Causes, Pain Relief & Prevention

Overview

Leg Cramps at Night

What are leg cramps?

Leg cramps are sudden, involuntary, intense muscle pains usually in your calf, foot or thigh. You might also know them as a “charley horse.” Sometimes the cramp may cause your leg to spasm – to tighten uncontrollably. Although painful to live with, cramps are generally harmless.

What does a leg cramp feel like?

A leg cramp feels like a clenched, contracted muscle tightened into a knot. It can be severely uncomfortable, painful or even unbearable. Your muscles in the area might hurt for hours after the cramp goes away.

How do I stop a leg cramp?

Try forcefully stretching the affected muscle (for example, stretch your calf muscle by flexing your foot upward). Jiggle your leg, massage it, or force yourself to walk. It might also help to apply ice or heat – use a heating pad or take a warm bath. (Read the “Management and Treatment” section for more tips.)

Unfortunately, there are no pills or injections that instantly relieve a leg cramp when it’s happening. There are, however, ways that may prevent the cramp from happening in the first place (see the “Prevention” section).

Can you get leg cramps at night?

Leg cramps at night happen when you’re not very active, or when you’re asleep. They may wake you up, make it harder for you to fall back asleep and leave you feeling sore all night. Yearly, monthly, weekly, nightly – the frequency of leg cramps depends on the person. Nocturnal leg cramps can happen to anyone at any age, but they happen most often to older adults. Of people over age 60, 33% will have a leg cramp at night at least once every two months. Nearly every adult age 50 and older will have them at least one time. Seven percent of children will, as well. Approximately 40% of pregnant women will experience leg cramps at night. The reason behind that is thought to be that the extra weight of pregnancy strains the muscles.

Three-quarters (75%) of all reported leg cramps happen at night.

How long do leg cramps last?

An instance of a leg cramp can last from several seconds to several minutes.

Who gets leg cramps?

The older you are, the more likely you are to have leg cramps. This is because your tendons (the tissues that connect your muscles to your bones) naturally shorten as you age. You’re also more likely to get them if you’re a woman. Up to 60% of adults get leg cramps at night, as do up to 40% of children and teenagers.

Are leg cramps a sign of something serious?

Leg cramps can sometimes be a symptom of a serious health condition. (See the “Symptoms and Causes” section.) If you are concerned that you have a serious health condition, don’t hesitate to contact your healthcare provider and report your symptoms, including your leg cramps.

How common are leg cramps?

Leg cramps are very common and normal, especially at night.

What is the difference between leg cramps and Restless Legs Syndrome (RLS)?

Although both nocturnal leg cramps (leg cramps at night) and restless legs syndrome tend to happen to you at night or when you’re at rest, restless legs syndrome doesn’t cause the severe pain. Restless legs syndrome is uncomfortable, but not agonizing. It’s a crawling sensation that makes you want to move your legs. When you do move, the restlessness stops, but there is still discomfort.

Symptoms and Causes

What causes leg cramps?

Some leg cramps happen for no known reason and they are called “idiopathic” cramps. “Secondary” leg cramps are a symptom or complication of a more serious health condition. The primary cause of idiopathic leg cramps is up for debate. Possible causes of them include:

• Involuntary nerve discharges.
• Restriction in the blood supply.
• Stress.
• Too much high-intensity exercise.

Women who are pregnant often have leg cramps during the day and at night.

Possible causes for leg cramps at night (nocturnal leg cramps) include:

• Sitting for long periods of time.
• Overusing the muscles.
• Standing or working on concrete floors.
• Sitting improperly.

Leg cramps are not likely to cause:

• Broken bones.
• Fainting.
• Nausea.
• Numbness.

What medications may cause leg cramps?

Drugs have side effects. It’s possible that a prescription you’re taking could be causing your leg cramps. In that case, work closely with your healthcare provider to determine the pros and cons of the medication vs. its side effects. It’s possible that your healthcare provider may be able to put you on a different medication that doesn’t have leg cramps as a side effect. Medicines that have leg cramps as a side effect include:

• Albuterol/Ipratropium (Combivent®).
• Conjugated estrogens.
• Clonazepam (Klonopin®).
• Diuretics.
• Gabapentin (Neurontin®).
• Naproxen (Naprosyn®).
• Pregabalin (Lyrica®)
• Statins.
• Zolpidem (Ambien®).

