Muscle Cramps

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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How can muscle cramps be prevented? (Part 4)

While experiencing rest cramps: Night cramps and other rest cramps can often be prevented by regular stretching exercises, particularly if done before going to bed. Even the simple calf-stretching maneuver (described in the first paragraph of the section on treatment), if held for 10 to 15 seconds and repeated two or three times just before going to bed, can be a great help in preventing nocturnal cramps. The maneuver can be repeated each time you get up to go to the bathroom during the night and also once or twice during the day. If nocturnal leg cramps are severe and recurrent, a foot board can be used to simulate walking even while recumbent and may prevent awkward positioning of the feet during sleep. Ask your doctor about this remedy.

Another important aspect of prevention of night cramps is adequate calcium and magnesium. Blood levels may not be sensitive enough to accurately reflect what is happening at the tissue surfaces where the hyperexcitability of the nerve occurs. Calcium intake of at least 1 gram daily is reasonable, and 1.5 grams may be appropriate, particularly for women with or at risk for osteoporosis. An extra dose of calcium at bedtime may help prevent cramps.

Supplemental magnesium may be very beneficial for some, particularly if the person has a magnesium deficiency. However, added magnesium can be very hazardous for people who have difficulty eliminating magnesium, as happens with kidney insufficiency. The vigorous use of diuretics usually increases magnesium loss, and high levels of calcium intake (and therefore of calcium excretion) tend to increase magnesium excretion. Magnesium is present in many foods (greens, grains, meat and fish, bananas, apricots, nuts, and soybeans) and some laxatives and antacids, but a supplemental dose of 50-100 milligrams of magnesium daily may be appropriate. Splitting the dose and taking a portion several times during the day minimizes the tendency to diarrhea that magnesium can cause.

Vitamin E has also been said to help minimize cramp occurrence. Scientific studies documenting this effect are lacking, but anecdotal reports are common. Since vitamin E is thought to have other beneficial health effects and is not toxic in usual doses, taking 400 units of vitamin E daily is approved, recognizing that documentation on its effect on cramps is lacking. Continue Reading

Reviewed on 4/21/2016
References
REFERENCES:

Longo, D.L., et al. Harrison's Principles of Internal Medicine, 18th ed. United States: McGraw-Hill Professional, 2011.

"Muscle Spasms, Cramps, and Charley Horse." WebMD.com. Sept. 5, 2012. <http://www.webmd.com/pain-management/muscle-spasms-cramps-charley-horse>.

United States. Food and Drug Administration. "FDA Drug Safety Communication: New Risk Management Plan and Patient Information Guide for Qualapin (Quinine Sulfate)." July, 8, 2010.

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