If you’re living with systemic lupus erythematosus (SLE), you likely experience a range of symptoms like joint pain, fatigue, and inflammation. One lesser-known symptom of lupus is leg cramps, which can range from mild to severe and occur at any time — day or night.

If you get leg cramps with lupus, it’s important to learn how to manage them so that they don’t interfere with 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’re involuntary, meaning you can’t control when they happen, and may affect the thighs or calves.

People with lupus experience leg cramps in different ways. Some find that their muscle cramps from lupus occur in the middle of the night during a flare-up, as one MyLupusTeam member described: “I get terrible cramps, jump-out-of-bed-and-stretch cramps, in the middle of the night.”

For some members, the pain persists and may even require a trip to the emergency room (ER). “I just recently got a bad cramp in my thigh that lasted hours, it seems,” one member said. “I went to the ER, and they found nothing!”

Another member can tell when their leg cramps are related to lupus: “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 reported losing some mobility because of cramping issues. “I get them horribly. I’m losing my ability to walk because of it,” they said.

Lupus and muscle spasms may often occur together. If you experience leg cramps with lupus, it’s important to understand why. That way, you can work with your doctor to identify potential causes and figure out ways to manage this symptom.

Does Lupus Cause Leg Cramps?

Lupus is an autoimmune disease that causes a wide variety of symptoms, all linked to inflammation driven by the immune system. 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.

Avascular necrosis (AVN), a condition in which bone tissue dies due to reduced blood supply, can occur in people with lupus, especially those who’ve used high doses of steroids over time. Although AVN causes joint and bone pain, one symptom is muscle spasms, according to the Lupus Foundation of America.

Lupus Medications and Leg Cramps

Several medications used to treat lupus (and other conditions) may cause muscle spasms as a side effect, especially at night. For example, diuretics (water pills) that help reduce swelling and blood pressure may cause an electrolyte imbalance and dehydration that may lead to cramps. Other drugs that may cause cramping as a side effect include:

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

Most of these aren’t first-line medications for lupus, though a doctor may prescribe them for managing pain or treating certain symptoms or recommend them when other medications don’t work. If you’re taking any of these medications for the treatment of lupus, talk to your healthcare provider about whether they could be causing your leg cramps.

Calf Pain

Lupus affects the muscles and can cause myalgia (muscle aches or pain) or myositis (inflammation in the muscles). This typically occurs in the thighs, hips, and shoulders but could affect the calves as well. Muscle pain in the calves may mimic the sensation of a cramp. Members of MyLupusTeam have reported experiencing lupus 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 the spine
• Insufficient blood flow to the affected area
• Liver problems
• Mineral deficiency, such as not enough calcium, magnesium, or potassium

Your rheumatologist (medical specialist who diagnoses and treats joint, muscle, and bone diseases) or primary care provider can help you figure out what’s causing your cramps so you can treat them and find relief from the pain.

7 Ways To Manage Leg Cramps With Lupus

There are several ways to manage leg cramps with lupus. You may need to try a few different approaches to find out what works best for you.

1. Gentle Stretches

Gently stretching the affected muscles can help the cramp release more effectively than it might on its own. Be careful not to overstretch, as that could worsen the cramp.

One technique that may relieve a calf cramp is to place your toes on the edge of a step and lower your heel down lightly. Hold the stretch briefly, then release and repeat as needed until the cramp eases.

Learn more stretches and exercises to help with joint pain.

2. Try Hot or Cold Therapy

If moving or putting weight on the cramping muscle feels too painful, try applying heat with a heating pad or a warm, damp towel. Running warm water from a faucet or a showerhead directly over the leg can also help. Heat increases blood flow to the muscle, helping it relax.

You can also try massaging the affected area with ice. Wrap an ice cube in a towel, leaving one side exposed, and rub it in circles over the cramped muscle to help release the spasm.

3. Exercise

If you experience regular leg cramps, exercise might help. Although it might seem counterintuitive to intentionally flex and use muscles that tend to cramp, regular movement helps keep them strong and functioning well — which can reduce how often cramps occur.

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. According to Mayo Clinic, women should aim for about 11.5 cups (92 ounces) of fluids each day, and men should get about 15.5 cups (124 ounces). These are general guidelines — your hydration needs depend on your overall health, activity level, and other factors. Ask your doctor for guidance. If you aren’t getting the amount of fluid they recommend, increasing your intake may reduce your muscle spasms.

While drinking water is an excellent way to stay hydrated, fluids from other sources also count. Beverages such as herbal tea, milk, and juice contribute to your fluid intake. Many foods — including watermelon, citrus fruits, and spinach — also have a high water content that supports hydration.

5. Make Sure You’re Getting the Right Nutrients

Certain vitamin and mineral deficiencies can contribute to leg cramps. Common culprits include low levels of vitamin D, calcium, magnesium, and potassium. You may need to work with your doctor to find out if you have any nutrient deficiencies and need to adjust your diet. Your doctor, a dietitian, or a nutritionist can help you choose foods to help fill any nutritional gaps.

You might also consider taking supplements, although researchers and doctors agree that getting nutrients from foods is best. Your healthcare team can suggest the best supplements and dosages for you.

In addition to diet and supplements, other strategies may help address vitamin and mineral deficiencies. For example, if a magnesium deficiency is contributing to cramps, a topical form may help. You can apply this to muscles as a preventive measure or at the first sign of a cramp. If you’re low on vitamin D, try spending more time in the sun — just be sure to protect your skin to avoid triggering a lupus flare.

6. Take Medication for Pain Management

If you already take medication for lupus-related pain, your doctor may suggest using that drug when you have leg cramps. Medication may not stop the cramp itself, but it can help ease the muscle pain that comes with it. If your current medication doesn’t provide enough pain relief, reach out to your doctor and ask if there’s a better option for you.

If you’re not already taking a nonsteroidal anti-inflammatory drug (NSAID) like naproxen or ibuprofen for lupus, be sure to check with your doctor before using one for muscle cramp pain. Regular use of NSAIDs can cause kidney damage, as can some types of lupus. It’s important to review all over-the-counter medications and alternative treatments with your doctor.

7. Communicate With Your Doctor

If you experience new or worsening leg cramps — or if nothing you try seems to help — talk to your rheumatology team at your next visit. They may be able to suggest treatment options to help get rid of or reduce your cramps. For example, if you get lupus leg pain at night, they may recommend adding a muscle relaxant to your medication plan to help prevent cramping.

Your doctor can also decide if you need tests to determine what’s causing the cramps. They might look for vitamin or mineral deficiencies or assess your liver function to better guide your treatment.

Your doctor can also help you find a physical therapist who specializes in working with people who have lupus. A physical therapist can help you find a safe, effective exercise or muscle rehabilitation program that will help your legs stay strong and, hopefully, become cramp-free.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 235,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Does lupus cause muscle cramps for you? How do you manage this symptom? Share your experience in the comments below, or start a conversation by posting on your Activities page.