The People's Perspective on Medicine

Busting Myths and Offering Unique Leg Cramp Remedies

What causes muscle cramps? Hint: They're NOT brought on by dehydration or electrolyte imbalance. Triggering TRP channels with leg cramp remedies might help.

Q. My wife told me about leg cramp remedies, including the mustard cure some time ago. I thought it sounded wild, as I don’t understand how it would work.

Last week, I participated in a run/walk in Indianapolis with some old friends. Two of them ran a half marathon. After the race, we were sitting in a bar when one guy had a massive and painful cramp in his left quad. He is a well-trained runner so the cramp was unusual.

Massage and stretching had no effect. I went to the unattended bar looking for anything that might help. There was a slice of lime, so I grabbed it, not thinking it would make any difference, but willing to try whatever was at hand. My friend sucked on it and said the effect was essentially immediate! The cramp dissipated quickly.

We joked about it for the rest of the day. I still don’t have an explanation.

TRP Channels to the Rescue:

A. Neuroscientists have shown that triggering special transient receptor potential (TRP) channels in nerve cells can stop muscle cramps quickly (Muscle & Nerve, May, 9, 2017).  This is an elegant explanation for why tasting strong flavors like pickle juice, mustard, ginger, quinine or cinnamon might be helpful. Perhaps lime also stimulates TRP channels.

Explaining Unusual Leg Cramp Remedies:

We have asked many health professionals if they’ve ever heard of TRP (pronounced trip) channels. Inevitably we get a blank stare. This is not something that is generally taught in medical school. It is certainly not an explanation employed to explain odd leg cramp remedies.

We think that stimulating TRP channels may explain a great many unusual treatments. But before we get carried away, let’s shoot down some myths associated with leg cramps.

Leg Cramp Myths:

The two leading explanations most frequently offered by health professionals to explain muscle cramps are:

  1. Leg cramps are caused by dehydration
  2. Leg cramps are caused by electrolyte imbalances

These are the two dominant theories that have been kicking around for decades. Neither is true, even though they persist to this day.

South African exercise physiologists debunked these ideas 20 years ago in the Journal of Sports Sciences (June, 1997). An article in the British Journal of Sports Medicine (June, 2009) put the nail in the coffin.

“Scientific evidence in support of the ‘electrolyte depletion’ and ‘dehydration’ hypotheses’ for the aetiology of EAMC [Exercise Associated Muscle Cramps] comes mainly from anecdotal clinical observations, case series totalling 18 cases, and one small (n = 10) case-control study. Results from four prospective cohort studies do not support these hypotheses. In addition, the ‘electrolyte depletion’ and ‘dehydration’ hypotheses do not offer plausible pathophysiological mechanisms with supporting scientific evidence that could adequately explain the clinical presentation and management of EAMC.”

Elite athletes in highly competitive sports get paid millions of dollars to perform at their best. Professional basketball, football, hockey and soccer teams employ high-priced trainers whose job it is, in part, to prevent cramps from interfering with athletes’ performance. If all it took to avoid muscle cramps was fancy water with added minerals, you can bet these teams would have employed it long ago.

Actual Data:

An actual experiment conducted on ultra-marathoners (56km road race) concluded (British Journal of Sports Medicine, Aug. 2004):

“The results of our study do not support the common hypotheses that EAMC [exercise associated muscle cramping] is associated with either changes in serum electrolyte concentrations or changes in hydration status following ultra-distance running. An alternative hypothesis to explain the aetiology of EAMC must therefore be sought.”

An Alternative Hypothesis:

Twenty years ago, South African scientists proposed that exercise associated muscle cramps were caused by (Journal of Sports Sciences, June, 1997):

“sustained abnormal spinal reflex activity which appears to be secondary to muscle fatigue.”

In other words, when muscles are overworked and exhausted, they send signals to the spinal cord that turn on a reflex that in turn triggers painful muscle cramps. If you could interrupt that spinal reflex by stimulating nerves in the mouth, throat and stomach, you might be able to turn off the cramps. Research now supports this hypothesis.

