Pickle Juice for Muscle Cramps?

Exercise-associated muscle cramps are common, involuntary spasms and contractions of muscles that usually occur during or following exercise. For over a century, the leading theory on the cause of cramps is the “electrolyte-depletion and dehydration theory”—where electrolytes, such as sodium (Na+) and potassium (K+), and water are lost through sweating. A traditional remedy is pickle juice, which in small amounts, is claimed to reduce cramps within 30 seconds. 

A Big Dill?

The secret supposedly lies in the high concentrations of sodium (salt) in the brine. This was first put to the test back in 2010, using electrical stimulation to induce cramping in the big toe, and then as quickly as possible, participants drank 1 milliliter per kilogram of body weight of either pickle juice or deionized water [1]. For a 150-pound person, that would be nearly 70 milliliters or 4.5 tablespoons.

As shown, after nearly 90 seconds (not as quick as the proposed 30 seconds), pickle juice was more effective in reducing the duration of cramps than water—compared to when each group had no pickle juice or water—by about 68 seconds. However, the pickle juice did not impact the intensity of the cramp.
Interestingly, the amount of electrolytes in the pickle juice could only restore 2% of what was lost during exercise, thus an unlikely mechanism. So, the authors concluded, “How pickle juice decreases cramp duration is unknown.”

This finding was supported in the PICCLES intervention for cramp reduction in cirrhosis patients, since cramps can be one of the strongest independent impacts on health-related quality of life. [2] “Participants were instructed to keep pickle juice (or tap water) on their person for 28 days. … If a cramp occurred, they were instructed to record the time, location, and duration of the muscle cramp. Patients were instructed to drink approximately 1 tablespoon of pickle juice or 1 small sip from the squirt bottle at the onset of a cramp.”

Cramp severity was measured on a zero to ten visual analog scale, where zero means no cramps and ten means worst cramps imaginable. This scale was measured between water and pickle juice groups when they enrolled in the study, and at day 28. On average, however, there was large variation from each mean, suggesting wide differences in how individuals responded to the treatments. This is a common theme of pickle juice and cramp research.

Seal the Dill?

So, with the souring of the electrolyte-depletion theory, It is now concluded that, “ … in the absence of any effect of the ingested pickle juice on circulating electrolyte concentrations, the mechanism by which pickle juice shortened cramp duration involved activation of receptors in the oropharyngeal region that resulted in a reduced firing rate of alpha motor neurons that innervate the affected muscle.” [3]

In other words, this current theory claims there are receptors in the mouth, oropharynx, esophagus, and stomach (called transient receptor potential [TRP] receptors) that pickle juice, perhaps the vinegar, acetic acid, and/or salt, might activate, and in turn trigger a neurological reflex that inhibits the cramp. In theory, then, simply using pickle juice as a mouth rinse should work as well as ingesting it. However, while trending as if the mouth rinse was reducing cramp time, there was not a statistically significant difference in cramp time or discomfort; likely due, again, to the large variation in individual responses, as shown by the standard deviation bars. [4]

The Real Dill?

In the end, the proposed pathogenesis or development of exercise-associated muscle cramps is complex [5]. Based on the evidence the effect of pickle juice to reduce exercise-induced muscle cramps is “plausible,” but with limited effect that varies greatly between individuals.

 References

1. Miller, K. C., Mack, G. W., Knight, K. L., Hopkins, J. T., Draper, D. O., Fields, P. J., & Hunter, I. (2010). Reflex inhibition of electrically induced muscle cramps in hypohydrated humans. Med Sci Sports Exerc, 42(5), 953-961.
2. Tapper, E. B., Salim, N., Baki, J., Zhao, Z., Sundaram, V., Patwardhan, V., & Nikirk, S. J. (2022). Pickle juice intervention for cirrhotic cramps reduction: The PICCLES randomized controlled trial. Official journal of the American College of Gastroenterology, 117(6), 895-901.
3. Maughan, R. J., & Shirreffs, S. M. (2019). Muscle cramping during exercise: causes, solutions, and questions remaining. Sports Medicine, 49(2), 115-124.
4. Georgieva, J., Brade, C. J., Ducker, K. J., Davey, P., Jacques, A., Ohno, M., & Lavender, A. P. (2021). Effectiveness of Mouth Rinsing versus Ingesting Pickle Juice for Alleviating Electrically Induced Cramp in Physically Active Adults. Applied Sciences, 11(24), 12096.
5. Miller, K. C., McDermott, B. P., Yeargin, S. W., Fiol, A., & Schwellnus, M. P. (2022). An evidence-based review of the pathophysiology, treatment, and prevention of exercise-associated muscle cramps. Journal of Athletic Training, 57(1), 5-15.