Nocturnal leg cramps - Clinically mysterious and painful-but manageable

Nocturnal leg cramps are common occurrences among older, generally healthy adults. Although there are many known causes - endocrinologic, neurologic a nd vascular disorders, treatment with certain drugs, and occupational facto rs - a significant portion of cases are idiopathic. History, physical exam, and laboratory testing can provide clues for distinguishing between cramps with identifiable causes and idiopathic cases. For nonidiopathic cass, man agement consists of treating the underlying cause whenever possible. A nonp harmacologic approach (massaging and stretching) is the recommended first-l ine treatment for idiopathic cases. Quinine sulfate also appears to offer s afe and effective symptom management of idiopathic cases, although its effi cacy has not been definitely established in clinical trials.