Others may include: Amoxicillin, bromocriptine (Parlodel), bupropion (Wellbutrin), celecoxib (Celebrex®), cetirizine (Zyrtec), chromium, cinacalcet (Sensipar), ciprofloxacin (Cipro), citalopram (Celexa), donepezil (Aricept), eszopiclone (Lunesta), fluoxetine (Prozac), IV iron sucrose, lansoprazole (Prevacid), levalbuterol, levothyroxine, metformin, niconitis acid, nifedipine, rivastigmine (Exelon), sertraline (Zoloft), telmisartan (Micardis), teriparatide (Forteo®) and teriparatide raloxifene (Evista®).

What medical problems can cause leg cramps?

Sometimes leg cramps happen to you for no reason, but other times they could possibly be a sign or symptom of a health condition. If you have any of the following conditions, it’s possible that your leg cramps are a result of that condition. Also keep in mind that if you don’t already know if you have any of these conditions, your leg cramps may be a sign that you do. Always consult your healthcare provider if you think your leg cramps are a symptom of a more serious medical condition.

Leg cramps can possibly be a sign of lifestyle choices such as:

• Alcoholism: An addiction to alcohol.
• Pregnancy.
• Dehydration: The lack of sufficient water in the body. (This sign is debated among experts.)

Leg cramps can also possibly be a sign of serious conditions including:

• ALS (amyotrophic lateral sclerosis/Lou Gehrig’s disease): Progressive neuromuscular disease.
• Cardiovascular disease: Heart conditions caused by blood clots or diseased blood vessels. Also, coronary artery disease: The narrowing or blockage of the coronary arteries.
• Cirrhosis of the liver: Scarring of the liver.
• Diabetes: A disease that prevents your body from properly using the energy from the food you eat.
• Flat feet: The absence of the supportive arch in the foot.
• Hypokalemia: Low potassium levels in your blood.
• Kidney failure (hemodialysis): A condition in which one or both kidneys no longer work correctly.
• Osteoarthritis (degenerative joint disease): The corrosion of the cartilage that protects your bones. Also, lumbar canal stenosis: A narrowing of the spinal canal in the lower back.
• Parkinson’s disease: A neurological movement disorder.
• Peripheral artery disease: Narrowing of the arteries. Also, peripheral neuropathy: Damage or dysfunction of one or more nerves.

Cancer treatments like chemotherapy can cause nerve damage, which may cause leg cramps.

There are rumors that leg cramps can also be a sign of the following conditions. Fortunately, that is not the case. Leg cramps are unlikely to be a sign of:

• Labor (giving birth).
• Lung cancer.
• Menopause.
• Multiple sclerosis.

Leg cramps are not likely to be a sign of a deficiency in:

• Alanine transaminase.
• Albumin.
• Bilirubin.
• Calcium.
• Creatinine.
• Glucose.
• Magnesium.
• Zinc, vitamin B12 or vitamin D.

What are the warning signs that leg cramps are coming?

Unfortunately, leg cramps happen very suddenly. There are no warning signs. However, there are risk factors such as pregnancy and the use of medications that have leg cramps as a side effect.

Diagnosis and Tests

How are leg cramps diagnosed?

Your healthcare provider will need to know your medical history, medications and a description of what you’re experiencing. Be specific. Report your symptoms to your healthcare provider and include the following information:

• When the leg cramps started happening.
• What your pain feels like.
• When the cramps happen (at night, for example, or after vigorous exercise).
• How long the cramps last.
• Any other symptoms you’re experiencing.

Your healthcare provider will need to tell the difference between your leg cramps from other conditions that may resemble them:

• Claudication.
• Peripheral neuropathy.
• Myositis.
• Restless legs syndrome.

