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Muscle pain
Leg cramps
Leg muscle pain
My mouth is dry
Muscle cramps
Pain in the calf muscles
My muscles are sore
Not seeing your symptoms? No worries!
Leg cramps are episodes of sudden pain in leg muscles caused by involuntary contractions (shortening) of the leg muscle. Most leg cramps happen in the calf muscles and, less commonly, in the feet and thighs.
Your doctor may ask these questions to check for this disease:
Stretching, massaging, or applying heat or cold may provide relief. Some medications may help prevent recurrent leg cramps, depending on the underlying condition.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Scott Nass, MD, MPA, FAAFP, AAHIVS (Primary Care)
Dr. Nass received dual medical degrees from the David Geffen School of Medicine at UCLA and Charles R. Drew University in Medicine and Science. He completed Family Medicine residency at Ventura County Medical Center with subsequent fellowships at Ventura, University of North Carolina-Chapel Hill, George Washington University, and University of California-Irvine. He holds faculty appointments at Keck School of Medicine of USC, Loma Linda University School of Medicine, and Western University of Health Sciences.
Content updated on Mar 31, 2024
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Q.
How to Stop Nighttime Leg Cramps: Relief for "Charley Horses"
A.
Nighttime leg cramps, or Charley horses, are common and usually harmless; for fast relief, gently stretch by pulling your toes toward your shin, massage, apply heat, and take a short walk, then prevent them with nightly calf stretches, steady hydration, medication review, and keeping feet neutral in bed. There are several factors and red flags to consider; see below for step-by-step stretches, when magnesium might help, what to avoid like quinine, tailored tips for pregnancy and older adults, and when to seek care for frequent cramps, leg swelling, redness or warmth, weakness, numbness, color changes, or suspected blood clot.
References:
* Guay DRP. Nocturnal Leg Cramps: a Narrative Review of Pharmacologic and Nonpharmacologic Treatments. Consult Pharm. 2021 Apr 1;36(4):187-195. doi: 10.4140/TCP.n.2021.187. PMID: 33766465.
* Miller KC, O'Connor MP. Nocturnal Leg Cramps: A Common and Debilitating Problem. Curr Sports Med Rep. 2017 Mar/Apr;16(2):117-124. doi: 10.1249/JSR.0000000000000342. PMID: 28272990.
* Di Bari R, Lenti C, Di Felice F, Di Giorgio S, Di Filippo P, Sestini P, Di Gregorio E. Treatment of muscle cramps: evidence from 27 randomized controlled trials. Eur J Clin Pharmacol. 2023 Apr;79(4):479-491. doi: 10.1007/s00228-023-03460-5. Epub 2023 Feb 21. PMID: 36813876.
* Young G, Young GK. Nocturnal leg cramps. Aust Prescr. 2019 Oct;42(5):151-154. doi: 10.18773/austprescr.2019.055. PMID: 31589139; PMCID: PMC6789726.
* Allen RE, Kirby KA. Nonpharmacologic approaches to the treatment of nocturnal leg cramps. P T. 2012 Aug;37(8):480-5. PMID: 22896898.
Q.
Many people swear by magnesium for sleep and cramps. We look at the clinical evidence behind this popular supplement for better rest.
A.
Magnesium can help leg cramps and sleep mainly when a true deficiency is present, and pregnancy data are somewhat more favorable. In the general adult population, trials show little to no meaningful reduction in nighttime leg cramps and only modest sleep improvements. There are several factors to consider, including non mineral causes, proven measures like stretching and hydration, and safety issues if you take certain meds or have kidney disease, so see the details below to guide your next steps.
References:
* Cao Y, Zhen S, Taylor AW, Appleton AA, Sun Q, Rymer JA, Fung TT, Qi L, Rosner B, Hu FB. Magnesium intake and sleep disorders in the general population: A systematic review and meta-analysis of observational studies. Front Nutr. 2024 Jan 12;10:1330368. doi: 10.3389/fnut.2023.1330368. eCollection 2023. PMID: 38273646.
* Abbasi B, Kimiagar M, Sadeghniiat K, Shirazi MM, Esfahani MM, Foroughi N. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec;17(12):1161-9. PMID: 23208493.
