It’s not a laughing matter. Fear really can stalk the night. You can be lying in bed, enjoying the moment as sleep slowly overtakes you at the end of tiring day when, with just the merest warning, the pain can strike, usually in the calves. Or you can be jerked unceremoniously from sleep. Nothing seems to protect you. You wonder about hanging garlic above the windows, but reject it. You experiment with temperature, adding or rejecting coverings. But cramp is not to be frightened away like a vampire, nor does it seem to care whether your legs are hot or cold. Those muscles can suddenly contract and tie themselves into a knot. And the pain! Even though it may only be a minute or so, it feels like forever. So what do you do apart from grab the leg and howl with pain. Well, some believe in rubbing it. Others try stretching – pulling or pointing the toes up or back can seem to help. While the more active leap from bed and walk it off. Well, that should be limp it off since putting weight on the leg only seems to add to the pain at first.

Let’s get the helpful piece of news out of the way. No one knows why it happens. For some it’s a regular disruption to sleep, particularly affecting some women during the later stages of pregnancy. People who play sport or exercise more vigorously also report more incidents than the couch potatoes among us. The only useful information is that muscles come in pairs, one to push, the other to pull. So, when you want to move, the relevant muscles have to cooperate by simultaneously contracting and relaxing. If the paired muscle will not relax when it’s supposed to, you get a cramp. When this happens, the worst thing you can do if try to force the muscles to relax by pulling violently at your leg. This can overstretch the muscles and tear them. Not surprisingly, this tear can be painful and, unlike the cramp, the pain will not simply fade away. Start with a massage and do not stretch until you feel some relaxation begin.

Truth be told, it would be better if we could prevent the cramps from coming in the first place. The traditional remedy has been quinine – with or without the gin as you prefer. This extract from the bark of a tree not only fights malaria, it also reduces the “excitability” of muscles, i.e. you lie more still when you go to sleep. Unfortunately, quinine interacts with several important modern drugs and so it has been withdrawn from the market by the FDA. This leaves you with the choice of drinking a bottle of tonic water every night, or looking for an alternative remedy. More people are looking at muscle relaxants like Carisoprodol. The first problem is the risk to the fetus if the drug is taken during pregnancy. This is unfortunate because night cramps are more common among pregnant women. But the risks outweigh the benefits. Carisoprodol may therefore be tried by men and women not planning a family. This is subject to one general warning. Over the short term, you may get relief. This drug will relax the muscles and prevent night cramps. But it cannot be taken over a long period of time. Equally important, Carisoprodol does not treat the underlying cause. If night cramps affect you on a regular basis, get medical advice on safer alternatives for the long term.