What causes nocturnal leg cramps. How can you relieve muscle cramps at night. What are effective prevention methods for leg cramps. Why do leg cramps occur more frequently in older adults. How do certain medications affect the likelihood of experiencing leg cramps.

Understanding Nocturnal Leg Cramps: A Common Nighttime Nuisance

Nocturnal leg cramps are sudden, involuntary contractions of muscles in the legs that typically occur during sleep. These painful episodes can last from a few seconds to several minutes, often leaving the affected muscle sore for days afterward. While they may be distressing, it’s important to note that leg cramps are generally harmless, albeit uncomfortable.

Distinguishing leg cramps from other nighttime leg discomforts is crucial. Unlike restless legs syndrome, which causes an urge to move the legs due to discomfort, nocturnal leg cramps involve intense, painful muscle contractions. This distinction is important for proper diagnosis and treatment.

Characteristics of Nocturnal Leg Cramps

• Sudden onset during sleep or while falling asleep
• Intense pain in the affected muscle, usually the calf
• Visible or palpable muscle hardness
• Duration ranging from seconds to minutes
• Potential soreness in the affected area for days following the cramp

Unraveling the Mystery: Causes and Risk Factors of Nighttime Leg Cramps

The exact cause of nocturnal leg cramps remains somewhat elusive to medical experts. One theory suggests that these cramps occur due to miscommunication between nerves and muscles. For instance, the brain might inadvertently signal leg muscles to contract during sleep, particularly during dream states, leading to confusion in the calf muscles and resulting in a cramp.

While the precise mechanism is not fully understood, several risk factors have been identified that increase the likelihood of experiencing nocturnal leg cramps:

Age-Related Factors

Why do older adults experience leg cramps more frequently? As we age, our muscles become more susceptible to fatigue and less flexible, potentially increasing the risk of cramps. Additionally, age-related changes in nerve function and decreased circulation may contribute to the higher prevalence of leg cramps in individuals over 50.

Physical Activity and Posture

• Overexertion of muscles
• Prolonged sitting without movement
• Extended periods of standing on hard surfaces

Hydration and Nutrition

Dehydration and electrolyte imbalances can significantly contribute to muscle cramps. Ensuring adequate fluid intake and maintaining proper levels of essential minerals like potassium, calcium, and magnesium may help reduce the frequency of leg cramps.

Medical Conditions Associated with Leg Cramps

Several health conditions can increase the likelihood of experiencing nocturnal leg cramps:

• Peripheral artery disease
• Diabetes
• Thyroid disorders
• Neurological conditions like multiple sclerosis
• Pregnancy, especially in the later months

Medication-Induced Leg Cramps

Certain medications have been associated with an increased risk of leg cramps. These include:

• Diuretics
• Statins
• Beta-blockers
• Antipsychotics
• Oral contraceptives

It’s important to consult with a healthcare provider if you suspect your medications may be contributing to leg cramps, as adjustments to your treatment plan may be necessary.

Diagnosing Nocturnal Leg Cramps: When to Seek Medical Attention

While occasional leg cramps are usually not a cause for concern, persistent or severe episodes warrant medical evaluation. A healthcare provider can help determine if underlying health issues are contributing to the cramps and recommend appropriate treatment strategies.

Diagnostic Process for Nocturnal Leg Cramps

1. Medical history review: Your doctor will inquire about the frequency, duration, and severity of your leg cramps, as well as any associated symptoms or potential triggers.
2. Physical examination: This may include assessing muscle strength, flexibility, and checking for signs of nerve or vascular issues.
3. Blood tests: In some cases, blood work may be ordered to check for electrolyte imbalances, thyroid function, or other metabolic abnormalities.
4. Additional tests: Depending on your specific symptoms and medical history, your doctor may recommend further diagnostic tests such as nerve conduction studies or vascular imaging.

When should you consult a doctor about leg cramps? Consider seeking medical attention if you experience any of the following:

• Frequent or severe leg cramps that disrupt your sleep or daily activities
• Cramps accompanied by muscle weakness, numbness, or tingling
• Leg pain or cramps that worsen with exercise and improve with rest
• Persistent swelling or redness in the affected leg
• Cramps that occur after starting a new medication

Immediate Relief: Strategies for Alleviating Nocturnal Leg Cramps

When a leg cramp strikes in the middle of the night, quick action can help provide relief. Here are some effective techniques to alleviate the pain and discomfort of nocturnal leg cramps:

Stretching and Movement

How can you effectively stretch to relieve a leg cramp? Try these methods:

• Straighten your leg and flex your foot, pulling your toes towards your shin
• Gently massage the cramping muscle
• Stand up and put weight on the affected leg
• Walk around to promote blood flow and muscle relaxation

Temperature Therapy

Applying heat or cold can help relax the cramping muscle:

• Use a heating pad or take a warm bath to relax the muscle
• Apply an ice pack wrapped in a towel to reduce pain and inflammation

Hydration and Electrolytes

Replenishing fluids and electrolytes may help alleviate cramps:

• Drink water or an electrolyte-rich beverage
• Consider consuming a small amount of salt to help retain fluids

Over-the-Counter Pain Relief

For persistent discomfort, over-the-counter pain medications may provide relief:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve)

Always follow the recommended dosage and consult with a healthcare provider if you have any concerns about using these medications.

Long-Term Management: Preventing Nocturnal Leg Cramps

While immediate relief is crucial during a leg cramp episode, implementing preventive measures can help reduce the frequency and severity of nocturnal leg cramps over time. Here are some strategies to consider:

Regular Exercise and Stretching

How can exercise help prevent leg cramps? Regular physical activity improves muscle strength, flexibility, and circulation, potentially reducing the risk of cramps. Focus on exercises that target the legs and feet:

• Daily calf stretches
• Ankle rotations
• Gentle leg exercises before bedtime
• Low-impact activities like swimming or cycling

Proper Hydration and Nutrition

Maintaining adequate hydration and a balanced diet can help prevent electrolyte imbalances that may contribute to leg cramps:

• Drink plenty of water throughout the day
• Consume foods rich in potassium, magnesium, and calcium
• Consider electrolyte supplements if recommended by your healthcare provider

Sleep Posture and Bedding

Your sleep position and bedding can impact the likelihood of experiencing leg cramps:

• Avoid pointing your toes while sleeping
• Use loose, breathable bedding that doesn’t restrict leg movement
• Consider using a pillow to elevate your feet slightly

Footwear and Ergonomics

Proper support for your feet and legs during the day can help prevent nighttime cramps:

• Wear supportive, comfortable shoes
• Use ergonomic mats if standing for long periods
• Take regular breaks to move and stretch if sitting for extended periods

Exploring Alternative Therapies for Nocturnal Leg Cramp Management

While conventional treatments are often effective, some individuals may find relief through alternative or complementary therapies. It’s important to note that the efficacy of these methods may vary, and it’s advisable to consult with a healthcare provider before trying new treatments.

Magnesium Supplementation

Some studies suggest that magnesium supplementation may help reduce the frequency of nocturnal leg cramps, particularly in pregnant women. However, the evidence is mixed, and more research is needed to confirm its effectiveness.

Vitamin B Complex

Vitamin B complex supplements, particularly vitamin B12, have been suggested to help with leg cramps. These vitamins play crucial roles in nerve function and muscle health.

Acupuncture

Some individuals report relief from leg cramps through acupuncture treatments. While more research is needed to establish its effectiveness for this specific condition, acupuncture may help improve overall circulation and muscle relaxation.

Essential Oils

Certain essential oils, such as lavender or peppermint, may help relax muscles when applied topically. Always dilute essential oils with a carrier oil and perform a patch test before use.

The Role of Medications in Managing Nocturnal Leg Cramps

In some cases, particularly when lifestyle modifications and non-pharmacological approaches are insufficient, medications may be prescribed to manage nocturnal leg cramps. It’s crucial to understand that medication use for leg cramps is often off-label and should be carefully monitored by a healthcare provider.

Commonly Prescribed Medications

• Diltiazem: A calcium channel blocker that may help reduce muscle contractions
• Gabapentin: An anti-epileptic drug that can also help with nerve-related pain
• Verapamil: Another calcium channel blocker that may be effective for some individuals
• Vitamin B complex: May be prescribed to address potential deficiencies

Why is quinine no longer recommended for leg cramps? Quinine was once commonly prescribed for nocturnal leg cramps. However, due to potentially serious side effects, including severe bleeding and heart rhythm disturbances, the FDA no longer recommends its use for this purpose.

Considerations for Medication Use

Before starting any medication for leg cramps, consider the following:

• Discuss potential side effects and interactions with your healthcare provider
• Start with the lowest effective dose and monitor for any adverse reactions
• Regularly reassess the need for continued medication use
• Explore non-pharmacological options in conjunction with medication therapy

Remember, while medications can be helpful in managing nocturnal leg cramps, they should be used judiciously and under medical supervision. The goal is to find a balance between effective symptom relief and minimizing potential risks associated with long-term medication use.

Lifestyle Modifications to Reduce the Impact of Nocturnal Leg Cramps

Beyond specific treatments and preventive measures, certain lifestyle modifications can significantly reduce the frequency and severity of nocturnal leg cramps. Implementing these changes may not only improve your symptoms but also contribute to overall health and well-being.

Sleep Hygiene

Improving your sleep habits can have a positive impact on leg cramps:

• Maintain a consistent sleep schedule
• Create a relaxing bedtime routine
• Ensure your bedroom is cool, quiet, and dark
• Limit screen time before bed to improve sleep quality

Stress Management

Stress and tension can contribute to muscle tightness and cramps. Incorporate stress-reduction techniques into your daily routine:

• Practice mindfulness meditation
• Try progressive muscle relaxation exercises
• Engage in regular yoga or tai chi sessions
• Pursue hobbies or activities that help you unwind

Dietary Considerations

While maintaining proper hydration and electrolyte balance is crucial, consider these additional dietary tips:

• Limit caffeine and alcohol intake, especially in the evening
• Incorporate foods rich in magnesium, such as leafy greens, nuts, and whole grains
• Consider reducing sodium intake if you have high blood pressure
• Eat a balanced diet with adequate protein to support muscle health

Regular Physical Activity

Staying active can improve circulation and muscle function:

• Aim for at least 30 minutes of moderate exercise most days of the week
• Include a mix of cardiovascular exercise and strength training
• Incorporate activities that improve flexibility, such as yoga or Pilates
• Consider low-impact exercises like swimming or cycling if you have joint issues

By implementing these lifestyle modifications alongside specific treatments and preventive measures, you can create a comprehensive approach to managing nocturnal leg cramps. Remember that consistency is key, and it may take time to see significant improvements. Be patient with yourself and celebrate small victories as you work towards better sleep and reduced leg cramp episodes.

Causes, Diagnosis, Treatment, and Prevention

What Are Nocturnal Leg Cramps?

Nocturnal leg cramps are a tight, knotted feeling in your legs that happens at night. They can last several seconds to several minutes. If the cramp is severe, your muscle may be sore for days.

Leg cramps are different from restless legs syndrome. Both tend to happen at night, but restless legs syndrome causes discomfort and an urge to move instead of painful muscle cramps.

As much as they may hurt, leg cramps are harmless.

Nocturnal Leg Cramps Causes and Risk Factors

Experts don’t know the exact cause of nighttime leg cramps. They could happen because your nerves send the wrong signals to your muscles. For example, your brain might mistakenly tell your leg to move while you dream. That confuses your calf muscles and causes them to contract.

You’re more likely to have a leg cramp if you:

• Are 50 or older
• Work your muscles too much
• Sit too long without moving
• Don’t drink enough water
• Stand too long on hard surfaces

Other health conditions can also raise your chances of leg cramps, including:

Some medications can cause leg cramps. These include:

Nocturnal Leg Cramp Diagnosis

If you often have severe leg cramps, talk to your doctor to be sure another problem isn’t causing them.