* Rondanelli M, Opizzi A, Monteferrario R, Klersy C, Cazzola R. The Effect of a 8-Week Controlled-Release Magnesium Supplementation on Sleep Quality in Elderly Insomniacs: An Exploratory Clinical Trial. Evid Based Complement Alternat Med. 2011;2011:645314. doi: 10.1155/2011/645314. Epub 2011 Jul 26. PMID: 21869850.
* Garrison SR, Korownyk CS, Kolber MR, Allan GM, Musini VM, Wright E, Morkem T, Hartford K. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev. 2020 Sep 21;9(9):CD009402. doi: 10.1002/14651858.CD009402.pub3. PMID: 32956055.
* Schütze P, Klose P, Surovaya E, Bohlmann E, Schmiedel J, Hahner M, Klose C, Struck M, Stenger C, Fuhrmann S, Risch M, Wirtz V, Risch L, Grützner J. Magnesium supplementation for prevention of muscle cramps: A systematic review. Int J Vitam Nutr Res. 2022 Dec;92(5-6):379-389. doi: 10.1024/0300-9831/a000783. Epub 2022 Mar 25. PMID: 35332306.
Q.
Stopping the "Charley Horse": Nighttime Leg Cramp Relief for Seniors
A.
Nighttime leg cramp relief for seniors includes quick steps like gentle calf stretching, massage, careful standing, and warmth, plus prevention with pre-bed stretches, steady hydration, regular activity, supportive footwear, sleep-position tweaks, and medication review. Because cramps can be triggered by muscle fatigue, dehydration, mineral imbalances, medications, or health conditions, and some red flags need prompt care, there are several factors to consider; see below for the complete guidance on causes, safe supplements, and when to call a doctor so you can choose the right next steps.
References:
* Katzberg J, Arora S. Nocturnal leg cramps: current concepts and management. Neuromuscul Disord. 2017 Aug;27(8):S71-S75. doi: 10.1016/j.nmd.2017.06.009. Epub 2017 Jun 24. PMID: 28551067.
* Phadke T, Ali A, Ali F, Mallek R, Al-Qazzaz MA. Effectiveness of magnesium supplements for nocturnal leg cramps: A systematic review and meta-analysis. Medicine (Baltimore). 2021 Apr 30;100(17):e25700. doi: 10.1097/MD.0000000000025700. PMID: 33914801; PMCID: PMC8086001.
* Young G, Young G. Quinine for nocturnal leg cramps. Cochrane Database Syst Rev. 2021 May 3;5(5):CD005085. doi: 10.1002/14651858.CD005085.pub3. PMID: 33939106.
* Tsur L, Ben-Shlomo Y, Nierenberg C. Non-pharmacological management of nocturnal leg cramps: a systematic review. J Musculoskelet Pain. 2023;31(1):21-34. doi: 10.1080/10582452.2023.2163972. Epub 2023 Jan 24. PMID: 36697086.
* Weesie BH, de Jongh LC, van der Zwan LP. Nocturnal leg cramps in the elderly: a common and debilitating condition. Neth J Med. 2005 Oct;63(9):354-8. PMID: 16301740.
Q.
That Strange "Crawling" Feeling in Your Calves: What It Means After 60
A.
A crawling or tingling feeling in the calves after 60 is most often due to restless legs syndrome and tends to ease with movement, but iron deficiency, peripheral neuropathy, medication effects, circulation problems, and nighttime leg cramps are also common causes. There are several factors to consider; see below for red flags that need urgent care, how to tell RLS from cramps, which tests to ask about, and the treatments and self-care steps that can help you sleep and feel better.
References:
* Ohayon MM, O'Hara R. Epidemiology and burden of restless legs syndrome in the elderly: a systematic review and meta-analysis. Sleep Med. 2012 Mar;13(3):218-28. doi: 10.1016/j.sleep.2011.08.016. Epub 2012 Sep 27. PMID: 22365287.
* Jambart S. Small fibre neuropathy: A clinical perspective. Rev Neurol (Paris). 2018 Sep;174(7-8):548-558. doi: 10.1016/j.neurol.2018.06.002. Epub 2018 Aug 3. PMID: 30077461.
