Hi everyone. My husband has a right arm tremor being managed by 125 cocareldopa, 4 times a day. He is getting severe cramps in the right thigh/leg most nights and unable to sleep. Some nights it is in the left thigh/leg. According to his sleep monitor he is getting about 1.5 hours sleep over a night and some nights nothing. I can vouch for this as some nights I stay awake with him. It is really getting him down, the GP has no solution!! He has tried codeine and Ropinirole.
Any ideas would be helpful.
Good evening … What makes you think that these cramps are caused
by the Co-careldopa or by Parkinson’s? I take the same drug and never have cramps.
Could it be a salt deficiency? The Co-careldopa can cause Insomnia & other sleep issues.
Neuropathy is another possibility. Up to 55% of Parkinson’s sufferers also have Neuropathy. I have and take Amitriptyline for it. An excellent drug.
Best wishes
Steve2
I have spoken to many sufferers of PD who also have the leg cramps. Some people call them fasciculations. Even if not caused by PD still need some treatment.
AI Overview
Yes, neuropathy, particularly motor neuropathy, can cause cramps in the legs. Damage to the nerves in the legs can lead to muscle weakness, twitching, and cramps. Neuropathy can disrupt the signals between muscles and the brain, causing muscles to contract involuntarily, resulting in cramps.
Here’s a more detailed explanation:
- Neuropathy and Nerve Damage:
Neuropathy is a condition where nerves, including those in the legs, are damaged. This nerve damage can disrupt the normal communication between the brain and muscles.
- Motor Neuropathy:
Motor neuropathy specifically affects the nerves that control muscle movement. When these nerves are damaged, they may send incorrect signals, leading to muscle twitching, spasms, and cramps.
- Symptoms of Neuropathy:
Besides cramps, other symptoms of motor neuropathy can include muscle weakness, difficulty with coordination, and muscle wasting (where muscles lose mass).
- Diabetes and Neuropathy:
Diabetes is a common cause of neuropathy, and leg pain, including cramps, is a potential complication of diabetic neuropathy.
- Other Causes:
While diabetes is a frequent cause, other conditions and factors can also contribute to neuropathy and leg cramps, such as nerve compression, electrolyte imbalances, and certain medications.
- Treatment:
If you experience frequent or severe leg cramps, it’s essential to consult with a healthcare professional to determine the underlying cause and receive appropriate treatment.
AI Overview
Yes, Parkinson’s disease (PD) patients are more likely to experience peripheral neuropathy than the general population according to the Parkinson’s Foundation. While the exact prevalence varies, studies indicate that peripheral neuropathy is a common non-motor symptom in PD, with some studies reporting a prevalence as high as 55%.
Elaboration:
Peripheral neuropathy refers to damage to the nerves outside of the brain and spinal cord, which can lead to a range of symptoms including:
- Sensory Changes: Numbness, tingling, pain, or increased sensitivity in the extremities (hands and feet).
- Motor Problems: Weakness, loss of coordination, or balance issues.
- Pain: Sharp, burning, or throbbing pain, sometimes described as feeling like “pins and needles”.
Connection to Parkinson’s Disease:
- Increased Risk:
People with PD are at a higher risk of developing peripheral neuropathy compared to the general population.
- Not Necessarily Medication-Related:
While some PD medications may contribute to neuropathy in some cases, research suggests that peripheral neuropathy can occur even before the start of Parkinson’s medication.
- Functional Impact:
Peripheral neuropathy can worsen motor symptoms in PD, leading to increased risk of falls, impaired gait and balance, and decreased mobility.
- Systemic Nature of PD:
The increased prevalence of neuropathy in PD highlights the systemic nature of the disease, suggesting that it affects more than just the brain’s basal ganglia.
Causes and Risk Factors:
- While the exact cause of neuropathy in PD is not always clear, it can be linked to factors like vitamin B12 deficiency, elevated homocysteine levels, or other underlying conditions.
