Leg Cramps

Cancer and its treatment may cause problems that lead to patients having leg and other types of muscle cramps.  Leg cramps or spasms are painful tightenings of the muscles in the leg, ankle, or foot. But it's important to know that other non-cancer related conditions and medicines can also cause problems that might cause leg cramps.

Some possible causes of leg cramps in people who have cancer include:

  • Certain chemotherapy, targeted therapy, and immunotherapy drugs
  • Radiation therapy to the lower extremities (hips, legs, etc)
  • Some hormone drugs (tamoxifen or raloxifene)
  • Medications to treat bone loss
  • Tumors that start in a muscle or press on a muscle
  • Having too many white blood cells or treatment given for too few white cells
  • Staying in bed or being inactive for longer than usual
  • Overuse of certain muscles
  • Changes in the temperature around you
  • Peripheral neuropathy or other nerve damage
  • Dehydration
  • Changes in electrolyte (blood chemistry) levels, especially phosphorus, calcium, glucose (sugar), or potassium
  • Non-cancer health problems

What to look for

  • Sudden pain or discomfort in a leg or foot and a tight or stiff muscle
  • Trouble moving the foot, or pain when moving the foot or leg
  • Changes in your quality of sleep if leg cramps happen at night.

Managing leg cramps

Your health care team can create a plan to help improve your sleep and manage leg cramps. One way to manage severe or frequent leg cramps is with a temporary muscle relaxant that can be prescribed by your doctor.

What the patient can do

  • Tell your health care team about any leg cramps. They may be able to give you medicine to help prevent or reduce them, or to manage the pain they cause.
  • Apply heat or cold to legs when they cramp, if it’s OK with your health care team. Ask what kind of heat or cold is best to use and how long you should use it.
  • Keep warm, and change position often.
  • If you are bed-bound, try propping the covers up or using a bed cradle to protect the legs and feet from the weight of the blankets. A bed cradle is a support at the end of the bed that holds the sheets and blankets up off the legs and feet.
  • Exercise your legs in bed by bending and straightening them several times throughout the day. A caregiver can help move your legs for you if you can’t.
  • Gently stretching the muscles before lying down may help prevent cramping.
  • Massage the leg, if it’s OK with your health care team.
  • When you have a cramp, sit up or stand up to stretch the tight muscle as much as you can without hurting it. For example, for a calf muscle cramp, try pointing the toes upward toward the knees, or walk around.
  • Follow your health care team’s instructions for correcting dehydration, or blood level imbalances in calcium, potassium, or phosphorus.

What caregivers can do

  • Help the patient gently stretch the tight muscle if they can’t.
  • Use heat, ice, or a cold washcloth to gently rub the cramped muscle if OK with the health care team and depending on which provides more comfort.
  • If medicines are prescribed to prevent cramping, be sure they are taken as directed and watch for dizziness or stumbling.

Call the health care team if the patient

  • Has a cramped leg that becomes red, swollen, hard, tender or warm.
  • If the patient has pain in the chest, arm, back, shoulder, or jaw, sudden coughing, increased heart rate or feeling light-headed, this can be an urgent problem and you might need to go to the nearest hospital emergency room right away.
  • Has cramping that’s not relieved by cold, heat, massage, or by stretching the cramped muscle (as described above).
  • Has cramping that lasts for more than 6 to 8 hours.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS ONE. 2017;12(6):e0178465. Accessed at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178465 on January 3, 2020.

Karatas F, Sahin S, Tan B.  Leg cramps associated with tamoxifen use-possible mechanism and treatment recommendations.  Journal of Balkan Union of Oncology. 2016;21(2):520-522.

National Comprehensive Cancer Network (NCCN).  Palliative care. Version 2.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf on September 19, 2019.

 

References

Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS ONE. 2017;12(6):e0178465. Accessed at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0178465 on January 3, 2020.

Karatas F, Sahin S, Tan B.  Leg cramps associated with tamoxifen use-possible mechanism and treatment recommendations.  Journal of Balkan Union of Oncology. 2016;21(2):520-522.

National Comprehensive Cancer Network (NCCN).  Palliative care. Version 2.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf on September 19, 2019.

 

Last Revised: February 1, 2020

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