They’ll ask about your medical history and your symptoms. They’ll also do a physical exam to look for possible causes. You might have blood tests if your doctor suspects a hidden problem.

Treating Nocturnal Leg Cramps

The next time a leg cramp strikes, try some of these tips:

• Stretch the muscle.
• Get out of bed and stand with your foot flat on the floor. Press down firmly.
• Massage the muscle.
• Flex your foot.
• Grab your toes and pull them toward you.
• Ice the cramp.
• Take a warm bath.

Your doctor might give you medications such as diltiazem (Cardizem), diphenhydramine (Benadryl), or verapamil (Calan, Verelan). But they don’t always work, and they can have harmful side effects. For example, experts used to use the anti-malaria drug quinine for leg cramps. Doctors and the FDA no longer recommend it because it can also cause severe bleeding and problems with your heart rhythm.

Nocturnal Leg Cramp Prevention

Some simple things you might keep you from getting cramps:

• Stretch during the day and before bed. Focus on your calf and foot muscles.
• Drink plenty of water.
• Move around during the day to exercise your feet and legs.
• Wear comfortable, supportive shoes.
• Sleep under loose covers, especially if you sleep on your back.

Muscle Cramps | Michigan Medicine

Topic Overview

What are muscle cramps?

A muscle cramp is a strong, painful contraction or tightening of a muscle that comes on suddenly and lasts from a few seconds to several minutes. It often occurs in the legs. A muscle cramp is also called a charley horse.

Nighttime leg cramps are usually sudden spasms, or tightening, of muscles in the calf. The muscle cramps can sometimes happen in the thigh or the foot. They often occur just as you are falling asleep or waking up.

What causes muscle cramps?

The cause of muscle cramps isn’t always known. Muscle cramps may be brought on by many conditions or activities, such as:

• Exercising, injury, or overuse of muscles.
• Pregnancy. Cramps may occur because of decreased amounts of minerals, such as calcium and magnesium, especially in the later months of pregnancy.
• Exposure to cold temperatures, especially to cold water.
• Other medical conditions, such as blood flow problems (peripheral arterial disease), kidney disease, thyroid disease, and multiple sclerosis.
• Standing on a hard surface for a long time, sitting for a long time, or putting your legs in awkward positions while you sleep.
• Not having enough potassium, calcium, and other minerals in your blood.
• Being dehydrated, which means that your body has lost too much fluid.
• Taking certain medicines, such as antipsychotics, birth control pills, diuretics, and steroids.

How can you stop a muscle cramp when it happens?

You may need to try several different ways to stop a muscle cramp before you find what works best for you. Here are some things you can try:

• Stretch and massage the muscle.
• Take a warm shower or bath to relax the muscle. A heating pad placed on the muscle can also help.
• Try using an ice or cold pack. Always keep a cloth between your skin and the ice pack.
• Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• If your doctor prescribes medicines for muscle cramps, take them exactly as prescribed. Call your doctor if you have any problems with your medicine.
• Drink plenty of fluids. Sports drinks, such as Gatorade, will often help leg cramps.

Here are some things you can try for a leg cramp:

• Walk around, or jiggle your leg.
• Stretch your calf muscles. You can do this stretch while you sit or stand:
  • While sitting, straighten your leg and flex your foot up toward your knee. It may help to place a rolled towel under the ball of your foot and, while holding the towel at both ends, gently pull the towel toward you while keeping your knee straight.
  • While standing about 2 ft (0.6 m) from a wall, lean forward against the wall. Keep the knee of the affected leg straight and the heel on the ground. Do this while you bend the knee of the other leg. See a picture of how to do this calf stretch.

If you think a medicine is causing muscle cramps:

• Before you take another dose, call the doctor who prescribed the medicine. The medicine may need to be stopped or changed, or the dose may need to be adjusted.
• If you are taking any medicine not prescribed by a doctor, stop taking it. Talk to your doctor if you think you need to continue taking the medicine.

How can you prevent muscle cramps?

These tips may help prevent muscle cramps:

• Drink plenty of water and other fluids, enough so that your urine is light yellow or clear like water.
• Limit or avoid drinks with alcohol.
• Make sure you are eating healthy foods (especially if you are pregnant) that are rich in calcium, potassium, and magnesium.
• Ride a bike or stationary bike to condition and stretch your muscles.
• Stretch your muscles every day, especially before and after exercise and at bedtime.
• Don’t suddenly increase the amount of exercise you get. Increase your exercise a little each week.
• Take a daily multivitamin supplement.

If you are taking medicines that are known to cause leg cramps, your doctor may prescribe different medicines.

What if muscle cramps keep coming back?

Talk with your doctor if you have muscle cramps that keep coming back or are severe. These may be symptoms of another problem, such as restless legs syndrome.

If cramps keep coming back, bother you a lot, or interfere with your sleep, your doctor may prescribe medicine that relaxes your muscles.

References

Other Works Consulted

• American Academy of Neurology (2010). AAN summary of evidence-based guideline for clinicians: Symptomatic treatment for muscle cramps. Available online: http://www.aan.com/practice/guideline/uploads/394.pdf.
• American Academy of Neurology (2010). AAN summary of evidence-based guideline for patients and their families: Drug treatments for symptoms of muscle cramps. Available online: http://www.aan.com/practice/guideline/uploads/395.pdf.
• Katzberg HD, et al. (2010). Assessment: Symptomatic treatment for muscle cramps (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 74(8): 691–696. Available online: http://www.neurology.org/cgi/content/full/74/8/691.
• Young G (2014). Leg cramps. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/1113/overview.html. Accessed April 14, 2016.

Credits

Current as of:
August 4, 2020

Author: Healthwise Staff
Medical Review:
Anne C. Poinier MD – Internal Medicine
Kathleen Romito MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Karin M. Lindholm DO – Neurology

Current as of: August 4, 2020

Author:
Healthwise Staff

Medical Review:Anne C. Poinier MD – Internal Medicine & Kathleen Romito MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Karin M. Lindholm DO – Neurology

What you need to know about leg cramps, sudden pain and when to see a doctor

You don’t have to be an Olympian to feel the misery of a leg cramp or a shooting pain that comes out of nowhere. You don’t even need to be a weekend warrior. The leg cramp, calf cramp or hamstring cramp, sometimes affectionately called a Charley Horse, can affect all of us — athletes and couch potatoes alike.

The good news is most cramps — which can occur anywhere on the leg — really aren’t anything to worry about, most of the time. Though, in rare instances, leg cramping can be a sign of underlying disease.

massaging calf / pain/ crampGetty Images stock

Here’s what you need to know.

1. Understanding the charley horse

First, some basic biology.

“A leg cramp is really just a muscle contracting and tightening spontaneously,” said emergency medicine specialist Dr. Scott Dresden of Northwestern Memorial Hospital in Chicago. “The problem is that can be very painful for several seconds or even several minutes.”

Why we get a leg cramp, calf cramp, or even a hamstring cramp, is really poorly understood. “There are a lot of thoughts as to why it happens, but there is not one definitive answer,” he explained.

Some potential reasons for cramping include dehydration (especially among athletes or any of us working out in hot, humid conditions.) Another potential reason could be electrolyte imbalance. Or it might be some type of miscommunication between nerves that make muscles contract and those that stop contractions. Even some medications have a side effect of leg cramping.

Don’t be surprised if your leg, calf or hamstring muscles ache for a while, even after the cramp has eased.

“What happens, especially when it’s a bad, painful cramp, is that some people might develop tiny micro-tears in the muscle from the strong contractions,” said Ron DeAngelo, director of sports performance training at the UPMC Rooney Sports Complex in Pittsburgh. “The micro-tears heal, but it can take about 24 hours or so to feel better.”

2. When a cramp wakes you up

So you’re snoozing, having a pleasant dream, and the next thing you know is that you’re writhing in bed because your calf, thigh or seemingly your entire leg cramped. Maybe even your foot cramped.

You’re not alone.

“These kinds of nighttime or nocturnal cramps are common and most of the time they’re not something that is indicative of disease,” said Dr. Michael Hanak, assistant professor of family medicine at Rush University Medical Center.

The nighttime pain can be on any part of your leg, and can affect everyone, both young and old, men and women.

There is a laundry-list of reasons why you might be experiencing nighttime leg cramping. Maybe you stand all day at work, or maybe you sit all day, or sit with your legs not flat on the floor. Maybe you’re pregnant or dehydrated. “Maybe people are just sleeping awkwardly,” said DeAngelo. “A lot of these nighttime leg cramps have a lot do with positioning while sleeping. ”

You might want to make sure you are wearing proper footwear during the day. “If your gait is off say due to wearing shoes that aren’t fitting right or inappropriate for the sport you do, you could cramp at night,” he says.

If you want to avoid that rude awakening, stay hydrated, and think about stretching your legs before you nod off. To relieve the ouch when you’re awakened, stretch it out.

Don’t confuse the aching nighttime leg cramp with the “crawling” sensation that happens with a sleep disorder called restless leg syndrome, which doesn’t cause cramping.

3. Weekend warrior leg cramps

So you started running or walking this summer only to experience stinging calves, quads and hamstring muscles. Chances are you were just dehydrated, according to DeAngelo.

“If people are deconditioned and start exercising they may underestimate how much they’re actually sweating,” he says.

All that sweat means you need to take in more water. If you don’t, the communication between the nerves that make your muscles relax or tighten may misfire, resulting in leg cramps, he said.

“The best thing to do is to stop exercising when you get a leg cramp, then stretch and rehydrate,” said DeAngelo, adding that it’s smart to hydrate before you begin your workout, too.

4. When to see a doctor

Many people worry that a leg or calf cramp signals a serious problem, like deep vein thrombosis (DVT), which is basically a blood clot that forms in one of the deep veins of your body, generally the leg.

Aside from cramping, which usually occurs in the calf, other symptoms include one-sided (generally) swelling of the leg, foot and ankle as well as severe pain in the foot and ankle. One area of the leg may seem warmer than other parts of the leg. And the skin may be discolored, either pale or reddish

It’s a serious condition that can lead to a life-threatening pulmonary embolism, according to Dr. Dresden, assistant professor in emergency medicine Northwestern University Feinberg School of Medicine.

“It’s smarter to get in to see someone right away if you have symptoms of a DVT or are just concerned,” he elaborated.

Since leg, calf and hamstring cramps generally go away on their own, no treatment is usually needed.

But for some people, leg cramps can be a regular occurrence. Individuals with endocrine problem like diabetes, structural problems like flat feet, poor circulation and those with neurological or neuromuscular disorders often have leg cramps.

“Once an underlying problem is brought under better control, the leg cramps might no longer be an issue,” said Dr. Hanak of Rush University Medical Center.

Certain medications used to treat high blood pressure, such as diuretics and beta-agonists, used to treat respiratory problems, can also cause cramping. “If that’s a problem, my advice is to talk to your doctor to see what can be done and what changes can be made,” said Hanak.

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When a Cramp Is Actually a Clot

Eryn Vorn/flickr

A glutton for good running weather, I could not resist the Thanksgiving-weekend weather. It was pitch-perfect: cloudless, warm, a cool breeze. The month before I had run my fastest marathon: just under four hours at the 2012 Marine Corps Marathon. So, I should have been recovering with light, slow, shallow runs.

But several hours on a cramped five-hour flight the night before had me buzzing with pent-up energy. So, I ran. Probably too far, probably too fast.

Sitting at a table in Starbucks on Saturday, Sunday, and Monday, plugging away all day on a project, time slipped by. It felt good to focus, all that energy cleared from my metabolic cache. When I stood to go home Monday night, my calves immediately tightened. The pain in the right calf eased, but the pain in the left calf did not.

