Cramp, characterized by a sudden, brief, intense, burst-like, involuntary contraction of muscle with pain, is a very common phenomenon, and mostly happens as a form of benign conditions like nocturnal leg cramps or exercise-associated muscle cramps in otherwise healthy people. Recent series of electrophysiological studies suggest that hyperexcitability of motor neurons induced by muscle afferent input is a main driving force of development of cramps. Detailed history taking and bedside neurological evaluation are sufficient in most case not only for differentiation from other similar complaints such as myalgia, paresthesia, but also for limiting the potential causes for the cramp. If neither associated with neuromuscular or medical disorders, nor precipitated by a certain factor, recurrent cramps should be managed with regular stretch exercise firstly as both preventive and abortive measure. Cases with cramps refractory to stretch exercise then may be managed with various agents like carbamazepine, gabapentin, and so on.
