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Muscle cramps

Published online by Cambridge University Press:  11 September 2013

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In a nutshell

Leg cramps are common in pregnancy, the elderly, some medical conditions and as exercise/heat cramps. Although they can be due to deficiencies of nutrients such as electrolytes (e.g. magnesium, calcium, sodium and potassium), there is not much evidence to suggest this is true in most cases.

Supplement trials of these nutrients and others (such as carnitine), paint an inconsistent and incomplete picture. The current evidence does not provide clear guidance to clinicians.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2011

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References

References:

1. Ahmad, S. et al. Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects. Kidney Int. 1990 Nov;38(5):912–8.Google Scholar
2. Bellinghieri, G. et al. Correlation between increased serum and tissue L-carnitine levels and improved muscle symptoms in hemodialyzed patients. Am J Clin Nutr. 1983 Oct;38(4):523–31.CrossRefGoogle ScholarPubMed
3. Thomas, S. et al. Effects of L-carnitine on leukocyte function and viability in hemodialysis patients: A double-blind randomized trial. Am J Kidney Dis. 1999 Oct;34(4):678–87.Google Scholar
4. Semeniuk, J. et al. Evaluation of the effect of intravenous l-carnitine on quality of life in chronic hemodialysis patients. Clin Nephrol. 2000 Dec;54(6):470–7.Google Scholar
5. Rathod, R. et al. Results of a single blind, randomized, placebo-controlled clinical trial to study the effect of intravenous L-carnitine supplementation on health-related quality of life in Indian patients on maintenance hemodialysis. Indian J Med Sci. 2006 Apr;60(4):143–53.Google Scholar
6. Casciani, CU. et al. Beneficial effects of L-carnitine in post-dialysis syndrome. Curr Ther Res. 1982;32:116127.Google Scholar
7. Valbø, A. et al. [Leg cramps in pregnancy--how common are they?]. Tidsskr Nor Laegeforen. 1999 Apr 30;119(11):1589–90.Google Scholar
8. Hensley, JG. Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health. 2009 May-Jun;54(3):211–8.Google Scholar
9. Naylor, JR. et al. A general population survey of rest cramps. Age Ageing. 1994 Sep;23(5):418–20.Google Scholar
10. Abdulla, AJ. et al. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999 Oct-Nov;53(7):494–6.CrossRefGoogle ScholarPubMed
11. Leung, AK. et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999 Jun;91(6):329–32.Google Scholar
12. Monderer, RS. et al. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010 Jan;10(1):53–9.Google Scholar
13. Butler, JV. et al. Nocturnal leg cramps in older people. Postgrad Med J. 2002 Oct;78(924):596–8.CrossRefGoogle ScholarPubMed
14. Sontag, SJ. et al. The cause of leg cramps and knee pains: an hypothesis and effective treatment. Med Hypotheses. 1988 Jan;25(1):3541.Google Scholar
15. Johnson, S. The multifaceted and widespread pathology of magnesium deficiency. Med Hypotheses. 2001 Feb;56(2):163–70.Google Scholar
16. Martens, H. et al. Pathophysiology of grass tetany and other hypomagnesemias. Implications for clinical management. Vet Clin North Am Food Anim Pract. 2000 Jul;16(2):339–68.CrossRefGoogle ScholarPubMed
17. Berkelhammer, C. et al. A clinical approach to common electrolyte problems: 4. Hypomagnesemia. Can Med Assoc J. 1985 Feb 15;132(4):360–8.Google ScholarPubMed
