Paging Dr. Frischer: Muscle Cramps
Every day I am asked about muscle cramps; I would imagine that we have all experienced them. What causes them? How can we stop them? Can they be prevented?
Muscle spasms (cramps) are painful contractions and tightening of the muscles. They’re common, involuntary and unpredictable. They are most common in our calves and thighs, but can involve any muscle. Spasms range from mild and uncomfortable to severe, intense pain. The muscle may feel harder than normal, and/or look distorted. Spasms typically last from seconds up to 15 minutes or longer, and may return.
Muscle cramps can occur after working a muscle too hard or straining it; as a result of dehydration from sweating; or from holding one position for a long time. These kinds of muscle cramps, although painful, are harmless.
Sometimes a muscle cramp is related to an underlying medical issue. Atherosclerosis (peripheral artery disease) narrows the arteries, leading to too little blood flow to the muscles. In that case, muscle pain tends to come on with use, and resolve with rest.
A mineral deficit (potassium, calcium, or magnesium) is a common cause. This may be due to a lack of these minerals in the diet, or could be a side effect of certain medicines, like some diuretics used to treat high blood pressure and congestive heart failure. Vitamin D and thyroid deficiencies can also cause muscle cramps. Simple blood tests can detect all of these deficits.
Pressure on a nerve in the spine can cause cramping pains in the legs, which worsens with walking.
Other factors that may lead to muscle cramps include older age, poor conditioning, muscle fatigue, exercising in the heat, lack of stretching, excessive sweating which removes minerals from the body, pregnancy, being overweight, and other underlying health conditions.
There is no good sure treatment. There is no pill or injection that can instantly relieve a spasm. The best thing to do is to stretch and massage the muscle. If it involves the leg, get up and walk around. Try ice or heat, whichever is effective for you. Ibuprofen or acetaminophen can give some pain relief, and muscle relaxants may be helpful. Some people who get frequent muscle spasms find relief by taking supplements of calcium, magnesium, and vitamins B12 and D.
Here are some tips for prevention: Stay hydrated by drinking plenty of fluids through the day and during activities. (Note that liquids with alcohol or caffeine don’t work as well). Stretch gently before and after exercise, and work towards better overall fitness. Avoid exercising in hot weather. Wear shoes that fit properly. Perform mild stretches or light exercise before bedtime. Discuss your medications with your physician; you might be taking one that can lead to muscle cramps.
If your muscle spasms are severe, occur frequently, respond poorly to treatment, and do not have an obvious cause, I urge you to see your doctor.
Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 10927 Downey Ave., Suite C, Downey, CA 90241.