Muscle Cramps: Causes, Relief and When to Get Help

Things that can bring on or contribute to muscle cramps include:

• muscle strain or overuse
• exercise, particularly in hot or humid conditions
• not drinking enough fluid
• pregnancy
• ageing
• sitting or staying in one position for a long time
• some medicines, including certain statins and diuretics (water tablets)
• some medical conditions, including problems affecting circulation, nerves, the thyroid, the liver or the kidneys

Very often no clear cause is found at all. Cramps can happen in people who are perfectly well, and not finding a reason does not mean something has been missed.

Please be careful with claims you may read elsewhere. It is not true that every cramp is caused by a vitamin, salt or mineral deficiency. Supplements are not a general answer to cramp, and taking them without advice can cause harm.

While a cramp is happening, these steps may help:

• Stop the activity safely. If you are walking, cycling, swimming or driving, come to a safe stop first.
• Gently stretch the affected muscle, and massage it with your hand.
• For a calf cramp, straightening the leg and gently drawing the toes up towards the shin may help, if you can do that safely and without force.
• Standing up and carefully placing weight on the affected leg helps some people — only do this if you feel steady and have something to hold on to.
• Some people find warmth on the muscle, or a warm bath or shower, soothing afterwards.

Do not force a stretch, and do not push on through severe pain or keep exercising while a muscle is cramping. Forcing it can strain or tear the muscle.

The muscle may ache for a while afterwards. Gentle movement is usually better than staying completely still, unless it is painful to move.

If cramps keep coming back, these general steps may reduce how often they happen:

• Regular gentle calf stretching — little and often, rather than one hard stretch.
• Warming up and cooling down properly around exercise.
• Avoiding sudden increases in strenuous activity — build up gradually instead.
• Drinking enough fluid, especially in hot weather or when active — where that is medically appropriate for you.
• Suitable, supportive footwear that fits properly.
• Reviewing exercise technique where relevant, for example with a coach, physiotherapist or gym instructor.
• Moving position or standing up regularly if you sit still for long periods.

Important: some people have been told to restrict their fluids because of a heart, kidney or other condition. If that applies to you, follow your healthcare professional's advice about how much to drink, not general advice about drinking more.

Cramps that happen at night can be very disruptive. They wake people suddenly, they are painful, and the muscle can stay sore afterwards — so it is hard to settle back to sleep. Broken sleep night after night affects mood, concentration and daytime energy, and it can wake a partner too.

Things some people find helpful before bed:

• a gentle calf stretch as part of a regular evening routine
• light movement in the evening rather than sitting still for hours
• keeping bedding loose over the feet, so the toes are not pulled downwards
• a warm bath or shower before bed if that is comfortable for you

If a cramp wakes you:

• gently straighten the leg and draw the toes towards the shin
• massage the muscle with your hand
• if you feel steady, stand carefully beside the bed and put a little weight on the leg — hold on to something for balance
• let the muscle settle before lying down again

Please make a GP appointment if cramps regularly disturb your sleep. This is worth being seen about — it is not something you simply have to put up with.

Some prescribed medicines can contribute to muscle cramps. Statins and diuretics (water tablets) are two examples, and there are others. Cramps that started soon after beginning a new medicine, or after a dose change, are worth mentioning.

A pharmacist or GP can carry out a medication review and look at whether anything you take may be playing a part. Community pharmacists are easy to reach and can advise without an appointment.

Do not stop prescribed medicine without professional advice. Stopping some medicines suddenly can be harmful, and the medicine may be protecting you from something more serious than cramp.

This page does not recommend supplements, and does not give doses for any medicine. In particular, quinine is not suitable for everyone and can cause serious side effects. It must only ever be considered by a clinician who knows the person's full medical history — never bought, borrowed or self-prescribed.

Please contact a GP if:

• cramps regularly disturb your sleep
• they happen frequently, or are getting worse
• a cramp lasts longer than 10 minutes
• there is numbness, weakness or swelling
• you have difficulty walking or carrying out everyday activities
• the cramps started after beginning or changing a medicine
• there are cramps in several parts of the body, or other unexplained symptoms

If you are not sure how quickly to act, NHS 111 can help you decide. Arrangements differ across the UK — see the trusted information section below.

A GP looking into repeated cramps will usually ask about:

• when and where the cramps happen — time of day, which muscles, at rest or on activity
• how long each episode lasts
• exercise, fluid intake and other possible triggers such as heat or long periods sitting
• current medicines, including anything bought over the counter
• other symptoms, such as weakness, numbness, swelling or weight change

They may examine the legs and muscles, check strength and sensation, and arrange blood tests where clinically appropriate — for example to look at kidney, liver or thyroid function.

Testing depends on the individual. Many people with cramps need no tests at all. What is offered will depend on symptoms, examination findings and medical history — that decision belongs to the clinician.

A short amount of preparation makes an appointment far more useful:

• keep a short record of when the cramps happen, over a week or two
• note which muscles are affected and how long each episode lasts
• record any swelling, weakness, numbness or skin changes
• bring an up-to-date list of medicines and supplements, including anything bought without a prescription
• note any connection with exercise, heat, illness or a recent medicine change
• write down the questions that matter most to you, in case time is short

These pages may be useful alongside this one — for finding local NHS services, for problems with walking or mobility, and for help putting a concern in writing.

Please use the official sources below for the most up-to-date guidance, and always check the organisation's own website for the latest information.

Urgent NHS advice differs across the UK:

• England: contact NHS 111 by phone on 111, or use NHS 111 online.
• Scotland: contact your GP practice, or phone 111 when the practice is closed.
• Wales: contact NHS 111 Wales by phone on 111.
• Northern Ireland: contact your GP practice, or the GP out-of-hours service when the practice is closed.

In an emergency — including leg pain or swelling with chest pain or breathlessness — call 999.