Acupressure for Muscle Cramps

MedlinePlus describes a muscle cramp as a muscle that tightens (contracts) on its own and does not relax. The calf, the back of the thigh and the front of the thigh are the most common places, but the feet, hands, arms, abdomen and the muscles along the ribs cramp too. The muscle may feel hard or bulging.

Cramps are common and often follow overuse or injury. Exercising without enough fluids, or with low levels of minerals such as sodium, potassium or calcium, makes them more likely. They can also come with pregnancy, menstruation, some medicines, alcoholism, an underactive thyroid or kidney failure.

The Cramps page is the reference; this post explains the routine and the evidence behind it. Cramping in the belly has its own pages: PMS and Period Pain and Stomach Cramps.

MedlinePlus puts it plainly: a cramp may be stopped by stretching the muscle. When one starts, stop what you are doing, then stretch and massage the muscle. Heat relaxes the muscle as the spasm begins; ice may help once the pain has eased. The routine below starts the same way, and the points come after.

A 2021 Cochrane review looked for trials of non-drug, non-invasive therapies for leg cramps, tested for at least four weeks, in anyone except pregnant women. It found three trials with 201 people, all aged 50 or older, and all three tested stretching. None tested acupressure.

• Daily calf and hamstring stretching for six weeks may make night-time leg cramps less painful in people aged 55 and older (low-certainty evidence). Whether it makes them less frequent is very uncertain.
• Calf stretching alone for 12 weeks may make little or no difference to how often night-time cramps come, in people aged 60 and older.

So little high-quality research exists on acupressure for cramps. The points below are tradition, labelled as such.

Traditional use: in TCM, points such as SP-6 and ST-36 are traditionally used for muscle cramps. Each point's page shows where to find it and when to skip it.

• Main points: SP-6 Three Yin Intersection (Sān yīn jiāo) on the inner lower leg, and ST-36 Leg Three Miles (Zú sān lǐ) below the knee.
• For leg cramps: GB-34 Yang Mound Spring (Yáng líng quán) below the outer side of the knee.
• For calf cramps: BL-57 Support the Mountain (Chéng shān) on the back of the calf.
• For back cramps: GV-8 Sinew Contraction (Jīn suō) on the spine, if you can reach it.
• When stress plays a part: LR-3 Great Rushing (Tài chōng) on the top of the foot. Optional: KI-3 Supreme Stream (Tài xī) at the inner ankle.
• For cramping in the lower belly: CV-4 Gate of Origin (Guān yuán) and CV-6 Sea of Qi (Qì hǎi), below the navel. The period pain post covers them in more detail.

The Cramp routine has the order and timings, 5 to 7 minutes in all. The idea behind it: stretch the cramping muscle first, then press the main points, which sit on the lower leg rather than on the knotted muscle. The local points come last, and lightly. GV-8 is light contact only, never pressing through a spasm. Find BL-57 once the cramp has let go: its page finds it by pointing the foot, which tightens the calf.

1. Stop your activity and gently stretch and massage the muscle.
2. Press SP-6 with firm, steady pressure for 1 to 2 minutes.
3. Press ST-36 for 1 minute on each leg.
4. For leg cramps, add GB-34 with moderate pressure, and stop if the leg cramps.
5. For calf cramps, add BL-57 with gentle, steady pressure.
6. For back cramps, rest a fingertip lightly on GV-8.
7. If stress is part of it, add LR-3, pressing beside the pulse rather than on it. KI-3 is optional.
8. For cramping in the lower belly, massage CV-4 and CV-6 in gentle circles, never deep.

If you are new to it, hold each point for 15 to 30 seconds and work up to 1 to 2 minutes. Pressure should be firm but never painful.

Pregnancy: leg cramps are common in pregnancy, but SP-6, CV-4 and CV-6 are not pressed during pregnancy. Leave them out and keep to stretching and the other points.

Skip: SP-6 and ST-36 after leg surgery; ST-36 with an injury or infection of the lower leg. GB-34 with a severe leg injury or a blood clotting disorder. LR-3 after foot surgery or with very low blood pressure. KI-3 after ankle surgery or with a fresh sprain. GV-8 during a seizure or over injured tissue. CV-4 and CV-6 with sudden, severe or inflamed belly pain, or after abdominal surgery. Don't press on broken, irritated or blistered skin, bruises or new scars. If you have a bleeding or clotting disorder or low platelets, press more lightly and for less time, or ask your doctor first.

MedlinePlus suggests:

• drinking fluids: during sport, not drinking enough is the most common cause of cramps. Water alone does not always help, and sports drinks also replace lost minerals;
• drinking plenty of fluids while you exercise;
• exercising within your ability;
• stretching to improve flexibility.

MedlinePlus says to contact your provider if your cramps:

• are severe;
• do not go away with simple stretching;
• keep coming back;
• last a long time.

A provider will ask about pregnancy, fluid loss (vomiting, diarrhea, heavy sweating, passing a lot of urine), your medicines, exercise and alcohol, and may check your blood for calcium, potassium and magnesium, and your kidney and thyroid function. Cramps that keep coming back can point to one of these causes, so acupressure is not a reason to wait. See also when not to self-treat.