AAN Guideline Evaluates Treatments for Muscle Cramps

February 22, 2010

A new guideline from the American Academy of Neurology recommends that the drug quinine, although effective, should be avoided for treatment of routine muscle cramps due to uncommon but serious side effects. The guideline is published in the February 23, 2010, issue of Neurology®.

The guideline states that quinine should be considered only when cramps are very disabling, when no other drugs relieve the symptoms, and when side effects are carefully monitored. It should also be used only after the affected person is informed about the potentially serious side effects.

The guideline found that naftidrofuryl, diltiazem, and vitamin B complex may be considered for use in the treatment of muscle cramps, but more research is needed on their safety and effectiveness.

The guideline authors also reviewed studies on the use of calf stretching to treat muscle cramps, but there was not enough evidence to determine whether it is an effective therapy.

Muscle cramps occur with neurologic disorders such as amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease) and peripheral neuropathy. They also occur with other conditions, such as hypothyroidism and low calcium levels in the blood. The guideline did not evaluate treatments for muscle cramps due to muscle diseases, kidney diseases, menstruation, pregnancy, or excessive exercise, heat or dehydration. 

For more information, refer to the full guideline.

Read an interview with the lead guideline author.

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