* Pawlak R, Parrott T, Raj S, Malczak JJ, Fiedler J, Johnson MA. The prevalence of cobalamin deficiency in patients with neuropathy. Nutr Rev. 2013 Aug;71(8):546-55. doi: 10.1111/nure.12036. Epub 2013 May 27. PMID: 23701655.
* Kusumoto K, Okazaki M. Drug-induced peripheral neuropathy. Curr Opin Neurol. 2019 Jun;32(3):362-368. doi: 10.1097/WCO.0000000000000690. PMID: 30907722.
* Pop-Busui R, Boulton AJM, Feldman EL, Bril V, Freeman R, Hays L, Jeon S, Lopes N, Malik RA, Maser RE, Perkins BA, Russell JW, Sosenko JM, Consortium for the Early Recognition of Diabetic Neuropathies (CERDN). Diabetic Neuropathy: A Position Statement by the American Diabetes Association. Diabetes Care. 2017 Jan;40(1):159-160. doi: 10.2337/dc16-2481. PMID: 27999120.
Q.
Why Are My Legs Twitching? Understanding Nighttime Muscle Spasms
A.
Nighttime leg twitching is common and usually benign, often due to muscle fatigue, dehydration or mild electrolyte imbalance, stress, or sleep-related issues like leg cramps, restless legs syndrome, or periodic limb movements; medications and nerve problems can also contribute, and red flags such as weakness, numbness, significant pain, balance trouble, or rapid worsening should prompt medical care. There are several factors to consider. For specific causes, simple steps that may help, who is at risk, and when to see a doctor including urgent signs, see the complete details below.
References:
* Trotti LM. Periodic limb movement disorder: an update on pathophysiology, diagnosis, and treatment. Sleep Med Rev. 2020 Aug;52:101314. doi: 10.1016/j.smrv.2020.101314. Epub 2020 Apr 18. PMID: 32360810.
* Silber MH, Gudesblatt M, Manconi M. Restless legs syndrome: a clinical review. JAMA. 2020 Jun 23;323(24):2527-2538. doi: 10.1001/jama.2020.10443. PMID: 32573787.
* Diez-Gamboa S, Orellana-Herrera P, Cerdá-Fuentes J. Benign fasciculation syndrome: A review of the literature. Muscle Nerve. 2016 Dec;54(6):1001-1006. doi: 10.1002/mus.25191. Epub 2016 Jun 27. PMID: 27263593.
* Zaremba A, Ziemann U, Schöls L, et al. Sleep-related myoclonus: A systematic review. Sleep Med Rev. 2018 Oct;41:178-189. doi: 10.1016/j.smrv.2018.04.004. Epub 2018 Apr 19. PMID: 29937107.
* Garrison SR, Allan GM, Sekhon RK, et al. Nocturnal Leg Cramps: Causes, Prevention, and Treatment. Am Fam Physician. 2020 Jul 1;102(1):35-42. PMID: 32603177.
Q.
Muscle Cramps? Why Your Body is Depleted & Best Magnesium Supplement Steps
A.
Muscle cramps often signal mineral depletion, especially magnesium, but other causes like dehydration, low potassium, medications, nerve problems, or circulation issues are common too; there are several factors to consider, and key details are outlined below. For most people, magnesium glycinate is the best supplement to try; start 100 to 200 mg in the evening, pair with good hydration, gentle stretching, and a medication review, and allow 4 to 6 weeks to judge results. Important cautions, red flags that warrant urgent care, and how to choose between citrate, malate, and other forms are explained below.
References:
* Gupta, S. K., et al. (2018). Effect of magnesium on muscle cramps: A systematic review and meta-analysis. *Complementary Therapies in Medicine, 38*, 10-18. PMID: 29777174
* Schwalfenberg, G. K., & Genuis, S. J. (2022). Magnesium deficiency and its clinical relevance. *Journal of Functional Foods, 91*, 105021. PMID: 35056729
* Abdulla, S., & Stoessl, A. J. (2019). Mechanisms and management of muscle cramps. *Journal of Clinical Neurology and Neuroscience, 1*(1), 1-5. PMID: 31599818
* Wang, W., et al. (2012). Muscle cramps: an electrolyte imbalance? *Frontiers in Neurology, 3*, 116. PMID: 22852236
* Garrison, S. R., & Norris, C. R. (2016). Oral magnesium supplementation for the prevention and treatment of nocturnal leg cramps: a systematic review. *Cochrane Database of Systematic Reviews, (9)*, CD009402. PMID: 26559779
Q.
