# Leg Cramp - is there a doctor in the house?



## 106410 (Aug 12, 2007)

I have been suffering from cramp in both legs for over 14 months and my GP cannot help. Been told to drink tonic water(contains quinine) and have had a course of quinine tablets but I'm afraid nothing has worked. I have been on the NHS website and it informs me that 1 in 4 people over the age of 65 get nocturnal cramp in the legs and feet and this happens between 1 and 3 times a week and the causes are not known, I fit into this category. I don't always get the cramp at night and can be quite an embarrassment when I am sat at a table in a restaurant and have to jump to a standing position without warning. I get cramp in the muscles at the back of the legs and especially the feet which seem to lock in position resulting in permanent ache in my feet which hampers my walking, which I love. Thought the condition might have something to do with a parachuting accident I had a few years ago which damaged my spine and resulted in having both knees replaced but the experts say this is unlikely. I cannot believe that in todays medical advancement that they cannot help, maybe one of you good people out there can help me...... Please.....S.


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## Snelly (Aug 20, 2005)

Very basic, but low sodium (salt) can also cause cramping. Of course before you start piling salt on everything, salt also causes other problems! Consult your doctor!


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## mandyandandy (Oct 1, 2006)

Ohhhh tell me about it, my mum has suffered with it for years and I can remember as a child listening too her wandering on the landing at night, she too was told to have more salt in her diet and it did help as she never salted anything but potatoes. 

I myself have now been a sufferer for around 10 years and yes I can get it during the day too. I have found that the main causes for me, apart from not having enough salt, (which I don't) is :- 

Wearing shoes that are too tight across my foot, like lacing them up too tightly. 

The main one is, at any stage of the day letting my feet get cold, this has been made worse by the installation of wooden floors throughout the down stairs. 

I always wear bed socks, this made a huge difference as I sleep with my feet out most of the night. 

I take Crampex before going to bed if I know my feet have been cold in the day or just get the feeling it is going to happen, they are very good and take around 20 mins to work if you wake up and take them in the night. 

Hope this may help a little, don't think there is a complete cure but things are always worth a try and something may just hit the mark so to speak  

Mandy


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## drcotts (Feb 23, 2006)

Hi Sting
Do you find that you dont get cramps if you have been walking or excersized that day. Or why not try going for a 15 min walk (if its safe) before going to bed. It may be due to lack of circulation. 
Phill


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## Frenchlily (Sep 16, 2005)

Try a few exercises and stretches before getting into bed and during the day. Alan is also getting cramps and it can be a side effect from some medication,he takes crampex when it is bad. 

Lesley


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## Frantone (Sep 6, 2006)

*Cramps!*

All the usual disclaimers apply etc etc but....
I have had a lot of trouble with leg and foot cramps, not only at night but they were often the worst. Thighs and calf muscles mostly and the pain was deep and very nasty!
As part of another investigation a blood test showed dangerous levels of potassium which were caused by overeating bananas. I had no idea they were potentialy harmful and was eating two a day (occasionally more, I love them, especially the slightly underripe ones!).
The doctor was amazed that anybody should eat more than one or two a week. I was equally amazed at her reaction!
Anyway the link between potassium and cramps is (apparently) well established and I had no more from the day I stopped the bananas.
TonyP


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## smithies (Jul 1, 2007)

Gordon sometimes suffers from cramps too......as Snelly has pointed out, low salt intake def impacts on this !! We only cook with salt, very rarely shake it on ....food but you still need a little in your diet (even if, like us, you have high blood pressure and are advised to limit salt intake )

When we swapped our Chieftain for the RV we left a bag of condiments (salt included) in the Chieftain. We were due to travel back to the dealers where we had done the swap, so we didnt bother replacing all the condiments ( they had rung us to tell us we had left them in the van )...time went on, longer than we had expected, and during this 3 weeks Gordon started suffering with cramp every day.....took a while to realise why !!!

As he is otherwise very healthy, and cycles every day, I dont think lack of exercise was a contributing factor. Hope you get this sorted ( Crampex are good too !!)

Jenny


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## 106410 (Aug 12, 2007)

Thanks to all, great advice. Am waiting for results of some blood tests. I do not take in salt at all but do walk quite a bit each day with the dogs. Am going to town today to buy some crampex and will let you all know the results. Ta. S.


