Baseball players coined the term charley horse more than 100 years ago for the cramps they got in their tired, overworked leg muscles. Whether you’re running the bases or lying in bed, nerves send signals to the muscles to tell them when to contract and relax. When these signals get scrambled, the muscle responds by cramping.
What mixes up the messages? The first suspected cause is a mineral imbalance, says Jacqueline Jacques, N.D., a naturopathic doctor and specialist in pain management in Portland, Oregon. That’s not the only possibility, though. Cramps can also be caused by strenuous exercise, excess salt loss from sweating, or sitting or standing too long.
When you get a cramp, stretch and gently massage the muscle immediately. This should relax the muscle and provide you with some much-needed relief. If you find that you’re having muscle cramps every night, your doctor is likely to prescribe quinine, but only for a limited time. This often-used treatment for leg cramps can quickly build to toxic levels in the blood and can cause nausea, vomiting, ringing in the ears (tinnitus), and deafness. It can even damage your eyesight.
A safer way to eliminate that knot of pain in your muscles is to try a combination of vitamin, mineral, and herbal supplements, say natural healers.
A Trio of Supplements for Nighttime Cramps
If you’re getting a nightly wake-up call from your leg muscles, you probably need to get more magnesium and calcium, says Mark Stengler, N.D., a naturopathic doctor in Beaverton, Oregon, and author of The Natural Physician: Your Health Guide for Common Ailments. Both of these minerals are involved in relaxing nerve impulses and regulating muscle activity. Calcium is needed to contract the muscle, and magnesium is needed to relax it. An imbalance in this dynamic duo can irritate and confuse the muscle.
Since the calcium in bone provides a nearly inexhaustible mineral supply to replenish the relatively tiny amount that you need in your blood, you’re more likely to be low on magnesium, says Dr. Jacques. If you’re like most people, you probably get only 75 percent of the Daily Value (DV) for magnesium, which is 400 milligrams from food and supplements.
Mix In Magnesium
Start with a dose of 250 milligrams of magnesium glycinate or chelated magnesium twice a day, says Dr. Jacques. These amino acid–based mineral supplements are easier to absorb than magnesium oxide. The more you absorb, the less likely it is that you’ll have diarrhea, a common problem with magnesium supplements.
Dr. Jacques is definitely not an advocate of magnesium oxide supplements. "Magnesium oxide is basically a rock," she says. "The reason it causes diarrhea is that it stays in the gut. We even see it occasionally on x-rays, where it shows up like little bone chips."
To help relieve cramps that interrupt your nightly Zzzs, take your second dose of magnesium right before you go to bed. If you don’t get relief in three to five days, increase the dose to 500 milligrams twice a day, says Dr. Jacques. Stay at that level for another week to allow the tissue levels of the mineral to build up.
A Time for Calcium
If cramps are still a problem at that dosage, it’s time to add 500 milligrams of calcium to the regimen. The average adult absorbs only about 30 percent of the calcium consumed.
To maximize absorption, Dr. Jacques gives her patients calcium citrate instead of calcium carbonate, the form commonly found in antacid tablets. It helps to take it with a glass of milk since vitamin D is necessary for calcium absorption. If you are unable to drink milk, you can take a calcium supplement that also contains vitamin D.
If you’re taking both calcium and magnesium, keep in mind that they work best when they are taken in certain ratios. The two ratios recommended by naturopathic doctors are either equal doses of calcium and magnesium or twice as much calcium as magnesium. "A lot of it is a guessing game, particularly with something like leg cramps," says Dr. Jacques. "You have to find out what ratio works best for you."
Try the one-to-one ratio first, taking 500 milligrams of calcium and 500 milligrams of magnesium twice a day, Dr. Jacques says. If that doesn’t give you the results you want, shift the ratio to 2:1 by reducing the magnesium to 250 milligrams.
The E Potential
Some patients with nighttime cramping have success with vitamin E, says Dr. Stengler. Although it has had mixed results in clinical trials, early studies suggest that you’ll improve arterial blood flow and reduce leg cramping at night if you take vitamin E.