I rested, iced, elevated the leg, and doubled up on liquids and bananas, but the pain did not subside. On Wednesday, I limped to work and trolled sports-medicine web pages. One website after another said generally the same thing: A deep-vein thrombosis (DVT), or blood clot, can closely resemble a leg cramp or a muscle tear. My stomach clenched.

Recent long travel; a prolonged period of remaining in the same position; and red, painful, swelling were among the causes and symptoms listed. I had all but the redness and swelling. I called my doctor. She said to go to the nearest emergency room. I meant to sound matter-of-fact when I told my boss why I was leaving early, but it came out more as a warble.

The emergency room’s ultrasound technician’s questions turned to silence as she tapped buttons on a keyboard and stared at the images on her screen, rarely looking up as she moved her wand over the clear jelly-like coating she’d smeared on my leg. When she stepped out of the room, I peeked at the images on her computer screen. I saw blue and grey shapes and a small red mound, like an ant hill.

I was poking my leg when the ER doctor came in. He told me to take my hand off of my leg and not to do that again.

It’s probably a muscle tear, the student doctor said. He came to prepare my history for the ER doctor. It would take a longer flight and longer period of immobility than a weekend at Starbucks to develop a DVT, he said. I was ready to believe him and would have, if it weren’t for that little red mound.

I was poking my leg to pinpoint the pain for the cheery nurse who’d come to check my vitals, when the ER doctor came in. He told me to take my hand off of my leg and not to do that again.

An estimated one in 1,000 Americans are diagnosed each year with a DVT, according to the Centers for Disease Control and Prevention. The number of Americans with DVTs, including those undiagnosed, is estimated to be up to 600,000. As many as 100,000 deaths each year are directly or indirectly linked to a DVT.

Though I have flown farther and sat still in coffeehouses for longer in the past, the doctor told me the blockage most likely was the result of my weekend sojourn in Starbucks, exacerbated by the flight. I might also have been a bit dehydrated from the travel and the run.

Whatever my particular cocktail of factors, the effect was the same: Blocked, the blood built up along the walls of the vein, clotting. Similar to a crash on a highway, the clot slowed the blood that tried to snake around it. The blood piled onto the clot, making it bigger and the passageway narrower.

A DVT is not usually life-threatening, by itself. But if part of the clot breaks loose and is thrown back into the bloodstream to travel freely, eventually it may lodge in a passageway too small for it, such as those found in the lungs. The result, a pulmonary embolism (PE), can kill you.

More than one-third of DVT patients have PE’s, according to the Surgeon General’s Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism, issued in 2008. “Often, the first symptom of DVT is a fatal PE,” Dr. Elizabeth G. Nabel, director of the National Institutes of Health’s Heart, Lung, and Blood Institute, wrote in the report.

DVT/PE is an underappreciated problem in our society, says Dr. Anthony Venbrux, a professor of radiology and surgery and the director of the vascular and interventional radiology division at the George Washington Medical Center, echoing the report’s findings.

“We tend to dismiss them, saying ‘I’ll take an ibuprofen or use a heating pad.’ We, meaning everyone, including physicians,” Venbrux says. “A classic example is a physician who was an athlete and didn’t want to acknowledge that it was DVT in the upper extremity that he was experiencing.”

“DVT diagnoses are easy to overlook because the signs and symptoms are often difficult to recognize. In many cases, there are no clinically apparent signs at all.”

Early diagnosis is the key to a positive outcome, and diagnosis is not difficult or painful. Now, completely noninvasively, we can rule in or rule out a DVT with 98 percent accuracy using a Doppler ultrasound, Venbrux says. “In the old days, we would have to inject contrast dye.” Nonetheless, many DVTs are believed to slip through the cracks, dismissed or unrecognized.

“The tragedy of these diseases is that their diagnosis is easy to overlook because the signs and symptoms are often diffuse and difficult to recognize. In many cases, there are no clinically apparent signs at all,” Nabel says.

As I quickly learned, the default treatment is to let nature takes it course, assisted by an intense, steady regimen of blood thinners, which rob the blood of its ability to stick to the little red mound, which my body would slowly absorb. The flip side was that my blood also could not stick together well enough to scab should I sustain a bleeding injury.

Around that time, I also discovered ClotConnect.org, which held a wealth of understandable information on blood clots for patients and doctors. Beth Waldron, the program director of Clot Connect at the University of North Carolina Hemophilia and Thrombosis Center, herself had a DVT and two PEs in 2003.

By her own account, Waldron thought she pulled a muscle in the gym. She went to the doctor and was prescribed muscle relaxers. When the pain continued, she tried to work through it until, walking up the stairs to the shower one day, she couldn’t catch her breath. “The world went floaty,” she says.

Eventually, she was prescribed antibiotics for a respiratory infection, she says. But, after taking her antibiotics for five days, under the impression that this wasn’t serious, Beth had a pulmonary embolism that “was off-the-chart painful,” she says. At the hospital, they found a pulmonary embolism in each lung and a DVT from mid-calf to her hip. She was in the hospital for nine days and because the doctors found that she has a genetic risk factor, she is now on blood thinners for life.

“Every DVT patient says ‘I thought I turned my ankle or slept funny or pulled a muscle.’ Almost every one of them tends to dismiss what it is.”

“About half of those who develop [DVT/PE] have two things in common. First, they have one or more identifiable risk factors for the disease. Second, they experience some sort of triggering event, such as hospitalization, trauma, surgery, or a prolonged period of immobilization,” the surgeon general’s report said. The other half of cases are mostly unprovoked, or “silent,” producing “few, if any, symptoms,” it said.

In Venbrux’s experience, a “normal patient is someone who comes in with pain and may or may not have swelling. Every one of them says, ‘I thought I turned my ankle or slept funny or pulled a muscle.’ Almost every one of them tends to dismiss or blow off what it is. Almost everyone discounts it initially and then after the diagnosis comes to an awareness,” he says, and noted that physician awareness is equally important.

Nowadays, blood-clot surveillance in hospitals is a standard of practice that “is on the tip of most people’s tongue,” according to Dr. Gregory Piazza, a Harvard Medical School instructor and a physician in the Brigham and Women’s Hospital’s Cardiovascular Medicine division. This development is owed, in part, to reports and studies such as the surgeon general’s report that found that hospitals often failed to identify and begin treating DVT/PE risk early.

Brigham and Women’s Hospital uses a computerized decision-support program to evaluate the risk of every patient in the hospital, Piazza says. The system uses electronic health records to look at risk factors and tabulates a score for each patient. For patients who are high risk, an electronic alert goes to the health-care provider that comes up when admission orders are being written, along with a template of commonly used prophylactic measures, according to Piazza, who also is on the board of directors of the North American Thrombosis Forum.

An electronic decision-support system “is not the norm quite yet,” Piazza says. “Others use simple paper and pencil and tabulate. The important thing is that immediately on admission you get the ball rolling,” he says.

By New Year’s, I had read my way through most of the online literature about DVTs. Beyond the basics, the internet was an information wasteland. My concern that I might develop a pulmonary embolism was shifting into anxiety about the road ahead if I made it through this.

Running was not an option, but neither was sitting still, just worrying and waiting. Hunkered into big jackets weighed down by pockets filled with pills, granola bars, and apple juice, with a medic-alert bracelet clamped on, I spent the winter weekend afternoons on long, slow walks.

After about three months, under the watchful eyes of the neighborhood YMCA’s staff, I ventured into more rigorous activities. If I could manage a cause to bleed on a stationary recumbent bike, I probably deserved an award, I figured. Having read that exercising while on blood thinners might reduce the pain and swelling that sometimes follow a blood clot, it was my mission to become a gym rat. Plus, the Y had cable.

So I pedaled, then I paddled, then climbed, then rowed, and then, with care, stepped into a yoga studio.

Finally, a month out from the end of my six-month blood thinner regimen, it was time to see a specialist to help me resolve this once and for all: Was the clot gone? Could I come off the blood thinners? Would I get another one? Could I run? I told myself I wouldn’t run as long as I had a real fear that I could not distinguish a cramp or a tear from a DVT.

There is great relief knowing that, after years of listening to my body’s signals as a runner, when I thought something was amiss, something was.

The specialist ordered three tests. The first, a Doppler ultrasound, confirmed that the blood clot in my calf was gone. The second test, a veinous insufficiency study, confirmed that the walls and valves of the vein were undamaged by the clot, which meant I was unlikely to have recurring aches and pains and less likely to develop another blood clot. For the final test, I was sent to a hematologist who took blood to identify any inherited blood factors that could increase the likeliness of another DVT. He found only one, minor genetic risk factor.

Overall, the news was good: no clot, no damage. Even finding I had a genetic risk factor was good news insomuch as we could note it in my medical records, and I could pass along information to my parents that one of them also carries the risk factor, which might be useful, considering that the incidence of DVT and PE increases with age, the surgeon general’s report said.

Knowing the clot is gone and that a small chance exists of developing another one left me uncertain about whether to return to running. On the one hand, getting figuratively kneecapped by a scary Scrabble word leaves an impression, and I often wonder what might have happened if not for that gut-instinct search for “calf tear.”

On the other hand, there is great relief knowing that, after years of listening to and interpreting my body’s signals as a runner, when I thought something was amiss, something was.

There was no easy answer. If you’ve had one DVT, your odds increase of getting another, more so if you have a genetic risk factor. But many factors are in play, some of which I can control.

I move around as much as possible. I wear seriously unsexy, but comfortable compression stockings to improve circulation in my legs when I am on my feet or sitting for long periods. And I keep up the activities that served me well as I recovered: yoga, swimming, bicycling.
  
In June last year, for the first time in six months, I ran. I ran slowly, carefully, self-consciously. I ran into some old and to-be-expected aches and pains, and I met some new ones. And anxiety was out on the trail too. But that day, I ran past it. Now, I don’t see it so often anymore. And last November, I ran the Marine Corps Marathon again, finishing with a new fastest time.

A Sign of Underlying Illness?

Leg cramps are characterized by sudden, severe, and involuntary muscle contractions.¹ Leg cramps commonly affect the calf muscles but may occur in the hamstrings or muscles of the feet, especially at night (ie nocturnal leg cramps).^2-4 These nocturnal cramps that occur primarily during sleep are classically characterized as unilateral, painful, and palpable, involuntary muscle contractions that often are localized and have a sudden onset.⁵ Leg cramps may also occur during periods of rest in the day.

Although anyone can experience leg cramps, the incidence is highest in women and older adults, affecting an estimated 33% of individuals older than 60 and an estimated 50% of individuals older than 80. ¹ Individuals with leg cramps may complain of sleep disturbances that may negatively affect their overall well-being. Pregnant women are extremely prone to leg cramps at night, especially during the second and third trimesters.¹ Up to 20% of patients who experience leg cramps have troublesome enough daily symptoms that they seek medical attention.⁶

The majority of leg cramps are idiopathic and harmless, but some may result from underlying illnesses such as diabetes or peripheral artery disease.^1,6 Other examples of secondary causes include neurologic disorders, structural disorders or positioning of the leg, and metabolic disorders, including extracellular fluid volume depletion and electrolyte disturbances. Medications such as statins, diuretics, and oral contraceptives may increase the risk of leg cramps, too.^1,6

Restless leg syndrome (RLS) can be confused with leg cramps, but they are 2 distinct conditions. ⁵ RLS is a neurologic movement disorder that causes limb sensations in which a person exhibits an uncontrollable urge to move the legs and is often associated with disruptions in sleep.⁵ Like RLS, leg cramps may have a circadian pattern and frequently occur at rest; however, nocturnal leg cramps are linked to physical changes, including muscle hardening and pain, which are not observed in RLS.⁵

TREATMENT

Although studies have revealed that quinine sulfate may be helpful in treating leg cramps, the FDA banned its OTC use in 1994 because of the risk for potentially dangerous and fatal adverse reactions, thrombocytopenia, and cardiac arrhythmia.⁷ In 2006, the FDA also banned the marketing of off-label prescription quinine products. Quinine remains available by prescription for the treatment of malaria, but its risks as prophylaxis or a treatment for nocturnal leg cramps outweigh any potential benefits, and the FDA warns against its use in prescription form. ^7,8 Fardet et al⁸ report that the use of quinine for nocturnal leg cramps was linked to a 3-fold higher mortality rate in individuals younger than 50.

