Patient information from BMJ

Leg cramps: what treatments work?

Last published:Jan 07, 2021

Leg cramps are painful muscle contractions (spasms). They're not usually serious and you might not need treatment. But if your leg cramps are troublesome or if they stop you sleeping, there are treatments that you can try.

We've brought together the best research about leg cramps and weighed up the evidence about how to treat and prevent them. You can use our information to talk to your doctor and decide which treatments are best for you.

Short-term treatment

The simplest way to relieve cramps in the short term is to gently stretch the muscles that are affected. Rubbing the muscles can also help. If you’re able to, you could try putting all your weight on the painful leg for a few minutes.

Painkillers, yes or no?

Although taking painkillers such as paracetamol or ibuprofen might seem like a good way to treat painful leg cramps, these medicines might not do you any good. This is because the spasm that causes the pain is likely to be over by the time the painkiller starts working.

Preventing leg cramps

You may be able to take steps to prevent cramps that keep coming back. However, what steps you take will depend on what is causing your cramps. It might mainly involve treating the condition that is causing the cramps.

Leg cramps from an unknown cause

There isn’t much good research on how to prevent the return of cramps with an unknown cause.

Many treatments have been used to try to prevent this type of cramp. Research suggests that the most effective might be:

• a drug called naftidrofuryl that’s sometimes used to treat a condition called peripheral arterial disease

• vitamin B complex supplements

• a drug called diltiazem that is often used to treat high blood pressure and a type of heart pain called angina.

You can discuss with your doctor whether any of these treatments might be the right one for you.

Leg cramps caused by exercise

Drinking plenty of fluids before exercising may help prevent leg cramps.

If you still get leg cramps after exercising:

• rest in a room that’s at a comfortable temperature and not stuffy

• gently stretch the affected muscles

• if your urine is dark, drink a sports drink and eat a salty snack.

If, after exercising, you have very severe cramps, feel very faint and dizzy, and feel either very hot or very cold, you should get medical attention right away.

Leg cramps linked to diabetes

If you have diabetes, you may get leg cramps during a hypoglycaemic episode (or 'hypo'), where your blood sugar gets too low. The simplest way to treat the cramps is to treat the hypo, by having a sugary drink or snack.

Good blood sugar control may help prevent more hypos and leg cramps. This could mean adjusting your diet, avoiding alcohol, and talking with your doctor to make sure you are taking the right medicines for you.

Leg cramps during pregnancy

Changes in the body during pregnancy can cause leg cramps. These usually stop after the birth.

Some doctors recommend magnesium salts supplements for preventing leg cramps in pregnancy. But high doses can cause diarrhoea. Vitamin B supplements may also help. However, you shouldn’t take any medicines, vitamins, or supplements while you're pregnant unless they are recommended by your doctor.

Leg cramps linked to dialysis

Some people get leg cramps when they have a treatment called dialysis. This treatment uses a machine to clean your blood if your kidneys don’t work properly.

There are treatments that can help prevent cramps caused by dialysis. For example, a combination of vitamin E and vitamin C supplements may help some people.

Another treatment that may help is a medicine called quinine. But this drug can have serious side effects, including nausea, headaches, dizziness, diarrhoea, liver damage, and sometimes blindness. Because of this, in some countries, including the US, it is not used for leg cramps, or is used only as a last resort.

Leg cramps caused by cirrhosis

Cirrhosis is a type of liver damage that’s usually caused by drinking too much alcohol over many years. It can cause leg cramps in some people. Zinc sulphate or vitamin E supplements are sometimes recommended for prevention.

Leg cramps caused by conditions that affect the muscles or nerves

Conditions such as multiple sclerosis (MS) and motor neuron disease can cause leg cramps.

There are many medicines and supplements you can try for preventing cramps if you have one of these conditions, but research has not given a clear picture about what works best. Possible treatments include muscle relaxers, drugs that are usually used for epilepsy, or antidepressants. You can talk with your doctor about what might work best for you.