Turning ON TRP Channels:

That is precisely what happens when you stimulate TRP channels with strong flavors (Muscle & Nerve, May 9, 2017). Researchers at Penn State University used a double blind, randomized, cross-over design to test this approach. Subjects drank either a strong-flavored placebo beverage or the special drink that stimulates TRP channels (capsicum, cinnamon, ginger). Fifteen minutes later they performed a challenging exercise designed to induce muscle cramps.

Here is what the researchers discovered:

“Our data suggest that TRP channel activation may have dampened alpha-motor neuron hyperexcitability to mitigate cramping…These results are very promising for athletes and for those who experience muscle cramps during recreational activity…In conclusion, in a group of young, healthy participants with a prior cramp history, ingestion of TRP channel agonists 15 min before testing positively altered EAMC [exercise associated muscle cramp] characteristics.”

TRP Channels and Unique Leg Cramp Remedies:

Here is why we think TRP-channel activation explains the mechanism of action of so many home remedies for leg cramps. These leg cramp remedies work very quickly, often within two minutes. There is no plausible explanation other than a nerve activation one. It takes far too long for a substance to be swallowed, absorbed into the blood stream, circulate to the muscles and turn off the cramps.

Stories from Readers:

Mustard:

M.B. tried everything before tasting yellow mustard:

“I just woke up from having leg cramps. I tried everything to get them to stop. But they wouldn’t. This was my first time trying the yellow mustard. I sit here now with no cramps. So I guess the mustard does work!”

J.R.A. offers this:

“I use to have bad leg cramps after a hard day’s work. Then I read about mustard. It usually takes about 2-3 tablespoons. I wash the mustard down with water and then the cramps are gone.”

Ken in Virginia responds:

“Yes, mustard works but I suggest you NOT wash it down with water because it works best the longer it stays in your mouth.”

Chuck in Illinois loves the taste of mustard:

“I keep some mustard packets in my bed stand drawer, and always bring some along when I travel. It’s true that it works almost instantly. Fortunately, I love the taste.”

Pickle Juice:

We think it’s the acetic acid (vinegar) in pickle juice that stimulates TRP channels.

Barbara in Spokane had success with pickle juice:

“Ever since I heard about swallowing a shot glass of dill pickle juice, I use it for nighttime cramps. IT WORKS! I keep it in my mouth for a few seconds before swallowing. There might be some new research about this, and it has something to do with nerve receptors in the pharynx, not electrolyte imbalance. Cheap, hasn’t harmed me.”

Ken says pickle juice works fast:

“You should also try the soap-under-the-sheet-method as a preventative. The other product that works instantly for me is pickle juice…swallowing just a teaspoonful works immediately for me.”

Karen took us to task:

“I am baffled by why your discussion of muscle cramps does not (and never does) begin with attention to basic electrolyte balance. Surely attention to potassium and magnesium in the diet is more useful to all-body health than drinking pickle juice?”

Sorry, Karen, the science suggests that electrolyte imbalance does not cause EAMC [exercise associated muscle cramps].

Turmeric:

Turmeric is the yellow spice in curry. This person reported that he couldn’t stand the taste of mustard but turmeric worked instead:

“Mustard works for leg cramps. But I really don’t like mustard straight up, especially at night. When I get leg cramps, I mix 1/4 tsp turmeric in four ounces of water and drink it down. Leg cramps subside in about one minute or less, faster than mustard and a whole lot more palatable.”

We cannot prove it, but we suspect that turmeric may also stimulate TRP channels.

Juice Combination:

Marsh came up with quite a concoction:

“I’ve found relief from nocturnal or recumbent leg cramps by mixing and drinking the following:

  • 1/2 cup of water
  • 1/2 cup of tomato juice
  • 1/2 cup of orange juice
  • 1 teaspoon of lemon juice

There are hundreds of comments about different leg cramp remedies. Here are just a few more about mustard and its potential mechanism of action:

We think TRP channel activation is the common denominator. Even soap may stimulate TRP channels. How else can you explain this fast response:

“My left hand was cramping badly. My fingers were twisting and the pain was unbearable. I searched ‘hand cramps’ on the web, found your suggestion and held a bar of soap. It worked within two minutes and the cramp hasn’t returned.”

