Self-Help Tips From Dr Sarah Brewer

How To Stop Leg Cramps

how to stop muscle cramps

Leg cramps are a common nuisance in which the excessive contraction of a muscle causes pain and tenderness, usually in the calf, although any muscle in the legs and feet can be affected. When they occur at night, nocturnal leg cramps are classed as a sleep disorder that has three diagnostic features:

  • A painful sensation in the leg or foot associated with sudden, involuntary muscle hardness or tightness, indicating a strong muscle contraction.
  • The painful muscle contractions occur during the time in bed, although they may arise from either wakefulness or sleep.
  • The pain is relieved by forceful stretching of the affected muscles to release the contraction.

A survey in one general practice found that over a third (37%) of patients had experienced leg cramps during the preceding 2 months, and they became more common with increasing age. Each cramp lasted, on average, for 9 minutes and one in five described their symptoms as very distressing. Of those experiencing cramps, 40% had cramps more than three times a week, and 6% had them at least daily.

Quick links: These are the products I recommend for leg cramps from Healthspan, Boots,

Causes of leg cramps

A muscle cramps when its muscle fibres receive rapid, repetitive nerve signals telling them to contract. This appears to arise spontaneously from peripheral motor nerves which are sensitive to irritation from a build-up of lactic acid and other waste products within muscles. These waste products also interfere with muscle relaxation (the release of cross bridges between myosin and actin filaments).

Cramping can occur as a result of dehydration or reduced blood flow to the legs which can occur for a variety of different reasons:

  • during or after physical exercise
  • sitting or lying in an awkward position
  • poor circulation to the peripheries.

The common underlying cause is reduced blood flow which decreases the supply of oxygen and nutrients to muscles, and reduces the flushing away of lactic acid and other irritants.

When muscles in the calf normally contract during exercise, they help to pump waste products from the legs into the deep veins. When lying down at night the legs become relatively immobile which can cause lactic acid and other wastes to build up. This makes leg cramps especially common at night, particularly if you have other blood flow issues such as varicose veins, chronic venous insufficiency or hardening and furring up of leg arteries.

After eating a heavy meal, blood is diverted away from peripheral muscles to aid digestion, which can also make leg cramps more likely due to reduced blood flow – one reason why swimming immediately after eating is often advised against.

Excessive sweating, a fever, and hot weather can also cause cramps due to dehydration.

Other causes of night cramps include:

  • electrolyte imbalances – especially of calcium, magnesium, potassium or sodium
  • drug side effects – especially diuretics (water tablets), inhaled long-acting beta 2 agonists used to treat asthma, statins, calcium channel blockers (especially nifedipine), acetylcholinesterase inhibitors, steroids, morphine, cimetidine, penicillamine, antiretroviral drugs and tranquillisers/sleeping tablets
  • having diabetes – two-thirds of people with diabetes experience leg cramps
  • diseases affecting the nervous system, kidneys, liver or other internal organs.

Cramps become more common with increasing age and once you start getting them they tend to recur unless you take steps to help prevent them.

Leg cramps in pregnancy

Night cramps are common during pregnancy, affecting up to one in three pregnant women. The exact cause is unknown, but changes in blood circulation, the weight of the uterus reducing venous return from the legs, or changes in calcium concentrations have been suggested.

A study involving 21 pregnant women experiencing leg cramps found that taking 1 gram calcium supplements, twice a day for 2 weeks significantly improved their symptoms, while a similar group of 21 woman who did not take calcium showed no improvement over the same time period.

Other studies have shown that taking magnesium supplements can help to reduce leg cramps during pregnancy. The effects of magnesium bisglycinate chelate (300 mg per day) were compared with placebo in 80 healthy pregnant women (14-34 weeks of gestation) who were experiencing troublesome leg cramps at least twice a week. There was a fifty per cent reduction of cramp frequency in 86% of those taking magnesium and a reducing in cramp intensity, which was a significantly greater improvement than in those taking placebo.

NB Do not take any supplements during pregnancy except with the permission and supervision of your doctor.

How to treat leg cramps

A cramping muscle can usually be relieved by gently stretching the muscle and rubbing it to help it relax.

