Leg Cramps

A note from Cleveland Clinic

What to Know About Magnesium and Your Leg Cramps

Frequent muscle cramps may occur if you have a magnesium deficiency or deficiencies in other nutrients. Some remedies, including massage, may reduce leg cramps.

If you have frequent leg cramps, one reason could be that your body needs more of the mineral magnesium. A 2017 study reported that up to two-thirds of the American population is magnesium deficient.

Magnesium is the fourth most abundant mineral in the body and is essential for regulating your body’s functioning. It’s involved in more than 300 of your body’s biochemical processes, including muscle contraction and nerve transmission.

Magnesium is a widely used remedy for leg cramps. But the evidence for its effectiveness is very limited. Here we’ll look at what studies report and what you can do for leg cramps.

Summary

Having a magnesium deficiency can be a cause of muscle cramps. And it’s common for people to need more magnesium. But, based on clinical studies, magnesium supplements have not proven to be an effective treatment for muscle cramps. There are still things you can do, with or without magnesium, to alleviate leg cramps.

The average length of the portion of a doctor appointment in which the patient actually sees the doctor is up from previous years, rising by about 12 seconds per year, according to Reuters. However, 60% of physicians report dissatisfaction with the amount of time they spend with their patients, athenaInsight Many doctors now spend more time on paperwork than seeing patients, and a primary care physician who spends 5 minutes of face-to-face time with a patient will spend another 19.3 minutes, on average, working on that patient’s electronic health records (EHRs).

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Anecdotally, it does help some people. And it’s safe to use.

If you’re magnesium deficient, increasing your magnesium levels may have other beneficial effects.

Athletes, in particular, need adequate levels of magnesium for performance. Magnesium has been found useful in treating people with conditions such as:

• asthma
• osteoporosis
• migraine headaches
• diabetes
• heart disease
• depression

How much magnesium you need depends on your age and sex. According to the National Institutes of Health (NIH) , men over 70 and teenage girls are the most likely groups to be magnesium deficient.

Suggested amounts of magnesium

• 400–420 milligrams a day for men
• 310–320 mg a day for women
• 350–360 mg a day for pregnant women

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Some drugs can interact with magnesium. If you’re taking any medications, check with a pharmacist or doctor before taking magnesium supplements.

Eating foods rich in magnesium can ensure that your levels meet the suggested daily intake. Your body absorbs about 30 percent to 40 percent of the magnesium you get from your diet.

At the top of the list for magnesium content per serving are:

• almonds (80 mg)
• spinach (78 mg)
• cashews (74 mg)
• peanuts (63 mg)
• soy milk (61 mg)
• shredded wheat cereal (61 mg)

You can also try magnesium supplements. These are available in many forms such as magnesium oxide, magnesium chloride, and magnesium citrate. A 2015 study of the medical uses of magnesium recommends taking magnesium citrate because it’s more easily absorbed by the body.

It’s also recommended that your magnesium intake is in proportion to your calcium intake, with magnesium in your diet being about half to two thirds of your calcium intake.

For example, if your magnesium intake is 500–700 mg, your calcium intake should be 1,000 mg. Or, more simply put: Eat a variety of foods and include good sources of calcium and foods that have magnesium.

Fast facts about magnesium deficiency

• Your body absorbs up to 30 percent less magnesium from foods as you age.
• Smoking and alcohol use reduce magnesium levels.
• Processed foods have lower levels of magnesium.
• Many common drugs, such as statins and antacids, reduce magnesium absorption.
• Low vitamin D levels reduce absorption of magnesium.

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Magnesium is widely used to treat leg cramps, particularly in Latin America and Europe. But almost all of the many clinical studies of magnesium treatment for cramps found it to be ineffective.

Here are some of the specific study results:

A 2017 study of 94 adults compared whether magnesium oxide capsules were better than a placebo capsule for reducing night cramps. The randomized clinical trial concluded that magnesium oxide supplements are no better than a placebo in reducing cramps.

