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Usually harmless and often a question of fluid, salts and stretching — rarely a sign of disease.
Also known as: muscle cramps · calf cramp · nocturnal leg cramps
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Sudden, painful hardening of a muscle, usually in the calf and often at night. In most people no illness is found — unaccustomed exertion, dehydration, prolonged standing and increasing age all contribute. Sometimes there are correctable causes: magnesium or potassium deficiency, an underactive thyroid, poor circulation in the legs, or diuretic medication. During a cramp, stretching helps — for the calf, pull the toes toward the shin. For prevention: regular stretching and drinking enough. Frequent, very painful cramps or those with muscle weakness should be checked.
Cramps together with muscle weakness and a stumbling heartbeat speak for a low potassium, usually under water tablets. Potassium and magnesium then belong looked at together.
The most reliable source — leafy greens, pumpkin seeds, almonds, beans, oats.
With reduced kidney function magnesium can accumulate — supplement only with medical guidance.
During the cramp straighten the leg and pull the toes firmly towards you, hold for 30 seconds, then stroke out the calf.
A calf cramp lasts seconds to a few minutes; the soreness afterwards holds for up to a day. Up to sixty out of a hundred adults have night cramps, more often with age. Magnesium changed little for night cramps without a documented deficiency in studies; in pregnancy a benefit did show. Stretching the calf before sleep lowered the frequency within six weeks in trials.
Quinine works measurably for night cramps, but is barely prescribed any more because of rare, serious blood disorders — an example that effectiveness and use are two different questions. Magnesium works with a documented deficiency and in pregnancy; without a deficiency the studies show little. What reliably helps costs nothing: stretching the calf during the cramp ends it in seconds, stretching before sleep lowers the frequency over six weeks.
A sudden, hard contraction lasting seconds to minutes and leaving soreness for hours. That is by far the most common form and usually harmless.
Cramps that occur during long exertion with heavy sweating have to do with fluid, salt and fatigue — and they often announce themselves with twitching.
Cramps together with lasting weakness, muscle wasting, numbness, dark urine after exertion, or cramps in trunk, hands and jaw instead of the calves. Then the search goes on.
Water tablets, cholesterol lowerers, certain asthma drugs and blood pressure drugs are among the most common triggers. Then potassium, magnesium, calcium, sodium, thyroid and sugar values.
The most-taken remedy for this — and one of the worst supported. In older people good studies found no difference from placebo; in pregnancy and with a proven deficiency they did. 200–400 mg a day over 4 weeks shows whether that was the reason.
With cramp after long sweating, sodium is the missing part, not magnesium — 0.5–0.7 g sodium per litre replaces what left with the sweat. Drinking plain water only dilutes further.
Water tablets lower potassium, and then the cramps come. The value belongs measured before adding — with reduced kidney function too much potassium is more dangerous than too little.
An underactive thyroid causes muscle cramps, stiffness and muscle pain — often before anything else stands out. With unexplained night cramps that is the value with the best hit rate.
Too little calcium in the blood lowers the nerves’ threshold — cramps and tingling around the mouth are the typical combination. After thyroid surgery that is the question to ask first.
Water tablets and a too high aldosterone level drive potassium out. Cramps together with muscle weakness and high blood pressure are the pattern that makes the question of Conn’s syndrome worth asking.
For night-time calf cramps in older people, studies with 300 mg a day showed no difference from placebo. In pregnancy some studies found a benefit. Both belong said side by side.
With heavy sweating over hours, 0.5–1.5 g of sodium goes per litre of sweat. Drinking only water dilutes further — electrolyte drinks or salted food are meant here, not everyday life.
The classic; in night calf cramps in older people it worked hardly better than placebo.
Drinking enough and salt after heavy sweating are the most commonly overlooked cause.
The traditional cramp herb — used as a tea for calf and lower belly cramps. Barely studied; the experience is old, the evidence thin.
Like willow it contains salicylate compounds. Traditionally used for muscle pain, and equally to be avoided with aspirin intolerance.
The traditional cramp oil, massaged diluted into the calf. The massage itself releases the cramp — the oil makes it pleasanter and leaves a smell.
In the evening in a foot bath or as a calf massage. With night cramps a look at magnesium and the thyroid comes first.
The Liver “governs the sinews” — cramps, stiffness and twitching all belong there in TCM. Today’s route runs through magnesium, the thyroid and fluid.
The sinew point, below the knee on the outside. With calf cramps traditionally combined with massage and warmth.
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