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Paul Cutler, MD
Jefferson Medical College Philadelphia

JAMA. 1985;253(6):776.

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In Reply.—

Dr Sugar believes that lumbar spondylosis could be a common cause of nocturnal cramps and suggests this hypothesis be tested in any low-back pain clinic. I would urge that he do so; anecdotal data have little value. Having searched the literature and textbooks, nowhere do I find nerve root irritation to be a cause of night cramps. Leg pain and low-back muscle spasm—yes! Leg pain and leg muscle spasm—no! The coincidence of night cramps and lumbar spondylosis may simply represent the concurrence of two common but unrelated problems in the elderly.

The theory presented by Dr Sugar seems plausible, but it is not substantiated by clinical research or published material. Furthermore, the pharmacologic reasons for the beneficial effects of quinine and diphenhydramine are far more complex than their actions on the myoneural junction. . . . [Full Text PDF of this Article]

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