Cramps in the legs

Leg muscle spasms are sudden, strong, painful and involuntary contractions of the muscle. The cramps usually occur at night and affect the legs.

Anyone who has ever woken up because of a sudden cramp in the night or had to stop while walking knows that this complaint can be accompanied by a stabbing muscle pain in the legs. Muscle spasms are usually harmless, but can temporarily prevent the use of the affected muscle.
Long periods of exercise or physical work, especially in the hot season, can cause muscle cramps. The causes include some medication intake and certain diseases. As a rule, muscle cramps can be treated at home with simple means.

Predominantly the muscles in the lower extremities are affected and especially in the calf, the sole of the foot and the big toe. But it can also affect the muscles in the thighs, arms and hands.

Muscle spasms can last from a few seconds to a quarter of an hour or even longer. Not infrequently, a cramp occurs several times before it resolves.
This disorder can partially or completely affect the muscle. But sometimes different muscles that work together are also affected, such as those that bend two adjacent fingers.

Muscle spasms are very common, almost all people (estimated at about 95%) have had a spasm once in their lives.
This disorder is common in adults, especially if they are over 50 years old. But even children can get cramps.


Causes of muscle spasms

The causes of muscle spasms are not always known. Muscle spasms can be caused by many medical conditions or activities, for example:

  • Exercises and muscle overload, especially if the muscles have already accumulated lactic acid.
  • Endurance sports (football, cycling, etc.) without adequate training.
  • Cramps can occur due to decreased minerals such as calcium and magnesium, especially in the last months of pregnancy.
  • Stay in the cold, especially in cold water.
  • Other diseases, such as circulatory problems (peripheral arteriopathy), multiple sclerosis, kidney and thyroid diseases.
  • Long standing on hard ground, long sitting or unfavorable position of the legs during sleep.
  • A lack of potassium, calcium and other minerals in the blood can cause diffuse and persistent spasms.
  • Dehydration, that is, when the body has lost too much fluid.
  • Some diseases such as: diabetes, cirrhosis, Parkinson’s disease, etc.

Do medications cause muscle spasms?

Numerous medications can cause cramps. Diuretics such as furosemide (Lasix) lead to loss of body fluids and can trigger cramps because the body is depleted of fluids and sodium.
Diuretics often lead to loss of potassium, calcium and magnesium.
Medications such as donepezil (Aricept, used for Alzheimer’s disease) and raloxifene (Evista, used to prevent osteoporosis) can cause cramps.
Tolcapone (Tasmar), used in Parkinson’s disease, can cause this disorder in about 10% of patients.
Convulsions have also been reported with nifedipine (Adalat and other medicines used for angina, arterial hypertension and other conditions) and some asthma medications.
Some medications taken to lower cholesterol, such as lovastatin (Mevinacor ®), can cause cramps.

Does vitamin deficiency cause muscle cramps?

Low levels of vitamins in the blood can directly or indirectly lead to muscle spasms.
Thiamine (B1), pantothenic acid (B5) and pyridoxine (B6) play a role in the development of this disorder, although the mechanism is not yet known.

Signs and symptoms of muscle spasms

As a rule, a muscle spasm is very painful and those who are affected by it must interrupt the activity they are currently performing.
When the cramps occur, you are no longer able to use the affected muscle.
In some severe cases, the cramps may be associated with severe pain and swelling that can last up to several days after the spasm has passed.
When the spasm occurs, the muscle becomes hard, painful, and you can observe thickening.
There are no special tests for muscle spasms. Nevertheless, the diagnosis is relatively easy to make. Most people know what cramps are and when one occurs in them.
If a doctor is present during a muscle spasm, he may notice the thickening and hardness of the muscle.

How to treat cramps in the legs?

Almost everyone thinks that the best way to interrupt a spasm is to stretch the muscles.
In fact, stretching the muscle during a spasm is wrong and is the worst thing you can do, because exactly the opposite should be done.
If you stretch a muscle, the body sends the signal to tense it, because in this way overstretching is avoided, which can lead to muscle damage.
If, on the other hand, the muscle ends are brought closer to each other, i.e. the muscle is shortened, the body reacts by relaxing the muscle, with the result that the spasm is interrupted.
In general, it is impossible to actively lengthen or shorten the muscle. This should be done with one arm or ask another person for help.
After the first 10-20 seconds of launching pain, the muscle partially relaxes and becomes less uncomfortable.
At this time, one should massage the affected area to achieve more relaxation.

With a calf cramp, the person concerned should bend the knee and at the same time bring the foot into a plantar flexion, practically kneel and sit on the heels.
In case of writing cramps, you should close your hand into a fist, with your thumb under your other fingers.
In this way, the tension on the finger flexors is released.
A spasm of the quadriceps is solved by bending the back forward, as if you wanted to touch the toes with your fingers.
Another method is used by football players during the game. The athlete lies down with his stomach up on the floor and a teammate lifts his leg stretched in the knee.

