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Br J Gen Pract. 2005 Mar;55(512):186-91.

Managing nocturnal leg cramps--calf-stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial.

Author information

  • 1The Surgery, Station Road, Overton, Basingstoke, Hants RG25 3DZ, UK. overtonsurgery@dial.pipex.com

Abstract

BACKGROUND:

Quinine is a common treatment for nocturnal leg cramps but has potential side effects. An uncontrolled study suggested that calf-stretching exercises could prevent nocturnal leg cramps (night cramps) but these findings have never been confirmed.

AIM:

To assess the effect of calf-stretching exercises and cessation of quinine treatment for patients with night cramps taking quinine.

DESIGN OF STUDY:

Randomised controlled trial.

SETTING:

Twenty-eight general practices in southern England.

METHOD:

One hundred and ninety-one patients prescribed quinine for night cramps were randomised to one of four groups defined by two "advice" factors: undertake exercises and stop quinine. After 6 weeks they were advised that they could take quinine and undertake the exercises freely. Documentation of cramp at 12 weeks was achieved in 181 (95%) patients. Main outcome measures were: symptom burden score, and frequency of night cramps and quinine usage.

RESULTS:

At 12 weeks there was no significant difference in number of cramps in the previous 4 weeks (exercise = 1.95, 95% confidence interval [CI] = -3.01 to 6.90; quinine cessation = 3.45, 95% CI = -1.52 to 8.41) nor symptom burden or severity of cramps. However, after 12 weeks 26.5% (95% CI = 13.3% to 39.7%) more patients who had been advised to stop quinine treatment reported taking no quinine tablets in the previous week (odds ratio [OR] = 3.32, 95% CI = 1.37 to 8.06), whereas advice to do stretching exercises had no effect (OR = 0.73, 95% CI = 0.27 to 1.98).

CONCLUSIONS:

Calf-stretching exercises are not effective in reducing the frequency or severity of night cramps. Advising those on long-term repeat prescriptions to try stopping quinine temporarily will result in no major problems for patients, and allow a significant number to stop medication.

PMID:
15808033
[PubMed - indexed for MEDLINE]
PMCID:
PMC1463088
Free PMC Article

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