To distinguish those differences, your healthcare provider may:

• Check the palpation of pulses.
• Evaluate physical sensations such as pinpricks.
• Test deep tendon reflexes.
• Test the strength of your leg.

Do I need to have any testing done to diagnose my leg cramps?

Blood, urine and other routine tests are not helpful in diagnosing leg cramps but they may help identify previously undiagnosed medical conditions that have leg cramps as a symptom. For example, your healthcare provider will likely perform typical tests such as taking your blood pressure, and that can reveal cardiac and vascular risks.

What questions might my healthcare provider ask about my leg cramps?

To help your healthcare provider diagnose you, they may ask the following questions about your leg cramps:

• When do you experience the leg cramps?
• How often do your leg cramps occur?
• How would you describe your leg cramps?
• How long do the leg cramps last?
• What medications are you currently taking?
• What known medical conditions do you have?
• Are you concerned about medical conditions that may be causing your leg cramps?
• Are you having any symptoms of another medical condition?

Management and Treatment

What can I do to make leg cramps go away if they happen?

You want to get rid of a leg cramp the moment it strikes. You might be finishing up an exercise routine, or you might be awakened in the middle of the night. In moments like that there are, unfortunately, no magical injections that can instantly relieve your pain. However, there are eight steps to take to possibly get rid of a leg cramp:

1. Stretch. Straighten your leg and then flex it, pulling your toes towards your shin to stretch the muscles.
2. Massage. Use your hands or a roller to massage the muscles.
3. Stand. Get up. Press your feet against the floor.
4. Walk. Wiggle your leg while you walk around.
5. Apply heat. Use a heating pad or take a warm bath.
6. Apply cold. Wrap a bag of ice in a towel and apply it to the area.
7. Pain killers. Take ibuprofen or acetaminophen to help with the pain.
8. Elevate. Prop up your leg after the cramp starts to feel better.

What kinds of stretches help get rid of leg cramps?

Try this if your cramp is in your calf muscle: While standing (or sitting with your leg unfolded before you), straighten your leg and lift your foot until your toes are pointing at your shin. Pull on your toes if you are able to reach them. You could also try walking around on your heels.

What medicines may help with leg cramps?

At this time, there is no recommended medication that can prevent leg cramps 100% of the time. However, there are some prescription medications that show a little evidence of preventing leg cramps. Under your healthcare provider’s watchful eye, you might want to try the following:

• Carisoprodol (Soma®): A muscle relaxant.
• Diltiazem (Cartia XT®): A calciuim-channel blocker.
• Orphenadrine (Norflex®): Treats muscle spasms and relieves pain and stiffness in muscles.
• Verapamil: A calciuim-channel blocker.

What vitamins may help with leg cramps?

No vitamin is likely to help with a leg cramp 100% of the time. However, some experts do recommend that you take a vitamin B12 complex.

Does quinine help with leg cramps?

Quinine was thought to show some promise with healing leg cramps, but it is no longer recommended. There are potentially life-threatening side effects: arrhythmias, thrombocytopenia and hypersensitivity reactions.

When should I get my leg cramps treated at the Emergency Department?

Go to the emergency department (ED) if a leg cramp lasts longer than 10 minutes or becomes unbearably painful. Also go if a leg cramp happens after you touch a substance that could be poisonous or infectious. For example, if you have a cut in your skin that touches dirt, you could get a bacterial infection like tetanus. Exposure to mercury, lead or other toxic substances should also be reason to go to the emergency department.

Is there a surgery that could help with my leg cramps?

At this time, surgery is not recommended as a cure for leg cramps.

Prevention

How can I reduce my risk of getting leg cramps?

Experts can’t promise that you’ll never have a leg cramp again, but there are some steps you can take that might reduce your risk!

• Make sure that you stay hydrated – drink six to eight glasses of water each day. Don’t drink as much alcohol and caffeine.
• Adjust how you sleep. Use pillows to keep your toes pointed upwards if you sleep on your back. If you lie on your front, try hanging your feet over the end of the bed. Both positions can keep you in a relaxed position.
• Gently stretch your leg muscles before you go to sleep.
• Keep blankets and sheets loose around your feet so that your toes are not distorted.
• Wear shoes that fit you well and support your feet.
• Perform frequent leg exercises.
• Stretch your muscles before and after you exercise.
• Experiment with mild exercise right before bed. Walk on the treadmill or ride a bicycle for a few minutes.

