Leg cramps: Most can be fixed with walking around


When woken by a cramp in the middle of the night, some gentle massage and whimpering will probably bring relief. Photo: Getty
The Washington Post, the paper that once brought down a president, has a nifty ‘Ask A Doctor’ feature.
And the doctor is a pretty good one: Trisha S. Pasricha, a physician at Massachusetts General Hospital, and an instructor in medicine at Harvard Medical School.
People write in, usually with an everyday complaint, such as “How do I get prepared to have blood taken?”
Or: “How can I make swallowing pills easier?”
This week Dr Pasricha was asked about what causes muscle cramps in the legs, and how best to alleviate them.
Her answer was long and detailed, but here she gets to the point:
“Evidence on how best to treat leg cramps is weak. But after reviewing the state of the medical literature, I often recommend trying two simple solutions: Gently stretch the muscle or take a sip of pickle juice.
“Yep, pickle juice.”
What the …?
Pickle juice for leg cramps is a thing, and not just in the US.
The “juice” is the salty water in a jar of dill pickles. But because it’s reportedly something of a go-to for athletes, companies now market pickle juice … without the pickle.

Where there’s a fad, there’s a marketer. You only need to have a shot to help your cramps.
Pickle Juice Australia sells six-packs online for $34.95.
Whereas you can buy a jar of dill pickles (so good with cheese and burgers) from the supermarket for about $4.60.
The thing is, you only need a shot to stop your cramps … when the juice actually works. And there is some research to say it does.
A 2010 study found it shortened cramp duration.
On average, it “relieved cramps in about 1.5 minutes, and 45 per cent faster than when nothing was taken after exercise”.
How does it work?
It’s not just a placebo effect (people have tried to prove this was the case, and failed). And studies have shown that it has nothing to do with replacing electrolytes, which remains a popular theory among enthusiasts.
According to a report at Healthline, researchers have suggested that pickle juice “may help cramps by triggering muscular reflexes when the liquid contacts the back of the throat”.
This reflex “shuts down the misfiring of neurons in muscle all over the body, and ‘turns off’ the cramping feeling.”
It’s thought that the vinegar in pickle juice is the magical ingredient.
So why not just drink a shot of vinegar? Because it can strip the enamel off your teeth unless you water it down. But, yes, it’s a thing too. So is mustard.
So … let’s get real
These vinegary remedies for preventing or easing leg cramps seem to work well after a workout.
But are they a practical or palatable solution for when you’re woken by a foot or leg cramp in the middle of the night?
Are you really going to hobble and wail your way out to the fridge? Are you even capable of walking?
Chances are, by the time you’ve made it to the kitchen, the cramp will have resolved itself.
Why? Because, well … because cramps are weird and mysterious and that’s often how it works out. They’ve become something of a fetish on health and wellbeing sites.
Hundreds of words at a time trying to unravel the mystery, when the solution for most foot and legs cramps is simple and boring and effective. We’ll get back to that.
What we know about cramps
A cramp is a sudden and painful spasm of a muscle, making it rock hard. It can come out of the blue.
This spasm squeezes all the little nerve endings inside the muscle. And that’s what creates the intense pain that can’t be ignored.
Three out of four reported leg cramps occur at night.
Cramps occur more often in older people or in pregnancy, but much of the time your doctor won’t be able to explain why they are happening to you.
These spasms may last a few seconds or a couple of minutes, they can drive you out of your mind for up to 15 minutes. Fifteen minutes could be a sign of a serious problem.
In fact, the Cleveland clinic recommends going to the hospital emergency department if a cramp lasts longer than 10 minutes.
If it persists beyond that, and the pain becomes unbearable, you might need to go to hospital and get checked out.
Also, leg cramps can be a sign of something serious, such as congestive heart failure, cirrhosis of the liver, diabetes or osteoarthritis.
For a full list of potential horrors, see here. If your cramps are frequent and long-lasting, get yourself checked out.
How to prevent cramping
There’s an idea that too little potassium, calcium or magnesium in your diet can cause leg cramps. Therefore if you get an adequate intake of these minerals you might avoid cramp.
Potassium, calcium and magnesium are certainly important for your wellbeing. For example, they are important for the management of blood pressure.
And they are significant electrolytes. While people continue to believe that a poor level of electrolytes cause cramps, the evidence doesn’t support this idea.
The most effective way to reduce the onset of cramp is to stay hydrated and to gently stretch your body before going to bed. This becomes more important as you get older. For more on this, see here.
The truth may be that cramp come from overworking a muscle, through athletic performance, or through ageing, when your tendons shrink and your nerves aren’t as efficient when interacting with your muscles.
How to ease your cramped leg or foot
Probably the best treatment for a cramp is walking it off or massaging it into submission.
This is known as “supportive” treatment.
However, the longer a cramp stays in play, the more you’re likely to experience ongoing pain once the spasm subsides.
The Cleveland Clinic has an eight-step plan:
- Stretch: Straighten your leg and then flex it, pulling your toes toward your shin to stretch the muscles. Stretch the cramped muscle, and gently rub. For a thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself
- Massage: Use your hands or a roller to massage the muscles
- Stand: Get up. Press your feet against the floor
- Walk: Wiggle your leg while you walk around
- Apply heat: Use a heating pad or take a warm bath
- Apply cold: Wrap a bag of ice in a towel and apply it to the area
- Take pain medications (for the ongoing pain): Take ibuprofen or paracetamol to help with the pain
- Elevate: Prop up your leg after the cramp starts to feel better.
Once the crisis is over, why not celebrate with a toasted cheese sandwich, with a pickle on the side?
Why not? Because it’s night time and you need your sleep, that’s why.