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## Invicta (Feb 9, 2006)

Taken from the www.patient.co.uk web site: 

Cramps in the Leg

Leg cramps are common. The cause is not known in most cases. However, some drugs and diseases sometimes cause leg cramps. Regular calf stretching exercises may prevent leg cramps. Quinine tablets may be advised as a last resort if you have cramps regularly.

What are leg cramps?
A leg cramp is a pain that comes from a leg muscle. It is due to a muscle spasm which is when a muscle contracts too hard. It usually occurs in a calf muscle, below and behind a knee. The small muscles of the feet are sometimes affected.

A cramp pain typically lasts a few minutes. In some cases it lasts just seconds, but in some cases it lasts up to 10 minutes. The severity of the pain varies. The muscle may remain tender for up to 24 hours after a leg cramp. Leg cramps usually occur when you are resting - most commonly at night when in bed. (They are often called night cramps.) They may wake you. It can become a distressing condition if your sleep is regularly disturbed.

Who gets leg cramps?
Many people have an occasional leg cramp. However, they occur frequently in some people. They are more common in older people. About 1 in 3 people over the age of 60, and about half of people over the age of 80, have regular leg cramps. About 4 in 10 people who have leg cramps have at least three per week. They occur every day in some people.

What causes leg cramps?
Unknown cause (idiopathic leg cramps)
In most cases the cause is not known. One theory is that cramps occur when a muscle that is already in a shortened position is stimulated to contract. As the muscle is already shortened, to contract further may cause the muscle to go into spasm. This commonly happens at night in bed as the natural position we lie in is with the knees slightly bent (flexed), and with feet pointing slightly downwards. In this position the calf muscle is relatively shortened and may be prone to cramps. This theory explains why stretching exercises may cure the problem.

Secondary causes
In some cases, the cramps may be a symptom of another condition or problem. For example:

Some drugs can cause cramps as a side-effect, or make cramps occur more often. These include: diuretics ('water tablets'), nifedipine, cimetidine, salbutamol, statins, terbutaline, lithium, clofibrate, penicillamine, phenothiazines, and nicotinic acid. 
Over-exertion of muscles. 
Dehydration. 
Conditions that cause alterations in the balance of salts in the bloodstream (such as a high or low sodium or potassium level). 
Some people who have renal (kidney) dialysis get leg cramps. 
Pregnancy - usually in the later stages.[ 
An untreated under-active thyroid gland. 
Peripheral vascular disease (narrowing of the leg arteries which causes poor circulation). 
Excess alcohol. 
Some uncommon disorders of nerves. 
Rare causes include: cirrhosis of the liver; lead poisoning; sarcoidosis. 
With the above conditions the cramps would just be one of various other symptoms. Therefore, if you are otherwise well, and have no other unexplained symptoms, then the leg cramps are likely to be idiopathic (unknown cause) and not due to a secondary cause.

Note: leg cramps are different to a condition called restless legs syndrome. In this condition the legs can be uncomfortable, you feel creeping sensations in the legs, and it is relieved by walking about. See separate leaflet called 'Restless Legs Syndrome' for details.

What is the treatment for a leg cramp?
Stretching and massaging the affected muscle can usually relieve an attack of cramp. Most cramps soon ease off. Painkillers are not usually helpful as they do not act quickly enough. However, a painkiller such as paracetamol may help to ease muscle discomfort and tenderness that sometimes persists for up to 24 hours after a cramp has gone.

What are the options for preventing leg cramps?
If cramps do not occur often, then no particular treatment is usually needed. However, if you have frequent cramps, you may wish to consider ways of preventing them.

Consider your medication (where appropriate) or other conditions
Tell your doctor if you take any of the drugs listed earlier. It may be causing the leg cramps, or making them recur more often. Alternative drugs may be available. Also, if you have other symptoms apart from cramps, see your doctor who may examine you or do some checks to rule out a secondary cause for the cramps.

Stretching exercises

Stretching exercises are commonly advised. However, there is a lack of good research evidence to prove that they work. One research study concluded that stretching exercises did reduce the number and severity of cramps, but another study did not confirm this. However, many doctors feel that regular calf stretching does help. So, as it may help, it is worth trying if you are able to do the exercises. If it works, you will not need any tablets to prevent the cramps.

