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Movement and muscles

Muscle cramps

Sudden painful tightening of a muscle that holds for a while and then releases, often in the legs, feet or hands.

The clinical word for this is .

Still being checked

What this is

Cramps are one of the problems people ask about most, and there are recognised things to try. They often come at night or after activity. Most people work through a combination of practical measures and, where cramps are frequent or troublesome, a conversation with a clinician about medicines. If the pattern changes noticeably, that is worth mentioning rather than putting up with.

What people often describe

  • A muscle seizing up suddenly, usually in a calf, foot or hand
  • Cramps waking you at night, or arriving after you have been on your feet
  • Having to stand up or stretch the leg out to break it
  • Soreness in the muscle afterwards, sometimes into the next day

Important distinctions

  • A cramp comes on suddenly and lets go. Stiffness is a muscle that resists being moved and stays that way. The same person can have both, and each is managed differently.

  • Twitching is not cramping. Fasciculations are small visible flickers under the skin, usually painless, and they are a different thing from cramp.

What may help

This page lists options that are used for this problem and says where each one comes from. It is not a ranking, it is not a recommendation, and it is not personalised to you. What suits you is a decision for you and your care team.

Practical and self-management

Things people do themselves, or with whoever is helping them.

  • Keeping fluids up

    Staying hydrated is one of the everyday measures people try first, alongside keeping warm and changing position.

    Discuss with

    Compass explains

Allied health

What a therapist can assess, teach or adjust.

  • Stretching and range-of-motion exercises

    Gentle stretching and keeping the muscle moving is common practice, and a physiotherapist can show you a routine that suits you. It has not been tested in a trial in MND, so it is widely used rather than proven.

    Highlighted: shows the sources for this statement

    Discuss with

    Compass explains

  • Heat or hydrotherapy

    Warmth before movement, and warm-water exercise where it is available and safe for you. Both are offered for comfort, and a physiotherapist advises on whether they suit you.

    Discuss with

    Compass explains

Medicines

Named here only where a guideline names them for this problem.

A medicine is named here only where a published guideline names it for this problem, and the guideline's own words are shown beside it. Compass does not advise on doses, and does not say which medicine is right for anyone.

  • Medicines for muscle problems

    Medicines are an option a doctor can consider when cramps are frequent or troublesome. NICE tells teams to discuss the options available, and to review how a treatment is working at each multidisciplinary assessment.

    Highlighted: shows the sources for this statement
    • Which one suits you depends on your situation and on what else you take. Tell your team about any night-time breathing or sleep symptoms before a medicine is started, and ask how the choice takes your breathing into account.

    Discuss with

    Compass explains

Who may help

Where Compass explains this

Questions

Cards

Other problems

Words explained

About this page

This page lists options that are used for this problem and says where each one comes from. It is not a ranking, it is not a recommendation, and it is not personalised to you. What suits you is a decision for you and your care team.

Evidence for this page

The sources behind the statements on this page, and where to find them. Compass does not decide which option is right for anyone.

  1. Statement 1 of 2. Gentle stretching and keeping the muscle moving is common practice, and a physiotherapist can show you a routine that suits you. It has not been tested in a trial in MND, so it is widely used rather than proven.

    • Qualifies this. Guidelines for the physiotherapy management of MND — Irish Motor Neurone Disease Association · Clinical guideline · 2014

      A physiotherapy guideline for MND records that stretching has not been tested in a randomised trial in this condition. It is widely used practice rather than something the research has settled.

      “No randomised controlled trial of stretching has been looked at in patients with MND.”

      Section 3.4b.2 Evidence, item C

      Link checked August 2026

  2. Statement 2 of 2. Medicines are an option a doctor can consider when cramps are frequent or troublesome. NICE tells teams to discuss the options available, and to review how a treatment is working at each multidisciplinary assessment.

    • Supports this. NICE MND guideline — NICE · Clinical guideline

      NICE tells teams to discuss the treatment options available for muscle problems. It sets out an order of choices, and notes that several were off-label uses when the guideline was published, which is one reason the choice sits with a clinician.

      “Discuss the available treatment options for muscle problems.”

      1.8.1

      Link checked August 2026

    • Supports this. NICE MND guideline — NICE · Clinical guideline

      NICE also says the treatment should be reviewed at multidisciplinary assessments, asking whether it is working and whether there are side effects.

      “Review the treatments for muscle problems during multidisciplinary team assessments, ask about how the person is finding the treatment, whether it is working and whether they have any adverse side effects.”

      1.8.4

      Link checked August 2026