Leg cramps - Treatments

Treatments that work

Quinine

Studies have shown that quinine can prevent cramps in your legs. One summary of the research (a systematic review) found that people who took quinine for a month had fewer leg cramps at night than those who took a dummy treatment (a placebo).[1] However, quinine has side effects, and can be dangerous if you take too much of it.

We don't know how much quinine you should take to treat leg cramps, or how long you should take it.[2] Your doctor might give you 200 milligrams to 300 milligrams to take at bedtime.[3] You might have to take quinine for up to four weeks before you see an improvement. Also, you'll probably need to take quinine every day for it to work.

One small study (a randomised controlled trial) found that taking quinine with another drug called theophylline worked better than taking quinine on its own.[4] But more research needs to be done before we can say for sure whether theophylline can help treat leg cramps and is safe for this purpose.

Side effects from a normal dose of quinine aren't all that common. It might cause a ringing in your ears (known as tinnitus), headaches, stomach upsets, a temperature, blurred vision, dizziness and itchy skin.[1] In studies, about 3 in 100 people taking quinine got ringing in their ears.[1]

A big problem with quinine is that it's poisonous if you take too much.[5] Too much quinine can cause a syndrome known as cinchonism.[6] You could feel sick, or get vomiting, headaches, tinnitus, deafness, vertigo and disturbed vision.

You shouldn't take quinine if you're pregnant or could become pregnant.

In the US, the organisation which monitors drug safety has warned that quinine can occasionally cause severe, or even fatal side effects.[7] Between 1969 and 2006, there were reports of 93 deaths in the US that were linked to quinine. US doctors are advised not to prescribe quinine for leg cramps, although they are free to do so if they think it will benefit a particular patient.

In the UK, doctors are advised to keep a close check on people taking quinine.[5] Your doctor will want to make sure you're not getting side effects.

If quinine doesn't help your leg cramps after a few weeks, you should stop taking it. Even if quinine does work, you should take a break from it every three months or so. If your cramps don't come back, there's no need to start taking it again.

Treatments that need further study

Magnesium

More good-quality studies are needed to show whether taking a supplement of magnesium can reduce the number of leg cramps you get and make them less painful.

The research has shown that magnesium can help pregnant women (see below). But two studies of people who had leg cramps for unknown reasons found that treatment with magnesium didn't work any better than treatment with a dummy treatment (a placebo).[8] [9]

Painkillers

There's no research to tell us if taking a painkiller, such as paracetamol or ibuprofen, helps leg cramps. But since the muscle spasm usually lasts for only a short time, the pain will probably go away before a painkiller has time to work.

Stretching exercises

When you get cramp, stretching or rubbing your leg often seems to get rid of it. So, some researchers think that regular stretching exercises might prevent leg cramps. However, there's no good research to tell us whether stretching works or not.

One study compared two different stretching exercises.[10] For the first, people stood in their bare feet, facing a wall from about 2 or 3 feet away. With their hands on the wall, they leant forward, keeping their backs upright and their heels on the floor. The aim was to feel moderate, but not painful, stretching in their calf muscles.

The second type of stretch involved people lying face up with their legs out straight. They then lifted their knees towards their chins, so their feet were brought towards their bottoms.

People held the stretches for 10 seconds, and did three of them, three times a day. However, neither of these exercises made any difference to the cramps people got.[10] It's possible that doing stretches for longer would be better, but there's no research to say.

Support stockings

Support stockings are stockings or tights made of strong elastic. You wear them throughout the day and take them off at night. People often wear these stockings to stop their veins from bulging if they have varicose veins in their legs (varicose veins happen when valves in veins don't work properly, so blood pools in the veins).

There's no evidence that wearing support stockings can prevent leg cramps. But they might help if varicose veins are causing your legs to cramp.

Vitamin E

Taking a supplement of vitamin E probably won't prevent your leg cramps. One small, poor-quality study found that people who took vitamin E had almost as many nights with leg cramps as those who took a dummy treatment (a placebo).[11] The study didn't show any side effects from taking vitamin E.

Treatments that are likely to work

Magnesium

Taking a magnesium supplement will probably help if you get leg cramps while you are pregnant.[12] Research has shown that this treatment is safe.

One small study (a randomised controlled trial) found that pregnant women who chewed three magnesium pills a day (300 milligrams in total) for three weeks had fewer leg cramps than women who had a dummy treatment (a placebo).[13]

The women who took either magnesium or the placebo had only mild side effects, most often slight nausea. More research is needed to find out how long the benefits of taking magnesium last.

Treatments that need further study

Calcium

We don't know if taking a calcium supplement helps. The results from the research are mixed.

One study (a randomised controlled trial) found that women who took a calcium supplement had fewer leg cramps during pregnancy.[14] But another study found that women who took calcium had just as many leg cramps as those who took a vitamin C supplement instead.[15]

More reliable research needs to be done before we can say for certain whether calcium can stop leg cramps if you're pregnant. Also, the studies don't tell us whether calcium supplements cause side effects during pregnancy.

Multivitamins and mineral supplements

Taking a multivitamin and a mineral supplement probably won't prevent your leg cramps if you are pregnant. Doctors don't usually recommend taking these kinds of supplements during pregnancy because they contain lots of different ingredients. Some vitamins aren't good for your baby if you have too much of them.

One small study (a randomised controlled trial) found no difference in leg cramps during the ninth month of pregnancy for women who took either a multivitamin plus a mineral supplement, or a dummy treatment (a placebo).[16]

The women had started taking the supplements three months into their pregnancy. About 1 in 25 women said they got nausea, vomiting and diarrhoea. But it's not clear from the study whether the women who got these side effects were taking the supplements or the placebo.

More than half of the women dropped out of the study, so the results aren't very reliable.

Adding extra salt to your food

We don't know whether eating extra salt while you're pregnant will stop your leg cramps. But it could make your blood pressure go up, which could be dangerous.

There has been only one study, which was done in 1947 and was not good-quality.[17] More research needs to be done before we can say whether adding salt to your food can help leg cramps without causing any unwanted effects.