grabbing the sole of the foot in pain

Q.  Several years ago my doctor prescribed 20 mg of Lipitor. Since then doctors have gradually raised the dose till I am now on 80 mg of generic atorvastatin.

Initially I experienced calf cramps that I could eventually stretch out. But more recently I’ve started having unbearable cramps in the backs of my thighs that literally make me scream in pain. I don’t mean groaning, I mean screaming like I’m being attacked with a sharp knife by a crazed killer!

They generally occur at night, but I’ve experienced them during the day too. NOTHING makes the cramp go away. I cannot move. I cannot stand. I grab my leg(s) [sometimes it’s both at the same time] and can literally feel the muscles roiling and twitching under my skin.

Sometimes just lifting or bending my leg the wrong way triggers an attack that can last up to 15 minutes.

My doctor scoffed at me when I mentioned my cramps. I suspect the atorvastatin because of something my pharmacist said about Lipitor and leg cramps, but my doctor doesn’t seem to believe me.  Can medication really cause leg cramps? Would quinine help control my pain?

A. Your physician has not been paying attention to the prescribing information or the scientific literature. Muscle pain is one of the most common complaints we hear from people taking statins. It can manifest as neck pain, back pain, leg pain, muscle fatigue and leg cramps.

An article in the Archives of Internal Medicine (online, Dec. 12, 2011) titled “Nocturnal Leg Cramps and Prescription Use That Precedes Them” noted that:

“The use of diuretics, statins, and inhaled long-acting beta-agonists (LABAs) is linked to muscle cramps but largely by anecdotal evidence. This study sought population-level data to better evaluate these associations.”

The authors report that their analysis “suggest that the use of diuretics, statins, and LABAs promotes muscle cramping in older adults.” Although statins were less likely to cause such problems compared to diuretics or inhaled bronchodilators, they were linked to this problem. This may just be the tip of the iceberg. As the authors point out, older people, who are most susceptible to leg cramps, are “poorly represented in most clinical trials.”

Other visitors to this website have shared similar experiences with a variety of statins:

“I know at least four people in my immediate environment who have had the ever-so-common reaction to statins of other-worldly painful muscle cramps at all hours of the day or night. In addition to myself, they include not only a relative (my father), but also my stepmother and a close friend.

“All of them had intense and painful muscle cramping that is hard to stop. The higher the doses of statin, the greater the extent of muscle cramping. I learned the hard way of this connection after a year’s worth of taking a wide variety of different statins, and altering the dosages to try to eliminate the severe and debilitating cramping.

“The problem got so bad that I could ultimately no longer open a jar lid because of cramping in the muscle at the crook of my elbow.  The most common problem came in muscles I couldn’t avoid using, e.g., knotting up of the muscles in the soles of my feet while sleeping.

“You should get this message out because doctors who deny muscle cramps are caused by statins have a total lack of understanding of how these side effects ruin the quality of your life.

“There are non-statin alternatives for bringing down cholesterol numbers. They may not be as easy or effective as statins, but they do work adequately to bring the cholesterol numbers to appropriate levels.

I feel that doctors should warn people about muscle cramps as a side effect when they prescribe any statin.” Randy G.

We agree with Randy that people should be alerted to muscle pains and cramping when they receive a statin prescription. But as noted above, diuretics that are often included in medications for hypertension can also cause cramps. So can the inhaled medicines used for asthma and COPD [chronic obstructive lung disease].

In many cases the drugs cannot be eliminated. That’s why people need a variety of treatments for leg cramps and restless legs. Even if you are not taking such medications, you may find the section on Muscle and Leg Cramps of interest in our book, The People’s Pharmacy Quick & Handy Home Remedies: Q&As for Your Common Ailments.

You will learn why you may need to avoid Earl Grey tea and why blackstrap molasses might be beneficial. Find out about massaging with castor oil. Why would a gluten-free diet help? Then there are the details about the benefits of minerals like magnesium and potassium. You will also be amazed by soap stories, turmeric tales, and reports of pickle juice and yellow mustard success, to name just a few of our favorite approaches to easing nighttime leg cramps.

