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Leg Cramps

While it lasts, the pain from a leg cramp can be excruciating. Usually it goes away within a few minutes, though bad ones can cause lingering soreness. Typically, leg cramps affect the muscles in the calf (the large one is called the gastrocnemius) or along the sole of the foot.

The best immediate response is gently stretching the taut muscles. With the calf muscles, you can do that by grasping your toes and then slowly pulling your foot toward you. Leaning forward against a wall while keeping your heels on the ground does the same thing. Just standing up and putting weight on the affected leg may help, though you should be careful about falling: Get some help if someone is there to assist you. Heat (from a heating pad or warm - not hot - water) or massaging of the leg and foot can also help muscles relax, although it's best to try stretching first.

Prevention tips

Here are five suggestions for preventing leg cramps before they happen:

Wear good shoes. Flat feet and other structural problems make some people particularly susceptible to leg cramps. Proper footwear is one way to compensate.

Loosen up the covers. Many people like to sleep under snug covers. But, especially if you're lying on your back, the covers can press your feet down, a position that tightens up the calf and the muscles along the bottom of the foot. Tight muscles are vulnerable to cramping. Just loosening the covers can help (see illustration below).

Tight covers can tighten your calf and foot muscles.

Loosening the covers and sleeping on your stomach with your feet hanging over the bed can keep them relaxed.

Stretch. Stretching your calf and foot muscles before you go to bed can help prevent cramps in the first place. Use the same techniques that stretch the calf and foot muscles during a leg cramp. You can also try placing the front part of your feet on the bottom step of a stairway and slowly lowering your heels so they're below the level of the step.

Take quinine tablets. Many doctors prescribe quinine for leg cramps. Better known as an antimalarial drug (and the ingredient that gives tonic water its bitter taste), quinine seems to help leg cramps by decreasing the excitability of nerves. Many doctors and patients swear by it, but mixed results in clinical trials have cast doubt on its effectiveness.

On rare occasions, quinine can cause thrombocytopenia, a significant reduction in the number of platelets in the blood that may result in easy bleeding. Because of this problem - and doubts about the drug's effectiveness - the FDA stopped the over-the-counter sale of quinine in the mid-1990s, although you can still buy quinine tablets because of the loophole for dietary supplements. The very small amount of quinine in tonic water (about 15 milligrams per 8 ounces) is low enough not to pose a danger, but probably too low to offer any benefit.

Drink plenty of water. If you're active (that includes walking, gardening, doing housework), you need fluids to avoid dehydration. But don't overdo it. High amounts of fluids can dilute the concentration of sodium in your blood. This causes a variety of problems, including muscle cramps. How much you should drink depends on how active you are and the foods you eat. As we get older, we tend to forget to drink enough water because the thirst impulse becomes weaker with age. Some people also worry about adding more trips to the bathroom, especially at night.

Muscle ache vs. cramp

Sometimes muscle aches in the legs are confused with leg cramps. The difference can be important. For example, constant muscle aches (not leg cramps) are a rare side effect of statins. Poor blood circulation in the legs may cause muscle pain when the muscles are in use - for example - while walking, whereas muscle cramps most often occur when the muscle is at rest.

January 2005 Update

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