Non-drug therapies for lower-limb muscle cramps are not well studied

Wednesday 29 September 2021

Vanessa Jordan

PEARLS No.

685

Clinical question

How effective are non-drug, non-invasive therapies for lower-limb muscle cramps?

Bottom line

A combination of daily calf and hamstring stretching may reduce the severity of night‐time lower-limb muscle cramps in people aged 55 and older, but the effect on cramp frequency is uncertain as the quality of the evidence is very low. Calf stretching alone may not be effective for reducing the frequency of night-time lower-limb muscle cramps in people aged 60 and older, although limitations in the study’s design impede interpretation of the results and clinical applicability.

It is also uncertain whether a combination of daily calf, quadriceps and hamstring stretching reduces the frequency and severity of leg cramps in 50 to 60‐year‐old women with metabolic syndrome, as the quality of the evidence is very low, with serious limitations in the study’s design that erode confidence in the results.

Many non‐drug therapies are yet to be evaluated.

Caveat

The effectiveness of non‐drug, non-invasive interventions for lower-limb muscle cramps associated with exercise or neurological disease have yet to be evaluated by randomised trial. No study has included anyone under the age of 50. As lower-limb muscle cramps can have a profound impact on people with neurological disease, including children, this should be a priority for future research.

Context

Muscle cramps are highly prevalent, especially in older adults and people with neurological disease, and have a substantial impact on physical and psychological health (distress, less sleep). Many interventions have been tried in the management of lower-limb muscle cramps. The most common interventions can be broadly categorised as drug or non‐drug interventions. Non‐drug interventions reported in the literature include muscle massage, relaxation, sensory nerve stimulation, physical exercise and changes in standing and sitting positions. Effectiveness and need for further research into these interventions requires evaluation.

Cochrane Systematic Review

Hawke F, et al. Non‐drug therapies for the secondary prevention of lower limb muscle cramps. Cochrane Database Syst Rev 2021;5:CD008496. This review contains 3 trials with a total of 201 participants.

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