Quinine poses a potential problem for some people. Side effects can include ringing in the ears and serious blood disorders. If you are not susceptible to such complications, a glass of tonic water might help prevent cramps. You may want to consider CoEnzyme Q-10 if you absoultely must continue on atorvastatin.

You will also learn how to follow Randy’s advice above about getting cholesterol (and other blood lipids) under control naturally with Certo and grape juice, cinnamon, red yeast rice and apple cider vinegar, to name just a few approaches. The book will provide practical details about implementing a low-carb Mediterranean diet. If you love natural approaches to what ails you, you will find Quick & Handy Home Remedies a powerful resource.

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  1. Susan

    When I learned to ride horses, the rule was always “heels down”. I never got cramps riding for hours. If while I am sleeping I feel a cramp coming in my calf I immediately go “heels down” and it stops. Now with the cramps below the calf into the ankles and feet I stretch toes out and that works too. My mother had horrible calf cramps and I would hear her screaming when I was young. I believe that if you stretch out while sleeping with toes forward you will cramp your calf.

  2. Les
    York S.C.

    I was prescribed lipitor by my heart doctor. I ask if the side affects would be bad. He said good effects out way bad effects. The first day i took it ever muscle in my body hurt. I thought i was catching the flu bug. I continued to take the medicine for 5 days by the fifth day i could barely do anything. I look at the side effects of that medicine and stopped taking it. Within a few days I was back to normal. I highly recommend that if you take this medicine and have any muscle side effects stop taking it and contact your doctor. If they don’t the medicine was causing the effects get a new doctor immediately. They will kill you if you let them.

  3. Pat

    My doctor prescribed hydrochlorothiazide, a diuretic for me to help control high blood pressure. I took it only a couple of weeks before I started getting cramps in my legs at night. Suspecting that’s what was causing it (because it took potassium and magnesium from my system), I quit and told the doctor I couldn’t take it. He insisted, so I tried it again and the same thing happened. He told me to take it only three times a week. I tried that, but the cramps persisted, although not as often. I told him I would not take it again. I guess he gave up. I have been drinking dandelion tea, but not every day. It’s a natural diuretic which replaces the minerals that are lost because of the diuretic effect. It does just as good a job as the prescription medicine and since my back yard is a safe foraging place, it’s free.

  4. Susan

    I started taking 40 mg of Atorvastatin about a year ago. I often get bad cramps in my shins, especially when I am siting with my feet up, lying in bed or driving. I was forced to stop the car yesterday in order to walk around to get rid of the cramps. I am 51 years old. Before starting the statin, my LDL cholesterol was borderline high, 97, but my HDL, the good stuff, was extremely high 116. According to my cardiologist, the very high HDL might be an indication that it is not doing its job. I have a blocked exterior carotid artery and some coronary plaque. With Atorvastatin, my LDL is 47 and HDL is 122. I do worry about how LOW is good for LDL.

  5. george miller
    west virginia

    on the leg cramping it was mentioned that doctors should advise about side affects . i think some advice is ok but to avoid suggesting to the patient that they may experience certain side affects sets a stage for being overly alert and mistaken reports unrelated to medication can be generated.. if a mysterious rash is expected from a statin medication i am sure reports will come in . asking generalized questions after prescribing might be better way to go same questions from a list given prior to first seeing the patient and followed up once a yr should generate unbiased results

  6. Lynne
    Fairlawn, VA 24141

    I, too, had the same problem with Lipitor. My doctor did not believe me initially. I, too, was afraid of Rhabdomyolysis. I tried another statin with the same side effect. I now take an over-the counter medication called CHOLESTOFF and I also take a store brand of 400 mg. of Coenzyme Q-10 which is a generic of COQ-10. I, too, periodically have leg cramps; mainly at night. Before going to bed, I take over-the-counter leg cramp pills. I understand that the potassium in bananas also helps with leg cramps. I am not currently nor was I formally a drug company representative. These comments are based on my own trial-and-error decisions after looking into things online.