Share your own story of muscle cramps below in the comment section and please vote on this article at the top of the page if you found it worthwhile.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I was having regular nighttime leg & ankle cramps for years until I started taking Magnesium Glycinate, all because of places like this, not the doctor. Most of it started ‘after’ my treatments for colon/rectal cancer which included chemo and radiation. Once I was past all that (2014 gone & hopefully for good) I’ve had cramps that make you cry at night and even some during the day. My hands during the day and legs during the night. Something had to change, so I searched till I found Magnesium.

I’m not saying it’s a cure all but, I’m of the opinion that it’s better to preempt cramping rather than react to it. After all, who wants to be awakened with leg cramps that are next to ‘crippling’? After starting my Magnesium Glycinate regimen I saw immediate relief. I couldn’t believe it but rather thought it was just a fluke. It’s now been over two months of using the MG and I’ve only had “ONE” bad cramp and that was last night. Usually, if any, they are so mild I can stand up and lay back down and everything is OK. To be fair, I worked my booty off yesterday in the yard.

Also, I was so impressed that I made a doctor’s appointment to see if I was deficient in other vitamins or minerals. After the blood tests they informed me to keep on taking my (other) supplements and the Magnesium. That’s all I got. No printout or anything else. My reason for thinking I was deficient was that I “empty” out EVERY DAY because of my cancer treatment damage. I would characterize it as mild diarreah every day. I had to be losing vitamins and minerals but never gave it much thought before trying the Magnesium.

Needless to say, I’ll keep on researching this topic. I appreciate what I’ve read already on this site. It’s hard to argue with real results. Before, I was the guy that thought “I must not be drinking enough”, which btw was counter productive when you have prostate issues. Now, I’m the guy who knows more and feels better, and it’s not because of doctors.

I’ll be back………..

Soap does not work for me.Mustard might help,but only started very recently so my vote is still out on that.The same unknown for raw apple cidar vinegar.Just tried pinching my lip and that shows promise.

Most of evidence cited seems to be about exercise induced cramps; these could be local lactate accumulation or local electrolyte abnormality without showing up in serum abnormality. Mine are mostly nocturnal or related to GI problems (vomiting to point of dehydration), lower extremity (primarily thigh adductors, hamstrings, calves.

While I like the idea in the article of gin and tonic (prevents scurvy and malaria too), magnesium helps mine quite impressively, short term treatment and prevention–but not magnesium oxide, which is what most pharmacies sell over the counter. It is derived from crushed rock and is very poorly absorbed. Magnesium malate is much better absorbed, and, for me, works MUCH better.

After reading today’s article in the paper I had to respond. I use to suffer from painful cramps in my feet at night. I had been taking turmeric for a while in the mornings. I was having a long spell of cramps, and one night I decided to take my turmeric at dinner time. That night, no cramps in my feet. Anyway, I have found if I take it a few hours before bedtime I do not have the feet cramps. I take 2 capsules which are 720 mg each. Hope this helps other suffers.

I agree that mustard works, but what I don’t see in the article or the comments is any explanation of WHY these cramps occur in the first place and what can be done to prevent them. Rather than racing for mustard when an excruciating cramp happens, I would love to prevent them. I would also love to understand what is happening in my body to cause the camps. My problem is hand cramps and I don’t think they can be attributed to heavy exercise.

Here’s what has been working for me: Went to my doc, and he prescribed a medication or two. Nothing helped. Went to another doc, and he said to take magnesium and potassium. Tried store medications that said “stop leg cramps”. Very marginal at best. Saw a bottle of pills labeled Apple Cider Vinegar and took two before bedtime for a couple of nights, and that only worked until maybe 3 am, and they were back full force. Tried mustard. Tried quitting sugar. All of them with no results. I had been holding off taking the liquid apple cider vinegar because of the stories of the horrible taste and smell but finally went ahead 7 days ago, taking 3 capfuls just before bed. NO CRAMPS so far! My cure for the taste and smell is to put it into maybe an inch or two of V-8, and hold your breath while you drink it. That really masks the pungent taste and makes it almost pleasant. Hope this works for you!!