A 2013 review of seven randomized trials of magnesium for leg cramps found that magnesium therapy doesn’t appear to be effective for the general population. The review noted that it may have a small positive effect for pregnant women.

A 2010 assessment by the American Academy of Neurology reported:

• A 2002 study of 58 people using magnesium citrate found no significant improvement in the number of cramps.
• A 1999 study using magnesium sulfate found that it was no better than a placebo in reducing the frequency, severity, or duration of cramps among 42 study participants.

Other factors to consider

• Supplements can still be okay to take. The magnesium studies note that magnesium supplements are safe and are not expensive.
• You might be low in something else. One possible reason for the lack of effectiveness on cramps in the magnesium studies is the complex relationship between magnesium and other basic nutrients. For example, calcium and potassium are also involved in muscle cramping. If a lack of one of these other nutrients is causing the muscle cramps, then magnesium wouldn’t help.
• Magnesium does help some people. Although the majority of the available research shows no overall correlation between using magnesium and reducing leg cramps, some study participants did report magnesium more effective than a placebo.

When increasing your magnesium intake doesn’t help stop your cramps, there are other things you can try. Stretching can be most effective, according to a 2016 review of studies.

Stretching

Here are three stretches you can try if you’re actively having a leg cramp:

• If your calf muscle is cramping, reach down and pull your toes toward your head until the cramp eases.
• Try lunging forward with the leg that isn’t cramped, stretching out the cramped leg behind you.
• Stand on your toes for a few seconds.

There’s evidence that stretching before you go to sleep reduces the frequency and severity of night leg cramps.

A 2012 study of 80 adults over age 55 found that those who stretched their calves and hamstrings before bed had fewer and less painful leg cramps during the night.

In general, walking around may relax your leg muscles and ease leg cramps.

Massage

Gently rub the muscle area that’s cramped.

Ice or heat

• Use an ice pack or a heating pad on the cramp, for 15 to 20 minutes at a time. (Wrap the ice in a towel or cloth, so that it’s not directly on the skin.)
• Take a hot bath or shower.

Hydration

Drinking some water may help with a cramp. For prevention, it’s important to stay hydrated.

Consider not consuming alcohol. A 2018 study reported that alcohol consumption was strongly associated with having leg cramps at night. The authors note that more studies would be necessary to confirm causality.

Medication

Try over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain from muscle spasms. Topical pain-relieving creams, such as Bengay or Biofreeze, may help.

You could also try a non-prescription muscle relaxant.

Getting more magnesium from your diet or from a supplement seems to help some people with their leg cramps, but the scientific evidence doesn’t support the effectiveness of magnesium for cramps.

Magnesium citrate may be the most effective type if you want to try a supplement.

If you’re magnesium deficient, there may be other benefits from increasing your intake of this nutrient. And other remedies are available for leg cramping that may help.

Last medically reviewed on July 8, 2019

Leg Cramps

Leg cramps are painful, involuntary muscle contractions that can last seconds or minutes. They affect your sleep, exercise routine and general quality of life. Some conditions and drugs can cause them, and there are risk factors you’ll want to avoid. When a cramp happens, try flexing the muscle, applying heat or ice and massaging the area.

Overview

Leg Cramps at Night

What are leg cramps?

Leg cramps are sudden, involuntary, intense muscle pains usually in your calf, foot or thigh. You might also know them as a “charley horse.” Sometimes the cramp may cause your leg to spasm – to tighten uncontrollably. Although painful to live with, cramps are generally harmless.

What does a leg cramp feel like?

A leg cramp feels like a clenched, contracted muscle tightened into a knot. It can be severely uncomfortable, painful or even unbearable. Your muscles in the area might hurt for hours after the cramp goes away.

How do I stop a leg cramp?

Try forcefully stretching the affected muscle (for example, stretch your calf muscle by flexing your foot upward). Jiggle your leg, massage it, or force yourself to walk. It might also help to apply ice or heat – use a heating pad or take a warm bath. (Read the “Management and Treatment” section for more tips.)