  7. Charlotte
    New Jersey

    This gets away from the Lipitor caused cramps, but good information. When you stretch in bed first thing in the morning, or anytime for that matter, always point your toes back toward your head. Do not point them straight out! This tip was given to me by a physical therapist and it works.

  8. Sharon

    I have COPD and use inhalers Spiriva and Symbicort I experienced severe leg cramps when went on Symbicort I went down to 1 puff a day for a few days and legs cramps lessened, went back on 2 and they came back so I heard about this soap theory I now have a bar of soap in my bed at night and very rarely if at at all have leg cramps anymore so maybe there is something about the old soap theory.
    Regards Sharon Clark

  9. Karen
    R. I.

    Hi everyone,

    I have been getting severe leg cramps as described for a couple of years.
    They have nothing to do with the taking of medications, or nutritional deficiencies, but are the result of bilateral disc disease of my spine.
    Just saying.

  10. Dan
    Detroit, MI

    After 3 1/5 years on 3 different statins I developed 15 severe side effects, including severe leg cramps, neuropathy, loss of balance, constant head ache, severe neck pain, loss of memory, and a heart attack after 2 years of statin therapy. After studying statins, fat, carbohydrates, and heart disease for 6 months, I found that there is no scientific link between cholesterol and heart disease/attack. All research showing a link is funded by statin manufacturers. The lipid hypothisis is based on junk science (Dr. Ansel Keys). I stopped the statin immediately and the majority of my side effects disappeared.

    Inflammation, caused by high carbohydrate intake, is the primary cause of heart disease. It causes the damage to the endothelium that enables the cholesterol to clump at the site of the damage. Cholesterol is a healing substance, not a cause of damage.

    I also began a high fat/low carbohydrate diet and my health has improved significantly.

  11. Randy A.
    Troy, Michigan

    Zocor/ Simvastatin for over 10 years resulted in calf cramping until June 2016 when it rapidly worsened until I could barely walk without a cane! Stopped taking it and Doctor blood work found elevated CK similar to what is detected after heart attacks! I will never take another Statin! Diet and walking regularly will have to be sufficient. Still not fully recovered after 3 months. CQ 10 appears to help, but quality of life appears to be forever changed . ……

  12. Billi

    There’s been quite a few comments related to muscle cramps I get them. Many people wrote in saying yellow mustard did wonders for their cramps
    Pass it on again

  13. Bob Jones
    New York

    I have found that when I get severe leg cramps I rub the pain area with the back of a medal spoon & the pain goes away very quickly. Unfortunately, the use of the back of a spoon doesn’t prevent it from happening in the first place.

  14. Lynn

    I am trying a lot of the suggestions. I am on Provastatin 40 mg and I have progressively gotten the worse cramps of my life. In my feet, legs, hands & thighs and back. I was on a step ladder putting some things in my kitchen cabinets when I got the most severe cramp in my foot that I fell and fractured my tail bone and bruised my body. I am desperate!!!. I have tried the honey, tonic water in crystal light, a bottle of “leg cramps from over the counter, to no avail. I am now trying the mustard and it works for 1 hour then I have to get up and do it again over & over. I dread going to bed and stay up til 2-3 oclock in the am. Sometimes I have stayed up all night because I can’t stand getting up and down all night. I did find a Magnesium gel from Bio Innovations from TV and I’m going to try that as well. If you haven’t taken Magnesium by mouth before it can cause diarrhea. I took it one night and had that problem for 2 days. Whoever comes up with the magic pill for cramps will be a multibillionaire.

  15. Richard
    Gastonia NC

    Statin drugs not only stop the liver’s production of cholesterol but also reduces or stops the production of CoEnzyme Q10 (CoQ10). This is a necessary enzyme for the body and is recommended for those talking statins. I am 73 and take 200mg daily. My wife is 76 and takes 300 mg of Ubiquinol, a more easily absorbed, and more expensive, form of CoQ10. Neither of us take stations but know, with age, the body’s production of CoQ10 decreases.

  16. Carol

    After experiencing leg pain, cramps in the calves, and a continuing, sporadic, inability to walk smoothly, all due to the suspected effects of different statin drugs, I am now off all statin drugs because I cannot tolerate them, according to my family Dr. and my Cardiologist.
    But the problem is that now I have residual effects, or possible permanet damage to my muscles and the tendons and ligaments in my legs.

