When you’re living with multiple myeloma, you might experience nighttime muscle spasms whether or not you’re in remission (when symptoms are few or disappear). However, these cramps may also be caused by an issue unrelated to a myeloma relapse or complication. It’s important to consider other possibilities and talk to your doctor about any new or changing symptoms.

Members of MyMyelomaTeam have described how muscle cramps disrupt their sleep. “I didn’t sleep well last night,” wrote one member. “I had severe muscle cramps in my left thigh — took five minutes of rubbing the muscle before I could put weight on the leg. Happened again about two hours later. Beginning to worry if this may be a new onset of my myeloma.”

Another member said, “Incredibly terrible night. This is two weeks of constant muscle spasms in the same leg. I get some relief when I combine muscle relaxers and pain medication, but it never totally goes away. It’s affecting my daily life.”

If you’re living with myeloma and notice changes in your health, like cramps that get worse or don’t go away, be sure to talk with your doctor. Here’s more on muscle spasms and cramps and why they may affect you at night.

What Does a Muscle Cramp Feel Like?

Muscle cramps, also called spasms, happen when a muscle suddenly tightens and can’t relax. These contractions are involuntary and often painful. Cramps can occur in any part of the body, including the arms, legs, neck, and back. Common symptoms include stiffness, twitching, or the feeling that the muscle is jumping around.

Depending on the cause, muscle cramps can also cause symptoms such as:

• Muscle pain
• Muscle weakness
• Temporary paralysis
• Problems with movement
• Numbness
• Difficulty sleeping
• Vision issues

“Lots of cramps in hands and calves,” a MyMyelomaTeam member wrote. “They wake me up at night. Then I’m more tired during the day!”

“Lots of cramps in hands and calves. They wake me up at night. Then I’m more tired during the day!”

— A MyMyelomaTeam member

Myeloma May Cause Muscle Cramps

Multiple myeloma can affect muscles and cause cramping due to two main causes — hypercalcemia and amyloidosis.

Hypercalcemia occurs when calcium levels in the blood become too high. Myeloma causes bones to weaken and form lesions that not only lead to bone pain but also release calcium into the blood. High calcium levels can damage organs and tissues throughout the body, including muscles. Cramping, twitching, and restlessness in muscles can be caused by hypercalcemia.

Myeloma also causes a plasma cell disorder called amyloidosis. This complication causes bone marrow to produce abnormal proteins — M protein and other antibodies — in the blood. Amyloidosis also damages body tissues, including muscles, and can cause cramps.

Both hypercalcemia and amyloidosis can occur when you’re first diagnosed with myeloma or if you have relapsed or refractory multiple myeloma (myeloma that returns or resists treatment). Either hypercalcemia or amyloidosis may be a sign of a myeloma relapse.

“Cramps in legs and ankles seem to be associated with MM,” wrote a MyMyelomaTeam member. “I’ve had them lately. I had a small relapse a month ago and will start second-line treatment.”

Some Myeloma Treatments Can Cause Muscle Spasms

Like all drugs, even those sold over the counter, multiple myeloma treatments can have side effects. Some medications can cause muscle spasms. When discussing treatment options, always talk to your doctor about potential side effects and ways to manage them.

Chemotherapy and Muscle Cramps

Some chemotherapy drugs can cause a condition called chemotherapy-induced peripheral neuropathy (CIPN). Peripheral neuropathy is a type of nerve damage that affects areas outside the brain, especially the hands and feet.

Peripheral neuropathy can cause a range of sensations and symptoms, including tingling, numbness, muscle spasms, and — in more severe cases — trouble moving. MyMyelomaTeam members with peripheral neuropathy have shared experiences such as these:

• “My neuropathy in my toes and feet started with cramps (which I have never had before) and then tingles. And along with the tingling came numbness.”
• “I do have occasional neuropathy in my toes. All of a sudden, they cramp up, and I have to physically move them.”
• “When I lie down in my bed at night, it takes me some time to get comfortable. I have neuropathy in my feet. I often get muscle spasms in my feet and sometimes in my back.”

