What really helps against aching calf cramps

Painful calf cramps - what helps?

Many people get it regularly: Nocturnal, very painful calf cramps suddenly wake you up. The spasm can sometimes last for several minutes, so that you can no longer think of a night's sleep. Usually such cramps are harmless but very annoying. Health experts explain what can be done about it.

Painful calf cramps can have a huge impact on quality of life and sleep. Well-tried home remedies for cramps can sometimes help, but unfortunately measures such as stretching and magnesium are not successful for everyone affected. As the German Society for Neurology (DGN) reports, quinine preparations can be used in people who suffer from frequent, long-lasting and extremely painful calf cramps. In a current study, these proved to be effective and have few side effects.

Calf cramps do not develop in the muscles

Most people have been woken up by violent calf cramps in their lives. Fortunately, the calf pain usually does not last long, so that in principle there is no need for (treatment) unless the cramps occur frequently or even very frequently, explains the DGN in a recent announcement.

According to the DGN, a calf cramp does not develop in the muscles, so it is not a muscular problem, as many think, but a neurological one: Muscle cramps are triggered by spontaneous depolarization of the nerve membranes: action potential develops, i.e. nerve impulses, which in the end result in an “excitement storm “Lead in the muscle.

Electrolyte shifts have been reported to increase the irritability of the nerves surrounding the muscle and promote cramping. This could also be the reason why more people get calf cramps in summer - you sweat more and may not drink enough. But there are other risk factors too: if, for example, the protective or insulating layer of the nerve fibers made of myelin is somewhat thinner or damaged, the risk of such cramp-triggering impulse discharges is higher.

Such demyelination can be caused by various diseases such as diabetic neuropathy (polyneuropathy) or thyroid diseases, but also by various medications, alcohol or vitamin B deficiency. It is obvious that they are more common in old age than in young healthy people, which is why leg cramps also occur more often in older people.

There are also mechanical triggers: if you lower your toes down so that the calf muscle is shortened - as is the case, for example, when the foot is pressed down by a heavy duvet or stuck in high heels - calf cramps can occur more easily. “We don't know exactly why. It is likely that tissue shifts put the sensitive nerve endings in the muscle under pressure, which favors the electrical discharges, ”explains Dr. Rainer Lindemuth, Siegen, first author of the S1 guideline "Crampi / muscle cramp" of the German Society for Neurology. "If you bend your foot in the opposite direction and stretch your calf muscle, the cramp will release. The acute recommendation is therefore to stretch the cramped muscle or tense its opponent. "

Prevention recommendations

For prevention, the guideline recommends regular passive stretching exercises for the calf muscles (for example, by bending the body while standing without the heels losing contact with the floor). However, the authors point out that the effectiveness was assessed differently in different studies, so there is no clear evidence. Magnesium is also recommended, although its effectiveness has not been sufficiently demonstrated.

“However, a therapy attempt should always be undertaken. Magnesium stabilizes the muscle membrane and reduces the potential for action that triggers contractions in the muscle. Many patients report that it relieves their tendency to muscle cramps. If it is not overdosed, magnesium is also harmless and has no side effects, ”explains Dr. Lindemuth. "Only people with impaired kidney function have to be careful, they should speak to their treating nephrologist before taking it continuously."

Effectiveness and tolerability confirmed

If the muscle cramps cannot be controlled with these measures and the quality of life and sleep is severely impaired, a doctor should be consulted. There follows a precise diagnosis and only when all treatable causes have been excluded and magnesium therapy has been attempted should quinine preparations be used for frequent and very painful cramps, according to the current guidelines.

However, this could now be outdated. A study recently published in the journal "MMW - medical progress" confirmed the effectiveness and tolerability of treatment with quinine sulfate in everyday care in adult patients with very frequent or particularly painful night leg cramps.

“The number, duration and pain intensity of the nocturnal calf cramps decreased in the majority of the patients and the side effect profile was tolerable. Adverse drug effects occurred in 35/592 patients, severe adverse drug effects not at all. I think it is possible to use these preparations less restrictively than the guidelines currently provide, ”said Prof. Dr. Hans-Christoph Diener, first author of the current study. (ad)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • Deutsche Gesellschaft für Neurologie e.V .: Frequent calf cramps - what helps ?, (accessed: October 22, 2019), DGN
  • German Society for Neurology (DGN): Crampi / muscle spasm, (accessed: October 22, 2019), DGN
  • MMW - Advances in medicine: Quinine sulfate in the therapy of nocturnal calf cramps: tolerance, compliance, quality of life and influence on symptoms, (accessed: October 22, 2019),

Video: 5 Easy Ways to Relieve u0026 Prevent Leg Cramps (January 2022).