Staying a Step Ahead of Those
Pesky Leg Cramps
For: Don't Let Them Cramp Your Game, January 2002
Few people have never had a calf cramp—that sudden clutch of the calf muscles that can wake you out of a sound sleep and send you groping for relief. The best thing to do when it happens is to flex your foot: point your toes toward your knee. If it hurts too much to do that, grab your toes and pull them toward your knee, then massage your calf gently. Try walking around if the cramp won't let up. Applying heat can help.
What brings them on
Here are some possible causes of leg cramps:
• Being sedentary: lots of sitting may shorten and weaken calf muscles.
• Overdoing a running or jogging program, thus fatiguing the muscles.
• Pregnancy.
• Circulatory problems.
• Diabetes or thyroid disease.
• Diuretics and other medications.
• Wearing high heels, particularly if you aren't used to them.
If you have severe and frequent cramps, you may need medical advice to pinpoint the cause. But most people can deal with calf cramps on their own.
Ways to prevent them
• Stretch your calf muscles two or three times daily, especially before going to bed.
• If you exercise strenuously, stretch your calves after your workout.
• Be sure the sheets and blankets on your bed aren't tucked in so tightly that they constrict your foot movements.
• Try sleeping on your side, or on your stomach with your feet hanging off the end of the bed. This will keep your leg and foot muscles stretched out.
• Don't wear high heels.
Remedies, high- and low-tech
Quinine is the classic drug for relieving leg cramps—but though there is some evidence that it works, it can have serious or even fatal side effects. The FDA took over-the-counter quinine tablets off the market because of quinine's blood-thinning effects, and also side effects such as vertigo, disturbances in vision, and ringing in the ears. A physician can still prescribe quinine, but would probably do so only as a last resort. (Don't take quinine if you are pregnant.)
What about that old favorite, quinine water (tonic water)? Previously we've advised that the beverage contains little or no quinine and thus won't help. However, researchers at New York University School of Medicine recently found that both quinine water and bitter lemon soda sometimes do contain significant amounts of quinine. The catch: There's no way to know, because manufacturers are not required to state the amount of quinine on labels. Some brands contain almost no quinine.
Another catch: The maximum amount of quinine in a quart of quinine water or bitter lemon is about 160 milligrams. If you could find a brand with that amount, you would have to drink two quarts of it to get a therapeutic dose—and you would need to drink it within a few hours of bedtime. The real catch: You would then be getting enough quinine to be at risk for serious side effects—not to mention having to get up to urinate during the night.
Some people say there's enough quinine in one glass of quinine water to do some good. But there's no way to know how much quinine you're getting, if any. If you think a glass of tonic water helps with your leg cramps, there's certainly no harm in it. There are sugar-free versions if you don't want the calories.
Calcium, magnesium, and potassium chloride supplements are often touted for leg cramps, but there's no proof they work, and we don't recommend them. Vitamin E, though often cited as a remedy, appears not to have any effect on leg cramps. More studies are needed.
UC Berkeley Wellness Letter, August 2000