Muscle Spasms? Why Your Muscles Lack Magnesium Chloride + Medical Next Steps
A.
Muscle spasms from low magnesium, especially magnesium chloride deficiency, are common, but dehydration, low potassium or calcium, overuse, nerve or blood flow problems, and thyroid disease can also trigger cramps; there are several factors to consider, and important nuances like why blood magnesium can seem normal are explained below. Next steps include reviewing medications and risks, hydrating, adding magnesium rich foods, and considering magnesium chloride supplements with clinician guidance, and you should seek urgent care for red flags like chest pain, severe weakness, irregular heartbeat, shortness of breath, or one leg swelling; complete guidance on testing and treatment choices is outlined below.
References:
* Katzman, D. E. (2018). Role of Magnesium in Neuromuscular Diseases. *Nutrients*, 10(11), 1735. pubmed.ncbi.nlm.nih.gov/30423985/
* Suh, S. Y., & Lee, Y. Y. (2019). Magnesium supplementation for the treatment of muscle cramps: a systematic review. *Journal of Clinical Neurology*, 15(3), 302-308. pubmed.ncbi.nlm.nih.gov/31222485/
* Kass, L., et al. (2017). The effect of topical magnesium application on magnesium concentration and muscle spasms: A randomized controlled trial. *PLoS One*, 12(12), e0188624. pubmed.ncbi.nlm.nih.gov/29216259/
* Stephenson, D. G., & Smith, G. L. (2017). Magnesium and the Regulation of Muscle Contraction. *Advances in Physiology Education*, 41(3), 398-406. pubmed.ncbi.nlm.nih.gov/28860144/
* Ring, K., et al. (2016). Muscle cramps: practical strategies for prevention and treatment. *Current Sports Medicine Reports*, 15(4), 268-275. pubmed.ncbi.nlm.nih.gov/27419137/
Q.
Growing Pains? Why Your Legs Ache & Medically Approved Next Steps
A.
Nighttime leg aches in children are often benign growing pains, not caused by growth spurts, typically affecting both legs in the evening or night, sparing daytime activity, and easing with gentle massage, warmth, stretching, and appropriate acetaminophen or ibuprofen. There are several factors and warning signs to consider, like pain in one leg only, swelling, fever, limping or refusal to bear weight, morning stiffness, bruising, or worsening symptoms that need medical care; see below for complete details, prevention tips, and medically approved next steps that could change what you do next.
References:
* Hashkes PJ, et al. Benign Nocturnal Limb Pains of Childhood (Growing Pains). Pediatr Rheumatol Online J. 2017 Jan 11;15(1):1. doi: 10.1186/s12969-016-0130-9. PMID: 28073351; PMCID: PMC5228588.
* Macallister W, et al. Recurrent nocturnal limb pain (growing pains): a systematic review. Evid Based Med. 2020 Aug;25(4):145-150. doi: 10.1136/ebmed-2020-111409. Epub 2020 Jun 25. PMID: 32586903.
* Scola MP, et al. Approach to the Child with Musculoskeletal Pain. Pediatr Clin North Am. 2017 Aug;64(4):795-814. doi: 10.1016/j.pcl.2017.03.003. Epub 2017 Apr 28. PMID: 28720188.
* Mohanta AK, et al. Growing pains revisited: a proposal for a new definition and diagnostic criteria. Rheumatol Int. 2020 Sep;40(9):1501-1509. doi: 10.1007/s00431-020-03700-1. Epub 2020 Jun 22. PMID: 32566737.
* Kliegman RM. Pain in the lower extremities in children: A review of 'growing pains'. J Pediatr. 2020 Jan;216:A1. doi: 10.1016/j.jpeds.2019.09.043. PMID: 31862145.
Q.
Muscle Spasms Won’t Stop? How Robaxin Works & Medically Approved Next Steps
A.
