Treatments for Muscle Cramps

Treatments for Muscle Cramps

Muscle Cramps

A muscle cramp is a painful contraction of a muscle that typically happens suddenly and involuntarily. They are sometimes called charley horses or muscle spasms and can occur in any muscle.

In my experience,  they most often occur in the legs (calf; thigh, both quadriceps and hamstring; and across the top of the foot to the shin).  Sometimes they occur in the upper or lower back and in the hands.

First Aid for Muscle Cramps

The immediate solution is to get the muscle out of the tension mode and relaxed.  One way is to stretch the muscle until it stops cramping.  Another is to massage the cramped area until it relaxes.  Often, these treatments are temporary and the cramp may return after a few minutes and need to be treated again.  Eventually the cramp will stay away.

There are two medications that I have found helpful for treating muscle cramps:

  • Arnica montana By Bernd Haynold (Own work) [CC BY-SA 2.5 (], via Wikimedia Commons

    Arnica montana
    By Bernd Haynold [CC BY-SA 2.5 ]

    Arnica cream.  It is a cream made out of Arnica montana, an herb, and various other incredients.  I use Natra-Bio – Arnica Rub.  A 2013 Cochrane Collaboration systematic review of topical herbal remedies for treating osteoarthritis concluded that “Arnica gel probably improves pain and function as well as non-steroidal anti-inflammatory drugs do.”  While this product is a homeopathic preparation, its 1X dilution leaves enough arnica to be effective.   There is also the action of rubbing the cream into the skin (massage) and the placebo effect that may contribute to the effectiveness of this remedy.
  • IbuprofenIbuprofen (Advil, Motrin, and Nurofen etc.) is a nonsteroidal anti-inflammatory drug used for relieving pain and inflammation.  It seems to relieve the pain enough that the muscles can relax.

That’s the ailment and the immediate treatment – first aid, if you will.  Yet there is something causing these cramps and true resolution does not come until we do something about the underlying causes.

Causes of Muscle Cramps and Charley Horses

Back PainThe exact cause of a muscle cramp is often hard to discern.  Here are few possible causes that are traditionally listed:

  • Overuse or injury of a muscle
  • Malfunctioning nerves
  • Dehydration
  • Mineral depletion
  • Insufficient blood (or oxygen) getting to the muscle
  • Alcoholism
  • Underactive thyroid
  • Kidney failure
  • Medications
  • Menstruation
  • Pregnancy

It will be up to you to associate what you have been doing and your general situation with your cramps, although that may be difficult.  Part of the problem has been identified by Roderick MacKinnon who won a Nobel Prize in 2003 for his work on structural and mechanistic studies of ion channels.  McKinnon realized that muscles are normally controlled by the nervous system.  One way to create muscle cramps is to have motor neurons in the spinal column become over-excited, sending too many contraction signals to the muscle.

I sometimes get cramps in my hands while turning over dirt in the garden using a shovel.  I suspect that these cramps are caused by a combination of muscle overuse, dehydration, nerve issues and perhaps insufficient blood movement in my hands.

My leg cramps don’t seem much associated with overworking my leg muscles, but they do seem to be associated with exertion in hot weather.  That leads me to think dehydration and loss of salt in sweat are the most likely culprits in this case.  Both loss of salt and dehydration are a common causes of muscle cramps among athletes, recreational runners, hikers and others that are sweating away both water and minerals.

I occasionally get a spasm in my back.  Sometimes in the lower back and sometimes in the upper back behind my shoulder blade.  These don’t seem to be related to any of the common causes, except, perhaps dehydration and, of course, nerve issues.

Treatment for Muscle Cramps

One way to identify the cause of your muscle cramps is to try one or another treatment.  Here are some possibilities that may work for you:

Drink More Water

Packaged WaterThe first thing I recommend is drinking more water.  Dehydration is the leading cause of these spasms.  Coffee, colas and other caffeine containing drinks and alcohol do not count, as they tend to cause dehydration rather than resolve it.  In fact,  if you are a heavy user of these beverages,  you might try replacing them with water as a first step in finding a cure for your charley horses and spasms.

Some people use bottled water, but it is quite expensive and contributes a lot of plastic to landfills.  I like bottled water, so I buy it in 5 gallon jugs that sit on my water cooler.  Then I just fill a stainless steel water bottle that I carry with me.  There are lots of options for reusable water bottles, so you are sure to find one that fits your needs.

There are also options if you would like to supplement your water with electrolytes designed to replace the minerals lost in sweat.

Treat Your Muscles Kindly

Normally my muscle spams don’t seem to be related to overworking my muscles or muscle injuries (the muscles don’t hurt until the cramp occurs).  If your muscles do hurt, that’s a clue that you should back off on whatever you are doing that is causing that pain and let those muscles heal.  Sometimes it’s not what you would think of as overwork.  Your muscles may get strained by simply sitting in a poor position for an extended period of time.

