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  • Muscle cramps: quinine derivatives likely to be effective but not recommended for routine use due to toxicity; vitamin B complex, naftidrofuryl and calcium channel blockers possibly effective

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Therapeutics
Systematic review
Muscle cramps: quinine derivatives likely to be effective but not recommended for routine use due to toxicity; vitamin B complex, naftidrofuryl and calcium channel blockers possibly effective
  1. Gavin Young
  1. Temple Sowerby Medical Practice, Penrith, Cumbria, UK
  1. Correspondence to Gavin Young
    Temple Sowerby, Penrith, Cumbria, CA10 1RW, UK; gavin.young{at}gp-a82038.nhs.uk

https://doi.org/10.1136/ebm1090

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    Commentary on:

    1. Katzberg HD,
    2. Khan AH,
    3. So YT
    . Assessment: symptomatic treatment for muscle cramps (an evidence-based review): report of the therapeutics and technology assessment subcommittee of the American academy of neurology. Neurology 2010;74:691–6.
    OpenUrlAbstract/FREE Full Text

    This paper reviews probably all the available reliable studies on treatment of muscle cramps. The authors limit themselves to idiopathic muscle cramps. The cause of such cramps is by definition unknown. Do not read this review to learn how to treat cramps associated with other conditions including pregnancy.

    Do cramps matter?

    The majority of people of retirement age and beyond will report frequent cramps, and the majority of sufferers will experience cramps more than once a week. Usually these occur through the night and disturb the sleep. Sometimes a person will experience multiple episodes throughout the night.

    What does this review tell us?

    Though the authors did not carry out a hand search of journals, they do appear to have done a thorough job and found 563 papers. In the end, only 24 matched the inclusion criteria. This in itself is disappointing but worse still, there were only two high quality studies of the most commonly used drug, quinine (one of these exclude those over 70). …

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    Footnotes

    • Competing interests GY is the author of ‘Leg Cramps’ in Clinical Evidence for BMJ Group for which he received an annual fee.