What kinds of stretches help prevent leg cramps?

Try the following to prevent leg cramps in your calves: Stand about three feet (one meter) away from a wall. Lean forward. Touch the wall with your arms outstretched while keeping your feet flat. Count to five before you stop, and do it over and over again for at least five minutes. Repeat three times per day.

Outlook / Prognosis

Can leg cramps be cured?

Leg cramps don’t have a cure at this time. Fortunately, there are steps you can take to prevent leg cramps (see the “Prevention” section) and manage your leg cramps (see the “Management and Treatment” section).

Can leg cramps get worse?

The severity of a leg cramp is difficult if not impossible to predict. Some people see improvement with prevention and treatment plans, while others struggle. It is possible that your cramps will feel worse and happen more often as you age.

Living With

How do I take care of myself?

Come up with a treatment plan with your healthcare provider that includes a prevention plan and an in-the-moment treatment plan. Ideas for a prevention plan include several activities you may want to do every day:

• Exercise: Do leg exercises during the day, and mild, brief walking or biking right before bed.
• Hydration: Drink eight glasses of water each day and avoid alcohol and caffeinated beverages.
• Medications and vitamins: Take all vitamins and medications (including muscle relaxants) exactly how they’re prescribed by your healthcare provider.
• Prepare your bed space: Keep a heating pad and massage roller next to your bed.
• Shoes: Purchase supportive shoes.
• Sleeping position: Experiment with different positions to see if one works better than another. Keep your toes up if you’re on your back and hang your feet over the end of the bed if you lie on your front.
• Stretch: Stretch your legs before and after exercising, and right before you go to sleep.

Your in-the-moment treatment plan could include the eight steps mentioned in the Management and Treatment section:

1. Stretch. Straighten your leg and then flex it, pulling your toes towards your shin to stretch the muscles (using a towel can assist).
2. Massage. Use your hands or a roller to massage the muscles.
3. Stand. Get up. Press your feet against the floor.
4. Walk. Wiggle your leg while you walk around.
5. Apply heat. Use a heating pad or take a warm bath.
6. Apply cold. Wrap a bag of ice in a towel and apply it to the area.
7. Pain killers. Take ibuprofen or acetaminophen to help with the pain.
8. Elevate. Prop up your leg after the cramp starts to feel better.

When should I see my healthcare provider about my leg cramps?

See your healthcare provider if your leg cramps are unbearably painful, happen frequently or last for a long time. Also, talk to your healthcare provider right away if you have any of the following symptoms in addition to leg cramps:

• Muscle cramps in other parts of your body.
• Significant pain.
• Swelling or numbness in the leg.
• Changes in the skin of your leg.
• Waking up over and over again with leg cramps.
• If your leg cramps are stopping you from getting enough sleep.
• If you have fluid abnormalities or electrolyte imbalances.
• See your healthcare provider immediately if you’re concerned that your leg cramps are a symptom of an underlying serious medical condition.

What questions should I ask my healthcare provider about leg cramps?

• Do you think that my leg cramps are a symptom of an underlying condition?
• Can you show me the best exercises I can do to stretch my muscles?
• Can you show me the best massage techniques I can use to help with my leg cramps?
• Is it safe for me to take medication for my leg cramps? Which medications should I take?
• Do you recommend that I see a physical therapist, sleep specialist, massage therapist, or other specialist?
• How can I help my child when they have a leg cramp?
• Should I keep an eye out for symptoms other than leg cramps that might indicate a more serious condition?
• How often should I come back to visit you about my leg cramps?

A note from Cleveland Clinic

Leg cramps can be unpredictable and agonizing. They can affect your sleep, your exercise routine and your general quality of life. They’re common – very normal – and, fortunately, temporary, and there are steps you can take to manage them. Do your best to avoid risk factors, avoid medications with leg cramps as a side effect and take recommended preventative measures.

