From the Guidelines
To help with muscle cramps, consider medications like baclofen (10 mg/day, with a weekly increase of 10 mg/day up to 30 mg/day) or albumin (20-40 g/week), as they have been shown to be effective in patients with liver disease 1. When experiencing muscle cramps, it is essential to stretch the affected muscle gently and hold for 30 seconds, massage the area, and apply heat to relax tight muscles or ice for inflammation. Staying hydrated by drinking water regularly throughout the day is also crucial, as dehydration is a common cause of cramps. Consuming foods rich in potassium (bananas, oranges, potatoes), magnesium (nuts, seeds, leafy greens), and calcium (dairy products, fortified plant milks) can help prevent muscle cramps. Over-the-counter options include magnesium supplements (250-400mg daily) or electrolyte drinks. For frequent or severe cramps, consider medications like acetaminophen (Tylenol, 325-650mg) or ibuprofen (Advil, 200-400mg) for pain relief, although muscle relaxants 1 may also be beneficial. Preventing future cramps by warming up before exercise, maintaining proper form during activities, and gradually increasing workout intensity is also important. Muscle cramps occur when muscles involuntarily contract due to nerve hyperexcitability, often triggered by electrolyte imbalances, dehydration, muscle fatigue, or poor circulation. If cramps are persistent, severe, or accompanied by swelling or weakness, consult a healthcare provider as they may indicate an underlying condition. Some key points to consider when treating muscle cramps include:
- Correcting electrolyte alterations, such as hypokalemia and hypomagnesemia 1
- Using medications like baclofen, albumin, orphenadrine, and methocarbamol 1
- Considering referral to pain management services, interventional specialist, physical therapy, physical medicine, and/or rehabilitation 1
From the Research
Treatments for Muscle Cramps
- Quinine has been shown to significantly reduce cramp frequency, intensity, and cramp days in dosages between 200 and 500 mg/day 2, 3
- The use of quinine is associated with a higher risk of minor adverse events, mainly gastrointestinal symptoms, but the incidence of serious adverse events is not significantly greater than for placebo 2, 3
- A quinine-vitamin E combination, vitamin E alone, and xylocaine injections into gastrocnemius were not significantly different to quinine across all outcomes, including adverse effects 2, 3
- Theophylline combined with quinine may improve cramps more than quinine alone, but further research is needed to confirm this 3
Magnesium Supplementation
- Magnesium supplementation is unlikely to provide clinically meaningful cramp prophylaxis to older adults experiencing skeletal muscle cramps 4, 5
- The literature on magnesium supplementation for pregnancy-associated rest cramps is conflicting, and further research is needed in this population 4, 5
- There is limited evidence on the use of magnesium supplementation for exercise-associated muscle cramps or disease-state-associated muscle cramps 4, 5
- Magnesium supplementation may not be effective for restless legs syndrome or periodic limb movement disorder, but the evidence is limited and inconclusive 6