r/o hypocalcemia, r/o drug (inhaled LABA, diuretics)
Acute treatment
Forcefully stretch affected muscle (eg. active dorsiflexion of foot with knee extended for calf cramp)
Heat or ice
Non-pharmacological treatment
Daily stretching
Stationary bicycle before sleeping
Keep bed covers loose
Avoid alcohol, caffeine, dehydration
Pharmacological treatment
Vitamin B complex TID
Vitamin E 800 units qHS
May consider iron and magnesium (although no evidence)
Diphenhydramine
Diltiazem or Verapamil
Gabapentin
Restless Legs Syndrome (RLS)
Unpleasant sensation in the legs (and occasionally the arms), accompanied by an urge to move, that emerges during periods of inactivity, is most prominent in the evening, and is transiently relieved by movement
Commonly associated with periodic leg movements of sleep (PLMS)
Treatment
Non-pharmacological
Avoid caffeine, alcohol, chocolate, smoking
Good sleep hygiene
Stretching/exercise/massage
Applied heat
Mental alerting activities (working on computer) at times of rest/boredom