    When I began to research statin drug side effects and saw the huge number of online examples of statin side effects similar to my own, I then asked the opinion of trusted pharmacists. Two different nearby pharmacists told me they would never take statin drugs, even if they were prescribed, due to such side effects. My leg pain and restrictions in my walking felt like the tendons in my calves had shortened, which was not only painful but which kept me from taking full-length steps. The muscle pains continue today, four years after stopping the statin drugs.

    With my family Dr.’s knowledge and his monitoring of my own careful diet changes, I saw my cholesterol numbers come into the acceptable range, and now I have a better life at the age of 75 and as a heart patient with several heart stents (and a family history of heart failure). I am active and grateful. I now handle my health matters in a more careful, informed way, and make certain that I ask questions and research any and all drugs or proposed changes in my medical care.

  17. Mark
    Indianapolis, IN (46260)

    I developed leg cramps after being on 80 mg of simvastatin for over 10 years. My doctor does a yearly CPK blood test. This test helps confirm any potential muscle issues from statins. I am now on 40 mg of pravastatin. My body seems to prefer the pravastatin both in terms of no muscle pain and better A1C blood sugar numbers. I had tried Lipitor, after simvastatin, but it raised my A1C.

  18. Carol S.

    I’m stunned that nobody has mentioned RHABDOMYOLYSIS, which is a KNOWN horrible side effect of “statins”. RHABDOMYOLYSIS means MUSCLE DESTRUCTION, that causes those intense CRAMPS IN MUSCLES. RHABDOMYOLYSIS is pronounced: :RAB-DOE-MY-OH-LIE-SIS.

    The products of the “statin” caused MUSCLE DESTRUCTION can CLOG UP THE KIDNEYS, causing not only kidney damage, but can cause KIDNEY FAILURE, which can be FATAL!!!

    When a cardiologist (heart doctor)–(an E.P./ElectroPhysiologist–heart rhythm specialist) years ago told me he wanted me to take a “statin” drug to lower my cholesterol, I replied, “NEVER”!

    So, that heart doc said, “Well, if you won’t take a statin, you should at least take FISH OIL (oral)”. I said “OK”, and have been taking FISH OIL ever since, and my palpitations that brought me to that cardiologist, went away!

    Patients should get the “paper package insert” describing adverse (bad) side effects, of any drug that their doctors want to prescribe, BEFORE taking any drugs. Then, patients should get both their pharmacists and their doctors to TRANSLATE the medical “jargon” in those “inserts”, into plain English! It might save their lives, doing that!

  19. Connie

    Regarding statins and cramping Instead of taking the pill at bedtime I take it after dinner. No cramping

  20. Esta
    Twin Falls, ID

    My Dr. put me on 5 mg Lipitor. After about three months I began having extreme leg cramps. My legs actually had large raised lumps in the muscles. My calfs, thighs and feet were involved. This happened at night, waking me up and finding myself barely able to walk. I took a vinegar tablet which someone told me would help and I think it did. I want off the Lipitor and reported it to my Dr. at my regular annual wellness exam and he then put me on 5 mg Crestor three times a week. The second night I experienced very severe cramping again. I will not take any more because I am scared of what might happen. I have decided to try changing my diet and losing weight to get the cholesterol down. My cholesterol was really not very high . My age is 78 and the Dr. put some figures into a computerized formula to see if I needed to use a statin. I think I cannot take these drugs. I have started taking CoQ-10.

  21. Joan

    My doctor did a genetic test that said I was NOT prone to problems from statins. I foolishly agreed to take 20 mg Lipitor, but actually only took 10 mg. Within a month, the severe calf cramps and foot and toe cramps started. I quit the statins immediately, but continue to have the cramps, which I never had before the statins. They are triggered anytime I stretch my legs in bed upon waking. I have changed my diet, and my cholesterol is 200 (down from 250). I plan to lose another 5 or 10 pounds and check again. I also exercise now (run 3 miles/day). I am 70, female.

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