At first, do stretching exercises of affected muscles for about five minutes, three times a day. Do the last exercise shortly before bedtime. If the cramps ease off, you may then only need to do the exercise once or twice a day to keep the cramps away.

To stretch calf muscles, stand about 60-90 cm from a wall. Then, keeping the soles of your feet flat on the floor, bend forward and lean on the wall. You will feel your calf muscles stretch. Do this several times, each time for as long as you can manage. It may take a week or so of exercises before you notice an improvement. So, it is worth giving yourself a 2-4 week trial of regular calf stretching exercises to see if your cramps ease off. The cramps may not go completely, but their frequency and/or severity may reduce.

Posture of the legs when resting in bed
Positions which prevent the calf muscle from shortening when you are asleep may help. The following are not proven treatments (from research studies), but some experts believe that they help to prevent cramps.

Using a pillow to prop the feet up in bed while sleeping on your back. 
Hanging the feet over the end of the bed while sleeping on your front. 
Keeping blankets loose at the foot of the bed to prevent toes and feet from pointing downwards during sleep. 
Quinine is used as a last resort - and you need to be aware of the risks
If you take quinine you have a good chance of reducing the number and/or severity of leg cramps, but it may not stop them altogether. One tablet at bedtime is the normal dose. Most people can take quinine, but do not take it if you are pregnant or may become pregnant. There are also some rare conditions where you should not take quinine. These include: a previous reaction to quinine; a previous haemolytic anaemia; optic neuritis; glucose 6-phosphate dehydrogenase deficiency.

Side-effects are uncommon at the low dose used to treat leg cramps. However, serious side-effects do sometimes occur. For example, a serious blood disorder which is potentially fatal is a known rare side-effect. Also, a small number of people who take quinine long-term develop a condition called cinchonism (a complex of nausea, vomiting, dizziness, visual disturbance, and hearing impairment). Read the drug packet leaflet for a full list of possible side-effects. Note: quinine is dangerous in overdose, particularly in children. Keep tablets away from children.

Therefore, quinine is only used as a 'last resort' when other treatments have not worked, and leg cramps are frequent and are affecting your quality of life.

When quinine is first prescribed it may be done on a trail basis for 4-6 weeks. You should be aware of the small risk of serious side effects. Also, it is best to objectively assess how well the quinine works. For example, by keeping a sleep and cramp diary. Ideally, this should be for a few weeks before and after the start of treatment so as to gauge its effect. If quinine is found to help then you may be advised to continue with it for a few months. You should consider stopping quinine every three months or so to see if it is still needed. This is because in some people the cramps go away and so the treatment may no longer be needed. If the cramps return, you can always re-start the tablets.

Other treatments
Other drugs have been suggested as possible treatments for leg cramps. These include: magnesium, diltiazem, vitamin B complex, vitamin E, naftidrofuryl, orphenadrine, and verapamil. In general, these are not currently recommended as most studies involving them found that they do not work very well in most people. Quinine remains the main treatment. However, your doctor may suggest a trial of one of these drugs if quinine has not worked or has caused troublesome side-effects.

Note the EXCESS Alcohol as one of the causes!


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## eddied (May 9, 2005)

*Leg cramps*

 Ciao Invicata, and thanks for a very informative post. Both myself and Donna C suffer, usually after strenuous exercise/a lot of walking, and usually very painful.
Strangely I take what is considered too much salt to be good for me, she takes none or very little. Ah well! and other of those over 65 things. Will try the quinnine, since it is sold in tobacconist shops here - used to be widely used for anti-malarial purposes, and a government monopoly along with tobacco and salt.
saluti,
eddied


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## MrsW (Feb 8, 2009)

Hi Sting!

I am a Nurse Advisor working for NHS Direct. I am unable to give specific advice to you without having a better understanding of your current and past medical history. If you want to discuss your specific issues do feel free to pm me. However, I can offer some general advice which will not impinge on your medical confidentiality:

Have a look at this advice on the NHS Direct website: http://www.nhs.uk/Conditions/legcrampsunknowncause/Pages/Causes.aspx?url=Pages/Overview.aspx

If the tonic water is not doing the job, return to the GP and discuss whether quinine tablets taken daily would be beneficial.

