From the Research
Nocturnal leg cramps should be managed with quinine sulfate 200 mg OD, as it has been shown to reduce the frequency, duration, and pain intensity of cramps, while also improving quality of life and sleep performance, as demonstrated in the most recent and highest quality study 1. Nocturnal leg cramps typically present as sudden, painful contractions of muscles in the legs, most commonly affecting the calf muscles, but sometimes involving the feet or thighs. These cramps occur during sleep, often waking the person, and are characterized by intense tightness, hardness, or knotting of the affected muscle. The pain can last from a few seconds to several minutes, and the muscle may remain tender for up to 24 hours afterward. Some key points to consider in managing nocturnal leg cramps include:
- To relieve an active cramp, gently stretch the affected muscle by straightening the leg and flexing the foot upward toward the shin.
- Applying heat to the cramped muscle or massaging it can also help.
- For prevention, regular stretching before bedtime, staying hydrated, and avoiding excessive exercise close to bedtime may reduce frequency.
- While the exact cause is often unclear, these cramps can be related to muscle fatigue, dehydration, electrolyte imbalances, or certain medications, such as diuretic and long-acting beta-agonist therapy 2.
- If cramps are severe, persistent, or associated with other symptoms like muscle weakness or atrophy, medical evaluation is recommended as they could indicate an underlying condition requiring treatment. It is essential to note that quinine sulfate should be used with caution, especially in older people, due to the risk of dose-related side effects and rare but serious immune-mediated reactions 2, 3. However, the most recent study 1 has shown that quinine sulfate is effective and well-tolerated in adults with frequent and painful nocturnal leg cramps, with a low incidence of adverse drug reactions.