People with nocturnal leg cramps will try anything...from drinking pickle juice to putting a bar of soap under their bedsheet.
Leg cramps are different from restless legs syndrome or statin muscle pain. And there's not much evidence for most leg cramp remedies.
Start by looking for meds linked to leg cramps...such as diuretics, inhaled beta-agonists (albuterol, etc), or nifedipine. Explain that switching to another med or lowering the dose might help.
Suggest trying nondrug strategies...such as stretching the calf muscles, applying hot or cold packs, and staying adequately hydrated.
Clarify the role of supplements...and encourage safe use.
Lean toward vitamin B complex as a low-risk option for managing leg cramps...it seems to do the trick for some people.
Magnesium or calcium might be helpful for pregnant women or if there's a deficiency...but isn't likely to help most other patients.
Recommend avoiding off-label use of Rx quinine (Qualaquin, etc)...due to risks of thrombocytopenia, arrhythmias, and death. Plus, it's only modestly effective for leg cramps...and costs about $5 per cap.
Explain that tonic water isn't likely to help...and homeopathics (Hyland's Leg Cramps, etc) aren't proven safe or effective.
Consider suggesting diltiazem or verapamil...if other measures aren't enough. A few small trials suggest a possible benefit.
Use our patient handout, What to Do for Nighttime Leg Cramps...and our Leg Cramps commentary to sort through what works and doesn't.
- Neurology 2010;74(8):691-6
- Age Ageing 2016;45(6):776-82
- Curr Neurol Neurosci Rep 2010;10(1):53-9
- Commentary: How to Prevent Nighttime Leg Cramps
- Patient Education: What to Do for Nighttime Leg Cramps