No specific medication is indicated for leg cramps; however, several have been used, including calcium-channel blockers, such as diltiazem, and vitamin B complex.^1,7 Some health care providers may suggest the use of OTC analgesics for pain in certain cases. Also available are nonprescription products formulated with homeopathic ingredients for the treatment of leg cramps. Patients with preexisting medical conditions should consult their primary health care provider before taking any medication, including OTC products, to avoid potential contraindications or drug—drug interactions.

NONPHARMACOLOGIC MEASURES AND PREVENTIVE STRATEGIES

Nonpharmacologic therapies such as hydration, warm or cold compresses, exercise, and muscle stretches may provide some relief from leg cramps. ⁷ Leg cramps can be prevented if the underlying cause is treated. Other preventive measures may include the following:

• Maintaining adequate hydration
• Stretching leg muscles before going to sleep
• Wearing shoes that fit properly
• Establishing a routine exercise regimen, if appropriate

Patients who experience severe and/or continual leg cramps should be encouraged to seek further assistance from their primary health care provider.

References

1. Nordqvist C. Leg cramps: causes, diagnosis, and treatments. Medical News Today website. http://medicalnewstoday.com/articles/180160.php. Published December 10, 2015. Accessed June 7, 2017.

2. Hallegraeff J, de Greef M, Krijnen W, et al. Criteria in diagnosing nocturnal leg cramps: a systematic review. BioMed Central website. bmcfampract.biomedcentral.com/articles/10.1186/s12875-017-0600-x. Published February 28, 2017. Accessed June 14, 2017.

3. Nocturnal leg cramps. Cleveland Clinic website. http://my.clevelandclinic.org/health/articles/nocturnal-leg-cramps. Published October 2014. Accessed June 7, 2017.

4. Monderer RS, Wu WP, Thorpy MJ. Nocturnal leg cramps. Curr Neurol Neurosci Rep. 2010;10(1):53-59. doi: 10.1007/s11910-009-0079-5.

5. Bozorg A. Restless legs syndrome differential diagnosis. Medscape website. http://emedicine.medscape.com/article/1188327-differential#1. Published February 22, 2017. Accessed June 7, 2017.

6. Allen RE, Kirby KA. Nocturnal leg cramps. Am Fam Physician. 2012;86(4):350-355.

7. Walker J. How can leg cramps be treated? The Medscape website. http://medscape.com/viewarticle/723218. Published June 10, 2014. Accessed June 7, 2017.

8. Fardet L, Nazareth I, Petersen I. Association between long-term quinine exposure and all-cause mortality. JAMA. 2017;317(18):1907-1909. doi: 10.1001/jama.2017.2332.

Ms. Terrie is a clinical pharmacist and medical writer based in Haymarket, Virginia.

Nocturnal Leg Cramps – American Family Physician

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11 Causes of Leg Cramps at Night

This article was medically reviewed by Connie Jennings, MD, a member of the Prevention Medical Review Board, on March 21, 2019.

If painful leg cramps wake you up in the middle of the night, you’re not alone—far from it. Up to 60 percent of adults say they’ve experienced leg cramps at night, according to a 2012 study in American Family Physician.

These ill-timed charley horses—characterized by a sharp muscle contraction that can last several seconds to minutes—usually affect the calf and foot, although they can also strike your hamstring. While we’ve all experienced a leg cramp at one point or another, they appear to be more common after age 50, shows a 2017 study in BMC Family Practice.

“You will find plenty of disparate opinions, but the simple truth is that nobody really knows why these [leg cramps] occur,” says Scott Garrison, MD, PhD, an associate professor of family medicine at the University of Alberta who has published multiple studies on nocturnal leg cramps.

There are theories, however. Here are some possible why your legs won’t stop cramping up—and what you can do to find relief.

What are the possible causes of leg cramps?

One or several of the factors below—combined with your individual physiology—could explain why you’re waking up in the middle of the night in pain.

1. Not stretching certain muscles

Some researchers have theorized that our modern lifestyle is to blame. While our ancient ancestors spent lots of time squatting—a position that stretches leg tendons and muscles—contemporary life has mostly removed the need for it. There’s also evidence that our mostly sedentary lifestyles (spending big chunks of time sitting or not moving) decreases muscle and tendon length and limberness, which may lead to cramping.

2. Sleeping in an awkward position

Other experts have observed that, when lying face down in bed, the foot is often in a “plantar flexion” position—meaning the toe points away from you, shortening the calf muscles. When the foot rests in this position for long periods, even small movements of the feet could trigger a cramp. Sleeping on your side, with your feet off the bed, or in some other position that keeps your toes neutral—not pointing away from you—may be a better position for these muscles.

3. Changing seasons

Dr. Garrison’s own research has shown nighttime leg cramps are more common in summer than in winter. While not true for everyone, the frequency of these cramps tends to peak in mid-July and crater in mid-January. It’s important to understand that these muscle cramps are caused by nerve issues—not muscle disorders, Dr. Garrison says. Electromyogram tests have shown that nerves running from the spine down to the calf trigger these cramps.

So why summer? “Nerve growth and repair might be more active in summer because of the greater vitamin D levels,” Dr. Garrison explains. Your body produces vitamin D from sun exposure. And so in summer, when your D levels are peaking, your body may engage in “sped up” neural repair, which could trigger these cramps, he says.

4. Dehydration

There’s some evidence that dehydration promotes nocturnal cramping. “There is a clear seasonal pattern in the frequency of muscle cramps, with higher numbers in summer and lower numbers in winter,” says Michael Behringer, MD, PhD, a professor of sports science at Goethe University in Germany. “This suggests that heat and possibly also fluid balance have an influence on the development of cramps.” Dehydration may promote electrolyte imbalances in the blood, which could be one cramp trigger.

5. Really tough workouts

Hard exercise has long been linked to muscle cramps. “Skeletal muscle overload and fatigue can prompt muscle cramping locally in the overworked muscle fibers,” write the authors of a study in the journal Current Sport Medicine Reports. This happens even among highly trained professional athletes, the study authors say. While staying hydrated may help, there’s no well-established method for preventing these kinds of overuse cramps.

6. Nutrient deficiency

There’s evidence—although much of it is mixed—that calcium, magnesium, and potassium imbalances play a part in cramping. Each of these electrolytes helps maintain fluid balance in the blood and muscles, and so it makes some sense that, if they’re out of whack, cramping may ensue. But again, studies have been inconsistent, so more research needs to be done to know how these nutrients affect cramping directly.

7. Standing all day

There’s also research showing that people who spend a lot of time each day standing are more likely to experience leg cramps than sitters. When you’re on your feet but not in motion, blood and water tend to pool in your lower body. This may lead to fluid imbalances, as well as muscle and tendon shortening—all of which could lead to cramping.

8. Medications

Another of Dr. Garrison’s studies links diuretics (high blood pressure meds like Clorpres and Thalitone, for example, have diuretic effects) and asthma drugs (specifically, long-acting beta-adrenoceptors, or LABAs) to a greater risk for nocturnal cramping. It’s possible these drugs have a “stimulatory” effect on motor neurons and receptors, which could promote cramping, his study concludes.

9. Pregnancy

Pregnancy, too, is associated with more frequent leg cramps, possibly due to weight gain and disrupted circulation. It’s also possible that the pressure a growing fetus places on the mother’s blood vessels and nerves causes cramping, according to the American Pregnancy Association.

10. Certain health conditions

Diabetes, hypertension, arthritis, neurological disease, and depression are all associated with leg cramping, too. In some cases, medications could be to blame, as mentioned above. But some of these conditions—namely diabetes and neurological disease—can cause disrupt or even kill your nerves, which may lead to cramping, research shows.

11. Aging

Aging might also play a role in leg cramping, Dr. Garrison says. “It is around the same time that we start losing our motor neurons”—roughly, our early 50s—“that rest cramps start to get more common,” he explains. Both strength and balance exercises may help maintain muscle and nervous system functioning in ways that prevent these issues, research suggests.

How to prevent and get rid of leg cramps

Ease leg cramps with this DIY calf massage:

Dr. Garrison says that, for many years, quinine pills were the go-to treatment for leg cramps. And while they provided “a modest benefit,” he says, they also caused some dangerous side effects like an irregular heartbeat. That’s why the FDA advises people to steer clear of the drug to treat leg cramps.

It’s really all trial and error. Since there is no definitive cause of nighttime leg cramps, there’s also no sure cure. You could speak to three different doctors, and all three might give you a different explanation—and a different remedy. Here are a few worth considering:

✖️ Stretch it out

While the research on stretching goes back and forth, a small 2012 study did find that people who completed hamstring and calf stretches just before bed enjoyed a significant drop in spasm frequency.

And if you’re in the midst of a spasm? “Stretching the affected muscle while you cramp helps abort a cramp,” Dr. Garrison says. If your cramp is in your lower leg or foot, try a standing calf stretch. If the cramp is in your upper leg, these hamstring stretches may help.

✖️ Eat a balanced diet

Ensuring you have plenty of magnesium in your diet—a mineral many Americans don’t get enough—may be beneficial. Beans, nuts, whole grains, and leafy greens are all great sources. (Some research shows that this may not be helpful for everyone, though, so make sure you talk to your doctor before you make any major diet changes.)

One small study found taking B vitamins supplements could help, too. That’s not enough evidence to warrant popping a new pill, but eating more fish, whole grains, and vegetables certainly doesn’t hurt.

✖️ Stay hydrated

You could also try to drink more water during the day—especially if you’re sweating or exercising. Dry mouth, headaches, fatigue, and dry skin are all signs that you’re not drinking enough water. The color of your urine is probably your best guide. If your pee is pale yellow or clear, you’re drinking enough h3O. If your urine is dark yellow (or closer to amber), you need to drink more.

Markham Heid
Markham Heid is an experienced health reporter and writer, has contributed to outlets like TIME, Men’s Health, and Everyday Health, and has received reporting awards from the Society of Professional Journalists and the Maryland, Delaware, and D.C.