If you’re concerned about the severity and duration of your leg cramps, or think that they may be caused by a serious condition, don’t hesitate to contact your healthcare provider. Ask questions and voice your concerns. You don’t have to just “live with” leg cramps.

How to Prevent Leg Cramps and Treat Them at Home – Cleveland Clinic

Painful leg cramps aren’t just annoying episodes of discomfort. Because they typically occur at night, they can wake you, interrupting necessary rest and sleep.  

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Complicating matters is the fact there are such a wide variety of causes for leg cramps, from overexertion to neurological conditions to circulation disorders. And there are idiopathic causes, too, which essentially means the causes are unknown. 

But just because they’re widespread and have so many causes doesn’t mean there aren’t good prevention and treatment options. Family medicine doctor Matthew Goldman, MD, walked us through the best options and also suggested some things to avoid. 

Leg cramp prevention

While it’s unlikely you’ll be able to totally prevent leg cramps, there are definitely actions you can take that will lower your risk of some of the more common causes for those aches and pains.

Hydration

One big cause of leg cramps — and muscle cramps in general — is dehydration. In general, you should be drinking at least 6 to 8 glasses of water every day, according to Dr. Goldman, but it’s recommended to increase your intake if you’re active, especially outside. 

Typically, the goal should be to keep urine clear. If urine becomes yellow, amber, orange, etc, this is an indication you may be dehydrated and probably need to increase water intake.

Another way to avoid dehydration is to limit the amount of alcohol and caffeine you take in. 

Speak to your provider further if you are concerned about urine color and/or dehydration.

Exercise care

Overexertion and other parts of your exercise routine could also contribute to leg cramps but there are ways to combat this. 

First, Dr. Goldman says you should make sure you’ve got the right fit for shoes and properly support your feet. Whether it’s dealing with a high or low arch, the type of midsole a shoe has, or the need for stability, picking the right running shoes can have a huge impact on your body. 

Next, be sure you’re properly stretching both before and after exercise. Stretching, especially dynamic stretching, helps warm your muscles up and gets them prepared for whatever activity you’re about to do and proper stretching can keep them from cramping both during exercise and later. 

One stretch, in particular, can help prevent leg cramps in your calves. Standing about three feet away from a wall, lean forward and touch the wall with your outstretched arms but keep your feet flat. Hold this position and count to five and then relaxing. Repeat this stretch for up to five minutes at a time, three times a day.

Bedtime prep

Finally, there are some bedtime things you can make part of your nighttime routine to help prevent leg cramps since they’re most likely to occur at night. Dr. Goldman suggests some gentle leg stretches or even mild exercise, like a walk or short bike ride, right before bed.

But there are also things you can do for your sleep that might help, including adjusting your sleep position. If you sleep on your back, try using pillows to keep your toes pointed upwards. And if you sleep on your stomach, try hanging your feet off the end of the bed. Both of these positions can help keep you in a relaxed position while you sleep, he adds. 

At-home treatment of leg cramps

Leg cramps are unpleasant and often painful so you want to get rid of them as soon as you can. While there’s nothing that’s guaranteed to immediately end a leg cramp, there are several ways to help alleviate the cramp. 

Stretching and other activities

One easy way to alleviate leg cramps once they happen is, yes, stretching. One stretch Dr. Goldman suggests: while standing (or sitting with your leg unfolded before you), straighten your leg and lift your foot until your toes are pointing at your shin, then pull on your toes if you are able to reach them or use a towel for assistance if unable to reach.

Other activities like walking and wiggling your legs as you do may help shake out those cramps. You can also try massaging the cramping muscles with your hands or a roller. And, finally, you can also try standing and pressing your feet against the floor to stretch out those cramping muscles. 

Hot and cold

A big change in temperature could help out those cramping muscles, according to Dr. Goldman. In addition to stretching, adding heat to your cramping muscles with either a heating pad or a warm bath can help relax and increase blood flow to the cramping muscle(s). 