Add Minerals to Your Diet

Sodium, Calcium, potassium, and magnesium are the four minerals most often associated with muscle cramps.  Salt deletion through sweating is often an immediate cause of muscle cramps.  Taking Salt Tablets or eating salty foods can help, but beware the adverse effects of too much salt (e.g. blood pressure).  All things considered,  I take a magnesium supplement and it seems to help.  My rationale is that it helps raise potassium levels that are needed to prevent muscle cramps and it is difficult to overdose on it.  Too much potassium or calcium can adversely affect the heart, so I avoid those supplements.  Here is more information on each of these minerals:

Sodium (table salt – NaCl)

salt“‘Heat cramping’ is defined here as severe, spreading, sustained, sharply painful muscle contractions that can sideline athletes. Not all cramps are alike, but three lines of evidence suggest heat cramping is caused by ‘salty sweating’, specifically by the triad of salt loss, fluid loss and muscle fatigue. The first line of evidence is historical. Dating back 100 years, heat cramping in industrial workers was alleviated by saline, and in a self-experiment, salt depletion provoked muscle cramping. The second line of evidence is from field studies of athletes. In tennis and football alike, heat-crampers tend to be salty sweaters. Some evidence also suggests that triathletes who cramp may lose more salt during the race than peers who do not cramp. The third line of evidence is practical experience with therapy and prevention. Intravenous saline can reverse heat cramping, and more salt in the diet and in sports drinks can help prevent heat cramping. For heat cramping, the solution is saline.” [Sports Med. 2007;37(4-5):368-70.]


magnesium supplementThere is limited research on magnesium, but studies that have been done suggest that it doesn’t help resolve muscle cramps in older people and that it may or may not benefit pregnant women.  It may or may not help those that lose minerals through sweating – apparently no studies have been done with that group of people. Personally I take a broad spectrum magnesium supplement.  While it seems to help prevent muscle cramps, it certainly helps keep my heart arrhythmia under control.  300 mg seemed to work best for me although the supplement I use suggests 400 mg.  The body easily eliminates excess magnesium, so an overdose is not an issue.


bananaOne of the causes of low potassium levels in the blood is low levels of magnesium in the blood, thus these minerals are interacting.  Another major cause of low potassium is sweating.

Symptoms of low potassium, besides muscle spasms, include abnormal heart rhythms, constipation, fatigue, muscle damage, tingling or numbness.  Just last night I had tingling in an arm that was followed by a leg cramp this morning.  Definite signs of a potassium shortage.  I just ate a banana.

Besides bananas, you can get potassium from avocados, baked potatoes, bran, carrots, cooked lean beef, milk, oranges, peanut butter, peas and beans, salmon, seaweed, spinach, tomatoes and wheat germ, according to MedLine Plus.

Potassium supplements are also available.  The Food and Nutrition Center of the Institute of Medicine recommends 4.7 grams/day of potassium for those over age 19.  Supplements typically have around o.1 gram.  There is a reason for this small amount.  First, you will normally get most of the potassium you need in your normal diet.  Second, excessive potassium can cause dangerous heart rhythms and hospitalization.  More is NOT always better.


milkAgain,  there is a lack of research on the effects of adding calcium to the diet as related to the incidence of muscle cramps. Calcium-rich foods include milk and dairy products, kale and broccoli, as well as the calcium-enriched citrus juices, mineral water, canned fish with bones, and soy products processed with calcium.  Again, there are calcium supplements available.

The Institute of Medicine sets the daily tolerable upper intake level (UL) for calcium based on age as follows:  19-50 years, 2500 mg; 51+ years, 2000 mg. Higher doses may have serious side effects. Some research also suggests that doses over the recommended daily requirement of 1000-1300 mg daily for most adults might increase the chance of heart attack.

Calm Your Excited Nerves

Roderick MacKinnon

Dr. Roderick MacKinnon
Photo by By PotassiumChannel
[CC BY-SA 3.0]

A couple of treatments that have been used, most notably drinking pickle juice or diluted mustard, stimulate sensory nerves as you drink them.  Roderick MacKinnon studied these treatments and found they they do indeed work on muscle cramps by breaking up the over-excited messages from the motor neurons.  Technically this is called transient receptor potential (TRP) ion channel activation.  This technique also has applications with involuntary muscle contractions found in multiple sclerosis patients.

Pickle juice, for example, is acetic acid, a weak activator of transient receptor potential, and may provide some temporary effect.  McKinnon and his research team presented their research at the American Academy of Neurology meeting in April 2015.  They reported: “Orally-administered TRP channel activators were studied in healthy volunteers across three independent, randomized, blinded, placebo-controlled crossover studies for efficacy in inhibiting electrically-induced cramps.
Testing of three naturally-occurring activators of TRPV1 and TRPA1 in hDRG’s demonstrated, as single agents or in combination, an increase in intracellular calcium as evidence of TRP ion channel activation. A proprietary product containing TRP activators was found efficacious in preventing electrically-induced muscle cramps in the foot across three studies combined (37 completed subjects) significantly reducing cramp intensity by 3-fold (p<0.001) and demonstrating an effect within minutes lasting up to 6-8 hours when compared to untreated subjects.”

The result of this research is a proprietary blend of these activators that is now being sold as as a sports drink called HotShot – Sports Shot with a Kick.  It is, basically, a combination of ginger, cinnamon, and bell peppers as its active ingredients.  It also contains filtered water, organic cane sugar, organic gum arabic, organic lime juice concentrate, pectin, sea salt, natural flavor, and organic stevia extract.  A six-pack of 1.7 ounce bottles costs $35, so you may want to try concocting your own version.

If these options fail . . .

See your doctor.  You may have a disorder of some sort that needs to be treated to resolve your issues with muscle cramps.  If the problem is a medication you are taking,  your doctor can probably find an alternative for you.

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