In one of the largest studies, 123 of 125 people who suffered from nighttime leg and foot cramps reported complete relief after taking vita min E supplements. To see if it works for you, take 400 to 800 international units (IU) a day, says Dr. Jacques.
Are You Lacking Potassium?
Potassium is another mineral that helps regulate muscle contraction, says Dr. Stengler. Deficiencies of this crucial electrolyte aren’t normally a problem if you eat a variety of fruits and vegetables. If you change your diet drastically, however, you might become deficient. This is a potential problem, if you go on one of the high-protein weight-loss diets that some experts advocate.
"When people go on high-protein diets, they begin to develop leg cramps. I see it repeatedly," says Dr. Jacques. She believes that such diets are related to potassium deficiency.
When protein makes up more than 30 percent of your daily calories, potassium levels may fall far short of the DV of 3,500 milligrams, according to Dr. Jacques. If you’re eating eight or nine servings of fruits and vegetables, you’ll get enough potassium to meet the DV, but the shift to a high-protein diet makes this significantly more of a challenge.
Cramps are more prevalent when you first start a high-protein diet, Dr. Jacques has observed. After a few months, they normally disappear on their own. To make them go away sooner, you can take one 99-milligram tablet of potassium a day, she suggests. This doesn’t amount to much more than a bite or two of banana, but it can make your legs feel better, she says.
A word of caution, though: Don’t take more than one tablet. It’s easy to get too much potassium this way, which can upset the balance of other minerals in your body and cause heart and kidney problems. That’s why Food and Drug Administration regulations don’t allow more than 99 milligrams per tablet in over-the-counter supplements.
Little Players That Loosen Your Legs
When you get leg cramps, the first suspects are naturally the big minerals that we’ve already discussed—calcium, magnesium, and potassium. But maybe those cramps are due to an imbalance of trace minerals, especially if the pain is triggered by overexertion, says Dr. Jacques. "Muscle and nerve function are electrical, and we need the right mix of minerals for that to happen. There are a lot of little players in there."
You can deplete levels of trace minerals as you perspire. Electrolyte drinks work well to help restore these depleted minerals. You can also take a trace mineral supplement that contains copper, manganese, zinc, selenium, and chromium, says Dr. Jacques.
Although trace mineral supplements vary in content, don’t exceed the dosage guidelines on the bottle, she says. "Trace minerals should be taken in small doses because that’s how they are found in your body. More is not better."
If you get leg cramps when you walk, see your doctor to rule out other conditions such as intermittent claudication, which is caused by poor blood flow to the legs.
Soothing Spasms
Herbal extracts offer a natural way to soothe and relax spastic muscles. One of the most valuable is black cohosh, says Dr. Stengler. Also known as black snakeroot and bugbane, black cohosh root contains active substances called triterpene glycosides, antispasmodics that act as natural muscle relaxants.
When muscles seize up with pain, take a 500-milligram capsule of the root powder or 30 to 60 drops of tincture in warm water every one to two hours.
For acute cramps, two or three doses should be sufficient for a therapeutic effect, says Dr. Stengler. Don’t use black cohosh during pregnancy, though, or for more than six months at a time.
Bilberry contains chemicals called anthocyanins, a type of flavonoids that have muscle-relaxant properties. Bilberry also helps to improve circulation in the extremities. To reduce muscle cramping, take 80 milligrams three times a day of an extract standardized to contain 25 percent anthocyanidin. You should take it for at least a couple of months, but you can continue indefinitely if necessary, says Dr. Stengler.
"Ginkgo is also useful, since it improves circulation through the extremities by dilating the arteries that feed the leg tissue," he says. While cramps are a problem, Dr. Stengler gives patients 60 milligrams three times a day of an extract containing 24 percent ginkgoflavoglycosides and 6 percent terpenelactones. If you have circulation problems, you can probably use ginkgo on a long-term basis.