Unfortunately, there are no pills or injections that instantly relieve a leg cramp when it’s happening. There are, however, ways that may prevent the cramp from happening in the first place (see the “Prevention” section).

Can you get leg cramps at night?

Leg cramps at night happen when you’re not very active, or when you’re asleep. They may wake you up, make it harder for you to fall back asleep and leave you feeling sore all night. Yearly, monthly, weekly, nightly – the frequency of leg cramps depends on the person. Nocturnal leg cramps can happen to anyone at any age, but they happen most often to older adults. Of people over age 60, 33% will have a leg cramp at night at least once every two months. Nearly every adult age 50 and older will have them at least one time. Seven percent of children will, as well. Approximately 40% of pregnant women will experience leg cramps at night. The reason behind that is thought to be that the extra weight of pregnancy strains the muscles.

Three-quarters (75%) of all reported leg cramps happen at night.

How long do leg cramps last?

An instance of a leg cramp can last from several seconds to several minutes.

Who gets leg cramps?

The older you are, the more likely you are to have leg cramps. This is because your tendons (the tissues that connect your muscles to your bones) naturally shorten as you age. You’re also more likely to get them if you’re a woman. Up to 60% of adults get leg cramps at night, as do up to 40% of children and teenagers.

Are leg cramps a sign of something serious?

Leg cramps can sometimes be a symptom of a serious health condition. (See the “Symptoms and Causes” section.) If you are concerned that you have a serious health condition, don’t hesitate to contact your healthcare provider and report your symptoms, including your leg cramps.

How common are leg cramps?

Leg cramps are very common and normal, especially at night.

What is the difference between leg cramps and Restless Legs Syndrome (RLS)?

Although both nocturnal leg cramps (leg cramps at night) and restless legs syndrome tend to happen to you at night or when you’re at rest, restless legs syndrome doesn’t cause the severe pain. Restless legs syndrome is uncomfortable, but not agonizing. It’s a crawling sensation that makes you want to move your legs. When you do move, the restlessness stops, but there is still discomfort.

Symptoms and Causes

What causes leg cramps?

Some leg cramps happen for no known reason and they are called “idiopathic” cramps. “Secondary” leg cramps are a symptom or complication of a more serious health condition. The primary cause of idiopathic leg cramps is up for debate. Possible causes of them include:

• Involuntary nerve discharges.
• Restriction in the blood supply.
• Stress.
• Too much high-intensity exercise.

Women who are pregnant often have leg cramps during the day and at night.

Possible causes for leg cramps at night (nocturnal leg cramps) include:

• Sitting for long periods of time.
• Overusing the muscles.
• Standing or working on concrete floors.
• Sitting improperly.

Leg cramps are not likely to cause:

• Broken bones.
• Fainting.
• Nausea.
• Numbness.

What medications may cause leg cramps?

Drugs have side effects. It’s possible that a prescription you’re taking could be causing your leg cramps. In that case, work closely with your healthcare provider to determine the pros and cons of the medication vs. its side effects. It’s possible that your healthcare provider may be able to put you on a different medication that doesn’t have leg cramps as a side effect. Medicines that have leg cramps as a side effect include:

• Albuterol/Ipratropium (Combivent®).
• Conjugated estrogens.
• Clonazepam (Klonopin®).
• Diuretics.
• Gabapentin (Neurontin®).
• Naproxen (Naprosyn®).
• Pregabalin (Lyrica®)
• Statins.
• Zolpidem (Ambien®).

Others may include: Amoxicillin, bromocriptine (Parlodel), bupropion (Wellbutrin), celecoxib (Celebrex®), cetirizine (Zyrtec), chromium, cinacalcet (Sensipar), ciprofloxacin (Cipro), citalopram (Celexa), donepezil (Aricept), eszopiclone (Lunesta), fluoxetine (Prozac), IV iron sucrose, lansoprazole (Prevacid), levalbuterol, levothyroxine, metformin, niconitis acid, nifedipine, rivastigmine (Exelon), sertraline (Zoloft), telmisartan (Micardis), teriparatide (Forteo®) and teriparatide raloxifene (Evista®).