“When I lie down in my bed at night, it takes me some time to get comfortable. I often get muscle spasms in my feet and sometimes in my back.”
— A MyMyelomaTeam member

Myeloma Medications and Muscle Spasms

Some drugs used in myeloma treatment plans can affect muscle tissue and parts of the central nervous system, sometimes leading to muscle spasms. These drugs may be used with chemotherapy and maintenance therapy to control the immune system and slow the growth of myeloma cells.

Myeloma medications linked to muscle cramps include:

• Dexamethasone, a corticosteroid
• Lenalidomide (Revlimid)
• Proteasome inhibitors, such as bortezomib (Velcade), carfilzomib (Kyprolis), and ixazomib (Ninlaro)
• Thalidomide (Thalomid)

“I also had severe muscle cramps in my legs, feet, and hands. My oncologist made changes to my treatment plan, and they almost went away completely. I also take electrolytes and magnesium citrate,” a MyMyelomaTeam member said.

Always talk with your oncology team before trying a new dietary supplement or making any changes to your myeloma medications.

Certain Factors Raise the Risk of Muscle Cramps

Some factors make muscle cramps in general more likely, regardless of whether you have multiple myeloma. These risk factors include:

• Illness
• Overexertion
• Use of medications such as pseudoephedrine (a decongestant), statins (for high cholesterol), and diuretics (to reduce blood pressure)

Dehydration and heavy sweating, such as during physical activity or night sweats, increase the risk of muscle cramps by depleting electrolytes such as salt, potassium, and magnesium. “If you sweat a lot at night, like many of us do, it might be your potassium level. Ask your doctor if your potassium level is low,” a MyMyelomaTeam member advised.

People Prone to Nighttime Leg Cramps

About one-third of people over 60 have leg cramps at night. Cramping is also common during pregnancy. Leg cramps can happen at night for a number of reasons, such as:

• Sitting for long periods during the day
• Standing on concrete surfaces for a long time
• Maintaining poor posture
• Overusing muscles
• Experiencing kidney damage or kidney failure, diabetes, blood circulation problems, and other diseases
• Feeling stressed

A Range of Approaches May Manage Muscle Cramps

If muscle cramps affect your quality of life, talk to your health care team. They may want to do blood tests or urine tests to see if you’re deficient in minerals or if something else might be causing your muscle cramps.

If you have muscle spasms at night due to CIPN, your doctor may recommend various treatment options, such as antidepressants, anticonvulsants, or medical marijuana. They might also suggest nondrug approaches like certain vitamin or herbal supplements, exercise, or acupuncture.

Other Ways To Help Relieve Leg Cramps

Muscle spasms can sometimes be relieved by staying well hydrated and moving and stretching cramped muscles. Your doctor may advise you to get more magnesium or potassium, either by eating foods rich in these minerals or taking supplements. In some cases, a doctor may recommend muscle relaxants.

Members of MyMyeloma Team have reported on how they manage muscle cramps in various ways, posting comments such as these:

• “The doctor put me on magnesium, and for the muscle cramps, I take a muscle relaxant at night about an hour before bed. I also found that when I’m dehydrated, I get more cramps.”
• “You can try pickle juice as soon as the cramps start. l find pink salt under my tongue can help.” (Researchers have found that pickle juice and mustard juice trigger a reflex in the central nervous system that can sometimes relieve muscle cramps.)
• “I have leg and foot cramps. They’re extremely painful. What works for me is placing a heating pad in the area of the cramp. Also, if at all possible, I get out of bed and try to walk it out.”

“What works for me is placing a heating pad in the area of the cramp. Also, if at all possible, I get out of bed and try to walk it out.”
— A MyMyelomaTeam member

Some supplements may interfere with medications or cause unwanted side effects, so it’s best to get a doctor’s advice before trying something new. Always follow up with your doctor if you notice potential relapse symptoms of multiple myeloma, including back pain, bone pain, shortness of breath, or excessive tiredness. Staying informed and proactive about your health can help you manage symptoms and improve your quality of life.

Find Your Team

MyMyelomaTeam is the social network for people with myeloma and their loved ones. On MyMyelomaTeam, more than 26,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Have you had nighttime muscle cramps while living with myeloma? Do you have any tips on how to manage spasms and cramps and get better sleep? Share your experiences in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.