AbstractBackgroundMuscle cramps are common among persons with cirrhosis and are associated with poor health‐related quality of life (HRQOL). Treatment options are limited. We compared stretching or meditation in a randomized‐controlled trial (RCT).PatientsWe enrolled 98 patients with a history of >4 muscle cramps in the prior month from 7/22–7/23. We randomized patients 1:1 to stretching versus meditation for 35 days. Our primary outcome was the change in cramp severity measured by the visual analogue scale for cramps (VAS‐cramps, scaled 0–10). Secondary outcomes included a patient global impression of change (PGIC), change in sleep quality and global HRQOL measured using the EQ‐5D and VAS‐global HRQOL.ResultsOverall, 48% of patients had cirrhosis, 40% had diabetes, 16% the median age was 63, most were women (67%) and 81% were college educated. Both arms experienced a reduction in cramp severity—a median of 1.44 (.58–2.29) points for stretching and 1.97 (1.01–2.93) points for meditation. These changes were significant changes from baseline (p = .001 for stretching, p < .0001 for meditation) but these changes were equivalent between arms (p = .4). The PGIC was improved: 1.33 (1.02–1.65) for stretching, 1.05 (.70–1.41) for meditation, p‐difference .2. Sleep was also improved for both. HRQOL did not change according to the Eq5D; according to the VAS, HRQOL rose for meditation by 6 (.1–11.8) points but not for stretching. More patients recommended stretching than meditation (79.2% vs. 55.3%, p = .02).ConclusionIn a randomized trial, stretching and meditation both reduced cramp severity and improved sleep quality and global impression of change. While patients preferred stretching, there was no difference in effect between arms.