About Muscle Cramps

Causes of Muscle Cramps

Muscle cramps are painful, but there are ways in which they can be prevented. A cramp is when the muscle spasm is “forceful and sustained”. Muscle cramps and spasms are painful to those who suffer from them. The most common locations for cramps and spasms are in the quadriceps, calves, hamstrings, back, hands, arms, and feet.

It is thought that cramps can come from fatigued muscles and not enough stretching prior to the patient’s engagement in prolonged physical activity. Overexertion, poor fitness, and dehydration are other potential causes. Medications can deplete the body’s store of magnesium, sodium, and potassium, which could also be a factor in contributing to the development of muscle cramps. Certain types of injuries and medical conditions might also lead to cramps and spasms.¹

Typically, cramps are experienced by the patient at night or after exercise. They may also be related to the presence of a pinched nerve in the back or neck, or a spinal cord injury.² The sharp pains can last anywhere from seconds to minutes of ongoing pain. Cramps may be accompanied by the feeling of a physical “lump of muscle tissue” under the skin.³ Sometimes cramps are called “charley horses”. Cramps can affect any area of the body, including the abdomen and rib cage muscles. Those who are pregnant might get cramps from a calcium deficiency.

Medications can have a known side effect of cramps, such as Aricept, which is used for Alzheimer’s disease, statin medications, which are taken for cholesterol management, Tasmar, which helps to manage the effects of Parkinson’s disease, Procardia, which is taken for angina and blood pressure, Evista, which is supposed to relieve osteoporosis, and certain asthma medications, such as albuterol. Patients should always check the side effects of any medication that they plan to take in order to expect any possible issues.⁴

What Types of Cramps Are There?

There are a few types of cramps which might afflict patients. True cramps occur as a result of the situation where nerves are over-excited and affect the muscles, especially skeletal muscles. These are the cramps which are caused by dehydration, injury, vigorous activity, and resting (night cramps). Tetany, or tetanic cramps, are when the nerves are hyperexcited due, for example, to low calcium and magnesium. Contractures are when the muscles are unable to relax on their own and are in constant spasm. Low ATP (adenosine triphosphate), the energy source of the cell, is the cause of this continuous cramping. Finally, dystonic cramps are when unneeded muscles are stimulated and contract. Often this may be from repetitive activities, such as writer’s cramp or repetitive stress from regularly using a mouse and keyboard for an extended period of time.⁵

Prevention and Treatment

To find relief in the case of leg cramps, flex the toes upward, immediately, then alternately flex and point the toes. The patient should repeat this motion until they begin to experience relief. If these leg cramps happen at night, getting up and walking around briefly may help to improve circulation. The patient should not perform too many tasks when they get up, as the stimulation could make falling back asleep more difficult. One stretch would be to stand, putting the leg which is not cramped in front, with the cramped leg behind, bending the knee of the front leg, and stretching the cramped calf. It may be helpful for some patients to balance on a wall.

Another type of stretch would be to stand straight, with the feet apart (hip width), holding onto a wall with the arms shoulder-width apart, and then leaning forward on bent elbows to stretch both calves.

One can perform self-massage by placing the cramped leg over the opposite thigh and massaging the muscle. Applying a warm compress or taking a warm shower may also help release some of the tension. Drinking 1-2 glasses of water is also important, because cramping may come from dehydration. Getting enough calcium, magnesium, and potassium in the diet is important. Quinine may also be useful as a supplement when used in moderation.

Another way to prevent muscle cramps is to wear shoes which feature proper arch support and cushioned foot beds. Some people may need compression stockings. It may help to use a pillow to prop up the knees in bed.

Before exercising, it is important to stretch and warm up properly. Performing especially vigorous activity without giving the body time to warm up and stretch out could cause injury even beyond cramping. Prevention and proper care are important so that a cramp does not lead to tears in tendons or muscles.⁶

In terms of dietary changes, avoiding soda, chocolate, caffeine, alcohol, and excessive sodium can improve the levels of calcium and magnesium in the body. Vitamin E may also be helpful. Having good posture can also relieve back pain.⁷