18. Witlin, AG. et al. Magnesium sulfate therapy in preeclampsia and eclampsia. Obstet Gynecol. 1998 Nov;92(5):883–9.Google Scholar
19. Ho, KM. Intravenous magnesium for cardiac arrhythmias: jack of all trades. Magnes Res. 2008 Mar;21(1):65–8.Google Scholar
20. Euser, AG. et al. Magnesium sulfate for the treatment of eclampsia: a brief review. Stroke. 2009 Apr;40(4):1169–75. Epub 2009 Feb 10.Google Scholar
21. Bartl, W. et al. [Pathophysiology and therapy of magnesium deficiency in pregnancy]. Z Geburtshilfe Perinatol. 1982 Nov-Dec;186(6):335–7.Google Scholar
22. Hantoushzadeh, S. et al. Serum magnesium levels, muscle cramps, and preterm labor. Int J Gynaecol Obstet. 2007 Aug;98(2):153–4.CrossRefGoogle ScholarPubMed
23. James, MF. Magnesium in obstetrics. Best Pract Res Clin Obstet Gynaecol. 2010 Jun;24(3):327–37. Epub 2009 Dec 14.Google Scholar
24. Pena Mendez, CA. et al. [Treatment of muscular cramps in pregnancy with magnesium cation]. Prensa Med Argent. 1957 Aug 16;44(33):2566–8.Google Scholar
25. Dahle, LO. et al. The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol. 1995 Jul;173(1):175–80.Google Scholar
26. Roffe, C. et al. Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of chronic persistent leg cramps. Med Sci Monit. 2002 May;8(5):CR32630.Google Scholar
27. Frusso, R. et al. Magnesium for the treatment of nocturnal leg cramps: a crossover randomized trial. J Fam Pract. 1999 Nov;48(11):868–71.Google Scholar
28. Wills, MR. et al. Disorders of calcium homeostasis in the fetus and neonate. Ann Clin Lab Sci. 1982 Mar-Apr;12(2):7988.Google Scholar
29. Zamponi, GW. et al. Role of voltage-gated calcium channels in epilepsy. Pflugers Arch. 2010 Jul;460(2):395403.CrossRefGoogle ScholarPubMed
30. Odendaal, HJ. [Calcium for the treatment of leg cramps during pregnancy]. S Afr Med J. 1974 Apr 17;48(18):780–1.Google Scholar
31. Hammar, M. et al. Calcium treatment of leg cramps in pregnancy. Effect on clinical symptoms and total serum and ionized serum calcium concentrations. Acta Obstet Gynecol Scand. 1981;60(4):345–7.Google Scholar
32. Hammar, M. et al. Calcium and magnesium status in pregnant women. A comparison between treatment with calcium and vitamin C in pregnant women with leg cramps. Int J Vitam Nutr Res. 1987;57(2):179–83.Google Scholar
33. Reid, IR. et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med. 2008 Nov 10;168(20):2276–82.Google Scholar
34. Tucker, R. et al. Muscle cramps: part i: theories and fallacies of muscle cramps. The Science of Sport, 2007, November 20, on-line at: http://www.sportsscientists.com/2007/11/muscle-cramps-part-1-theories-and.html# Google Scholar
35. Eichner, ER. The role of sodium in ‘heat cramping’. Sports Med. 2007;37(4–5):368–70.Google Scholar
36. Casa, DJ. et al. American College of Sports Medicine roundtable on hydration and physical activity: consensus statements. Curr Sports Med Rep. 2005 Jun;4(3):115–27.CrossRefGoogle ScholarPubMed
37. Schwellnus, MP. et al. Increased running speed and previous cramps rather than dehydration or serum sodium changes predict exercise-associated muscle cramping: a prospective cohort study in 210 Ironman triathletes. Br J Sports Med. 2010 Dec 9.Google Scholar
38. Schwellnus, MP. Cause of exercise associated muscle cramps (EAMC)--altered neuromuscular control, dehydration or electrolyte depletion? Br J Sports Med. 2009 Jun;43(6):401–8.Google Scholar