Last week ( September 12, 2017), in the middle of the night, I woke up with an extremely painful cramp in my upper right leg. I managed to get to the refrigerator, grabbed the yellow mustard container, squirted a teaspoon full and swallowed it. In less than 30 seconds the cramp was gone. No further problems.

By the way, I am the same fellow described in the article above who suffered a very painful cramp in my right leg after finishing the 2017 500 Festival Min Marathon in Indianapolis. A raw lime cured the cramp that time.

Two days ago I awoke about 1:30 AM with pain in both legs — felt like tight tourniquets had been applied. Pain shot up under my knees. I could not straighten my legs. Pain bordered on excruciating. After 7 to 10 minutes I remembered reading about mustard as a remedy. I slowly made my way downstairs to the kitchen refrigerator, took out the mustard, placed a small amount on a teaspoon, then put it on my lips and tongue. Within 10 seconds the pain was gone.

Now I’m a believer!!

I HAVE HAD A BAR OF SOAP UNDER THE BOTTOM SHEET OF MY BED FOR YEARS AND THE LEG CRAMPS ARE GONE. I EVEN CARRY A BAR OF SOAP, WHEN I TRAVEL. WHEN I TELL PEOPLE THEY LAUGH AND LOOK AT ME WITH A QUESTIONABLE LOOK. THEIR PROBLEM IF THEY DON’T WANT TO EVEN GIVE IT A TRY.

Hello, I had leg cramps for years, excruciating pain every night. I used to be a marathon runner and wore orthotics, no cramps at that stage. After stopping hard exercise a few years later I started wearing flat shoes as I’m reasonably tall. Ballerina shoes are the worst as are flip flops.

As you get older your feet drop flatter (the arch) and get longer as a result. After years of cramp and trying EVERY way possible to elevate the pain I remembered the orthotics . So I started wearing running shoes every day, then found a shop selling only support shoes, cramps are 99% gone. Such a relief, now I’m learning how to get a good uninterrupted nights sleep. Good luck.

What can one do BEFORE going to sleep so the horrible leg cramps don’t come at all? I’ve been suffering immensely the last 3 months every night. Have not put the soap under the sheets. Can someone refine that approach? Taking & applying magnesium, as well as leg cramp meds. Pickle juice last night worked but I was up for 4 hours after the attack. THANK YOU!

I have been suffering from nighttime muscle cramps/spasms and RLS for years. When I do have a really, really bad spasm, especially in my thighs, there is no way on earth that I can get out of bed to walk, let alone go down to the kitchen to mix or get a ‘remedy’. I’ve tried mustard packets at my bedside with no relief. However, since using magnesium bis-glycinate (about 700mg over the course of the day) I haven’t had any terrible spasms, just infrequent ones mainly in my calves and feet, and measuring only around 5 to 7 on a scale of 1 to 10. BTW, I have used a bar of Ivory in my bed for many years, recently switching to a lavender soap. I keep a ‘log’ to remind me when and how bad my spasms occur.

I used to get leg cramps almost everyday. then i read that a banana a day would help. I tried them and a few days later my leg cramps stopped. If i stop eating bananas for about a week, they start to come back a little stronger each time. I try to eat bananas on regular basis.

Mustard stops my cramps immediately. Brown or yellow – a tablespoon of either does the trick. However, the affect can wear off in 30 min. To get longer lasting relief, I can ingest my multivitamin (Androvite) or drink a glass of Emergen-C drink mix with water. Either of these buys me at least 6 hours of relief. I have also been ingesting them BEFORE working out, and do not cramp after exercise. I hope my remedies can help someone else!

Lack of oxygen causes leg cramps just as it did when your mom said don’t go in the water until your food digests since, digestion requires additional blood – oxygen to digest your food and this will take additional oxygen starving your legs!!! If you get cramps anywhere simply take deep heavy breaths and shortly the cramps will be gone!!!

Much to my dismay, neither mustard nor pickle juice helped my night cramping leg. Soap under the sheet did, but only once. My current, incredibly reliable, go-to remedy is Hyland’s homeopathic Bio-plasma salts. Go figure!