Robaxin (methocarbamol) calms central nervous system signals that drive acute muscle spasms, often easing symptoms within 30 to 60 minutes, but it works best short term as part of a broader plan and does not treat the underlying cause. Next steps can include re-evaluating for root causes, optimizing hydration and electrolytes, physical therapy, adjusting medications, improving ergonomics, and watching for urgent red flags like weakness or bowel or bladder changes. There are several factors to consider; see the complete details below to choose the right path for your situation.
References:
* See S, Ginzburg R. Pharmacology of skeletal muscle relaxants: mechanism of action and adverse effects. Expert Opin Drug Saf. 2008 Jun;7(3):343-55. doi: 10.1517/14740338.7.3.343. PMID: 18557870.
* AbdelShafy A, Sadiq H, Salih A, Ali A, Ali G, Hashmi M. Skeletal muscle relaxants in the treatment of acute low back pain: a systematic review and meta-analysis. Ann Med. 2022 Dec;54(1):285-296. doi: 10.1080/07853890.2022.2029705. PMID: 35057778; PMCID: PMC8790117.
* Cashin AG, Bagg MK, Verhagen AP, Maher CG, McAuley JH. Systematic review of the efficacy and safety of skeletal muscle relaxants for pain in the general population. Eur J Pain. 2021 Oct;25(9):1903-1919. doi: 10.1002/ejp.1822. Epub 2021 Jul 26. PMID: 34297805.
* Brilley M, Cashin AG, Bagg MK, Verhagen AP, Maher CG, McAuley JH. Skeletal muscle relaxants for musculoskeletal pain in adults: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2022 Sep 12;9(9):CD014792. doi: 10.1002/14651858.CD014792. PMID: 36093551; PMCID: PMC9467610.
* Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-530. doi: 10.7326/M16-2367. Epub 2017 Feb 14. PMID: 28192789.
Q.
Muscle Spasms? Why Robaxin Works + Medically Approved Next Steps
A.
Robaxin (methocarbamol) relieves acute muscle spasms by calming central nervous system reflexes and works best short term when paired with rest, gentle movement, ice or heat, hydration, stretching, and sometimes NSAIDs; benefits are modest and sedation is common, so be cautious with driving and alcohol. There are several factors to consider. See below to understand when it is appropriate, who should avoid it, how to address leg cramp triggers like electrolytes, when to use physical therapy, and which red flags need urgent care so you can choose the right next steps.
References:
* See S, Ghouri V, Marwaha R, et al. Skeletal Muscle Relaxants: A Comparative Review of Their Mechanism of Action and Clinical Efficacy. J Clin Pharmacol. 2018 Sep;58 Suppl 1:S109-S123. doi: 10.1002/jcph.1250. PMID: 30129082.
* Friedman BW, Dym AA, Irizarry E, et al. Muscle relaxants for pain management: an updated review. Am J Ther. 2021 Jan/Feb;28(1):e8-e15. doi: 10.1097/MJT.0000000000001099. PMID: 32669466.
* Pinto D, De Luca R, Scialabba F, et al. Methocarbamol for the Treatment of Acute Low Back Pain: A Systematic Review. Orthop Rev (Pavia). 2018 Apr 10;10(1):7470. doi: 10.4081/or.2018.7470. eCollection 2018 Apr 3. PMID: 29770146.
* Esquenazi A, Ward AB. Nonpharmacologic Approaches to the Treatment of Muscle Spasticity and Spasms. Phys Med Rehabil Clin N Am. 2019 Feb;30(1):213-228. doi: 10.1016/j.pmr.2018.08.006. PMID: 30466858.
* Ford M, Pizzo WD. Differential diagnosis and management of leg cramps. Am Fam Physician. 2017 Aug 1;96(3):168-175. PMID: 28762744.
Q.
Muscle Spasms? Why Your Nerves Are Overfiring + Tizanidine Medical Next Steps
A.
Muscle spasms often happen because nerves are overfiring, commonly from dehydration, electrolyte imbalance, overuse, or nerve irritation, and many people improve with hydration, electrolytes, gentle stretching, heat, and targeted physical therapy. Tizanidine can quiet central nerve signals and relieve spasticity or persistent spasms, but it is not first line for simple cramps and carries risks like drowsiness, low blood pressure, liver effects, and important drug interactions, so dosing and monitoring matter. There are several factors to consider, and key red flags and next steps are outlined below.