When I do unusual bike training, I sometimes get leg cramps and then have to dismount immediately to relax and massage the muscle.
The triggering pain is like a knife stab, but if I don’t massage the muscle, I can’t get back on the bike and keep riding. It usually takes a quarter of an hour before I can get back on the saddle.

Drug treatment Medication is of no use in the treatment
of the spasm, because usually it passes spontaneously even before a medicine has been absorbed.
Treatment of muscle spasms related to a particular disease focuses on treating the underlying disease.
Sometimes additional medications are prescribed for this complaint.
In recent years, botulinum toxin (Botox) has been successfully injected in therapeutic doses for certain localized complaints of muscular dystonia.
A good response to this can last for a few months and the infiltration can be repeated.

Natural remedies for muscle spasms

Massage helps to relax the muscle. The same applies to the application of heat.

Taping for contracture and leg cramps.
Action: relaxing. Shape: a “Y” stripe. Length: from below the heel to the hollow of the knee. Apply the tape without tension, starting just below the heel and stretching the calf. With the tape cover the outer area of the twin muscle bellies.

If the spasm is associated with fluid loss, as is often the case with strenuous physical activity, fluid and mineral salts, especially sodium and potassium, must be returned.

However, if the spasms are frequent, severe and persistent and have little response to routine treatments or there is no apparent reason for their occurrence, then the doctor and patient must consider more aggressive therapy or consider that the spasms are the symptom of another condition.

There are many possibilities. The patient may have problems with:

  • Circulation
  • Annoy
  • Metabolism
  • Hormones
  • Medicines
  • Nutrition.

Pregnancy: Magnesium and calcium supplements have been shown to help and prevent muscle spasms during pregnancy.
An adequate supply of these two minerals during pregnancy is important, but the supervision of a healthcare professional is essential.

Occupational spasm is a movement disorder in which prolonged involuntary contractions of the muscles occur. It is caused by repetitive movements that are not too vigorous or by incorrect posture.

These cramps (for example, the writing spasm) are triggered by the type of activity and can be prevented or minimized by paying attention to ergonomic factors, such as wrist rests, avoiding high heels on the shoes, regulating chair positions, interrupting the activity and taking a more comfortable position during work.
Learning to avoid strong tension during the performed activity can help. Nevertheless, the unpleasant cramps can persist if the activities are difficult to change, for example when playing a musical instrument.

Rest: Cramps that occur at night and at rest can be prevented by a program of stretching exercises, especially if they are performed before bedtime.

Also, simple stretches from the calf while standing, held for 10-15 seconds and performed two or three times before bedtime, are a great help in preventing nocturnal cramps.
The process can be repeated every time you get up to the toilet at night and also once or twice during the day.
If the nocturnal cramps are severe and occur repeatedly, you can put on an orthosis to prevent the feet from adopting an incorrect posture during sleep.
It is important to wear comfortable shoes with a custom-made insole during the day.

Another important aspect of preventing nocturnal cramps is taking extra magnesium and calcium.
The blood level could be insufficient for the demands of the body.

Prevention of leg cramps

Until you know the exact causes of muscle spasms, it’s difficult to understand how to prevent them.

Combined Kinesio Taping for the Anterior Thigh Muscles

Combined application to the medial vastus and lateral vastus muscles. Useful in case of fatigue of the quadriceps, double contracture of the external and internal quadriceps or muscle stiffness.

Some recommendations are given by professionals and athletes alike:

  • Improve fitness and prevent muscle fatigue.
  • Pursue a step-by-step training program to avoid overexertion unless prepared.
  • Regular stretching exercises after training.
  • Warm up well before training and competitions, especially the legs.
  • Stretch calf muscles: take the position of the lunge, i.e. take a big step forward from a standing position, bend the front leg, the other points backwards and remains stretched in the knee.
  • Stretching the thigh biceps: the best position not to strain the back is to sit on the floor with your legs outstretched and try to reach the tips of your toes with your hands.
  • Stretching the quadriceps muscles: when standing, grasp the ankle with the opposite hand and carefully pull the heel towards the buttocks. (Repeat with the other leg).

Most muscle spasms are not of a serious nature.
If they are very painful, occur frequently or cause anxiety, one should consult the doctor.

Before training, you should not eat, or limit yourself to foods that are easily digestible, such as fruit.

You can adjust your diet, especially in summer, to maintain adequate levels of vitamins, antioxidants and mineral salts (potassium, magnesium and calcium).
Bananas are rich in potassium, milk and dairy products contain plenty of calcium, while for magnesium whole grains and dried fruits are recommended: nuts, almonds, wheat bran, beans, roasted peanuts, peeled millet and corn.

If no treatment is given, a muscle will be painful for a few days after a spasm because there is a contracture.
Physiotherapy is very useful because it releases contractures and prevents further disorders of the muscles.
The physiotherapist may perform massage therapy or Tecar therapy to relax the muscles.

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