To ease a cramped calf muscle, stand up, put your weight on the affected leg and slightly bend your knee.

To ease a hamstring cramp at the back of your thigh, sit up with your legs in a straight position, and pull the top of your foot forwards.

To ease a quadriceps cramp in the front of your thigh, stand and face a wall, steadying yourself with the hand of the unaffected side. Use the other hand to pull your foot on the affected leg up towards your buttock.

Get out of bed and carefully walk around to stimulate your circulation.

Drink a glass of water.

Apply a hot pack or, if you prefer, a cold pack to ease pain.

Contact your doctor if:

  • The leg looks swollen, red, or shows skin changes
  • You have a temperature
  • Your muscles feel weak
  • A cramp lasts longer than an hour

These red flag symptoms mean you need assessment to diagnose the cause and to rule out other medical problems such as deep vein thrombosis (DVT).

How to prevent leg cramps

Avoid dehydration by drinking plenty of fluids during the day, especially mineral water. The aim is to maintain a urine colour that is pale straw coloured rather than dark.

Increase your dietary intakes of calcium (eg low-fat milk, cheese, yoghurt and other dairy products, dark green leafy vegetables) and magnesium (nuts, seafood, dairy products, wholegrains, dark green, leafy vegetables).

If you smoke, do your utmost to stop.

The following can also help.

Magnesium supplements for leg cramps

Magnesium is needed to maintain the ‘pumps’ that control movement of salts in and out of cells, and is essential for nerve conduction, muscle relaxation and energy production in cells. Magnesium deficiency is common. Adults need around 375mg magnesium per day according to the EU nutrient reference value, yet national dietary surveys suggest average intakes for women are just 229mg per day. If you are experiencing annoying symptoms such as muscle cramps, constipation, insomnia, tiredness all the time, or restless legs then a lack of magnesium could be involved.

Magnesium supplements have been shown to reduce leg cramps in pregnancy. One study also compared the effects of magnesium citrate versus placebo in 46 non-pregnant volunteers who experienced regular, recurrent leg cramps. When taking magnesium citrate supplements (equivalent to 300 mg magnesium per day) there was a trend towards fewer leg cramps (an average of 5 episodes over 4 weeks versus 9 on placebo) but no difference in cramp severity and duration. Significantly more people thought the treatment had helped after taking magnesium (78%) compared with after taking placebo (54%). The most common side effects was loose bowels. Some studies have not shown benefit from taking magnesium in reducing leg cramps, however, and it is only likely to work if you are magnesium deficient.

Magnesium dose for leg cramps: 200mg to 400mg per day. If you experience loose bowels, try switching to magnesium gluconate, or absorb the magnesium through your skin by using  magnesium flakes in a bath, or applying magnesium oil or magnesium body butter to your skin.

Magnesium is often combined with calcium for treating cramps.

See the best magnesium supplements at Healthspan, Boots, or

Quinine for leg cramps

Quinine is an alkaloid extracted from the bark of the cinchona tree, and is sometimes called quinquina. Quinine has been used for centuries to stop leg and works by reducing the excitability of nerve-muscle junctions to suppress any repetitive firing.

The results from 23 clinical trials involving 1,586 people, show that taking quinine at an average dose of 300mg per day (range 200–500 mg/day) was more effective than placebo for stopping leg muscle cramps. Quinine reduced the number of cramp episodes by 28% over a 2 week period compared with placebo (about 2.5 fewer cramps). They also had 1 extra day out of 14 without cramps (20% reduction) and their cramp intensity significantly reduced.

Although quinine is the only medication proven to reduce the frequency and intensity of leg cramps, it is associated with some rare but serious immune-related side effects, especially a low platelet count (thrombocytopenia). These side effects occur in between one and two out of every 1000 people using quinine.

Taking quinine, even at low-doses in young healthy volunteers is also associated with a measurable deterioration in hearing in many people.

Although quinine tablets are widely available, official advice in many countries, including USA, Australia, New Zealand, UK and Ireland is to avoid its routine use, although it is permitted for severe cases under careful monitoring, with a trial stop after 4 weeks treatment.

