Your treatment plan
If your leg cramps have an underlying cause (secondary leg cramps) then treating the underlying cause may help to relieve your symptoms in many cases.
For example, secondary leg cramps related to liver disease are caused by high levels of toxins in the blood triggering muscles spasms. So muscle relaxants can be used to help prevent muscles from going into spasms.
If there is no known underlying cause (primary idiopathic leg cramps) then a combination of exercise and painkilling medication is usually recommended.
Self-help
Most cases of leg cramps can be treated with exercises.
There are two types of exercise that you can do:
- an exercise that you carry out during an episode of cramping to relieve the pain and end the cramping
- exercises that you carry out during the day to reduce how often you get leg cramps
Exercises during cramps
If you get a leg cramp, try stretching and massaging the affected muscle. For example, if the cramp is in your calf muscle:
- straighten your leg and lift your foot upwards, bending it at the ankle so that your toes are lifted towards your shin (the front of your lower leg)
- try walking around on your heels for a few minutes
Exercises to prevent cramps
To reduce your chance of having leg cramps in the future, do exercises to stretch the affected muscles three times a day.
For example, if your calf muscles are affected by cramps, then the following exercise should be beneficial:
- stand one meter (3.3ft) away from a wall
- lean forward with your arms outstretched to touch the wall while keeping the soles of your feet flat on the floor
- hold this position for five seconds, then release
- repeat the exercise for five minutes
It is recommended that you do the above exercise three times a day, including one session just before you go to bed.
If you find these exercises useful then carry on doing them for as long as you are able to.
Painkillers
If you have lingering leg pain after an episode of cramps, an over-the-counter painkiller such as paracetamol or ibuprofen should reduce any pain.
Quinine
Quinine is a medication that was originally designed to treat malaria. Research has since found that it can be moderately effective in reducing the frequency of leg cramps.
However, there is a small chance that quinine may cause unpleasant side effects, such as:
- tinnitus (ringing in your ears)
- impaired hearing
- headache
- nausea (feeling sick)
- disturbed vision
- confusion
- hot flushes
A more serious and rare complication of quinine is thrombocytopenia, when your level of platelets (a type of blood cell) drops to a dangerously low level. Platelets help the blood to clot, so people with thrombocytopenia are prone to excessive bleeding, such as:
- nose bleeds
- bleeding gums
- bleeding inside the eye
- bleeding inside the skull or digestive system – both of which can be fatal
There have been a number of reported cases of people dying from thrombocytopenia after taking quinine to prevent leg cramps.
Never take more than your recommended dose of quinine. An overdose of quinine can result in permanent blindness and death.
Because of these potential risks, however small, your GP will only prescribe quinine if there is evidence that the potential benefit of treatment outweighs the risks.
It is recommended that quinine is only prescribed when:
- you have tried the exercise techniques discussed above and they have not helped to prevent leg cramps
- the leg cramps are frequent and affecting your quality of life
If this is the case, you will be prescribed a four-week course of quinine. If you gain no benefit, the treatment will be withdrawn.
If you have any of the side effects listed above, stop taking quinine immediately and contact your GP.
Your treatment will be monitored closely and reviewed regularly. For example:
- you may be asked to keep a ‘sleep and cramp’ diary to check how often you are getting leg cramps
- your GP is likely to review your initial treatment after three months
- if your condition improves, your GP may reassess your treatment needs every three to six months