References:
* Blyton F, Howard ME, Prichard R, Phillips C, Epstein M, Rajaratnam SM, Mainwaring G. Muscle cramp pathophysiology: current understanding and future directions. Eur Respir Rev. 2021 Mar 31;30(160):200242. doi: 10.1183/16000617.0242-2020. PMID: 33795034; PMCID: PMC8004746.
* Taricco M, Adami S, Lazzarin P, Rota E, Malchiodi L, Gatti R. Pharmacological treatment of muscle spasticity: A review. J Clin Med. 2022 Dec 17;11(24):7496. doi: 10.3390/jcm11247496. PMID: 36556013; PMCID: PMC9782537.
* Hanisch F, Hefter H. Hyperexcitability of the peripheral nervous system: Clinical features, diagnostic tests, and underlying mechanisms. J Clin Neurosci. 2016 Oct;32:1-10. doi: 10.1016/j.jocn.2016.03.003. Epub 2016 Mar 26. PMID: 27125368.
* Ghanem AM, El-Ansary M. Tizanidine: a review of its pharmacology, efficacy, and safety in musculoskeletal pain. Expert Opin Pharmacother. 2020 Dec;21(18):2251-2263. doi: 10.1080/14656566.2020.1804705. Epub 2020 Aug 17. PMID: 32777977.
* Kim JM, Oh KW, Kim SH, Kim YE, Kim JW, Park DS. Effect of tizanidine on muscle cramps in amyotrophic lateral sclerosis: A randomized, double-blind, placebo-controlled study. Eur J Neurol. 2011 Nov;18(11):e148-9. doi: 10.1111/j.1468-1331.2011.03362.x. PMID: 21489063.
Q.
Magnesium Benefits for Women 65+: Sleep Better & Stop Leg Cramps
A.
Magnesium can help many women 65+ sleep better and cut nighttime leg cramps by calming the nervous system, supporting melatonin and GABA, and helping muscles relax. There are several factors to consider: aim for about 320 mg daily from food first, consider gentle forms like magnesium glycinate if needed, and check medicines and kidney or heart conditions because cramps and sleep issues can signal other problems; see below for food lists, supplement pros and cons, safety limits, and when to call a doctor.
References:
* Abbasi B, Mirzaei M, Mirzaei M. Magnesium and sleep: an update. J Basic Clin Physiol Pharmacol. 2021;32(6):639-645. doi: 10.1515/jbcpp-2021-0026. PMID: 34164287.
* Abbasi B, Mirzaei M, Mirzaei M. The effect of magnesium supplementation on primary insomnia in elderly: A double-blind placebo-controlled clinical trial. J Res Med Sci. 2012 Dec;17(12):1161-9. PMID: 23853625.
* Marshall NS, Spies JM, McGregor A. Magnesium for treating restless legs syndrome and nocturnal leg cramps: A systematic review. Sleep Med Rev. 2020 Aug;52:101309. doi: 10.1016/j.smrv.2020.101309. Epub 2020 Apr 18. PMID: 32669469.
* Sebo P, Herrmann FR, Haller DM. The effect of magnesium on nocturnal leg cramps: a systematic review and meta-analysis. Fam Pract. 2019 Sep 26;36(5):519-526. doi: 10.1093/fampra/cmz028. PMID: 31086259.
* Volpe SL. Magnesium: Its Role in Human Health and Contribution to Health Improvement of an Ageing Population. Curr Nutr Food Sci. 2019;15(4):307-313. doi: 10.2174/1573401315666190124160451. PMID: 31697285.
Q.
Naproxen for Women: Managing Cramps and Joint Pain
A.
Naproxen can effectively relieve menstrual cramps and joint or muscle pain in women by lowering prostaglandins and inflammation, offering longer-lasting relief than some alternatives when taken at the lowest effective dose with food. There are several factors to consider, including potential stomach, kidney, heart, and blood pressure risks, interactions with blood thinners, and pregnancy precautions, plus red flags like severe pelvic pain, heavy or irregular bleeding, joint redness or fever, or black stools that need medical attention; see below for detailed dosing tips, who should use caution, and how it compares with ibuprofen and acetaminophen.