I experienced leg or foot cramp almost every early morning. I told my husband it’s my morning wake-up call! I mentioned to my doctor it could be the 10 mg atorvastatin that I take every evening that causes the cramp. She agreed for me to cut the dosages to every other day. Since reducing the dosages over 2 weeks ago, I have no leg or foot cramp! I even tried to stretch my legs and feet before I get out of bed to see that will trigger the cramp, no cramp!!!

My husband gets cramps in his calf and behind the knee after doing strenuous work or a lot of bending. His cure…a cold wet cloth applied to the area….instantly gone. So we keep a cold gel pack in the fridge for this purpose to avoid the wet cloth in bed.

Sure enough, the other night he got one so I placed the gel pack on the site, and it disappeared immediately. Have not tried the mustard one yet and I may just try the bar of soap too. But this method really works.

In 1988, Surgeon-General Koop advised that we cut back on the amount of salt in our daily food intake. The violent leg cramps I (an elderly tennis player) suffered from for years in the middle of the night I now attribute to insufficient salt in my diet; I decided to reintroduce salt into my daily regime and since then no longer suffer from those agonizing nightly leg cramp attacks.

I often wake with leg cramps. I have used tonic water, mustard, pickle juice, lemon juice. All have worked instantaneoulsy for a few times then don’t work again. The only thing now that seems to do me any good is 12 oz or so Gatorade or a beer just before I go to bed.

I still get the cramps but they don’t cause me to hurt myself trying to throw myself out of bed while still mostly asleep. The cramps come on slower and I wake fully before getting up to force my toes down against the floor which ends it, for the moment anyway.

I will suffer from leg cramps if I sweat a lot. Doesn’t matter if I am standing at the register in a hot store for 8 hours or outside in hot weather for one hour. Excessive sweating always results in leg cramps.

Mustard works, as does salted Gatorade. If I add magnesium, potassium, and salted Gatorade to my diet during the hot months, I can reduce the frequency of the cramps. I don’t think it is from overuse, but from excessive sweating. I have always sweated, never just perspired, and my doctors say nothing is wrong. It would seem the sweating depletes something that results in cramping. Proactive prevention works best for me.

Does Honey Mustard work?? I love it but would have a hard time with plain mustard.

I use Honey Mustard….tastes much better and relieves leg cramping immediately.

I have leg cramps at night if I don’t take potassium. As long as I take it, I am fine. A few days with out it and they start again.

I can’t believe you didn’t give the bar of soap under the bed sheets cure a mention in this article. When we saw it in your articles about two years ago, I tried it. My husband has been plagued with terrible night cramps in his legs for years. Since we tried this, he has had none. Close to a miracle cure for him.

I totally agree. I always have soap under the sheet and have no more leg cramps. When traveling, I rub a bar of soap on my leg if I get a cramp. It stops immediately.

I find that I have to focus on hydration and electrolytes in order to prevent leg cramps. If I go on a long hot hike I need to drink plenty of water with an electrolyte product like NUUN – plain water doesn’t do it – or I will get leg cramps in the car on the way home. Once the leg cramps start up, it’s not too late to start hydrating, but it won’t immediately stop the cramping. Also, if I wake up in the night with leg cramps eating mustard or drinking pickle juice helps immediately, but they may come back later in the night if I don’t also drink a big glass of water. Drinking alcohol in the evening will bring on leg cramps in the night for me, if I haven’t been drinking enough water during the day. Stretching after exercise also helps.

Thank you for this updated article on leg cramps. Last week at a doctor’s visit I spoke about the phantom pains I get on the inside of my thighs which seem to come from my knees. She took x-rays of my knees (only some arthritis) and blood work showed everything was perfect, including potassium levels. Another incident where doctors have no explanation so thank you for explaining TRP channels. Frankly the mustard was disgusting. I love cinnamon so how do I use this?

After reading about TRP channel effect in your newsletter, I tried simply taking a mouthful of dill pickle juice, swishing it around in my mouth a minute or two and then spitting it out. Works!! Didn’t have to swallow it.

Leg cramps are caused by a calcium deficiency. Simplest preventive, take calcium, drink milk, yogurt, orange juice, a good source of calcium. Antacids will work in a pinch as a treatment, but they make a hash of your digestive tract. So just for emergencies.

