Other preventive measures may include the following: 7 Leg cramps can be prevented if the underlying cause is treated. Nonpharmacologic therapies such as hydration, warm or cold compresses, exercise, and muscle stretches may provide some relief from leg cramps. NONPHARMACOLOGIC MEASURES AND PREVENTIVE STRATEGIES Patients with preexisting medical conditions should consult their primary health care provider before taking any medication, including OTC products, to avoid potential contraindications or drug-drug interactions.
Also available are nonprescription products formulated with homeopathic ingredients for the treatment of leg cramps. 1,7 Some health care providers may suggest the use of OTC analgesics for pain in certain cases. No specific medication is indicated for leg cramps however, several have been used, including calcium-channel blockers, such as diltiazem, and vitamin B complex. 7,8 Fardet et al 8 report that the use of quinine for nocturnal leg cramps was linked to a 3-fold higher mortality rate in individuals younger than 50. Quinine remains available by prescription for the treatment of malaria, but its risks as prophylaxis or a treatment for nocturnal leg cramps outweigh any potential benefits, and the FDA warns against its use in prescription form.
7 In 2006, the FDA also banned the marketing of off-label prescription quinine products. 5Īlthough studies have revealed that quinine sulfate may be helpful in treating leg cramps, the FDA banned its OTC use in 1994 because of the risk for potentially dangerous and fatal adverse reactions, thrombocytopenia, and cardiac arrhythmia. 5 Like RLS, leg cramps may have a circadian pattern and frequently occur at rest however, nocturnal leg cramps are linked to physical changes, including muscle hardening and pain, which are not observed in RLS. 5 RLS is a neurologic movement disorder that causes limb sensations in which a person exhibits an uncontrollable urge to move the legs and is often associated with disruptions in sleep. Restless leg syndrome (RLS) can be confused with leg cramps, but they are 2 distinct conditions. Medications such as statins, diuretics, and oral contraceptives may increase the risk of leg cramps, too.
1,6 Other examples of secondary causes include neurologic disorders, structural disorders or positioning of the leg, and metabolic disorders, including extracellular fluid volume depletion and electrolyte disturbances. The majority of leg cramps are idiopathic and harmless, but some may result from underlying illnesses such as diabetes or peripheral artery disease. 1 Up to 20% of patients who experience leg cramps have troublesome enough daily symptoms that they seek medical attention. Pregnant women are extremely prone to leg cramps at night, especially during the second and third trimesters. 1 Individuals with leg cramps may complain of sleep disturbances that may negatively affect their overall well-being. 5 Leg cramps may also occur during periods of rest in the day.Īlthough anyone can experience leg cramps, the incidence is highest in women and older adults, affecting an estimated 33% of individuals older than 60 and an estimated 50% of individuals older than 80. 2-4 These nocturnal cramps that occur primarily during sleep are classically characterized as unilateral, painful, and palpable, involuntary muscle contractions that often are localized and have a sudden onset. 1 Leg cramps commonly affect the calf muscles but may occur in the hamstrings or muscles of the feet, especially at night (ie nocturnal leg cramps). Leg cramps are characterized by sudden, severe, and involuntary muscle contractions.
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