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Calambres musculares.

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 17 Jul 2025
Last updated: 21 May 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
  • inicio nocturno (calambre idiopático)
  • afectación del músculo gemelo con o sin afectación del pie (calambre idiopático)
  • duración <10 minutos (calambre idiopático)
  • unilateral (calambre idiopático)
  • desencadenamiento tanto por parte de los movimientos triviales como de las contracciones fuertes (calambre idiopático)
  • bulto muscular visible o palpable
  • buena respuesta al estiramiento activo/pasivo (calambre idiopático)
  • examen neurológico normal (calambre idiopático)
  • exploración física general normal (calambre idiopático)
  • afectación de otro músculo local (calambre de enfermedad neuromuscular)
  • calambres musculares generalizados (enfermedad de la neurona motora inferior)
  • duración >10 minutos (causa orgánica)
  • examen neurológico anormal (causa orgánica)
  • examen osteomuscular anormal (causa orgánica)
Full details

Other diagnostic factors

  • síntomas de enfermedades crónicas (causa orgánica)
Full details

Risk factors

  • embarazo
  • ejercicio extenuante
  • hemodiálisis
  • cirrosis
  • uso de imatinib
  • uso de betabloqueantes con actividad simpaticomimética intrínseca
  • edad >60 años
  • sexo femenino
  • antecedentes familiares de calambres
  • uso de estatinas
  • uso de otros fármacos que pueden causar calambres musculares
  • hipoglucemia en pacientes con diabetes mellitus
  • enfermedades crónicas
  • nutrición parenteral domiciliaria
Full details

Diagnostic tests

1st tests to order

  • diagnóstico clínico
Full details

Tests to consider

  • hCG en suero u orina
  • perfil metabólico sérico en ayunas
  • hormona estimulante de la tiroides (TSH)
  • HbA1c
  • pruebas de la función hepática séricas
  • tiempo de protrombina (TP) e INR
  • mioglobina sérica y análisis de orina
  • creatina cinasa (CK)-MM en suero
  • alfatocoferol sérico (vitamina E)
  • zinc sérico
  • electromiograma
  • estudios de conducción nerviosa
  • aldolasa sérica
  • biopsia muscular
  • estudios genéticos
Full details

Treatment algorithm

ONGOING

calambres idiopáticos

asociados con el ejercicio

asociados con la hipoglucemia en diabetes mellitus

asociados al embarazo

asociados a la diálisis

asociados con la cirrosis

asociados con la esclerosis múltiple o la enfermedad de la neurona motora inferior

asociados con un síndrome hereditario

asociados con los medicamentos

Contributors

Authors

Michael Rubin, MD, FRCP(C)

Professor of Clinical Neurology

Weill Cornell Medical College

Attending Neurologist

Director, Neuromuscular Service and EMG Laboratory

New York Presbyterian Hospital

New York

NY

Disclosures

MR states that he has no competing interests.

Acknowledgements

Dr Michael Rubin would like to gratefully acknowledge Dr Justin Mhoon and Dr David R.P. Guay, previous contributors to this topic. JM declares that he has no competing interests. DRPG is an author of a reference cited in this topic.

Peer reviewers

Timothy M. Miller, MD, PhD

Assistant Professor of Neurology

Department of Neurology

Washington University School of Medicine

St. Louis

MO

Disclosures

TMM is an author of a reference cited in this topic.

Sami Khella, MD

Physician

Department of Neurology

Penn Presbyterian Medical Center

University of Pennsylvania Health System

Philadelphia

PA

Disclosures

SK declares that he has no competing interests.

Felicity Goodyear-Smith, MB CHB, DipObs, MGP, FRNZCGP, MFFLM, RCP

Professor and Goodfellow Postgraduate Chair

Department of General Practice & Primary Health Care

University of Auckland

Auckland

New Zealand

Disclosures

FG-S declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Katzberg HD. Case studies in management of muscle cramps. Neurol Clin. 2020 Aug;38(3):679-96. Abstract

Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-32.Full text  Abstract

Maughan RJ, Shirreffs SM. Muscle cramping during exercise: causes, solutions, and questions remaining. Sports Med. 2019 Dec;49(suppl 2):115-24. Abstract

Zhou K, West HM, Zhang J, et al. Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev. 2015;(8):CD010655.Full text  Abstract

Maquirriain J, Merello M. The athlete with muscular cramps: clinical approach. J Am Acad Orthop Surg. 2007;15:425-431. Abstract

Garrison SR, Korownyk CS, Kolber MR, et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev. 2020 Sep 21;(9):CD009402.Full text  Abstract

El-Tawil S, Al Musa T, Valli H, et al. Quinine for muscle cramps. Cochrane Database Syst Rev. 2015;(4):CD005044.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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