If you want to take quinine, check with your doctor first – especially if you have another medical condition or if you are taking any prescribed drugs.

NB Quinine is used as a bitter flavouring in tonic water – a standard mixer bottle of tonic water contains between 7mg and 14mg of quinine depending on the brand.

So, given that quinine is no longer routinely recommended, what other treatments may help to prevent cramps?

Padma Circosan for leg cramps

Padma Circosan capsules, made by the Swiss Pharmaceutical company, Padma, are based on a traditional Tibetan medical formula known as Gabur. Padma Circosan contains a combination of the mineral, calcium sulphate hemihydrate, plus 20 traditional Tibetan herbs:

  • costus (aucklandia) root
  • Iceland moss
  • neem fruit
  • cardamom fruit
  • myrobalan fruit
  • red sanderswood
  • allspice fruit
  • Bengal quince fruit
  • European columbine herb
  • liquorice root
  • ribwort plantain
  • knotgrass herb
  • golden cinquefoil herb
  • clove
  • kaempferia galanga rhizome
  • heart leaf sida herb
  • valerian root
  • lettuce leaf
  • calendula flower head
  • camphor oil

Padma Circosan provides a range of antioxidant flavonoids, tannins and essential oils that have a stimulating effect on the circulation. It is traditional used to treat problems associated with poor blood flow such as tired heavy legs, leg cramps, cold feet and Raynaud’s syndrome.

Padma Circosan is especially helpful for people whose leg cramps are associated with diabetes. This is because this blend of Tibetan herbs can reduce the production of advanced glycation end products (AGE) that damage blood vessels by more than half (56.7%) to help reduce diabetes-related complications.

Many patients have told me they find it helpful for reducing leg cramps and other circulatory problems, with many reporting that their cramps have stopped completely, allowing them to sleep undisturbed.

Dose of Padma Circosan for leg cramps: 2 capsules, three times a day. This can be reduced to 1 to 2 capsules per day once cramps subside. Wait at least 1½ – 2 hours before taking any other medicine.

Here is a link to the UK MHRA Patient Information Leaflet for Padma Circosan capsules to help you determine if it is right for you.

See Padma Circosan at or

Ginkgo biloba extracts for leg cramps

Ginkgo biloba has been used in Chinese medicine for thousands of years to increase poor circulation. The distinctive fan-shaped Ginkgo leaves contain unique antioxidants (ginkgolides and bilobalides) that relax blood vessel walls to dilate arteries through an effect on nitric oxide. Ginkgo also increases the flexibility of red blood cells so that oxygen-rich blood flows more freely through tiny capillaries to improve blood flow to the legs. Ginkgo also reduces the effects of platelet activating factor (PAF) – a blood clotting substance that has been linked to reduced blood flow. Ginkgo biloba is so effective at improving circulation that a single dose was found to increase peripheral blood flow to nail fold capillaries by 57% within just one hour.

In 14 trials, involving 739 people with intermittent claudication (leg pain on walking due to poor circulation), taking Ginkgo supplements allowed them to walk 200 feet further on a flat treadmill (at a speed of 3.2km/hour) before leg pains occurred, compared with placebo although the researchers didn’t think this was a clinical benefit!

Ginkgo extracts appear to be just as helpful in treating leg cramps by increasing blood flow and oxygen delivery to muscles during the night.

Dose of Ginkgo biloba for leg cramps: 120 mg. Select extracts standardised to provide a known amount of ginkgolides: eg at least 24%.

See recommended Ginkgo biloba products at Healthspan, or

Pycnogenol for leg cramps

Pycnogenol is an extract obtained from the bark of the French maritime pine tree. It is highly antioxidant, and promotes blood vessel dilation by improving the production of nitric oxide.

These pine bark extracts are widely taken to treat conditions associated with poor circulation, including leg cramps. Pycnogenol also reduces abnormal blood clotting, in a similar way to aspirin, but without the side effects of stomach irritation or prolonged bleeding.

