Muscle cramps in the legs, symptoms and therapy

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

Who ever because of who has woken up from a sudden cramp at night or had to stop while walking knows that this complaint can be accompanied by a sharp muscle pain in the legs. Muscle cramps are usually harmless, but can temporarily prevent the affected muscle from being used.
Long training times 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.

Leg cramps
© fotolia.com

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

Muscle cramps can last from a few seconds to a quarter of an hour or longer. It is not uncommon for a cramp to appear several times before it resolves.
This disorder can partially or completely affect the muscle. But sometimes different muscles that work together are affected, such as those that bend two adjacent fingers.

Muscle cramps are very common, almost all people (an estimate of around 95%) have had a cramp once in their life.
This disorder is common in adults, especially if they are over 50 years old. But children can also get cramps.

Causes of muscle spasms

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

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

Medications cause muscle spasms?

Numerous medications can cause cramps. Diuretics such as furosemide (Lasix) lead to loss of body fluids and can cause 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 in Alzheimer’s disease) and Raloxifene (Evista, to prevent osteoporosis) can cause cramps.
Tolcapone (Tasmar), used in Parkinson’s disease, can cause this disorder in about 10% of patients.
Cramps have also been reported with nifedipine (Adalat and other medicines used to treat angina, arterial hypertension and other diseases) and with some asthma medications.
Some medications used to lower cholesterol, such as lovastatin (Mevinacor ®), can cause cramps.

Causes vitamin deficiency muscle cramps?

A low level of vitamins in the blood can directly or indirectly lead to muscle cramps.
Thiamine (B1), pantothenic acid (B5) and pyridoxine (B6) play a role in the development of this disorder, even if the mechanism is not yet known.

Signs and symptoms of muscle cramps

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

How to treat leg cramps?

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

In the case of 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 cramps, one should close the hand into a fist, with the thumb under the other fingers.
This releases the tension on the flexors of the fingers.
A quadriceps cramp can be relieved by bending your back as if you wanted to touch the toes with your fingers.
Another method is used by soccer players during the game. The athlete lies on the floor with his stomach up and a team-mate raises his leg stretched in the knee.

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

Medication
Medicines are of no use in the treatment of the cramp, because this usually passes spontaneously before a medicine has been absorbed.
The treatment of muscle spasms associated with a particular disease focuses on the treatment of 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 symptoms of muscular dystonia.
A good reaction to this can last for a few months and the infiltration can be repeated.

Natural remedies for muscle cramps

Massage helps relax the muscle. Likewise the application of heat.

Taping for leg cramps
© Massimo Defilippo

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

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

However, if the cramps are common, severe, and persistent, and do not respond well to routine treatments, or if there is no apparent reason for their occurrence, then the doctor and patient must consider more aggressive therapy or consider that the cramps are the symptom of another condition.

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

circulation,
annoy,
metabolism,
hormones,
drugs,
nutrition.

pregnancy: Magnesium and calcium supplements have shown that they can help and prevent muscle cramps during pregnancy.
Adequate supply of these two minerals during pregnancy is important, but supervision by a healthcare professional is essential.

The occupational cramp is a movement disorder in which there are prolonged involuntary contractions of the muscles. It is caused by repetitive, not too vigorous movements or incorrect posture.

These cramps (for example, the cramp of writing) are triggered by the nature of the activity and can be prevented or minimized by taking ergonomic factors into account, such as wrist supports, avoiding high heels on the shoes, adjusting the chair positions, interrupting the activity and taking it a more comfortable position while working.
Learning to avoid severe tension during the job can help. Nevertheless, the uncomfortable cramps can persist if the activities are difficult to change, for example when playing a musical instrument.

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

Even simple stretching of the calf while standing, which is held for 10-15 seconds and performed two or three times before bed, is one size Help prevent cramps at night.
The process can be repeated every time you get up to the toilet at night and once or twice during the day.
If the night cramps are severe and occur repeatedly, an orthosis can be put on to prevent the feet from adopting an incorrect posture during sleep.
It is important to wear comfortable shoes with a custom-made insert during the day.

Another important aspect to prevent nighttime cramps is the intake of additional 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 cramps, it’s difficult to understand how to prevent them.

Combined kinesio taping for the front thigh muscles

Combined application on the vastus medialis and vastus lateralis. Useful in case of quadriceps fatigue, double contracture of the outer and inner quadriceps or in case of muscle stiffness.

Some recommendations are given by professionals and athletes alike:

Improve fitness and avoid muscle fatigue.
Follow a gradual exercise program to avoid overexertion as long as you’re not prepared.
Regular stretching exercises after training.
Warm up well before training and competitions, especially the legs.
Stretching the calf muscles: take the position of the lunging step, i.e. one 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 your back is to sit on the floor with your legs straight and try to reach the tips of your toes with your hands.
Stretching the quadriceps muscles: While standing, grasp the ankle with the opposite hand and gently pull the heel towards the buttocks. (Repeat with the other leg).

Most muscle cramps are not of a serious nature.
If they are very painful, frequent, or cause anxiety, you should see a doctor.

Do not eat before training or limit yourself to foods that are easily digestible, such as fruit.

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

If no treatment is given, a muscle will be painful for several days after a cramp because of a contracture.
Physiotherapy is very useful because it loosens contractures and prevents further muscle disorders.
The physiotherapist can perform massage therapy or tecar therapy to relax the muscles.