Medicines for Leg cramps

What it is

Leg cramps are sudden, involuntary, and often painful tightenings (spasms) of a muscle in the leg, most commonly affecting the calf muscle, but also sometimes the feet or thighs. They are very common, and many people experience them from time to time; they become more common with age and are also common in pregnancy. Leg cramps often occur at night (nocturnal cramps), sometimes waking a person from sleep, and can also happen during or after exercise. During a cramp, the muscle contracts tightly and feels hard, and the pain can be intense; it usually lasts from a few seconds to several minutes, and afterwards the muscle may feel tender for a while. In most cases, leg cramps are harmless and not a sign of a serious problem, and no specific cause is found (this is called idiopathic cramp). Sometimes leg cramps are associated with factors such as ageing, pregnancy, exercise or overuse, dehydration, or, less commonly, certain medicines or underlying conditions (such as problems with the nerves, circulation, thyroid, or the balance of salts in the body). Although leg cramps are usually harmless, they can be painful and can disturb sleep. During a cramp, stretching and gently massaging the muscle usually helps to relieve it. Various measures may help prevent cramps, particularly regular stretching. It is worth seeing a GP if leg cramps are frequent, severe, or disturbing sleep significantly, if they do not settle, or if there are other symptoms (such as numbness, weakness, swelling, or skin changes in the legs), as occasionally cramps can be related to an underlying cause that may need attention or a review of medicines. The key messages are that leg cramps are common and usually harmless, that stretching relieves and helps prevent them, and that frequent, severe, or unusual cramps are worth getting checked.

How it is treated

Leg cramps are usually harmless and managed with simple measures to relieve them when they occur and to help prevent them, with assessment if they are frequent, severe, or unusual. During a cramp, the most helpful immediate measures are to stretch and gently massage the affected muscle — for a calf cramp, this often means straightening the leg and gently pulling the toes and foot up towards the shin (or standing and putting weight on the affected leg with the knee straight) to stretch the calf, which usually eases the cramp; gentle massage and warmth can also help, and the muscle may feel tender afterwards. To help prevent leg cramps, particularly for people who get them often: regular stretching of the calf and leg muscles (for example before bed, for night cramps) is one of the measures most often suggested; staying well hydrated; keeping active and maintaining good general fitness; and, for night cramps, some people find measures such as keeping bedclothes loose over the feet helpful. Where a possible contributing factor is identified (such as a medicine that may be contributing, or an underlying condition), addressing it may help, so a review can be useful. It is worth seeing a GP if leg cramps are frequent, severe, persistent, significantly disturbing sleep, or accompanied by other symptoms — such as numbness, tingling, weakness, swelling, changes in the skin or colour of the legs, or if the cramps came on unusually — as, occasionally, cramps can be linked with an underlying cause (such as circulation or nerve problems, thyroid problems, salt imbalances, or medicines) that may need attention. Treatments specifically for cramps are considered only in certain situations and under medical guidance. The reassuring messages are that leg cramps are very common and usually harmless, that stretching and massage relieve them and regular stretching helps prevent them, and that frequent, severe, or unusual cramps, or cramps with other symptoms, are worth getting checked so any underlying cause can be considered.