Muscle Cramps

A sudden, painful knot in a muscle, most often the calf, often at night. Usually harmless, very common, and annoyingly hard to prevent. Stretching is the best-tested fix; most tablets disappoint.

Typical signs: a muscle suddenly tightens and hardens, usually the calf or foot, for seconds to minutes. The muscle can feel sore for hours afterwards. About 3 in 4 happen at night.

Why it happens: often no clear cause. Cramps are more common with age (about 1 in 3 people over 60), in pregnancy (about 1 in 3, mostly late), after hard exercise, with dehydration, and with some medicines such as statins and water tablets (diuretics), or with liver, kidney, thyroid or nerve problems.

Diagnosis: from your story and examination. Your GP may review your medicines and order blood tests (such as kidney function, salts, sugar and thyroid) if cramps are frequent or unusual.

The cramp ladder

Cramps are a nuisance, not a danger, for most people. Start with stretches and a medicine review before reaching for tablets.

1. Step 1 · Self-careStretch it outDuring a cramp: pull your toes up towards you, or stand and lean forward with your heel down. Walk around, then massage the muscle.

   Works

   The quickest way to stop a cramp; based on how muscles work rather than trials

   Cost

   Free

   How long

   Seconds to minutes

   Watch for

   A cramp lasting more than 10 minutes that won’t ease with stretching needs a same-day check.

   Stand up, swear quietly, stretch the calf.

2. Step 2 · Self-careNightly calf and hamstring stretchesA few minutes of calf and hamstring stretching every night before bed.

   Works

   In a trial of 80 older adults, nightly stretching for 6 weeks meant about one fewer cramp a night and milder ones, vs no stretching

   Cost

   Free

   How long

   Daily, ongoing; judge after 6 weeks

   Watch for

   Gentle, not bouncing.

   Three minutes of stretching beats an hour of 3 am swearing.

3. Step 3 · Self-careBedtime and daytime habitsLoose bedding, toes pointing up (on your back) or feet over the end of the bed (on your front); regular daytime walking; enough fluid.

   Works

   Commonly advised, low-risk; little trial evidence

   Cost

   Free

   How long

   Ongoing

   Watch for

   Big changes in fluid intake with heart or kidney disease: ask your GP first.

   Tight sheets pointing your toes all night? There’s your cramp factory.

4. Step 4 · GPMedicine and health reviewYour GP checks whether a medicine (such as a statin or diuretic) or a health condition could be behind it.

   Works

   Changing or treating the cause can stop cramps; varies person to person

   Cost

   GP visit; often bulk-billed

   How long

   One or two visits

   Watch for

   Don’t stop a prescribed medicine without talking to your GP first.

   Sometimes the cause is in the pill box, not the calf.

5. Step 5 · PrescriptionQuinine (rarely, specialist-level decision)Once common for night cramps. The leg-cramp use has been removed in Australia, New Zealand, the UK and the US.

   Works

   Reduces cramp numbers by about a quarter in trials, but has caused serious harm, including dangerously low platelets

   Cost

   Not recommended for cramps

   How long

   Not applicable

   Watch for

   Can be fatal in overdose; interacts with other medicines. Keep away from children.

   A modest benefit with a scary side-effect list.

Costs are rough Australian prices in November 2026 and vary by pharmacy and provider. PBS co-payment: $25, or $7.70 with a concession card. Results are typical figures from trials, not promises.

Save your money

Popular, heavily marketed or often asked about, but the evidence is weak or says no.

• Magnesium tabletsFor older adults with ordinary night cramps, a Cochrane review found magnesium unlikely to help, and it often causes diarrhoea. Evidence in pregnancy is mixed and uncertain.
• Quinine and tonic waterPrescription quinine is no longer used for cramps because of serious side effects, and tonic water is not a treatment.
• Sports drinks and electrolyte tablets for everyday crampsNo good evidence they prevent night cramps in people who aren’t dehydrated.
• Pickle juice, mustard and soap under the sheetsFun folklore, little or no evidence. The soap does nothing, but it does make the bed smell nice.

What you can do

• Stretch your calves and hamstrings every night before bed for at least 6 weeks.
• Keep active through the day; a daily walk helps.
• Loosen the bedding at your feet.
• Ask your GP or pharmacist whether any of your medicines can cause cramps.
• In pregnancy, cramps usually ease after the birth. Ask your midwife or GP before taking supplements.

See your GP if

• Cramps are frequent, disturb your sleep or affect your quality of life
• Cramps started after a new medicine
• You also have muscle weakness, wasting, twitching, numbness, or cramps in many muscles
• Cramps come with leg pain on walking that eases with rest (possible poor circulation)

See a doctor the same day for a cramp lasting more than 10 minutes that doesn’t ease with stretching, a swollen, red, warm or tender calf (possible blood clot), cramps or stiffness after a dirty wound (tetanus risk), or dark urine with severe muscle pain and weakness after hard exercise or a new medicine.

Helpful resources

• nidirect (NHS Northern Ireland): Leg crampsClear guide to causes, stretches and when to see a GP. Free, UK.
• Exercise handoutsPrintable home programs, including calf and balance work. Free, from us.

Evidence and more information

• nidirect: Leg cramps
• Hallegraeff et al, J Physiotherapy 2012: stretching before sleep for night leg cramps
• Cochrane (2020): Magnesium for skeletal muscle cramps
• Cochrane (2015): Quinine for muscle cramps
• Medsafe (NZ): Quinine no longer indicated for leg cramps

Reviewed 1 November 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP, physio or pharmacist.

maladywise.com/cramps/