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90,000 Muscle-tonic syndrome – treatment, symptoms, causes, diagnosis

Muscular-tonic syndrome is a frequent manifestation of osteochondrosis of the spine. Sometimes the pain in the spine is not associated with a herniated disc or protrusion, but with muscle-tonic syndrome. Muscle-tonic syndrome is a painful muscle spasm that occurs reflexively, and, as a rule, with degenerative diseases of the spine, which is associated with irritation of the nerve that innervates the outer part of the fibrous capsule of the intervertebral nerve (Lyushka’s nerve) In addition, muscle-tonic syndrome can occur due to excessive load on the back or prolonged static load (impaired posture and posture).Muscles under prolonged static load are in constant tension, which leads to impaired venous outflow and the formation of edema of the tissues surrounding the muscles. Edema is the result of muscle spasm. Dense tense muscles affect the nerve receptors and blood vessels in the muscles themselves, which leads to the development of persistent pain syndrome. The pain, in turn, in a reflexive way, causes an increase in muscle spasm and, thus, further limits the range of motion. A vicious circle is formed – spasm – tissue edema – pain manifestations – spasm.But sometimes muscle spasm of a reflex nature is a protective reaction of the body to external effects on the bones of the skeleton (protection of nerves, blood vessels and internal organs) in various diseases. But a prolonged muscle spasm from a protective reaction turns into a pathological one, and therefore it is necessary to remove this condition, since a prolonged spasm can lead to changes in the muscles and disruption of their functions. Muscular-tonic syndrome is characterized by muscle tension, thickening and shortening and, as a consequence, a reduction in the range of motion in the supporting structures.The increased muscle tone can be local with the involvement of a portion of the muscle and diffuse (the tone of the entire muscle). In addition, there is both regional and generalized – muscle spasm of both flexors and extensors. The intensity of the increased tone can be either moderate or pronounced. With moderate hypertonicity, muscle soreness is noted on palpation and the presence of seals in the muscle is noted. With severe hypertonicity, the entire muscle becomes very dense, painful, and massage or heat only intensifies the pain.Distinguish between complicated and uncomplicated muscle hypertonia. With an uncomplicated tone, the pain is localized only in the muscle, and with a complicated tone, the pain can radiate to neighboring areas. The mechanism of pain in complicated hypertonicity is associated with ischemic manifestations in the spasmodic muscle (impaired microcirculation, compression of neurovascular formations). Often, with muscular-tonic syndrome, trigger points are formed, which are a sign of the formation of myofascial pain syndrome.The most common muscle-tonic syndromes are the following:

1. Anterior scalene muscle syndrome . This syndrome is caused by the increased tone of this muscle. With hypertonicity of this muscle, conditions arise for the formation of a tunnel syndrome (between the first rib and the scalene muscle) with irritation of the neurovascular bundle with conduction-type disturbance in the zone of innervation of the ulnar nerve. When turning and unbending the head, painful manifestations intensify.Typically, the syndrome occurs on one side.
2. Syndrome of the lower oblique muscle of the head . This syndrome is characterized by pain in the back of the head on the side of the spasmodic muscle and their intensification when turning the head. Often this syndrome is accompanied by occipital nerve irritation and spasm of the vertebral artery.
3. Syndrome of the anterior chest wall . Pain manifestations in this syndrome simulate the picture of angina pectoris, but unlike true cardialgia, there are no changes in the ECG.In addition, this syndrome is characterized by a decrease in pain during movement. Diagnosis of this syndrome is rather difficult and is possible only after the exact exclusion of heart disease.
4. Pectoralis minor syndrome . This syndrome manifests itself with excessive abduction of the shoulder and its displacement to the ribs. In this case, the brachial plexus is compressed in both the subclavian part and the artery, which leads to a violation of the blood supply to the limb and a violation of innervation. The result is numbness, paresthesias, and muscle weakness in the distal upper limb.
5. Scapular-rib syndrome . It is characterized by pain in the upper corner of the scapula, a crunch when the scapula moves, a decrease in the range of motion. The cause of the syndrome is degenerative changes in the cervical spine (C3-C4 and C7). In addition, the cause of this syndrome may be associated with the synovitis of the muscles of the scapula.
6. Piriformis syndrome . The cause of this syndrome is compression of the sciatic nerve by the muscle that rotates the thigh outward in the area of ​​the lower buttock opening (where the sciatic nerve and the gluteal artery pass).Pain in piriformis syndrome resembles pain in sciatica. In addition, there may be numbness in the lower limb.
7. Syndrome of the muscle, stretching the fascia lata of the thigh . The occurrence of this syndrome is associated with degenerative changes in the lumbar spine, and can also be of a reflex nature in diseases of the hip joint or changes in the sacroiliac joints.
8. Iliopsoas syndrome .The formation of this syndrome is associated with both degenerative changes in the lumbar spine and in connection with muscle blocks in the thoracolumbar segment or with diseases of the abdominal cavity and pelvic organs.
9. Crumpy (convulsive spasms) of the gastrocnemius muscle . The duration of the crumpy can be from seconds to minutes. A sharp bending of the foot can be a provoking factor. Head injuries are considered to be the cause of crumpie. Sometimes crumpy can be in the presence of venous or arterial insufficiency of the lower extremities.
10. Crumpy back extensors. As a rule, these are spasms in some part of the muscle, most often in the mid-back. Such spasms last up to several minutes and pain sometimes requires the need to differentiate with pains of cardiac origin (angina pectoris). Trigger points are often found in the extensor muscles of the back.

Diagnostics

1. History of the disease, patient complaints (duration of pain syndrome, intensity of pain, nature of pain, connection with movement or other provoking factors.
2. Assessment of neurological status. The condition of the muscles is the presence of areas of spasm or pain points (triggers), mobility of segments of the spine, movements that cause increased pain.
3. X-ray of the spine (when examining the cervical spine, it is possible to carry out with functional tests. X-ray allows you to detect pronounced degenerative changes (in the bone tissue).
4. MRI and CT. These studies are necessary to visualize degenerative changes in soft tissues (disc herniation, protrusion, presence of compression of neural structures)
5. EMG – the study allows you to determine the degree of conduction disturbance in nerves and muscles.

Treatment

Treatment for muscle-tonic syndromes is mainly aimed at treating the underlying disease that caused the muscle spasm. But often the removal of muscle spasm leads to positive dynamics of the disease itself. In addition, prolonged muscle spasm leads to the formation of a closed pathological circle. And therefore, the patient’s task is to consult a doctor as soon as possible and eliminate muscle spasm. The following therapeutic measures are recommended:

1. Orthopedic products.Wearing a corset (lumbar region) or a Schanz collar to relieve the corresponding parts of the spine. Use of orthopedic pillows.
2. Drug treatment. To reduce muscle spasm, it is possible to use muscle relaxants, such as mydocalm, sirdalud, baclofen. NSAIDs (Movalis, Voltaren, Ibuprofen, etc.) help reduce pain and inflammation.
3. Local injections of anesthetics, sometimes in conjunction with corticosteroids, help to interrupt pathological trigger point impulses.
4. Massage and manual therapy are quite effective for muscular-tonic syndrome. These methods allow to normalize muscle tone, mobility of motor segments and thus eliminate the cause of the pain syndrome.
5. Acupuncture is a well-proven method of treating muscle-tonic syndromes. The method, first of all, helps to minimize medication intake, normalizes conduction along nerve fibers and relieves pain.
6. Physiotherapy.Procedures such as electrophoresis, magnetotherapy, DDT, SMT can reduce tissue edema, improve blood circulation and reduce pain.
7. exercise therapy. After reducing the pain syndrome, a set of exercises helps to normalize the muscle corset, muscle tone and is the prevention of muscle spasms

Trismus of the chewing (jaw) muscles

Trismus is a spasm of the chewing muscles or their involuntary contraction. As a result of the trismus, the jaws are closed and it is extremely difficult to unclench them.Usually the problem lies in dysfunction and muscle tone, and this, in turn, can be associated with various diseases. It is very difficult to get rid of spasms of the jaw muscles on your own, therefore it is important to seek help from a dentist – he will assess the condition and refer you to narrow specialists if necessary.

The mechanism of occurrence of trismus

The chewing muscles set our jaw apparatus in motion. A sudden muscle contraction, accompanied by a strong closing of the jaws, limitation of movement of the lower jaw, temporary loss of the ability to speak and eat, is called trismus.Strong teeth clenching often causes breathing problems.

Excessive muscle tension leads to their hardening. The disease can become a factor in a significant decrease in the quality of life, deterioration of the psycho-emotional background. The appearance of a person changes, the organs of the digestive tract suffer, so it is important to consult a doctor as soon as possible. Without timely assistance, general health can deteriorate, and it is also necessary to find out the causes of spasms.

Types of trismus and diagnostic methods

There are two main types of spasm of the chewing muscles:

• One-sided.Most often, it is associated with an inflammatory process or injury to the mandibular joint and adjacent tissues. As a result of unilateral pathology, the lower jaw is displaced to the side when the mouth is opened, as well as the asymmetry of the face.
• Bilateral. The cause of the disease is neuralgia and general infectious diseases. With this type of trismus, the jaws close with each other with a slight retreat of the lower jaw. There is an inability to open the mouth, difficulty speaking and eating.

To diagnose trismus, the doctor will find out information about past illnesses, operations, injuries, collect anamnesis, listen to complaints.External examination is supplemented with radiography and other methods of clarifying the diagnosis.

Causes of trismus

The problem of spasm of the lower jaw can be associated not only with damage to nerve endings and reflex contraction, but also with other factors:

• infectious and inflammatory diseases of the oral cavity;
• suffered injuries;
• unsuccessful anesthesia of the teeth of the lower jaw;
• arthrosis of the mandibular joints;
• ENT organ pathology;
• irritation, inflammation of the trigeminal nerve;
• purulent processes, etc.

In addition, trismus can result from pseudobulbar paralysis, meningitis, epilepsy, calcium deficiency, etc. Symptoms may first appear after trauma, temperature changes, and sudden hypothermia. Sometimes the jaw is cramped after a wide opening of the mouth, for example, removal of a wisdom tooth.

Symptoms and Manifestations

Trismus of the masticatory muscles is accompanied by limited mobility of the joints responsible for closing the jaw. The inability to unclench them can be of a different nature – from partial to complete immobilization.The mouth can open 40, 20 or 10 mm or less, depending on the severity of the condition. Spasmodic contractions can worsen general well-being, cause headaches and other consequences.

One of the manifestations is inflammation due to jamming of the jaws, in this case, there is an alternate convergence of the sides of the face. Less commonly, trismus is associated with tumor processes, accompanied by a noticeable increase in education and an increase in symptoms. With viral infections, an increased body temperature is often observed.

Treatment methods

Patients with essential hypertension should receive help as soon as possible, since trismus can accompany a hypertensive crisis. It is also important to call an ambulance for suspected rabies and tetanus. In the absence of severe concomitant pathologies, you can consult a dentist.

Knowledge of how to relax the jaw muscles on your own is necessary for self-help directly in case of spasm – but in the future, examination and consultation with a specialist is necessary.A warm compress may help if the jaws close together spasmodically. Its use is not recommended if there are foci of inflammation in the oral cavity, for example, with pulpitis, periodontitis, periostitis, suspected abscess. Light massage of the muscles can also help to relax, but remember that the movements should be light, in no case should you press on the muscles with force.

The approach to the treatment of trismus includes a detailed analysis of the condition and the search for the causes of the disease. To eliminate the causes, it may be necessary to remove the inflamed tooth or surgical treatment of purulent inflammation.In the event of a fracture, the doctor will immobilize the jaw.

Physiotherapy methods are widely used as an adjunct. Laser, ultrasound therapy, electrophoresis with the use of anesthetic drugs can be used.

Antibiotic therapy is used for the inflammatory nature of spasms, for example, inflammation of the trigeminal nerve.

Treatment of spasm of the masticatory muscles often includes the use of sedatives if the pathology was caused by diseases of a neurological nature.However, the appointment of such drugs is handled by a neurologist.

Also, if an infectious nature of muscle tone disorders is suspected, vaccination is mandatory. Rabies virus infection requires immediate attention.

Preventive measures for trismus

For the prevention of trismus, it is important to sanitize the oral cavity in a timely manner: remove teeth that cannot be restored, treat caries and inflammatory gum disease. If you need prosthetics, you should contact only qualified specialists, and orthodontic structures should be replaced in a timely manner.The presence of neurological diseases requires constant monitoring by a neurologist.

In case of trismus, you can get advice from the dentists of the STOMA clinics. If the pathology of the temporomandibular joints is detected, experienced specialists will prescribe an additional examination and give recommendations aimed at eliminating the causes of the disease. You can sign up for an examination by calling the specified phone number or through a special form on the website.

