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Same problem. I finally found a doctor who could explain it. If you're borderline diabetic, cortisone can mess with your sugar levels. That results in a diuretic effect (stimulates your kidneys to work harder).

At night, when you're lying down, your kidneys can suck moisture out of your legs more easily and that's what gives you the cramps.

Cure: magnesium or unflavored tonic water.

My comment: You'll be up more often at night, but be sure to drink more water before you go back to bed. You'll still be up again, but not in pain.

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I had a cortizone shot in my shoulder 5 weeks ago and i have had severe muscle cramps in my legs and feet every night. They wake me out of a dead sleep. I am fine during the day.
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I had 2 steroid shots in my right knee 4 weeks apart, and now have lower leg pain (shin area). The pain will wake me at night, it makes me difficult to walk. Has anyone else had this problem?
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Yes, it's been 4 months since I had my steroid injections! SEVERE NEAR DEATH CRAMPS ALL IN MY BODY BEHIND MY EYES MY HEAD MY BACK NECK LEGS FEET. I was rushed to the ER when this first started. I thought I was having a stroke. Do you know after being in the hospital 12 hours an ER doctor told my family it's from the steroid injections in my back. My iron and magnesium and all blood work said I was healthy as a horse. No stroke. The only medicine that helps believe me please is Methocarbomol. Please ask your Dr's for it. I'm on month 4 and still the pain is agony!!!! CHARLEY HORSES EVERYWHERE INCLUDING GROIN BUT METHOCARBAMOL TAKES THE PAIN COMPLETELY AWAY. I can sleep because of methocarbomol. Please try it let me know if this helps. Dr said 3 months to 1 year for this pain to stop.
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Maybe what I write will help someone out there. I had a cortisone injection in both knees the same day. About a week or so later I started having weird leg cramps every hour on the hour. They weren't the normal type. I would lay still in the bed and the minute I moved they would start. Six or Seven times a night at the least. I started sleeping on the sofa so as to not wake my husband up. I also was afraid to go to sleep knowing they would start again. I lost so much weight and I don't need that. I had a sonogram only thyroid, my blood vessel, and a neurologist did the test for neuropathy on my legs...multiple blood test to check my levels of magnesium, Potassium, toxic poisoning etc. I was a living Zombie. Three months and much money later they started getting a little better...like two or three instead of seven. Good thing because I wouldn't be here if they didn't. I feel like the steroid injections were finally leaving my body..The neurologist also gave me Gabapentin which helped but I had to be careful with that...I took the lowest dose..100mg and still it made me a little crazy. I took myself off of it. I am so very sorry for all of you experiencing this. Funny thing...I just developed a bone spur but no way will I go in for a steriod injection. All of the doctors looked at me like I was crazy when I told them I "thought" it "might" be the injections. Also...I did the mustard, pickle juice, tonic water, magnesium, potassium etc. etc. I know they helped with the normal cramps I use to have...but not these. They are different.
I hope this reaches someone to help them...
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