What medical problems can cause leg cramps?

Sometimes leg cramps happen to you for no reason, but other times they could possibly be a sign or symptom of a health condition. If you have any of the following conditions, it’s possible that your leg cramps are a result of that condition. Also keep in mind that if you don’t already know if you have any of these conditions, your leg cramps may be a sign that you do. Always consult your healthcare provider if you think your leg cramps are a symptom of a more serious medical condition.

Leg cramps can possibly be a sign of lifestyle choices such as:

• Alcoholism: An addiction to alcohol.
• Pregnancy.
• Dehydration: The lack of sufficient water in the body. (This sign is debated among experts.)

Leg cramps can also possibly be a sign of serious conditions including:

• ALS (amyotrophic lateral sclerosis/Lou Gehrig’s disease): Progressive neuromuscular disease.
• Cardiovascular disease: Heart conditions caused by blood clots or diseased blood vessels. Also, coronary artery disease: The narrowing or blockage of the coronary arteries.
• Cirrhosis of the liver: Scarring of the liver.
• Diabetes: A disease that prevents your body from properly using the energy from the food you eat.
• Flat feet: The absence of the supportive arch in the foot.
• Hypokalemia: Low potassium levels in your blood.
• Kidney failure (hemodialysis): A condition in which one or both kidneys no longer work correctly.
• Osteoarthritis (degenerative joint disease): The corrosion of the cartilage that protects your bones. Also, lumbar canal stenosis: A narrowing of the spinal canal in the lower back.
• Parkinson’s disease: A neurological movement disorder.
• Peripheral artery disease: Narrowing of the arteries. Also, peripheral neuropathy: Damage or dysfunction of one or more nerves.

Cancer treatments like chemotherapy can cause nerve damage, which may cause leg cramps.

There are rumors that leg cramps can also be a sign of the following conditions. Fortunately, that is not the case. Leg cramps are unlikely to be a sign of:

• Labor (giving birth).
• Lung cancer.
• Menopause.
• Multiple sclerosis.

Leg cramps are not likely to be a sign of a deficiency in:

• Alanine transaminase.
• Albumin.
• Bilirubin.
• Calcium.
• Creatinine.
• Glucose.
• Magnesium.
• Zinc, vitamin B12 or vitamin D.

What are the warning signs that leg cramps are coming?

Unfortunately, leg cramps happen very suddenly. There are no warning signs. However, there are risk factors such as pregnancy and the use of medications that have leg cramps as a side effect.

Diagnosis and Tests

How are leg cramps diagnosed?

Your healthcare provider will need to know your medical history, medications and a description of what you’re experiencing. Be specific. Report your symptoms to your healthcare provider and include the following information:

• When the leg cramps started happening.
• What your pain feels like.
• When the cramps happen (at night, for example, or after vigorous exercise).
• How long the cramps last.
• Any other symptoms you’re experiencing.

Your healthcare provider will need to tell the difference between your leg cramps from other conditions that may resemble them:

• Claudication.
• Peripheral neuropathy.
• Myositis.
• Restless legs syndrome.

To distinguish those differences, your healthcare provider may:

• Check the palpation of pulses.
• Evaluate physical sensations such as pinpricks.
• Test deep tendon reflexes.
• Test the strength of your leg.

Do I need to have any testing done to diagnose my leg cramps?

Blood, urine and other routine tests are not helpful in diagnosing leg cramps but they may help identify previously undiagnosed medical conditions that have leg cramps as a symptom. For example, your healthcare provider will likely perform typical tests such as taking your blood pressure, and that can reveal cardiac and vascular risks.

What questions might my healthcare provider ask about my leg cramps?