90,000 Back pain (lumbodynia, sciatica, sciatica)

The most common causes of back pain are:

• Acute muscle spasm (persistent tension).
  It usually occurs after an unsuccessful movement, increased physical axial load, prolonged work in an uncomfortable position. Acute muscle spasm can be triggered by prolonged hypothermia, stress. Muscle spasm leads to poor blood circulation in the muscle, the development of edema and back pain.
  Back pain can increase muscle spasm (tension) when trying to make any movement, and the resulting muscle spasm (tension) increases back pain, thus forming a vicious circle.

• Subluxation of the intervertebral joints leads to the appearance or intensification of reflex (protective) muscle spasm – this is a kind of “automatic defense reaction”, thanks to which the body prevents further damage to the tissues and structures of the spine.
  This also causes back pain, since pain receptors are located not in the bones, but in the tissues surrounding the spinal column – muscles, ligaments, tendons. At first, as a rule, the process occurs at the same level, when the start of treatment is “delayed” and the proper method of recovery is not used, back pain can not only intensify, but also tends to spread to other nearby muscle areas and spine.

• Herniated disc. The disc lost its ability to absorb the axial load on the spine, decreased in height, and a hernia formed. The process of hernia formation is often very long and in most cases is associated with a deterioration in its blood supply due to a violation of the “pumping” function of the surrounding muscles.
  A herniated disc of the spine is located in 95% of cases under the posterior longitudinal ligament of the spine, which stabilizes it.A herniated disc of the spine puts pressure on the posterior longitudinal ligament, which, through the so-called recurrent nerve Lyushka, leads to reflex (protective) irritation of the deep muscles of the spine and their spasm (tension), causing back pain. The hernia itself does not hurt.
  So, for example, with a hernia in the cervical spine, changes in the tone of the deep muscles of the neck occur and pain appears in the neck itself. The pain can spread to the shoulders, arm, or both arms, to the scapula.The pain can also increase with movement, turning and tilting the head and accompanied by numbness in the hands, headache.

Today, treatment in Krasnodar for this condition requires the patient to have understandable information about the causes of back pain and even some knowledge and understanding of human anatomy and physiology. This is due to the fact that treatment in Krasnodar for back pain is the most common reason for most people of working age seeking help.

Doctors and specialists of the “Doctor Bubnovsky Center” in Krasnodar are ready to offer you qualified assistance. Together with you, we will find out the cause of the pain, determine objectively the degree of your health condition, draw up an individual program for recovery and relief from pain.

What is varicose veins

08/13/2020

One of the most common diseases in phlebology is varicose veins.

“Good” (oxygenated and nutrient-rich) blood flows from the heart to the legs through the arteries.Further, all the cells of the skin, bones, muscles of the legs take all useful substances from the arterial blood (this process takes place in the capillaries) and give into it all the used (waste) waste, and it is this blood that enters the veins further.

Difference between arterial and venous blood

There is used, waste blood in the veins, containing, so to speak, “waste”. This blood must go through the veins from the legs upward, for cleaning – into the kidneys, liver, lungs.That is, the BASIC FUNCTION OF THE VINS IS THE PUMPING OF USED BLOOD FROM THE LEGS TO THE BODY. But the problem is that when the patient stands in an upright position, the waste blood flows through the veins against the force of gravity, and this is a very complicated process. Blood is pumped by the heart and lungs, which are very high from, for example, the feet. What other mechanisms help blood rise? Firstly, these are the gastrocnemius muscles, inside which there are deep popliteal veins with their tributaries. During the contraction of the muscles of the legs, the popliteal veins are compressed, providing additional “blowing” of blood, therefore, with varicose veins, walking and swimming are useful, and, on the contrary, prolonged standing in one place is harmful.

The work of the gastrocnemius “venous pump” of the muscles of the legs

But, no matter how perfectly the pump system worked – the blood during pauses (or standing on its feet without moving) should have flowed back, but this does not happen. Why? Because the following mechanism comes into play here. It turns out that all veins have valves that prevent blood from flowing back (flowing down). Here they are – in the picture. On the left are normal valves that close when blood flows back.

A in the figure on the right – dilated (varicose) veins in which, due to overstretching or inflammation of the vein wall, the valves stopped working and as a result, the used blood containing harmful substances through such veins goes back down to the legs, creating an excessive concentration of harmful substances in the tissues and muscles. This leads to complaints typical of varicose veins – a feeling of fullness in the legs (the outflow of blood and excess fluid in the leg is disturbed), itching (irritation of the skin receptors by waste cells), discomfort, a feeling of heaviness, venous pain, a feeling of “goose bumps”, burning, cramps (muscle spasm), a feeling of heaviness in the legs.Outwardly, this can be manifested by swelling of the legs, swelling of veins, increased vascular pattern, blueness of the skin, etc. In the initial stages of varicose veins, symptoms appear only with prolonged exertion or in the evening. Then they begin to repeat themselves more and more often. Finally, they become almost permanent or appear under low stress. The puffiness does not go away in the morning. The skin color in the area of ​​varicose veins becomes first reddish, then dark, indicating the development of trophic eczema – skin damage that can become irreversible.Long-term edema and eczema can ultimately lead to the development of a trophic ulcer. At this stage, the treatment of venous pathology is very difficult and in some cases may not lead to complete healing, but only to maintain the situation in a relatively stable state.

What is varicose veins

So, what is varicose veins – this is an excessive expansion (hyperextension) of some veins with IMPAIRMENT OF THEIR FUNCTION. That is, the used blood does not flow through the varicose vein up to the body for cleaning, but on the contrary – down to the foot, causing a number of problems.

Why is it necessary to remove diseased veins through which waste blood containing waste of cellular metabolism flows not upward for cleaning, but back to the legs? There are several reasons for this. The first reason is that overstretched veins containing used blood are a common source of blood clots in the body. Blood is a complex biological fluid, practically a tissue, containing, in addition to water, a large number of substances, cells, protein structures. For normal functioning, it must flow all the time and not stagnate, as it happens in varicose veins.Let’s show clearly what it is about. In order to understand what happens during blood stagnation, we draw blood into a test tube and see what happens. If the test tube is not shaken, but left to stand on the table, after a few minutes a blood clot of coagulated plasma and blood cells – a thrombus – will fall out to the bottom of the test tube. If such a blood clot forms inside a vein, it can “travel” through the vessels, causing blockage in those places that are smaller than its diameter, and the first target on its way is the vessels of the lungs.This phenomenon is called pulmonary embolism, or pulmonary embolism for short. This is a very serious disease, the treatment of which is usually carried out in intensive care units of large hospitals, which is associated with a sharp deterioration in blood flow in the lungs and disruption of gas exchange in blood clogged blood vessels. Clinically, this is manifested by a sudden onset of severe shortness of breath, which is very difficult to stop even on a ventilator. If the thrombus does not detach from the veins of the legs and PE does not occur and the thrombus remains in the varicose node, then with thrombosis, inflammation of the vein wall in the thrombus zone is almost always observed, manifested by redness, thickening of the varicose vein, as well as the feeling of a tight “tightness” along the dilated nodes.In such a situation, surgical treatment of varicose veins or the appointment of drugs that thin the blood to prevent further growth and detachment of a blood clot is indicated. If the first stage is anticoagulant therapy, then varicose veins should be treated (remove diseased veins), since the risk of re-thrombosis of varicose veins after anticoagulant withdrawal is about 5 times higher than before thrombosis.

Another reason why it is necessary to remove dilated non-working veins is that the presence of such veins, due to the reverse flow of waste blood, constantly creates an increased concentration of harmful substances in the tissues of the legs, as well as overfilling the venous system with blood and poor removal of fluid in general from legs.This leads to swelling, leg pain, bloating, itching, cramps, and other clinical symptoms of venous insufficiency. Gradually, these symptoms worsen, reducing the resistance of the injured leg to stress. Prolonged increased concentration of waste substances in the skin, in the zone of which there is a varicose inflow, leads to a disruption of its nutrition (poisoning with its own waste products of cells), that is, trophic changes, such as venous eczema and ulcers, prolonged edema, damage to the microcapillary and lymphatic channels and ultimately as a result, to irreversible changes in the skin and subcutaneous tissue of the legs.In this regard, the most important component of the treatment of varicose veins today is the planned removal of patients with dilated and non-functioning areas of the venous bed. And as supportive therapy, drug and compression therapy can be used, but after the correction of the main problem.

Causes of varicose veins

1. Hereditary predisposition:

More than 25% of people suffering from varicose veins, close relatives also have one of the forms of this disease.Most likely, a connective tissue defect is inherited, which further leads to the development of varicose veins. The connective tissue is the skeleton of all organs and tissues of the body, including the skeleton of the vessels (arteries and veins).

2. Lifestyle:

• Prolonged, static loads (lifting weights, motionless standing or sitting) can trigger the development of varicose veins. The risk category includes surgeons, cooks, hairdressers, waiters, teachers and office workers.If a person is forced to stand for most of the day, and there are no active muscle contractions, his venous system cannot resist gravity. As a result, physiological stasis develops – the lower limbs are filled with blood and edema develops.
• Insufficient physical activity.
• Smoking, which increases blood pressure and increases the risk of varicose veins.
• The lack of raw vegetables and fruits in the diet, as well as a high level of food processing, causes a lack of fiber, which is necessary for the normal functioning of the vein walls.In addition, such a diet can contribute to the development of chronic constipation, which, in turn, leads to an increase in intra-abdominal pressure.
• Tight underwear, corsets, especially at the level of the groin folds, increase intra-abdominal pressure, which can provoke the onset or development of varicose veins.
• Overweight is a scientifically proven risk factor for the onset and development of varicose veins for women of reproductive and post-reproductive age.For men, obesity is not a statistically confirmed risk factor for varicose veins. However, being overweight increases the stress on the legs and veins of the lower extremities. For the same reasons, high growth is a risk factor for varicose veins.
• Hormonal imbalance. The role of this factor has increased manifold in recent years due to the wide popularity of hormonal contraceptives and substitution therapy in pre- and postmenopausal women. Progesterone, estrogen and their analogs contribute to a decrease in the tone of the venous walls due to the destruction of elastic and collagen fibers.

3. Pregnancy, childbirth, physical stress. With such an excessive load, there is a sharp increase in pressure in the veins of the lower extremities and damage to the valve apparatus, which triggers the mechanism of superficial varicose veins.

Every third woman after 30 years has signs of varicose veins. Legs hurt, swell, so-called spider veins appear, which eventually turn into varicose veins.You have to give up high heels, and often hide your legs under long skirts. Varicose veins are not a purely cosmetic problem . Varicose veins are a disease caused by a malfunction of the valves responsible for the movement of blood through the veins from the bottom up. With varicose veins, the pressure increases, the blood stagnates, which leads to painful heaviness in the legs, edema, varicose veins (in Latin “varix”), and in a neglected state – to thrombophlebitis, thrombosis, lymphovenous insufficiency and trophic ulcers.

Get out of the shell

Muscle clamp is a signal of the body about internal overstrain. The accumulation of clamps can be devastating.

Muscle block, clamping or spasm is a defense-adaptive response in response to any disease, injury or stress. A muscle or group of muscles that is in a state of chronic tension cannot relax properly, resulting in painful sensations when moving.Clamping can result from injury, an uncomfortable workplace, or a sleeping place. “For example, when we hit painfully, we instinctively curl up around the bruised area, protecting it from the external threat of re-traumatization,” says Alexander Leontyev, a neurologist, chiropractor, author of books on massage and physical education of a new generation. in response to any disease of internal organs, twisting the torso in such a way as to create maximum peace and favorable conditions for the diseased organ to perform its function. “

In addition, the nervous system directly influences the formation of muscle tension. Emotional overload or prolonged stress – all this contributes to the displacement of the anatomical structures in the human body through which the nerves pass. A person who is not accustomed to openly expressing emotions, especially negative ones, may be faced with the fact that suppressed resentment, aggression, fear, anger will persist in the body, like information on a hard disk, accumulating until a critical moment – muscle spasm.

