What is a muscle cramp?

A muscle cramp is a sudden and involuntary contraction of one or more of your muscles.

According to eMedicine, “A muscle that involuntarily contracts without our consciously willing it is called a “spasm.” If the spasm is forceful and sustained, it becomes a cramp. A muscle cramp is an involuntarily and forcibly contracted muscle that does not relax.”

There is usually pain and you may feel the muscle tense.

Muscle cramps are most common in the calves and hamstrings but any skeletal muscle can cramp.

Muscle cramps can be exercise or non-exercise related.

Among people over 60, almost half report having leg cramps. A third say they are awakened by cramps at night and 15% report weekly episodes. Harvard Health

What causes muscle cramps?

A muscle cramp is thought to be secondary to an overactive nerve-muscle reflux arc. Scientific American

Muscle cramps may occur due to dehydration and electrolyte deficiency but there is little evidence to support this.

Prevention of a muscle cramp

Avoid dehydration

Look at your urine color. Your urine should be light yellow, it should not be dark.

Consider a sports drink and keep yourself hydrated prior to and during exercise.


Multi-vitmains may help. Deficiencies of certain  vitamins such as  thiamine (B1), pantothenic acid (B5), and  pyridoxine  (B6) may cause muscle cramps. Harvard Health 

Studies suggest magnesium, zinc, and vitamins B, D, and E may limit the risk of getting a muscle cramp.

Ensure you are eating a well balanced diet and consuming enough magnesium.


Massage and stretch your muscles prior to vigorous exercise, this will bring blood and oxygen to your muscles. Stretching appears to

Ensure you are making time to warm up and cool down.


To prevent nighttime calf cramps, try not to sleep with your toes pointed.

And don’t tuck in your sheets too tightly, this usually causes your toes to point downward.

Try sleeping on your stomach with your feet having over the edge of the bed to prevent your toes from pointing downward.

Wear proper shoes

If you have flat feet you may be at higher risk for developing muscle cramps. “They are common among people with musculoskeletal problems like flat feet or high arches, metabolic disorders, or neurological conditions such as Parkinson’s disease or neuropathy (nerve damage).” Harvard Health


Clinical trials have shown some benefit using quinine for muscle cramps but the benefit appears to be small.

In addition, quinine has been shown to lower platelet counts in some people. There is an increased risk of bleeding as platelets are needed for blood clotting.

FDA has warned againist using quinine for leg cramps.

Tonic water-AAN found insufficient data to make a recommendation for or against its use.

Pickle juice

Some athletes swear it can help alleviate muscle cramps.

There was one study to support it. The researchers believed that pickle juice inhibits electrically induced muscle cramps in  humans. They suspected that there is a neurally mediated reflex that originates in the mouth and acts to inhibit the firing of alpha motor neurons of the cramping muscle.”

Over the counter treatment for a muscle cramp

Coenzyme Q10

There is no convincing medical evidence to suggest that  (CoQ10) prevents muscle pain in people taking statins. But because the risk of side effects from CoQ10 is low, many doctors would recommend a one-to-two month trial of the supplement (doses range from 100 to 200 mg daily) to help with statin-related muscle cramps, pain, or weakness. Make sure your doctor knows you are taking it. Harvard Health


Magnesium citrate and magnesium sulfate did not notably improve the number of cramps, and were associated with abdominal discomfort and diarrhea. American Family Physician

Hot Shot

According to the manufacturer Flex Pharma,

HOTSHOT™ is the sports shot with a kick that is scientifically proven to prevent and treat muscle cramps.”

“Studies that measure electrolyte levels parameters in marathoners or triathletes before and after races find essentially no difference between those who cramp and those who don’t.”

“New research has shown that cramps and spasms do not originate in the muscle itself, but are caused instead by a neural mechanism: excessive firing of the motor neurons in the spinal cord that control muscle contraction.”

HOTSHOT complements the Company’s drug development business and is not intended to diagnose, treat, cure or prevent any disease.”

“This 1.7-ounce dose of cinnamon, ginger, lime juice, sweeteners, and capsaicin (the active compound in chili peppers) was developed by Dr. Bean and Dr. Rod MacKinnon, a Nobel Laureate in Chemistry at Rockefeller University, as a remedy for cramping during rigorous exercise. It works along the same principle as mustard and pickle juice, but has longer-lasting effects. It is currently available commercially as a sports beverage. “Although I am aware of people using it for nocturnal leg cramps, it has not yet been formally tested for that use,” Dr. Bean says.” Harvard Health

According to the manufacturer’s website ingredients include,

Filtered Water, Organic Cane Sugar, Organic Gum Arabic, Organic Lime Juice Concentrate, Pectin, Sea Salt, Natural Flavor, Organic Stevia Extract, Organic Cinnamon, Organic Ginger, Organic Capsaicin

Hot shot is not FDA approved as it is not marketed as a drug. Supplements do not require premarket approval by the FDA.

Prescription medications for a muscle cramp

These medications are FDA for other indications, they are not FDA approved for muscle cramps.

Calcium channel blocker diltiazem (Cardizem)  may be effective for the treatment of muscle cramps. Minor adverse effects included lightheadedness and nausea can occur. American Family Physician

Anticonvulsants gabapentin (Neurontin) have been used to treat muscle cramps.

Muscle relaxants have been used to treat muscle cramps but they are addicting and should not be used for  long periods of time.

Medical conditions that increase your risk for a muscle cramp




Magnesium or potassium deficiency

Pinched nerves

Exercising in the heat -Reference WebMD

Medications that can cause muscle pain

Diuretics which cause you to lose water  (and electrolytes) through urination.

Statins that are used to lower cholesterol such as Lipitor can cause muscle pain.

Diuretics which reduces fluids in your body such as Lasix.

Asthma medications such as Proventil.

Alzheimer’s medications such as Aricept.

Parkinson’s medications such as Tasmar.

Osteoporosis medications such as Exista.

Blood pressure medications such as Procardia.

Myasthenia medications such as Prostigmine.

If a muscle cramp occurs

“it is well recognized that, once induced, stretching the affected muscle can ameliorate cramping. Stretches should be held for 15 to 30 seconds or until the muscle relaxes and the cramp does not recur when the muscle is returned to its normal relaxed position. ” Scientific American

Warm compresses or heating pads can help decrease muscle pain.

Over the counter medications such as non steroidal (Advil or Motrin) help decrease inflammation.

“once cramping starts, exercise should be curtailed for at least an hour, which allows the muscles and the CNS to recover.” Scientific American

Further investigation is warranted for a recurrent or persistent muscle cramp

Recurrent muscle cramps can signal a muscle or nerve problem.

According to eMedicine,

“Blood tests for the muscle enzymes (CPK, aldolase, LDH, ALT, AST) can be helpful to determine if muscle injury is occurring.

Other blood testing may include evaluation of the levels of calcium, phosphorus, potassium, and magnesium, as well as thyroid function.

Occasionally, testing with a neurologist might include tests of nerve conduction velocity (NCV) and an electromyogram (EMG)”.  These tests will check the nerves.

Exercises for Muscle cramps

Ed Thorpe from The Far Side of 55 lists some great exercises that can help with leg cramps.

What do you do if you have a muscle cramp?


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