To help your healthcare provider diagnose you, they may ask the following questions about your leg cramps:

• When do you experience the leg cramps?
• How often do your leg cramps occur?
• How would you describe your leg cramps?
• How long do the leg cramps last?
• What medications are you currently taking?
• What known medical conditions do you have?
• Are you concerned about medical conditions that may be causing your leg cramps?
• Are you having any symptoms of another medical condition?

Management and Treatment

What can I do to make leg cramps go away if they happen?

You want to get rid of a leg cramp the moment it strikes. You might be finishing up an exercise routine, or you might be awakened in the middle of the night. In moments like that there are, unfortunately, no magical injections that can instantly relieve your pain. However, there are eight steps to take to possibly get rid of a leg cramp:

1. Stretch. Straighten your leg and then flex it, pulling your toes towards your shin to stretch the muscles.
2. Massage. Use your hands or a roller to massage the muscles.
3. Stand. Get up. Press your feet against the floor.
4. Walk. Wiggle your leg while you walk around.
5. Apply heat. Use a heating pad or take a warm bath.
6. Apply cold. Wrap a bag of ice in a towel and apply it to the area.
7. Pain killers. Take ibuprofen or acetaminophen to help with the pain.
8. Elevate. Prop up your leg after the cramp starts to feel better.

What kinds of stretches help get rid of leg cramps?

Try this if your cramp is in your calf muscle: While standing (or sitting with your leg unfolded before you), straighten your leg and lift your foot until your toes are pointing at your shin. Pull on your toes if you are able to reach them. You could also try walking around on your heels.

What medicines may help with leg cramps?

At this time, there is no recommended medication that can prevent leg cramps 100% of the time. However, there are some prescription medications that show a little evidence of preventing leg cramps. Under your healthcare provider’s watchful eye, you might want to try the following:

• Carisoprodol (Soma®): A muscle relaxant.
• Diltiazem (Cartia XT®): A calcium-channel blocker.
• Orphenadrine (Norflex®): Treats muscle spasms and relieves pain and stiffness in muscles.
• Verapamil: A calciuim-channel blocker.

What vitamins may help with leg cramps?

No vitamin is likely to help with a leg cramp 100% of the time. However, some experts do recommend that you take a vitamin B12 complex.

Does quinine help with leg cramps?

Quinine was thought to show some promise with healing leg cramps, but it is no longer recommended. There are potentially life-threatening side effects: arrhythmias, thrombocytopenia and hypersensitivity reactions.

When should I get my leg cramps treated at the Emergency Department?

Go to the emergency department (ED) if a leg cramp lasts longer than 10 minutes or becomes unbearably painful. Also go if a leg cramp happens after you touch a substance that could be poisonous or infectious. For example, if you have a cut in your skin that touches dirt, you could get a bacterial infection like tetanus. Exposure to mercury, lead or other toxic substances should also be reason to go to the emergency department.

Is there a surgery that could help with my leg cramps?

At this time, surgery is not recommended as a cure for leg cramps.

Prevention

How can I reduce my risk of getting leg cramps?

Experts can’t promise that you’ll never have a leg cramp again, but there are some steps you can take that might reduce your risk!

• Make sure that you stay hydrated – drink six to eight glasses of water each day. Don’t drink as much alcohol and caffeine.
• Adjust how you sleep. Use pillows to keep your toes pointed upwards if you sleep on your back. If you lie on your front, try hanging your feet over the end of the bed. Both positions can keep you in a relaxed position.
• Gently stretch your leg muscles before you go to sleep.
• Keep blankets and sheets loose around your feet so that your toes are not distorted.
• Wear shoes that fit you well and support your feet.
• Perform frequent leg exercises.
• Stretch your muscles before and after you exercise.
• Experiment with mild exercise right before bed. Walk on the treadmill or ride a bicycle for a few minutes.

What kinds of stretches help prevent leg cramps?

