cramps. These range from mild to severe and can occur at any time of the day or night.

If you get leg cramps with lupus, it’s important to learn how to manage them. That way, you can work to prevent them from affecting your mental health, quality of life, and overall well-being.

What Do Leg Cramps Feel Like?

Leg cramps (or spasms) are painful muscle contractions in the legs. They are involuntary — meaning you cannot control when they happen. In the legs, they may occur in the thigh or calf muscles.

Individuals with lupus experience leg cramps in different ways. Some people find that they mostly occur in the middle of the night during a flare-up, like one MyLupusTeam member who said, “I get terrible cramps, jump-out-of-bed-and-stretch cramps, in the middle of the night.”

Some MyLupusTeam members get cramps in their legs that last for a long period of time. As one explained, “I just recently got a bad cramp in my thigh that lasted hours, it seems like. I went to the ER and they found nothing!”

Another member experiences lupus leg cramps differently from regular cramps. They put it like this: “They aren't like regular muscle cramps. They’re more like spasms, and the pain is excruciating.”

For some people, the cramps are debilitating. One member, who lost some mobility because of them, said, “I get them horribly. I’m losing my ability to walk because of it.”

If you get leg cramps with lupus, it’s important to understand why. That way, you can work with your doctor to figure out what is causing them, and take action to help manage them.

What Causes Leg Cramps With Lupus?

Lupus has a wide variety of symptoms, all related to inflammation caused by the immune system. As such, it is an autoimmune disease. Lupus flares can happen anytime and may or may not be triggered by something you can identify.

Scientists aren’t exactly sure how lupus might cause leg cramps. However, the condition is known to affect the muscles, bones, tendons, joints, and soft tissue of the body, which could result in muscle spasms or cramps in some people.

While uncommon, lupus can cause a bone problem called avascular necrosis (AVN), which occurs when bone tissue dies due to lack of blood flow. It can affect people who have taken high doses of steroids over a long period of time to treat their lupus. One symptom of AVN is muscle spasms.

Lupus Medications and Leg Cramps

Additionally, several medications for treating lupus (and other conditions) may cause muscle spasms as a side effect, especially at night. Some include:

• Naproxen (Naprosyn)
• Clonazepam (Klonopin)
• Gabapentin (Neurontin)
• Pregabalin (Lyrica)

Most of these are not first-line medications for lupus, though a doctor may prescribe them to treat certain symptoms or when other medications don’t work. If you’re taking any of these medications, talk to your health care provider about whether they could be causing your leg cramps.

Calf Pain

Lupus affects the muscles and can cause myalgia, muscle aches or pain. Lupus can also cause myositis, inflammation in the muscles. This typically occurs in the thighs, hips, and shoulders, but it could happen in the calves as well. Muscle pain in the calves may mimic the feeling of a cramp. Members of MyLupusTeam have reported feelings of calf pain in addition to leg cramps.

If you have sharp, severe pain in your calf muscle that feels different from a cramp, talk to your doctor. It could be a sign of a calf muscle injury or something else.

Other Causes

Other conditions unrelated to lupus can cause leg cramps. These include:

• Compression on nerves in your spine
• Insufficient blood flow to the affected area
• Liver problems
• Mineral deficiency, such as not enough calcium, magnesium, or potassium

Your rheumatologist or primary care provider can help you figure out what is causing your cramps so you can treat them and find relief from the pain.

7 Way To Manage Leg Cramps With Lupus

There are a variety of ways you can manage your leg cramps with lupus. You can try several of these to find out what works for you.

1. Gentle Stretches

If you’re experiencing leg cramps, try gently stretching the affected muscles. This can help the spasmed muscle release better than it might do on its own. Take care not to stretch them too much, as you don’t want to accidentally make the cramp worse.

One technique that may relieve a calf cramp is to rest your toes on the edge of a step and push your heel down lightly. Hold this for a short time, then release and repeat as needed to relieve your cramp.

Learn more stretches and exercises to help with joint pain.

2. Try Hot or Cold Therapy

If you can’t bear to move or put weight on the cramping muscle, try applying heat to it instead. You can use a heating pad or even a warm, wet towel. Warm water from a faucet or a showerhead directly on the leg can work, too. Heat can bring additional blood to the muscle, which can help it relax.

You can also try massaging affected muscles with ice. Hold an ice cube in a towel with one end exposed. Gently rub this in circles on the cramped muscle and see if it will release.

3. Exercise

If you experience regular leg cramps, exercising those muscles might help. This may sound counterintuitive, because it may not make sense to intentionally flex and release muscles that cramp. However, using the muscle keeps it strong and in good working order and can reduce the number of leg cramps you experience.

4. Increase Your Fluid Intake

If you aren’t drinking enough fluids, then dehydration could be contributing to your muscle cramps, especially if they happen while you’re exercising or moving. Per Mayo Clinic, women should get around 11.5 cups (2.7 liters) of fluids each day and men should get around 15.5 cups (125 ounces). If you aren’t consuming that much fluid, increasing your intake by any amount may help your muscle spasms.

Notably, although drinking water is a great option for staying hydrated, there are other ways to get the fluids you need. Beverages like herbal teas, milk, and juice are made mostly of water. Coffee, soda, and other caffeinated drinks can help provide hydration, too, though go easy on the sugary varieties. Additionally, some foods, including watermelon and spinach, contain a lot of water.

5. Make Sure You’re Getting the Right Nutrients

Certain vitamin and mineral deficiencies can cause leg cramps, too. Possible culprits here include a lack of vitamin D, calcium, magnesium, and potassium. You may need to work with your doctor to determine if you have any nutritional deficiencies so you can adjust your diet accordingly. Your doctor, a dietitian, or a nutritionist can help you choose foods that can help fill any nutrient gaps in your diet.

You may also consider taking supplements, although health experts agree getting nutrients from foods is best. Work with your health care team to determine which supplements and doses would be best.

Other than eating the right foods and taking supplements, there are other ways to compensate for vitamin and mineral deficiencies. For example, if a magnesium deficiency is causing your cramps, you can get it in a topical form. You can rub this on muscles preventatively or if they begin to cramp. If you’re low on vitamin D, spending more time in the sun may also help.

6. Take Medication for Pain Management

If you already take medication for lupus-related pain, your doctor may suggest taking it when you experience cramps. The medication may not alleviate a cramp, but it can help your muscle pain to feel better during a cramp. If that medication doesn’t help you achieve total pain relief, reach out to your doctor and ask if there’s a better option for your needs.

7. Talk to Your Doctor

If you experience new leg cramps, your cramps are getting worse, or you can’t find anything that helps your cramps, talk to your rheumatology team the next time you see them. They may be able to prescribe some treatment options to help get rid of or reduce your cramps. For instance, they may recommend adding a muscle relaxer to your medication regimen to keep the cramps at bay.

Your doctor can decide if you need tests to determine what is causing the cramps. They might look for a vitamin or mineral deficiency or test your liver. That way, they’ll know exactly how to treat the problem.

A doctor can also help you find a physical therapist who works specifically with people with lupus. They can help you find an exercise program or a muscle rehabilitation program that will help your legs stay strong and, hopefully, become cramp-free soon.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you living with leg cramps due to lupus? Share your experience in the comments below, or start a conversation by posting on your Activities page.