I’ve learned I usually don’t get leg cramps, in general (perhaps because I don’t over-indulge in exercise). From your interesting article, I believe the “TRP” theory, regarding how certain foods can immediately stop EXERCISE induced muscle cramping.

But, what about muscle cramps that are NOT exercise-related???

For example:

When I needed to take an antibiotic (like for an infected tooth, I ALSO take some Florastor (a very helpful “yeast” probiotic, that fights Clostridium difficile infection that is COMMONLY brought on by taking antibiotics).

The only problem with Florastor (made of the friendly/probiotic “yeast” called Saccharomyces boulardii), is that yeasts contain a lot of phosphorus. And when one is a meat eater, one is ALSO eating a lot of phosphorus (from the meats).

The added phosphorus, coming from the Florastor, can promote too much removal of CALCIUM in one’s body, resulting in leg cramps that are NOT EXERCISE RELATED! (This is perhaps what the other lady was referring to, when she commented about electrolyte imbalances.)

My solution to THIS problem is to take extra calcium, and this gets rid of the phosphorus-induced leg cramps within a minute or so, consistently and reliably.

For those who should NOT take Calcium supplements, because, for example, “supplemental” calcium is potent enough, that this can promote Atrial Fibrillation, in susceptible folks, because calcium SUPPLEMENTS excite the heart too much, these heart patients can re-supply their bodies with calcium, by using FOOD sources of Calcium, such as almonds (raw, unsalted, organic), &/or sesame seeds (crushed up, it’s called “tahini”, or, sesame seed “butter’).

Perhaps the leg cramps brought on by too much exercise, is the body’s attempt to get the person to STOP doing “too much” exercise. So the next question this brings up, is: Is it good to keep doing the over-exercise, while ignoring the “signs” of doing too much exercise? (This might be akin to taking a pain killer without looking for underlying causes of the pain itself.)

And, the next question I have, is: What causes NON-EXERCISE-related cramps? I know the answer to this, when it comes to taking Florastor–but now, I’m curious as to the underlying CAUSES of non-exercise related muscle cramping (other than “rhabdomyolysis”, that is caused by statin drugs!).

My friend on most nights have leg cramps and on some occasions laryngeal spasms,is there a link – would taking 500gm of Turmeric supplement help in anyway.

Another testimony for mustard! My husband often wakes with muscle cramps, but when I suggested the mustard remedy he laughed. After being forced to “just try” it, he is still amazed that it always works.

You say:

“In other words, when muscles are overworked and exhausted, they send signals to the spinal cord that turn on a reflex that in turn triggers painful muscle cramps. ”

Sounds to me like the body is telling you to rest. Don’t you think it possible that damage might be done if you don’t pay attention?

My muscle cramps were not due to exercise and usually happened during the night. They were especially bad after a long car trip. After taking a magnesium tablet every night they have completely disappeared.

I am very active 73 year old who works outs and stretches daily but no from my doctor to my pharmacist mentioned that Omeprazole or Prilosec could rob your body of Magnesium and cause severe cramps. I treated my cramps by immediately getting out of bed or standing up and walking. They would disappear almost immediately. I know longer take Omeprazole because I cured my Silen Reflux by not eating any caffeine containing products after 8 PM an sleeping with an elevated head.

My husband also gets muscle cramps. His friend told him to buy a small bottle of iodine. Before bedtime rub a couple dipsticks of iodine on the affected muscles. The iodine soaks in the skin. It works!

I get cramps in my feet sometimes when I take weight off them, either to sit in a recliner or sometimes just putting on my socks and shoes. Usually they go away after I walk around a bit, but that’s annoying if I want to relax for a while. No one else mentions this type of cramp. Next time I want to relax with my feet up, I’ll have some mustard or lime juice handy.

I eat 2 tablespoons of capers every evening before dinner. I’m thinking the vinegar helps.
No more cramps at night.

My issue was nighttime foot and ankle cramps. I had tried a teaspoon of mustard before bed but that did not work as prevention. A shot of pickle juice would kill the cramp after it occurred. I did find an article about salt water and that works great for me. I take about a half teaspoon of sea salt in a couple ounces of water. All of it does not dissolve but it does the trick. No nighttime cramping for over 6 months now.

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