Leg Cramps: Dr. Peter J. Rice

Leg Cramps

During my recent adventure biking along the Erie Canal, I woke up to use the bathroom and discovered that I could not bend my legs without triggering excruciating leg cramps in my inner thighs. I was caught between needing to “go” and needing to remain perfectly still – or else!

As a pharmacist, I’ve encountered many, many patients who have asked for advice regarding leg cramps. I’d had leg cramps that responded well to repositioning a leg or foot. I could control a cramp to allow it to work itself out and go away. I don’t think I had any real idea of how some patients suffer.    

Cramps are mysterious in their own way.

There are some activities known to trigger cramping – like over-exercising muscle groups – that make us think we know what’s going on.  But then there are athletes who are well-trained and suddenly find themselves incapacitated by cramps.

  • Electrolyte imbalances – sodium, potassium, calcium, magnesium – can contribute to cramping.
  • Many athletes use sport drinks like Gatorade™ or Powerade™ designed to replenish salts lost through sweat during exercise. 
  • In my case – biking in the heat and humidity of upstate New York – this was my explanation.
  • I pushed water and electrolytes during the Erie Canal ride hoping that would help.
  • It did help a bit, but not much.

Along the way, there was a report on an interesting idea from Nobel prize winner Rod McKinnon.  McKinnon became interested after experiencing cramping during his own athletic endeavors; he did not believe his cramps could be due to lack of training. He considered the possibility that cramps might be triggered not within the muscles, but by nerves. He proposed that “strong sensory input causes inhibition of the motor output”; spicy food may excite the nervous system and prevent it from triggering the muscles to cramp.

Leg Cramps

Leg Cramps

Try some spicy foods and see if that helps your cramps.

There is even a commercial product – HotShot™ – to prevent and treat muscle cramps based on the McKinnon hypothesis. Don’t be too impressed by the data for HotShot™ ; it is still quite a new product.

It’s likely that all cramps are not the same, and that your cramps will respond best to a treatment aimed at their true underlying cause. That “cure” might be Gatorade™ or similar drink if you’re electrolyte depleted from excessive sweating.  It might be a spicy food or HotShot™ if your underlying trigger is nerve activity. It might be something else. There is evidence that certain drugs can contribute to leg cramps and other drugs can help with leg cramps. More on that next time.

It’s nice to know that medical science is advancing on remedies for cramping, but you’ll still need to try some of the possibilities to see what works best for you.

Along the way, remember that your prescriber and community pharmacists are there to help you make good health decisions. 


The Wall Street Journal:  A New Way to Prevent Muscle Cramps




Dr. Peter J. Rice

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.
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