- Other potential contributors include diabetes, which is also more common in people with PD, and certain medications.
Implications:
- Comprehensive Assessment:
Given the potential impact of neuropathy on mobility and quality of life, it’s important for individuals with PD to have a comprehensive assessment to identify and manage neuropathy.
- Multidisciplinary Approach:
Managing neuropathy in PD often requires a multidisciplinary approach, including medication adjustments, physical therapy, and other supportive measures.
His consultant says it is not neuropathy. But does not know what it is 
Hi Cyril123, we’re sorry to hear what your husband is experiencing. We have some information on muscle cramps here, including how you can ease them, which you may find useful: Muscle cramps and dystonia | Parkinson's UK
We’re sorry his GP has not found a solution. Please feel free to call our helpline on 0808 800 0303 and we can put you in touch with one of our Parkinson’s nurses who will be able to advise you.
We hope this is helpful.
Parkinson’s UK Moderation Team 
Leg cramps can be caused by pd, hydration and electrolytes imbalance . Possibly neuropathy but the neurologist doesn’t think so.
What to do ?
I would suggest ensure you are hydrated and your electrolytes are ok.
Muscle massage with a magnesium rub.
Some people take magnesium in the evening.
Do you think his medication is wearing off at night ?
Possibly a slow release carbodopa at night might help.
This approach may help if not back to the pd team for advice , he needs his sleep.
I get night cramps in my legs. Certainly smarts, doesn’t it.
I apply gentle pressure to the cramping leg. I just swing out of my bed and apply pressure. Just the weight of my body suffices. This will clear my cramp.
I hadn’t linked this directly to PD. But I have linked it to the reduction in general exercise which is indirectly PD.
It is too easy to blame Parkinsons for everything.
I am dreading the possible loss of sleep. But reduce the effect by not worrying about it.
Good luck
Sooty
Thanks for your reply. It may not be linked to my PD. Waiting for my consultant to get back to me.
AI Overview
While a severe salt deficiency can lead to muscle cramps, it’s not the most common cause, and other factors like dehydration and electrolyte imbalances are more likely culprits. Many people believe salt is the key to preventing cramps, but the reality is that water and overall electrolyte balance are more crucial.
Hello Cyril … There is so much guess work with Parkinson’s. The only option our medical team have is to prescribe more pills. Most of the pills we take do us more harm than good or make no difference at all. Misdiagnosis is a fact of life.
As to being salt deficient … maybe eat a packet of crisps a day. What have you got to lose? If it doesn’t help stop eating the crisps.
Maybe try drinking electrolyte water or more water generally. Also exercise is important.
In consultation with a private neurologist I trialed taking no Parkinson’s at all for
2 months. When I went back on the medication I found I felt better. However I now only take pills at 7am & 1pm. I leave out the evening pills & have found I sleep a lot better.
Maybe experiment with when you take your pills, after discussing with your medical team to be safe.
Best of luck.
Steve2
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Thank you so much for reaching out and sharing your husband’s experience. We’re really sorry to hear he’s been having such a tough time with severe cramps and disrupted sleep—this can be incredibly challenging for both of you. Leg cramps can sometimes be a symptom associated with Parkinson’s itself or with certain Parkinson’s medications. Some people find relief by gently stretching before bed, massaging the affected area, or using a warm compress. Magnesium supplements or increasing hydration may help for some, but we always recommend discussing any new approaches with your Parkinson’s specialist or nurse to ensure they’re safe and appropriate for your husband’s specific situation.
As things haven’t improved with the GP and medications like codeine and ropinirole, you might want to ask for a referral to a Parkinson’s specialist if you haven’t already. Sleep clinics or physiotherapists with experience in Parkinson’s can sometimes provide additional strategies. If things feel overwhelming or you need further support, our Parkinson’s UK helpline is here to listen and offer tailored advice.
Hi there, you can buy magnesium spray (oil). Recommended by my PD hubby’s personal trainer and seemed yo work for him. Bev