39. Horswill, CA. et al. Sodium balance during U. S. football training in the heat: cramp-prone vs. reference players. Int J Sports Med. 2009 Nov;30(11):789–94.Google Scholar
40. Ganio, MS. et al. Evidence-based approach to lingering hydration questions. Clin Sports Med. 2007 Jan;26(1):116.Google Scholar
41. Khajehdehi, P. et al. A randomized, double-blind, placebo-controlled trial of supplementary vitamins E, C and their combination for treatment of haemodialysis cramps. Nephrol Dial Transplant. 2001 Jul;16(7):1448–51.Google Scholar
42. Connolly, PS. et al. Treatment of nocturnal leg cramps. A crossover trial of quinine vs vitamin E. Arch Intern Med. 1992 Sep;152(9):1877–80.Google Scholar
43. Konikoff, F. et al. Vitamin E and cirrhotic muscle cramps. Isr J Med Sci. 1991 Apr;27(4):221–3.Google ScholarPubMed
44. Ayres, S Jr. et al. Leg cramps (systremma0 and “restless legs” syndrome. Response to vitamin E (tocopherol). Calif Med. 1969 Aug;111(2):8791.Google Scholar
45. Haralambie, G. Vitamin B2 status in athletes and the influence of riboflavin administration on neuromuscular irritability. Nutr Metab. 1976;20(1):18.Google Scholar
46. Cantaluppi, G. [Clinico-experimental data on the use of riboflavin in the therapy of muscular cramps in pregnancy]. Minerva Ginecol. 1962 Oct 15;14:984–7.Google Scholar
47. Morgan, AA. Treatment of cramp. J R Soc Med. 1983 Aug;76(8):712.Google Scholar
48. Avsar, AF. et al. Vitamin B1 and B6 substitution in pregnancy for leg cramps. Am J Obstet Gynecol. 1996 Jul;175(1):233–4.Google Scholar
49. Horoschak, A. Nocturnal leg cramps, easy bruisability and epistaxis in menopausal patients: treated with hesperidin and ascorbic acid. Del Med J. 1959 Jan;31(1):1922.Google Scholar
50. Stephens, FB. et al. New insights concerning the role of carnitine in the regulation of fuel metabolism in skeletal muscle. J Physiol. 2007 Jun 1;581(Pt 2): 431–44.Google Scholar
51. Mujais, SK et al. Acute complications of hemodialysis and their prevention and treatment. In: Jacobs, C. et al. (eds). Replacement of renal function by dialysis. Kluwer Academic, 1996.Google Scholar
52. Kreider, RB. Effects of creatine supplementation on performance and training adaptations. Mol Cell Biochem. 2003 Feb;244(1–2):8994.CrossRefGoogle ScholarPubMed
53. Helman, A. Creatine as a sports supplement. Arb Clin Nutr Upd. 2003 (Nov);175:12.Google Scholar
54. Greenwood, M. et al. Creatine supplementation during college football training does not increase the incidence of cramping or injury. Mol Cell Biochem. 2003 Feb;244(1–2):83–8.Google Scholar
55. Schilling, BK. et al. Creatine supplementation and health variables: a retrospective study. Med Sci Sports Exerc. 2001 Feb;33(2):183–8.Google Scholar
56. Poortmans, JR. et al. Adverse effects of creatine supplementation: fact or fiction? Sports Med. 2000 Sep;30(3):155–70.Google Scholar
57. Kugelmas, M. Preliminary observation: oral zinc sulfate replacement is effective in treating muscle cramps in cirrhotic patients. J Am Coll Nutr. 2000 Feb;19(1):13–5.Google Scholar
58. Baskol, M. et al. The role of serum zinc and other factors on the prevalence of muscle cramps in non-alcoholic cirrhotic patients. J Clin Gastroenterol. 2004 Jul;38(6):524–9.Google Scholar
59. Mizuno, S. et al. CSF iron, ferritin and transferrin levels in restless legs syndrome. J Sleep Res. 2005 Mar;14(1):43–7.Google Scholar
60. Connor, JR. et al. Decreased transferrin receptor expression by neuromelanin cells in restless legs syndrome. Neurology. 2004 May 11;62(9):1563–7.Google Scholar