Cramping Pain: What Causes Cramps and How to Stop Them

Two kinds of cramping pain

What causes cramps in the hands and fingers

Hand and finger cramps are a common search because they are disabling: fingers curl or lock and cannot straighten. The main causes:

Overuse and fatigue

Long periods of writing, typing, gaming, gripping tools, playing an instrument or gardening tire the small muscles of the hand. Cramps come during or after the activity and settle with rest.

Dehydration and electrolyte imbalance

Heavy sweating, vomiting, diarrhea, diuretics (water pills) and drinking too little can lower body water and minerals. Cramps in the hands, along with tingling around the mouth, are a classic sign of low calcium (hypocalcemia), which can follow thyroid or parathyroid surgery, low vitamin D or kidney disease. Low magnesium (hypomagnesemia) and low potassium also cause cramps. In hypocalcemia, the hand may curl into a characteristic spasm with the thumb drawn in (carpopedal spasm).

Nerve compression and nerve damage

• Carpal tunnel syndrome: numbness, tingling and cramping in the thumb, index and middle fingers, often at night.
• Ulnar nerve compression at the elbow: affects the ring and little fingers.
• A pinched nerve in the neck can cause cramps and weakness in one hand.
• Peripheral neuropathy from diabetes or other causes.

Constant cramps in one hand, such as the left hand and fingers, are more likely to come from a local cause like nerve compression, overuse or focal dystonia than from a body-wide problem like low minerals, which usually affects both sides.

Focal hand dystonia (writer's cramp)

A neurological condition where the hand muscles cramp or twist only during a specific task, such as writing or playing an instrument. It is painless or mildly painful, and the hand works normally for other tasks. A neurologist can diagnose it, and botulinum toxin injections help many people.

Arthritis and tendon problems

Arthritis, trigger finger and Dupuytren's contracture can make fingers stiff or locked, which people often describe as cramping.

Other causes

• cold hands, Raynaud's phenomenon
• medicines such as diuretics, statins and some asthma inhalers
• thyroid disease, kidney disease and pregnancy
• rarely, motor neuron disease, where cramps come with muscle twitching and wasting

See hand or finger cramps for more detail.

Leg and foot cramps

Night-time calf and foot cramps are very common, especially after 50 and in pregnancy. Most have no identifiable cause. Contributors include muscle fatigue, prolonged sitting or standing, dehydration, diuretics, statins, diabetes, kidney disease and peripheral artery disease. Calf cramping pain that comes on with walking and eases with rest is different: it suggests narrowed leg arteries (claudication). See leg cramps.

Abdominal and pelvic cramping

• Gas, indigestion and constipation: short-lived cramps relieved by passing gas or stool.
• Gastroenteritis: cramps with diarrhea and vomiting.
• Irritable bowel syndrome: recurring cramps linked to bowel habit changes.
• Period pain (dysmenorrhea): lower belly cramps starting just before or with bleeding.
• Kidney stones: waves of severe pain from the back or side to the groin.
• Gallstones: steady pain under the right ribs after fatty meals.
• Bowel obstruction: worsening colicky pain with vomiting and a swollen belly. An emergency.
• Pregnancy: mild cramps are common, but cramps with bleeding need prompt review.

How doctors find the cause

A doctor will ask where the cramps are, when they happen, how long they last, what triggers them, and about medicines, fluids, alcohol and other symptoms such as numbness or weakness. Examination may include checking strength, reflexes, sensation, pulses and the abdomen.

Tests can include:

• blood tests for calcium, magnesium, potassium, sodium, kidney and thyroid function, blood sugar and creatine kinase
• vitamin D level
• nerve conduction studies for suspected nerve compression
• ultrasound or CT for abdominal cramps

How to stop a cramp

For a muscle cramp:

• Stretch the muscle gently. For hand cramps, straighten the fingers and press the palm flat on a table, or gently pull the fingers back. For calf cramps, pull your toes toward you.
• Massage the knotted muscle.
• Apply heat to relax the muscle, or ice afterwards for soreness.
• Drink fluids if you have been sweating, vomiting or have diarrhea.

For belly cramps, a heating pad and over-the-counter pain relief may help. Ibuprofen or naproxen work well for period cramps. Follow the label dose and avoid NSAIDs if you have stomach ulcers or kidney disease.

Preventing cramps

• take regular breaks and stretch during repetitive hand tasks
• use ergonomic pens, keyboards and tool grips
• stay hydrated in heat and during exercise
• stretch calves before bed if you get night cramps
• ask your doctor to review medicines that may cause cramps

Quinine is no longer recommended for routine leg cramps in the US because of serious side effects.

Frequently asked questions

What causes cramps in the hands and fingers?

Common causes are overuse from writing, typing or gripping, dehydration, low calcium, magnesium or potassium, nerve compression such as carpal tunnel syndrome, and cold. Focal dystonia (writer's cramp) causes cramping only during specific tasks. Arthritis and trigger finger can feel similar.

Why do I have constant cramps in my left hand and fingers?

Cramps in one hand usually have a local cause: overuse, carpal tunnel or ulnar nerve compression, a pinched nerve in the neck, or focal dystonia. If one-sided hand cramping comes with weakness, numbness or facial changes, seek urgent care. Otherwise see a doctor for nerve and blood tests.

What does cramping pain mean?

Cramping pain means a muscle is contracting hard and not relaxing. In the limbs it is a muscle cramp. In the belly it is colicky pain from the gut, womb or urinary tract squeezing in waves. The location and pattern point to the cause.

Can low magnesium cause hand cramps?

Yes. Low magnesium and low calcium both make nerves and muscles overexcitable, causing cramps, twitching and tingling, often in the hands and around the mouth. A blood test can check both. Do not take high-dose supplements without advice, especially if you have kidney disease.

When should I worry about muscle cramps?

See a doctor if cramps are frequent, severe, disturb sleep, come with weakness, numbness, muscle wasting or twitching, follow a new medicine, or occur in one hand only. Seek emergency care for cramps with dark urine, stroke signs or severe belly pain with vomiting.