Freud’s follower Wilhelm Reich called this phenomenon “muscle carapace”. Its function is to protect against displeasure or potential danger. “Reich identifies seven segments of the muscle carapace: the eye area, the mouth area, throat, chest, solar plexus, abdomen and pelvis. The blockage in each of these segments directly depends on an unresolved emotion. For example, deep sadness can be expressed in the chest clamp, suppressed tears – in the throat. And stopped tears – in the spasm of the eye muscles “, – says the candidate of psychological sciences Nina Kanevskaya.

Destructive Power

The contracted muscle practically ceases to be supplied with blood, therefore, nutrients and decay products are not excreted into it. As a result, not only the muscles themselves suffer, but the surrounding areas, including organs. “When a lot of clamps accumulate in the body, this can lead to displacement of the vertebrae, large and small joints, the innervation (supply of nerve cells) of many organs is disrupted, which can ultimately lead to serious diseases,” says the doctor of osteopathy, neurologist, chief physician of the Neonatus clinic –Sanus “Olga Kalinovskaya.“Take the pancreas, for example. Sometimes we hear from the media that some famous artist or politician is admitted to the hospital with a diagnosis of acute pancreatitis. Such patients come to see me quite often. During the examination, I feel that the pancreas is almost stone in density, as if it becomes a solid clamp. “

Energy leak

Spasm can form in one or more places. The locality of a particular clamp depends on the individual characteristics of a person, such as personality type, age, body structure and structure.But there are also so-called target muscles that are pinched in most people. They are located in the upper part of the body, most often in the neck-collar region. The prevalence of these blocks is associated with an increase in stressful situations and a sedentary lifestyle. Thus, restricting blood flow to the brain leads to severe headaches. This constant stress negatively affects the entire body. After all, he spends too much energy to maintain such unhealthy muscle tension. Hence, rapid fatigability, sleep disturbance, a person all the time lacks strength, vigor.Irritability and depressive states appear.

In some cases, muscle clamps pass spontaneously, but this is rather an exception. Studies have shown that most often the first stage of clamping passes imperceptibly and painlessly, gradually developing into pain. And if you do not consult a specialist in a timely manner, then reversible changes in muscles develop into organic ones, which are much more difficult to cope with.

Chewing gum principle

The most effective treatment for clamps is manual therapy and osteopathy.Specialists of this profile will help not only to eliminate the changes that have appeared, but also find out more important factors and causes of the onset of the disease. If muscle spasm is a consequence of any disease, such as stomach ulcer or gastritis, then, of course, it is necessary to undergo treatment in conjunction with a gastroenterologist. It is also worth contacting a psychologist in addition, since these diseases can be of a psychosomatic nature.

In addition to supervision by specialists, do not forget about independent work and proper physical activity.

Yoga, Pilates or swimming are great for relaxing your muscles, especially on your back. Each of this type of activity is aimed at warming and high-quality stretching of the muscles, which perfectly helps to get rid of muscle blocks.

Alexander Leontiev draws attention to two important principles when engaging in physical activity. “The first is the principle of chewing gum. If you pull the gum fast and hard, it will break. Therefore, smoothness and regularity of actions are very important,” says the expert.- For a long time, any biological tissue will necessarily be stretched. But there is a possibility of damage if the efforts are significant and short-lived. The second principle is “if you don’t warm it, you won’t stretch it.” At low temperatures, any fabric is fragile, and after heating it becomes more elastic. That is why it is imperative to warm up problem areas before stretching. This can be achieved through warm-up, exercise, or a heating pad applied to the area of ​​the muscle being stretched. “

“It is necessary to exclude asymmetric loads (archery, tennis), extreme loads, entailing strong muscle tension, and loads associated with lifting weights,” adds Olga Kalinovskaya.

Correct daily routine, physical activity, stress resistance training and positive emotions are a guarantee of life without armor and pain.

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Gnathology | The network of dental clinics “Dental-Service”

What kind of gnathology is this?

Gnathology is a branch of medicine that studies the mutual work of the temporomandibular joints, facial muscles and teeth.All of them are involved in the process of chewing food. If the teeth do not close properly, the chewing load is unevenly distributed. It disrupts muscles and joints, leading to discomfort and pain. The task of the gnathologist is to achieve symmetrical work of the masticatory muscles and the correct position of the joints, and then stabilize it. Here are just some of the complications caused by an imbalance in the dentition:

• restriction in opening the mouth, the jaw can jam in certain positions,
• discomfort, fatigue when chewing food,
• clicks and crunches in the jaw, displacement of the jaw to the side when opening the mouth,
• persistent or episodic headaches,
• ear and neck pain,
• pain in the mandibular joints,
• constant clenching of teeth, grinding of teeth,
• increased abrasion of teeth,
• loss of gums around the tooth.

Where to go with similar symptoms? Take, for example, headaches that sometimes radiate to the ear. If their cause is a spasm of the facial muscles, then neither the ENT nor the neurologist will help or even diagnose. In our practice, there have been many cases when patients who have suffered from headaches for years have come to us. Our specialists performed diagnostics, prescribed treatment, and in a matter of days the patient felt relief.

9002 image / svg + xml

Disorders in the joints-muscles-teeth system accumulate gradually.For example, when a baby tooth is removed from a child and a space retainer is not installed in the vacant space, this leads to displacement of the remaining teeth and distortion in the closing of the jaws. The body adapts to the asymmetry of the bite, but its adaptive properties are not endless. With age, the skew in the closure increases. The age at which gnathological failures most often begin is 30-40 years. Here are the factors that contribute to the imbalance in the dentition:

Focus in the bite

Don’t just fill the gap in the dentition.We restore the function. Orthopedic dentistry in Dental-Service.

• fillings that are made without taking into account the anatomy of the tooth,
• crowns, veneers, bridges that are installed without taking into account the anatomy of the oral cavity,
• prolonged absence of teeth in the dentition,
• malocclusion,
• stress (it causes spasm of the facial muscles),
• injuries (e.g. spine).

We diagnose gnathological problems

The first thing a gnathologist starts with is diagnostics.The doctor determines the exact parameters of your dentition. Note that muscle and joint pain is not always caused by its imbalance. Their reason may be associated with the anatomy of the joint, with cysts and arthrosis. In this case, the gnathologist will refer the patient to an arthrologist who will prescribe conservative or surgical treatment. A complete gnathological diagnosis consists of several procedures and takes about two hours.

• Inspection and consultation. The doctor examines the oral cavity, assesses the closure of the teeth, the integrity of the dentition, collects a detailed anamnesis.Assesses the tone of the masticatory muscles, the presence of pain points, the range of motion of the upper and lower jaw and the width of the mouth opening.
• 3D axiography. The doctor conducts a computer analysis of the movement of the jaws. Are there any obstacles to the movement of the lower jaw? Do the articular heads move out of the joint evenly when opening and closing the mouth? Does the closure he observes in the patient’s mouth match the closure that would be comfortable for the muscles and joints?

Diagnostics on the verge of fantasy

High-tech

axiograph analyzes the movements of the jaws
which the patient performs under the guidance of a doctor.The data is saved on the computer in the form of 3D models and motion graphs.

Digital
face bow
with motion sensors

Instant
data visualization.
Doctor analyzes
motion graphics
and 3D models

Doctor
directs
movements
patient

Axiograph
receives information from sensors and simulates the trajectory of jaw movement

Paraokklyu-
zion fork
lower jaw
with motion sensors

• Computer tomogram. Shows the structure of the joints, the position of the articular heads at the base of the skull.
• Myography. The gnathologist evaluates the condition of the facial muscles: compression force, work symmetry, tone.
• Analysis of the movement of the jaws on the articulator. The doctor takes an impression and makes a plaster model of the jaw, which is analyzed on an articulator. An articulator is a device that reproduces the movements of the jaws. Most modern articulators are programmed for average parameters. We use a new generation articulator that works with individual parameters. The doctor enters the data that he received on a 3D axiograph and observes on a plaster model exactly how your dentition works. He receives the parameters required for gnathological treatment with the highest precision.

image / svg + xml New generation articulator reproduces jaw movements We adjust the device according to individual parameters obtained on the axiograph and analyze the movements of the plaster model

Correct gnathological disorders

Stage 1.Relax the muscles

Relaxing tense facial muscles, bringing them to a natural, symmetrical state is not an easy task, especially if the jaws do not close properly over the years. Wearing mouthguard helps to get the muscles out of their usual, spasmodic state. Its other name is muscle relaxant splint . The mouthguard “reprograms” the muscles, removes muscle memory. In most cases, the patient will quickly experience symptom relief. Pains caused by spasm go away. The mode of wearing the mouthguard is determined by the doctor.At first, the mouthguard is worn around the clock. Then the regime softens, it becomes predominantly night. How long it will take for stable muscle relaxation is difficult to say, everything is individual. The average term is 3–12 months.

image / svg + xmlTherapeutic mouthguard “reprograms” muscles, erases muscle memory. Manufactured individually from transparent plastic

Step 2. Fix the correct position

Once the muscles have relaxed and returned to their natural position, it is important to stabilize it.To do this, you need to restore the correct anatomy of the oral cavity. This can be done with orthodontic treatment or prosthetics. A difficult path, but it doesn’t work out otherwise. If you just stop wearing a mouth guard, the muscles quickly return to a spasmodic position, because the cause of the tension has not been eliminated. You want your teeth to hold the muscles in the correct position – instead of a mouthguard. Correct closing of teeth is a guarantee that there will be no relapses.

We prepare correctly for orthopedics and orthodontics

Any global intervention that changes the anatomy of the teeth or the structure of the dentition – the installation of crowns, veneers, braces – we start with gnathological diagnostics. If a patient has a gnathological imbalance, it must be identified – before starting any treatment. This imbalance is not always visible to the naked eye, it is not necessarily worrisome. But it can be seriously enhanced by adding volumetric work in the oral cavity. Dentures, which are made taking into account the data of gnathology, are ideally comfortable and require a minimum of time to get used to.

image / svg + xmlLOMAKINAndrei SergeevichOrthopedist-gnathologistHow to help a patient with facial pain? First of all, figure out what exactly hurts.Muscles? Teeth? Joints? We quickly and accurately diagnose and help in situations that seem hopeless. We also properly prepare for prosthetics and treatment with braces. We have unique diagnostic equipment (axiographs!), An excellent dental laboratory and a team of expert gnathologists. 90,000 Spasms of the muscles of the back in the lumbar spine treatment in Moscow, we treat muscle spasms in the clinic Dr. Long

Free admission and diagnostics of a chiropractor, osteopath, neurologist

Lower back spasm

Free reception
and diagnostics

Pain relief
for 1-2 sessions

Author’s method
treatment

Internships in the USA,
Israel, Germany

The vertebral column is a complex system consisting of many elements, the well-coordinated work of which allows a person to move in an upright position.An integral part of this system is the muscles that support the required position of the body in space.

1

Positive dynamics in 97% of cases

The results of the treatment course are confirmed by control MRI scans.

2

No side effects

The methods used in our clinic are safe and have no side effects.

3

Long-term effect

Treatment minimizes the risk of new hernias in other segments, as well as hernia recurrence.

The muscular corset of the back is formed of two layers of muscles: deep and superficial.

• The muscles of the deep layer connect the vertebrae and support the lumbar physiological curve.
• Superficial spinal muscles provide the movement of the spine in the lower back: tilts, torso turns, body rotation and others.
• Strong muscle corset protects the spinal cord, spinal structures, internal organs from external influences.