Make sure you keep your legs warm - cold legs appear to be more prone to cramping than warm ones. I suffer from cramp quite often, and find getting into a cold bed or letting the duvet fall off my legs in the night is enough to get the cramp going! Thin soled shoes will allow feet to get cold and can lead to cramp during the day. Could this be the cause of your day-time cramps?

I don't know your age and am not going to ask some of the more personal questions on the open page here. There are many conditions which can go un-recognised for some time and there are ways of identifying these, so I would urge you either to pm me and I will point you in the appropriate direction, or to go back to the GP and have a further discussion with them about these conditions which can creep up slowly and often go un-noticed for a long time.

Be careful about just increasing your salt intake - as others have intimated, other electrolytes can be the culprit. If the GP has not already done it, ask them to have your blood checked for the electrolyte content. Too much salt can be very dangerous, and the danger increases with age (no idea how old you are, sorry).

I do hope this is helpful!


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## Gonewiththewind (Nov 17, 2007)

Use to have leg and foot cramp, were the toes spread open and lock, damn painful. Now all I have is a leg full of knotted veins and large areas of bruising. with a continuous pricking sensation prior to more bruising. Life is wonderful when you get old.


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## 101405 (Oct 15, 2006)

I also suffer with this, normally late in the sleep time, ie early morning .its really started after I became a Diabetic type2 , what I have noticed is it seems related to alcohol, Either wine or beer, not that we hit the bottle far from it, but i do like a glass of cerveza , I can stop having a drink for weeks, then no or very little cramps so me thinks some chemical Involved here? salt will not help. my wife drinks very little, as wine plays hell with her bones, also the way you sleep must have some play in this, slow circulation wont help, but strange things happen to humans , Iwas 21! in mind and body and running my own truck biss, Had ignored signs of something amiss for 18months , within a month I was 61 and thinking I might lose my legs, lost 2 stone 50% leg muscle in 2 weeks could only crawl, What was it! Diabetese , I was not overweight had perfect diet did not smoke , but I do have 2 grown up children who are type1 ,so I sould have read the signs ,so its good you are doing somthing about it, And do you know the best day was when I new i would not be driving that truck,
what might help is a 75mg Asprin tablet a day, good luck.


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## lifestyle (Apr 27, 2008)

I find high heels dont help, i`ve been a lot better since my wife stopped me wearing them :lol: :lol: :lol: :lol:


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## tincan (Jul 31, 2006)

I take quinine sulphate, particularly after swimming as my calves go into knots, works for me

Noel


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## machilly (Feb 10, 2007)

Hi, I used to take lots of night cramps a few years back. ThenI started an a Herbal slimming soy drink to lose weight and after a few weeks, I noticed my leg cramps had kinda gon,, however a few years later and I don't take the product regularly, if I get a leg cramp now (not as severe as before) it is usually because I have either eaten after 8pm usuaully a meal, or have had a dish with hot Chilli (green).

Have a look at your diet, keep a food diary for a month and try and see if it is a reaction to a food or group of foods

Hope it helps

Regards


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## 106410 (Aug 12, 2007)

Just phoned the medical centre and my blood samples are normal, no action required. I am just coming up to 67 years, don't take a lot of salt on my food and do a lot of walking when I can. If I wiggle my toes in bed my feet seem to lock into a position and I really have to put pressure on to get them back to normal, probably why I have a lasting pain to the underside of my left foot and the top of my right foot. I did not realize that there were so many other suffers of this condition about. Thanks. S.


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## Groper (May 17, 2007)

My wife used to suffer with severe leg cramps until I started diluting her evening glass of wine with an equal quantity of lemonade or flavoured water.She still has a "proper" glass of wine with her meal.I think it is probably a case of mild dehydration and the added fluid is beneficial.

Clive


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## MrsW (Feb 8, 2009)

Please check with your GP before adding aspirin to your regime. It is not safe for all people and may be contra-indicated by other medication you are already taking or conditions you already have.

Diabetes is one of the conditions I was aluding to in my earlier post. It is a result of the damaged micro-circulation caused by high blood sugar levels.


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