Muscle Cramps: Causes | Prevention

Muscle cramps are painful, but they can be prevented.

Causes of Muscle Cramps

A cramp is when the muscle spasm is “forceful and sustained”. Muscle cramps and spasms are painful. The most common locations for cramps and spasms are the quadriceps, calves, hamstrings, back, hands, arms, and feet. It is thought that cramps can come from fatigued muscles and not enough stretching. Overexertion, poor fitness, and dehydration are other potential causes. Medications can deplete the body of magnesium, sodium, and potassium, which can lead to muscle cramps. Certain injuries and medical conditions can also lead to cramps and spasms.¹ Typically, cramps are experienced at night or after exercise. They may also be related to a pinched nerve in the back or neck, or a spinal cord injury.² The sharp pains can last seconds or minutes. Cramps may be accompanied by a “lump of muscle tissue” under the skin.³ Sometimes cramps are called “charley horses”. Any area of the body can be affected by cramps, including the abdomen and rib cage muscles. Pregnant women can get cramps from a calcium deficiency. Medications can have a sideeffect of cramps, such as Aricept (for Alzheimer’s disease), statin medications (for cholesterol), Tasmar (for Parkinson’s disease), Procardia (for angina and blood pressure), Evista (for osteoporosis), and certain asthma medications, such as albuterol.⁴ There are a few types of cramps. True cramps are when nerves are over-excited and affect the muscles, especially skeletal muscles. These are the ones 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 can’t relax and are in constant spasm. This is caused by low ATP (adenosine triphosphate), the energy source of the cell. Finally, dystonic cramps are when unneeded muscles are stimulated and contract. Often this may be from repetitive activities (i.e., writer’s cramp).⁵

Prevention and Treatment

In the case of leg cramps, relief can be found by flexing the toes upward, immediately, then alternately flexing and pointing the toes. If these leg cramps happen at night, getting up and walking may help to improve circulation. One stretch would be to stand, putting the uncramped leg in front, with the cramped leg behind, bending the knee of the front leg, and stretching the cramped calf. It may be helpful 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. Self-massage can be performed 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. 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. Another way to prevent muscle cramps is to wear shoes with 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. Prevention and proper care are important so that a cramp doesn’t 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