What are the options for preventing leg cramps?
If cramps do not occur often, then no particular treatment is usually needed. However, if you have frequent cramps, you may wish to consider ways of preventing them.

Consider your medication (where appropriate) or other conditions
Tell your doctor if you take any of the medicines listed above. It may be causing the leg cramps, or making them recur more often. Alternative medicines may be available. Also, if you have other symptoms apart from cramps, see your doctor who may examine you or do some checks to rule out a secondary cause for the cramps.

Stretching exercises
Stretching exercises are commonly advised. However, there is a lack of good research evidence to prove that it works. One research study concluded that stretching exercises did reduce the number and severity of cramps, but another study did not confirm this.

So, as it may help, it is worth trying if you are able to do the exercises. If it works, you will not need any tablets to prevent the leg cramps.

At first, do stretching exercises of affected muscles for about five minutes, three times a day. Do the last exercise shortly before bedtime. If the cramps ease off, you may then only need to do the exercise once or twice a day to keep the cramps away.

To stretch calf muscles, stand about 60-90 cm from a wall. Then, keeping the soles of your feet flat on the floor, bend forward and lean on the wall. You will feel your calf muscles stretch. Do this several times, each time for as long as you can manage.

Posture of the legs when resting in bed
Positions which prevent the calf muscle from shortening when you are asleep may help. The following are not proven treatments (from research studies), but some experts believe that they help to prevent cramps.
* using a pillow to prop the feet up in bed while sleeping on your back. 
* hanging the feet over the end of the bed while sleeping on your front. 
* keeping blankets loose at the foot of the bed to prevent toes and feet from pointing downwards during sleep.

Quinine
Quinine tablets are a common treatment. Quinine often reduces the number and severity of leg cramps, but may not stop them altogether. One tablet at bedtime is the normal dose. A four-week course is commonly tried at first and can be continued if the number of leg cramps is reduced. It may be worth stopping the quinine tablets every three months or so to see if they are still needed.

Most people can take quinine, but do not take it if you are pregnant or may become pregnant. There are also some rare conditions where you should not take quinine. (These include: a previous reaction to quinine; a previous haemolytic anaemia; optic neuritis; glucose 6-phosphate dehydrogenase deficiency.) Side effects are uncommon at the low dose used to treat leg cramps. Read the medicine packet leaflet for a full list of possible side effects. Note: quinine is dangerous in overdose, particularly in children. Keep tablets away from children.

Other treatments
Other medicines have been suggested as possible treatments for leg cramps. These include: naftidrofuryl, vitamin E, verapamil, diltiazem, painkillers, aspirin, orphenadrine, magnesium, calcium, and sodium chloride. TENS of machines have also been suggested as a possible treatment. So far there is little research evidence to prove that these treatments work well. Your doctor may suggest trying one if all else fails.
prof@cardiacclinic.co.bw