Leg Cramps

What does published research recommend to avoid or relieve leg cramps?

SUMMARY – Prevention – avoid long periods of standing or sitting; stay hydrated, reduce alcohol consumption;

Things that probably help: stretch, drink water, massage leg, potassium, quinine – see Source 5 below is best information from the Cleveland Clinic

Things that probably do not work; magnesium, calcium, sodium

Source 5) How do I stop leg cramps immediately?

You want to get rid of a leg cramp the moment it strikes. You might be finishing up an exercise routine, or a cramp might wake you up in the middle of the night. In moments like that, unfortunately, there aren’t any magical injections that can instantly relieve your pain. However, there are eight steps to take to possibly get rid of a leg cramp:

  1. Stretch: Straighten your leg and then flex it, pulling your toes toward your shin to stretch the muscles. Stretch the cramped muscle, and gently rub. For a thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself.
  2. Massage: Use your hands or a roller to massage the muscles.
  3. Stand: Get up. Press your feet against the floor.
  4. Walk: Wiggle your leg while you walk around.
  5. Apply heat: Use a heating pad or take a warm bath.
  6. Apply cold: Wrap a bag of ice in a towel and apply it to the area.
  7. Take pain medications: Take ibuprofen or acetaminophen to help with the pain.
  8. Elevate: Prop up your leg after the cramp starts to feel better.

Source 1) National Institutes of Health BMJ Clin Evid. 2015; 2015: 1113.

We found 16 studies that met our inclusion criteria. We present information relating to the effectiveness and safety of the following interventions: analgesics; anti-epileptic drugs; calcium salts; diltiazem; magnesium salts; multivitamin and mineral supplements; quinine; sodium chloride; stretching exercises; verapamil; vitamin B6 (pyridoxine); and vitamin E.

Quinine reduces the frequency of idiopathic leg cramps at night compared with placebo. CAUTION: quinine may be associated with cardiac arrhythmias, thrombocytopenia, and severe hypersensitivity reactions.

We don’t know whether analgesics, anti-epileptic drugs, diltiazem, magnesium salts, stretching exercises, verapamil, vitamin B6, or vitamin E reduce idiopathic leg cramps.

Source 2) Up to 60 percent of adults report that they have had nocturnal leg cramps. Medications that are strongly associated with leg cramps include intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide.  Limited evidence supports treating nocturnal leg cramps with exercise and stretching, or with medications such as magnesium, calcium channel blockers, carisoprodol, or vitamin B(12). Adjusting for alcohol consumption, we observed an association between Nocturnal Leg Cramps and a sedentary lifestyle OR = 9.84.  Recently, we also showed a strong association with the global consumption of alcoholic beverages15 prolonged standing2

 Source 3) Magnesium is commonly used to treat muscle cramps. Moderate quality evidence indicates that magnesium is not effective for treating or preventing cramps in older adults.[6]  With exertional heat cramps due to electrolyte abnormalities (primarily potassium loss and not calcium, magnesium, and sodium), appropriate fluids and sufficient potassium improves symptoms.[27] Vitamin B complex, naftidrofuryl, lidocaine, and calcium channel blockers may be effective for muscle cramps.[26]  

Prevention: Adequate conditioning, stretching, mental preparation, hydration, and electrolyte balance are likely helpful in preventing muscle cramps.[25]