Try the following to prevent leg cramps in your calves: Stand about three feet (one meter) away from a wall. Lean forward. Touch the wall with your arms outstretched while keeping your feet flat. Count to five before you stop, and do it over and over again for at least five minutes. Repeat three times per day.

Outlook / Prognosis

Can leg cramps be cured?

Leg cramps don’t have a cure at this time. Fortunately, there are steps you can take to prevent leg cramps (see the “Prevention” section) and manage your leg cramps (see the “Management and Treatment” section).

Can leg cramps get worse?

The severity of a leg cramp is difficult if not impossible to predict. Some people see improvement with prevention and treatment plans, while others struggle. It is possible that your cramps will feel worse and happen more often as you age.

Living With

How do I take care of myself?

Come up with a treatment plan with your healthcare provider that includes a prevention plan and an in-the-moment treatment plan. Ideas for a prevention plan include several activities you may want to do every day:

• Exercise: Do leg exercises during the day, and mild, brief walking or biking right before bed.
• Hydration: Drink eight glasses of water each day and avoid alcohol and caffeinated beverages.
• Medications and vitamins: Take all vitamins and medications (including muscle relaxants) exactly how they’re prescribed by your healthcare provider.
• Prepare your bed space: Keep a heating pad and massage roller next to your bed.
• Shoes: Purchase supportive shoes.
• Sleeping position: Experiment with different positions to see if one works better than another. Keep your toes up if you’re on your back and hang your feet over the end of the bed if you lie on your front.
• Stretch: Stretch your legs before and after exercising, and right before you go to sleep.

Your in-the-moment treatment plan could include the eight steps mentioned in the Management and Treatment section:

1. Stretch. Straighten your leg and then flex it, pulling your toes towards your shin to stretch the muscles (using a towel can assist).
2. Massage. Use your hands or a roller to massage the muscles.
3. Stand. Get up. Press your feet against the floor.
4. Walk. Wiggle your leg while you walk around.
5. Apply heat. Use a heating pad or take a warm bath.
6. Apply cold. Wrap a bag of ice in a towel and apply it to the area.
7. Pain killers. Take ibuprofen or acetaminophen to help with the pain.
8. Elevate. Prop up your leg after the cramp starts to feel better.

When should I see my healthcare provider about my leg cramps?

See your healthcare provider if your leg cramps are unbearably painful, happen frequently or last for a long time. Also, talk to your healthcare provider right away if you have any of the following symptoms in addition to leg cramps:

• Muscle cramps in other parts of your body.
• Significant pain.
• Swelling or numbness in the leg.
• Changes in the skin of your leg.
• Waking up over and over again with leg cramps.
• If your leg cramps are stopping you from getting enough sleep.
• If you have fluid abnormalities or electrolyte imbalances.
• See your healthcare provider immediately if you’re concerned that your leg cramps are a symptom of an underlying serious medical condition.

What questions should I ask my healthcare provider about leg cramps?

• Do you think that my leg cramps are a symptom of an underlying condition?
• Can you show me the best exercises I can do to stretch my muscles?
• Can you show me the best massage techniques I can use to help with my leg cramps?
• Is it safe for me to take medication for my leg cramps? Which medications should I take?
• Do you recommend that I see a physical therapist, sleep specialist, massage therapist, or other specialist?
• How can I help my child when they have a leg cramp?
• Should I keep an eye out for symptoms other than leg cramps that might indicate a more serious condition?
• How often should I come back to visit you about my leg cramps?

A note from Cleveland Clinic

Leg cramps can be unpredictable and agonizing. They can affect your sleep, your exercise routine and your general quality of life. They’re common – very normal – and, fortunately, temporary, and there are steps you can take to manage them. Do your best to avoid risk factors, avoid medications with leg cramps as a side effect and take recommended preventative measures.

If you’re concerned about the severity and duration of your leg cramps, or think that they may be caused by a serious condition, don’t hesitate to contact your healthcare provider. Ask questions and voice your concerns. You don’t have to just “live with” leg cramps.