Deep muscles are involved in the trophism of the intervertebral discs, which, without their own blood supply system, receive nutrition from nearby tissues. During the contraction of the dorsal muscle fibers, a transudate enriched with oxygen and nutrients is released into the intercellular space of the spine. Due to the diffusion of these substances, the cartilaginous tissue of the disc is nourished.

For the full performance of its functions muscle tissue must be elastic and when moving, evenly strain and relax.

The dorsal muscles of the lower back receive innervation from the lumbar plexus, which is located in the thickness of these muscles. Any pinching of nerve fibers leads to impaired conduction of the impulse, which provokes the formation of myofascial pain syndrome with the formation of trigger points. A trigger point is a local muscle hypertonicity, the external manifestation of which is severe pain.

Spasm – reflex (involuntary) muscle contraction, as a rule, is accompanied by painful sensations, while muscle function is impaired.

Muscle spasm can involve both a single muscle and a whole group of muscles. Reflex muscle spasms sometimes persist for years, which negatively affects the state of the entire human musculoskeletal system.

Risk factors provoking muscle spasm in the lower back:

• strenuous physical labor;
• weight lifting;
• overweight or obesity;
• pathology of the joints of the lower extremities;
• deformity of the foot;
• hypodynamia;
• prolonged stay in an uncomfortable static position.

Many diseases of the spine and surrounding tissues cause spasm of the muscles of the lumbar spine:

• Osteochondrosis caused by degenerative-dystrophic processes in the intervertebral discs and its complications: protrusion of the annulus fibrosus, intervertebral hernia.
• Destabilization of the location of the vertebrae with a decrease in the height of the intervertebral discs or as a result of stretching of the ligamentous apparatus.
• Ankylosing spondylarthrosis (ankylosing spondylitis).
• Complications after spinal surgery.
• Infectious and aseptic inflammatory processes in the spine.
• Posture defects.
• Congenital and acquired deformities of the spinal column.
• Traumatic injuries of the back in the lumbar region: bruises, dislocations and fractures of the vertebrae, sprains and ruptures of ligaments, tendons, muscles.
• Compression of the spinal roots and sciatic nerve.
• Osteoarthritis of the ilio-sacral joints.

In addition to diseases, the cause of spasm of the muscles of the lower back in a healthy person can be the effect of excessive physical exertion on the muscular frame of the back – for example, lifting heavy objects, a sharp turn of the body, a prolonged static posture.

When the spine is injured, a reflex contraction of the paravertebral muscles occurs, which tend to stabilize the damaged segment. A protective mechanism is triggered – the body tries to limit the mobility of the affected area due to the tension (spasm) of the muscles surrounding the spine.

Prolonged muscle spasm causes compression of blood vessels and nerve trunks, metabolism is disturbed. In the muscles, as a result of incomplete oxidation of glucose in conditions of oxygen deficiency, lactic acid begins to accumulate. An increase in the concentration of lactic acid in the muscles is the cause of the onset of pain.

With lumbar injuries, an acute muscle spasm occurs, accompanied by unbearable pain, difficulty in movement, inability to bend or straighten the back.

If muscle spasm is accompanied by local numbness of the skin, muscle dystrophy, this may be evidence of such serious complications as a rupture of a nerve or a fibrous ring of the intervertebral disc.

When a person is in one position for a long time, positional muscle overstrain is formed. Muscle spasm in the lumbar region is often seen in people with a sedentary lifestyle. They develop the so-called “inhibitory effect”, when the muscle fibers, “remembering” their position, tend to maintain it in the future.The resulting hypertonicity of muscle tissue is characterized by strong muscle tension, decreased range of motion, pain syndrome.

In professional athletes, severe spasm of the lumbar muscles occurs against the background of numerous injuries associated with tears and sprains of the ligaments, the formation of microhematomas in the thickness of the muscle fiber.

Additional signs – pallor of the skin of the face, dizziness, lethargy, apathy, nausea, motion sickness while traveling in transport.When the legs and arms do not feel nerve impulses, while the condition is not caused by diabetes mellitus, constant thirst worries, and prolonged wound healing is observed. Due to the reduced innervation of the extremities, the patient does not feel the effect of temperature, therefore, he is susceptible to burns or frostbite.

The success of treatment is 90% dependent on experience
and the qualifications of the doctor.

Free consultation and diagnostics of a doctor

• Chiropractor
• Vertebrologist
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During the consultation, we carry out a thorough diagnosis of the entire spine and each segment.We for sure
determine which segments and nerve roots are involved and causing pain symptoms. Following the consultation
we give detailed recommendations for treatment and, if necessary, prescribe additional diagnostics.

1

We will carry out functional diagnostics of the spine

2

We will perform a manipulation that significantly relieves pain

3

We will compose an individual treatment program

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Myofascial syndrome of the muscles of the lumbar spine

Spasms and pain in the lower back – myofascial syndrome – in 40% are associated with the development of deforming arthrosis of the hip joint.In 30% of cases, the culprits are degenerative processes in the spine in the area of ​​localization of the lumbar nerve plexus. This causes compression of the nerve fiber, and the reflex muscle spasm that occurs in response, upsets the innervation of the muscles.

Other reasons leading to muscle spasm include inflammatory processes, tumor neoplasms in the small pelvis, frequent hypothermia. Myofascial syndrome can form in a woman during multiple pregnancies or with polyhydramnios.

Symptoms of the myofascial syndrome of the muscles of the lower back:

• Low back pain radiating to the area of ​​the hip joint and the outer surface of the thigh.
• Stiffness in the lumbar spine in the morning and after a long stay of a person in a static position.
• Difficulty bending the leg in the hip joint and when trying to move it away from the body.
• Pain and muscle spasm causes changes in gait and posture.

Treatment

Any muscle spasm in the back and lower back is a reason to consult a specialist.

Muscle spasm in the lumbar spine is not a specific symptom; it accompanies many diseases. Therefore, before treatment, a thorough examination of the patient is carried out in order to identify the causative factor that caused the disease.

In the clinic of Doctor Length, the therapy of pathologies of the musculoskeletal system is carried out according to the latest techniques using the achievements of both domestic and foreign medicine.An individual course of treatment is developed for each patient, capable of relieving acute manifestations of the disease in several sessions, and then restoring the lost functions.

In the acute period, with severe pain, drug therapy is used: blockade of the affected muscle segment, administration of muscle relaxants.

The process of non-drug treatment includes the techniques of osteopathy , manual therapy, a unique method of Di-Tazin therapy, therapeutic massage.

Soft manual techniques in combination with electrophoresis and photodynamic laser therapy help to increase the elasticity of muscle tissues, improve metabolic processes in muscles, and restore blood and lymph circulation.As a result, muscle spasm is relieved, pain is relieved, and the muscles are in normal physiological tone.

Reflexology in the form of acupuncture. Acupuncture of biologically active points eliminates inflammation and edema, relieves spasm and excessive tension in the muscles, and starts the process of regeneration of damaged tissues at the cellular level.

Kinesiotherapy – this technique helps the body to restore the lost motor abilities, restores mobility and normal tone of muscle tissue.

The methods used in the clinic of Doctor Length are safe , have no side effects, have a long-term therapeutic effect and can be used to treat patients of all age groups.

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Thank you for your trust and your choice.

Video reviews of patients

Hernias in the lower back and neck

I came to the clinic of Doctor Length with spinal problems.With two intervertebral inferior hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months my lower vertebrae completely disappeared and the crunches in my neck disappeared …

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Lumbosacral hernia

“After the first time, my back stopped hurting.I felt relieved. Now I have already passed 7 sessions and my back really does not hurt. I began to forget about it. And at first it hurt badly. ”

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Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours.After 6 courses, the pain practically disappeared. ”

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Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that they put me on my feet in the truest sense of the word.I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were of a rather prolonged nature and the ineffective treatment that I used in the past. Fortunately, I ended up at the clinic of Dr. Length and his team of super professionals!

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Osteochondrosis of the cervical spine

“Appealed 2 months ago with osteochondrosis of the cervical spine.I have a sedentary job and my neck muscles cramped very badly. It was impossible to work. Before that I turned to other doctors, but this did not solve my problem. For 2 months I have quite positive dynamics. It gets better and better every week. ”

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Ankylosing spondylitis

“I have had ankylosing spondylitis for 10 years.The vertebrae began to move out, I began to slouch. I have consulted other chiropractors, very famous media therapists. As a result, I did not get the result. After 2 sessions, I felt much better. Now nothing hurts me. ”

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Pain in the spine

“I came with problems in the back, cervical, thoracic and lumbar spine.I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made me feel much better. I’m already turning my head. I have no pain. ”

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Shoulder-scapular periarthrosis

I went to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up in pain.After the first session of procedures, it became much easier for me. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

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Arthrosis of the knee joint of the 2nd degree

She came with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I underwent a course of treatment in the Clinic and now I am going 100%.

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Herniated disc

“I came to the clinic after I had back pain and turned out to be a herniated disc. I went to other places, but there they only removed the attacks of pain. Only Sergei Vladimirovich, his golden hands, gave the hope for a return to ordinary life! ”

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Scoliosis

“From adolescence I was worried about scoliosis in the thoracic region.I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a masseur, an osteopath, but I did not feel a strong effect. After treatment at Length S.V. I almost have an even spine now. Currently I don’t feel any problems or discomfort. ”

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Herniated disc

“On the 5-6th session, there was an improvement.I felt much better. The pain was gone. The improvement progressed more and more each time. Today is the 10th lesson. I feel great.”

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Pain in the lumbar and cervical spine

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical spine. I also sometimes had sharp pains.After undergoing therapy, I felt a significant improvement in my back. I have no pain. The general condition has improved. ”

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Back pain

“At the beginning of the treatment, my back ached very badly. I could no longer walk. I take 5 steps and stop. My whole journey consisted of such stops.During the first procedure, I left the office with no pain in the spine. ”

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Hernia of the cervical spine

“I came up with a problem in my neck and my right arm was very sick. The neck did not turn, the hand did not rise. After the 3rd session I felt better. After the 5th, all this pain went to decrease.It turns out that I have 2 hernias in my cervical vertebra. After the sessions, I did an MRI and one hernia decreased. Now I started to move, my hand started working. ”

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Neck pain

“I went to Dr. Long because my neck was very painful on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t help much.Now everything is fine, there were some consequences, the muscles were spasmodic. When I came there were steel muscles, now my neck is very soft. ”

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Pain in the thoracic region

“I went to the clinic with pain in the back, namely in the thoracic region. After 10 treatment sessions, I could calmly do my usual things, sit at work until lunchtime, without howling in pain.Now I have already come to the correction after 2 months. I’m fine, my back doesn’t hurt. ”

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Hernia and protrusion

“I came to the clinic with hernia L4-L5 and protrusion L5-S1. The course of treatment ended today. The lower back hurt, it was difficult to bend over. After completing the course and receiving instructions in the form of physical exercises, it became much easier.After a month of treatment, I do not feel any stiffness of movements. ”

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Pain in the lower back and hip joint

“From a young age I was worried about back pain. When they became unbearable, I went to the clinic of Dr. Length. After the first procedure, pain disappeared from the hip joint. After the third procedure, the shooting pains in the lower back stopped.»

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Very effective procedures

The procedures turned out to be very effective. I used to go to other clinics and absolutely did not relieve my pain, they bothered me. After this specialist, after three or four sessions, my functions recovered, the pain in my joints went away.

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Calling today will help

avoid surgery tomorrow!

Remove pain and inflammation

After 2-3 treatments, the exhausting pain goes away, you feel better.

Let’s eliminate the cause of the disease

Complex improvement of the spine improves well-being: you feel a surge of strength and energy.

Start the regeneration process

The process of repairing damaged tissues begins, hernias and protrusions are reduced.

Strengthen the muscle corset

Strong back muscles support the spinal column, preventing recurrence of the disease.