What do you do for muscle cramp pain? Some people use massage, and others swallow a spoonful of yellow mustard. By far the most popular preventive used to be quinine tablets. At one time, doctors would prescribe them. However, the FDA has restricted quinine to be used only for the treatment of malaria. After all, quinine can cause a range of very severe reactions, some of which can be lethal (American Journal of Hematology, May 2016). On the other hand, the agency has done nothing to limit access to tonic water. Several brands of the beverage still contain quinine. Can tonic water help ease muscle cramps?
Is Quinine in Tonic Water Effective Against Nighttime Leg Cramps?
Q. I have suffered from nighttime leg cramps for years. This agonizing muscle cramp pain affected my sleeping habits. Recently, I read that quinine contained in tonic water is effective in treating leg cramps.
I’ve been drinking half a small bottle of tonic every night for the past six nights and the cramps have disappeared. Have you had experience with this treatment?
A. Doctors used to prescribe quinine to treat leg cramps. In fact, quinine was once sold over the counter for this purpose. The dose of quinine that many doctors prescribed was 200 to 300 mg.
Quinine Is No Longer Available to Treat Muscle Cramp Pain:
However, the FDA banned the use of quinine for leg cramps more than a decade ago. That’s because some people are extremely sensitive to this bitter drug. It can trigger rare but potentially life-threatening blood and immune-mediated reactions.
The FDA has not banned quinine from tonic water. The amount you would get from half a small bottle would be around 10 mg. Many doctors would probably call this a homeopathic dose. But we think the bitter taste of quinine could be triggering special receptors in the mouth, throat and stomach. Stimulation of these TRP channels can help nerves relax muscle cramps. Even a small dose of quinine might be helpful. Many other readers, like the one who follows here, have also shared success stories with tonic water against nighttime leg cramps.
Tonic Water for Muscle Cramp Pain Was a Game Changer:
Q. For years, I’ve suffered severe muscle spasms all over my body. One cramp would begin, and I’d stretch the muscle to try to rid myself of it. No sooner would it start to relax than another would begin. The pain would be excruciating, with tears and exhaustion following.
My doctor did not seem very concerned, although he prescribed muscle relaxers. These never did help, even when he doubled the dose and I took them three times a day. I often wondered how I could continue to live this way.
Finally, someone suggested tonic water, and it changed my life. I can’t believe the relief I’ve gotten. Each night I open a can of tonic water and let it sit because carbonation bothers me. Once it is flat, I drink the full can and haven’t suffered a cramp since.
What Does Quinine Do?
A. We used to think that the small amount of quinine (20 mg) in a glass of tonic water would be inadequate to prevent or treat muscle cramps. That’s because doctors used to prescribe 200 to 300 mg of quinine for patients with leg cramps.
Nonetheless, many readers have stories similar to yours. We now think we have figured out the explanation.
Quinine and TRP Channels:
Quinine stimulates a specialized channel on cell membranes called TRPM7 (British Journal of Pharmacology, June 2012). Such transient receptor potential (TRP) channels are found on nerves throughout the body. Activating them through the TRP channels appears to reverse the nerve hyperactivity that causes muscle spasms and results in muscle cramp pain. In addition, other things can trigger TRP channels. They include vinegar, ginger, garlic and chili peppers. We suspect that tonic water has a more pleasing flavor for managing muscle cramps.
You can learn more about TRP channels and how they can be utilized to reverse muscle spasms by listening to our interview with Dr. Bruce Bean, neuroscientist and co-founder of HotShot. It is Show 1054: The Scientific Explanation for a Weird Remedy. To learn more about the science behind this and many other simple treatments you may also find our eGuide to Favorite Home Remedies of interest.