If the cause of your leg cramps is known, it may be possible to treat the underlying cause.

For example, secondary leg cramps that are related to liver disease are caused by high levels of toxins in the blood which trigger muscles spasms. Therefore, muscle relaxants can be used to help prevent your muscles from going into spasm.

If the cause of your legs cramps is unknown (primary idiopathic leg cramps), a combination of exercise and painkilling medication is usually recommended.

Exercises

Most cases of leg cramps can be treated with exercises. There are two types of exercise that you can do:

• exercises you do during an episode of cramping to relieve the pain and stop the cramping
• exercises you do during the day to reduce how often you get leg cramps

The two types of exercises are explained below. 

Exercises during cramps

During an episode of leg cramp, stretch and massage the affected muscle.

For example, if the cramp is in your calf muscle:

• Straighten your leg and lift your foot upwards, bending it at the ankle so that your toes point towards your shin.
• Walk around on your heels for a few minutes.

Exercises to prevent cramps

To reduce your risk of getting leg cramps in the future, you should do exercises to stretch the affected muscles three times a day.

For example, if your calf muscles are affected by cramps, the following exercise should be beneficial:

• stand about a metre away from a wall
• lean forward with your arms outstretched to touch the wall while keeping the soles of your feet flat on the floor
• hold this position for five seconds before releasing
• repeat the exercise for five minutes

For the best results, you should repeat this exercise three times a day, including one session just before you go to bed. Here's an alternative calf stretch.

If you find these exercises useful you can carry on doing them for as long as you are able to.

Painkillers

If you have leg pain that persists after an episode of cramping, an over-the-counter painkiller, such as paracetamol or ibuprofen may help reduce the pain.

Quinine

Quinine was originally designed as a medication to treat malaria. Subsequent research has found that it can also be moderately effective in reducing the frequency of leg cramps.

However, there is a small chance that quinine may cause unpleasant side effects including:

• tinnitus (ringing in your ears)
• impaired hearing
• headache 
• nausea (feeling sick)
• disturbed vision
• confusion
• hot flushes

Thrombocytopenia is a rarer but more serious complication of quinine. It occurs when the number of platelets in your blood falls to a dangerously low level. Platelets help the blood to clot which means people with thrombocytopenia are at increased risk of excessive bleeding such as:

• nosebleeds 
• bleeding gums
• bleeding inside the eye
• bleeding inside the skull or digestive system (both of which can be fatal)

There have been a number of reported cases of people dying from thrombocytopenia after taking quinine to prevent leg cramps.

Never take more than your recommended dose of quinine. An overdose of quinine can result in permanent blindness and death.

Due to these small but potential risks, your GP will only prescribe quinine if there is evidence that the potential benefit of treatment outweighs the risks.

It is recommended that quinine is only prescribed when:

• you have tried the exercise techniques discussed above and they haven't helped prevent your leg cramps
• you have frequent leg cramps which affect your quality of life

In these circumstances, you may be prescribed a four-week course of quinine. After this time, if you have not gained any benefit, the treatment will be withdrawn.

If you experience any of the side effects listed above, stop taking quinine immediately and contact your GP.