Pycnogenol has beneficial effects on the circulation to reduce cramp and muscular pain associated with reduced blood flow to the legs. Pine bark extracts are so effective they can even help heal venous ulcers and Pycnogenol has been shown to improve arterial blood flow in people with coronary heart disease.

Sixty six people with leg cramps or muscular pain took 200mg Pycnogenol per day for 4 weeks and were also advised to drink at least 1.5 litres of water every day. On average, the number of cramps experienced was reduced from 4.8 cramps per week down to 1.3 after the four weeks. In a second study involving people with leg pain due to clogged arteries (intermittent claudication) or diabetes, there was also a significant decrease in the number of cramp episodes compared with placebo.

Dose of Pycnogenol for leg cramps: 60mg to 200mg per day

See recommended Pycnogenol supplements at Healthspan, or

Coenzyme Q10 for leg cramps

Coenzyme Q10 is a vitamin-like substance that’s needed to process oxygen and generate energy-rich molecules within cells. Cells which work the hardest, including heart and skeletal muscle cells need the most coenzyme Q10. While you can generate coenzyme Q10 yourself, its production starts to decline from around your mid 20s so that, by the age of 40, the amount of coenzyme Q10 present in cells is up to a third lower. Without sufficient coenzyme Q10 to process oxygen generate energy, cells function at a sub-optimal level and muscles are more like to cramp.

One of the reasons that statin drugs can cause muscle aches, pains and cramps, is that statins switch off the production of both cholesterol and coenzyme Q10 , so that circulating levels of coenzyme Q10 fall by one half within 2 to 4 weeks.

Coenzyme Q10 is available in two forms, as ubiquinol, which is the most active form, and as ubiquinone which your muscle cells must convert into ubiquinol before it can get to work. This conversion becomes increasingly less efficient with age, so to help reduce muscle cramps I recommend trying the ubiquinol form.

Many people with leg cramps find coenzyme Q10 helpful, especially when their cramps are due to reduced circulation and reduced oxygen uptake in muscle cells.

Dose of coenzyme Q10 for leg cramps:

The dose depends on the form of coenzyme Q10 taken.

Ubiquinol: 100mg per day

Ubiquinone: 100mg to 200mg per day

See recommended coenzyme Q10 products for stopping cramp at Healthspan, Boots, or

Magnetic therapy for leg cramps

I’ve found magnetic therapy immensely helpful for preventing leg cramps. Magnetic therapy is traditionally believed to boost the electromagnetic field of cells so they can function more easily. Each muscle cell generates its own electromagnetic field as ions are pumped in and out across the cell membrane. This movement of electrolytes allows muscles to both contract and relax.

Magnetic therapy also increases blood flow through tiny capillaries to open up the circulation, providing cells with more oxygen and nutrients as well as flushing away cell wastes to help prevent muscle cramps. In addition, magnetic therapy encourages red blood cells to line up in the same direction so they pass through tiny blood vessels more easily to improve peripheral blood flow. Another mechanism is that magnetic therapy reduces inflammation and irritation to promote recovery.

In fact, magnetic therapy is so effective for opening up the circulation that a magnetic leg band is available on NHS prescription to boost healing of diabetic leg ulcers. The same product can help to prevent leg cramps. Simply wrap the magnetic band around your lower leg, just below the knee before going to bed. You can also stick magnetic patches over the affected muscle.

See the best magnetic products at or

What treatments have you found most helpful for stopping nocturnal leg cramps?

author avatar
Dr Sarah Brewer ex-Medical Director (20 years)
Dr Sarah Brewer MSc (Nutr Med), MA (Cantab), MB, BChir, RNutr, MBANT, CNHC, Dip IoD qualified from Cambridge University with degrees in Natural Sciences, Medicine and Surgery. After working in general practice, she gained a master's degree in nutritional medicine from the University of Surrey. Sarah is a registered Medical Doctor, a registered Nutritionist and a registered Nutritional Therapist. She is an award winning author of over 70 popular self-help books and a columnist for Prima magazine. Her debut novel is White Powder Of Gold. Dr Sarah Brewer is a registered medical doctor, nutritionist, nutritional therapist and author of over 70 self-help books.

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