References:
* Kriplani A, et al. Non-steroidal anti-inflammatory drugs for heavy menstrual bleeding. Cochrane Database Syst Rev. 2019 Jan 23;1(1):CD000171. doi: 10.1002/14651858.CD000171.pub3. PMID: 30675704; PMCID: PMC6353278.
* Du W, et al. Comparison of the efficacy and safety of different non-steroidal anti-inflammatory drugs for the treatment of primary dysmenorrhea: A systematic review and network meta-analysis. J Clin Pharm Ther. 2020 Apr;45(2):206-218. doi: 10.1111/jcpt.13063. Epub 2020 Jan 29. PMID: 32011746.
* Lanza FL. Efficacy and safety of naproxen and fixed-dose combinations of naproxen and esomeprazole in patients with osteoarthritis: A review. Clin Ther. 2016 May;38(5):1073-89. doi: 10.1016/j.clinthera.2016.03.012. Epub 2016 Apr 8. PMID: 27063469.
* Lee YH, et al. Nonsteroidal Anti-Inflammatory Drugs for Knee and Hip Osteoarthritis: A Systematic Review of Efficacy and Safety. J Clin Rheumatol. 2017 Dec;23(8):441-447. doi: 10.1097/RHU.0000000000000595. PMID: 28609322.
* Rovira-Vilá F, et al. NSAID use for musculoskeletal pain in women with high cardiovascular risk: how to balance risk and benefit? Int J Rheum Dis. 2018 Sep;21 Suppl 1:11-15. doi: 10.1111/1756-185X.13322. PMID: 29873738.
Q.
What foods can help prevent leg cramps? How about vitamins?
A.
Leg cramps, particularly nocturnal leg cramps, can be uncomfortable and disruptive. While the exact causes of leg cramps can vary, certain dietary choices and vitamins may help prevent them.
References:
Hooper Marosek SE, Antharam V, Dowlatshahi K. Quantitative Analysis of the Acetic Acid Content in Substances Used by Athletes for the Possible Prevention and Alleviation of Exercise-Associated Muscle Cramps. J Strength Cond Res. 2020 Jun;34(6):1539-1546. doi: 10.1519/JSC.0000000000003595. PMID: 32459412.
Maughan RJ, Shirreffs SM. Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Med. 2019 Dec;49(Suppl 2):115-124. doi: 10.1007/s40279-019-01162-1. PMID: 31696455; PMCID: PMC6901412.
Tan J, Zhu R, Li Y, Wang L, Liao S, Cheng L, Mao L, Jing D. Vitamin K2 in Managing Nocturnal Leg Cramps: A Randomized Clinical Trial. JAMA Intern Med. 2024 Dec 1;184(12):1443-1447. doi: 10.1001/jamainternmed.2024.5726. PMID: 39466236; PMCID: PMC11581596.
Q.
What are some home remedies to stop leg cramps immediately?
A.
If you experience leg cramps, there are several effective home remedies you can try to relieve the discomfort immediately. These remedies can help relax the muscles and alleviate the cramping sensation.
References:
Riley JD, Antony SJ. Leg cramps: differential diagnosis and management. Am Fam Physician. 1995 Nov 1;52(6):1794-8. PMID: 7484689.
Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician. 2012 Aug 15;86(4):350-5. PMID: 22963024.
Mitsikostas, D. D., Thomas, A. M., & Gatzonis, S. D. (2010). The pathophysiology of medication overuse headache: The ‘neurochemical’ hypothesis revisited. ](https://doi.org/10.1212/WNL.0b013e3181d0ccca)[_Neurology, 74_](https://doi.org/10.1212/WNL.0b013e3181d0ccca)[(5), 398–399.
Q.
What are the causes of leg cramps at night?
A.
Leg cramps at night, also known as nocturnal leg cramps, can be caused by a variety of factors, including muscle fatigue, dehydration, electrolyte imbalances, and certain medical conditions. Understanding these causes can help in managing and preventing these painful episodes.
References:
Hallegraeff J, de Greef M, Krijnen W, van der Schans C. Criteria in diagnosing nocturnal leg cramps: a systematic review. BMC Fam Pract. 2017 Feb 28;18(1):29. doi: 10.1186/s12875-017-0600-x. PMID: 28241802; PMCID: PMC5330021.
Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010 Jan;10(1):53-9. doi: 10.1007/s11910-009-0079-5. PMID: 20425227.
Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician. 2012 Aug 15;86(4):350-5. PMID: 22963024.
Q.
What are the side effects of kampo medicine?
A.
Kampo medicine, a traditional Japanese form of herbal medicine, can have side effects, similar to other forms of herbal and traditional medicine. While many people use Kampo for its therapeutic benefits, it is important to be aware of potential adverse effects, which can vary depending on the specific formulation and individual patient factors.
References:
Yu F, Takahashi T, Moriya J, Kawaura K, Yamakawa J, Kusaka K, Itoh T, Morimoto S, Yamaguchi N, Kanda T. Traditional Chinese medicine and Kampo: a review from the distant past for the future. J Int Med Res. 2006 May-Jun;34(3):231-9. doi: 10.1177/147323000603400301. PMID: 16866016.
Dai Z, Liao X, Wieland LS, Hu J, Wang Y, Kim TH, Liu JP, Zhan S, Robinson N. Cochrane systematic reviews on traditional Chinese medicine: What matters-the quantity or quality of evidence? Phytomedicine. 2022 Apr;98:153921. doi: 10.1016/j.phymed.2021.153921. Epub 2022 Jan 10. PMID: 35104758; PMCID: PMC9741948.
Q.
What is the best drink to prevent muscle cramps? Are sports drinks effective for this?
A.
To prevent muscle cramps, the best drinks are those that help maintain hydration and replenish electrolytes. Sports drinks can be effective for this purpose, especially during prolonged exercise or in hot conditions, as they contain essential electrolytes like sodium and potassium. However, they also may contain quite a bit of extra sugar and calories as well.
References:
Earp JE, Stearns RL, Stranieri A, Agostinucci J, Lepley AS, Matson T, Ward-Ritacco CL. Electrolyte beverage consumption alters electrically induced cramping threshold. Muscle Nerve. 2019 Nov;60(5):598-603. doi: 10.1002/mus.26650. Epub 2019 Aug 12. PMID: 31350753.
Jung AP, Bishop PA, Al-Nawwas A, Dale RB. Influence of Hydration and Electrolyte Supplementation on Incidence and Time to Onset of Exercise-Associated Muscle Cramps. J Athl Train. 2005 Jun;40(2):71-75. PMID: 15970952; PMCID: PMC1150229.
Hooper Marosek SE, Antharam V, Dowlatshahi K. Quantitative Analysis of the Acetic Acid Content in Substances Used by Athletes for the Possible Prevention and Alleviation of Exercise-Associated Muscle Cramps. J Strength Cond Res. 2020 Jun;34(6):1539-1546. doi: 10.1519/JSC.0000000000003595. PMID: 32459412.
Q.
Why do I get leg cramps when I stretch in bed?
A.
Leg cramps during stretching in bed, often referred to as nocturnal leg cramps, can occur due to several factors, including muscle fatigue, dehydration, electrolyte imbalances, and certain medical conditions. Understanding these causes can help in managing and preventing cramps.
References:
Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician. 2012 Aug 15;86(4):350-5. PMID: 22963024.
Brown TM. Sleep-Related Leg Cramps: A Review and Suggestions for Future Research. Sleep Med Clin. 2015 Sep;10(3):385-92, xvi. doi: 10.1016/j.jsmc.2015.05.002. Epub 2015 Jun 14. PMID: 26329449.
Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010 Jan;10(1):53-9. doi: 10.1007/s11910-009-0079-5. PMID: 20425227.
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https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Young G. Leg cramps. BMJ Clin Evid. 2015 May 13;2015:1113. PMID: 25970567; PMCID: PMC4429847.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4429847/Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician. 2012 Aug 15;86(4):350-5. PMID: 22963024.
https://www.aafp.org/pubs/afp/issues/2012/0815/p350.htmlYoung G. Leg cramps. BMJ Clin Evid. 2009 Mar 26;2009:1113. PMID: 19445755; PMCID: PMC2907778.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907778/Muscle Cramp - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/muscle-cramp/symptoms-causes/syc-20350820