Conversely, an ice pack can help ease the pain of a leg cramp while you wait for it to subside. Just be sure to wrap the ice in a towel or other piece of material so that the ice doesn’t make direct contact with your skin. 

Medication

Over-the-counter painkillers won’t make the cramping immediately go away, but ibuprofen (Advil, Motrin) and/or acetaminophen (Tylenol) can help ease the pain associated with the cramps. Speak with your provider first about whether or not these medications are safe for you.

Take that, muscle cramps! – Harvard Health

Here are the best ways to stop painful cramps — and prevent them from returning.

 Image: © ChesiireCat/Getty Images

A muscle cramp always feels like a surprise. The involuntary contraction strikes without warning, whether it’s a charley horse in the middle of night or a back spasm as you reach for an everyday object. But don’t let that cramp throw you for a loop. “When it suddenly strikes, don’t exercise or tighten the muscle. Just gently stretch it to your tolerance. That helps to relax the muscle and relieve the uncontrolled contraction,” says Madhuri Kale, a physical therapist at Harvard-affiliated Brigham and Women’s Hospital.

What causes cramps?

Exercising without properly warming up the muscles can lead to cramps. Cramps also occur when a muscle is not able to relax properly (such as from a deficiency of magnesium or potassium in your diet) or when it becomes irritated by a buildup of lactic acid (which can happen if you don’t rest your muscle after it has exercised a lot). Dehydration can worsen both of these problems. Kale says older adults often don’t drink enough water at night because they want to avoid having to go the bathroom, and they end up dehydrated.

Reduced blood flow to the muscles also can cause cramps. This can occur from narrowing of the arteries to your legs caused by atherosclerosis. It can even happen for stranger reasons. “Some people say they get cramps at night if their feet stick out from under the blankets. Being cold can constrict the blood vessels,” Kale says.

Misfiring nerves that get confused because of neurological conditions (such as Parkinson’s disease, neuropathy, or spine problems that compress nerves in the low back) can cause cramps as well. Even common foot problems (such as flat arches) can do it.

Finally, Kale says, cramps sometimes result from certain medications, like diuretics, that can cause both dehydration and mineral imbalances. Statin drugs, on the other hand, can cause constant muscle aches, but they rarely trigger cramps.

Relief for cramps

Learn some stretches that provide rapid relief when cramps come.

Kale’s shortcut for nighttime leg cramps in the calf: “Sit up in bed, loop the blanket around your foot, and gently pull your toes toward you while you keep the knee straight,” she suggests

Alternatively, for cramps in the front of the lower leg, just stand up at the side of the bed, put your weight on your toes, and lift your heels; this gently stretches the cramped muscle.

For back cramps, Kale recommends the “child’s pose” yoga posture (see “Move of the month”).

For hamstring cramps (in the back of the thigh), sit on the floor with your legs extended in front of you. Slide your hands down your legs until you feel a burning sensation in the cramped muscle. Hold for 30 seconds, then slowly return to a sitting position.

After you’ve stretched the muscle, Kale recommends putting a heating pad on the area to promote blood flow. Then gently massage the muscle.

Tips to prevent cramps

Kale suggests staying hydrated throughout the day, eating foods rich in magnesium (especially leafy greens) and potassium (bananas, black beans), wearing warm socks at night if you have leg cramps, and keeping your muscles strong and flexible with regular exercises.

Quinine tablets used to be recommended, but aren’t anymore unless cramps are disabling. “They can have some bad side effects and interactions with other medications,” Kale says.

And one more point: “Cramps are extremely painful, but they’re not a sign of serious illness,” says Kale. “Stretch the muscle and resume your activity once the cramp goes away.”

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Muscle Spasms | Charley Horse 

What are muscle cramps?

Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They are very common and often occur after exercise. Some people get muscle cramps, especially leg cramps, at night. They can be painful, and they may last a few seconds to several minutes.

You can have a cramp in any muscle, but they happen most often in the

• Thighs
• Feet
• Hands
• Arms
• Abdomen
• Area along your ribcage

What causes muscle cramps?

Causes of muscle cramps include:

• Straining or overusing a muscle. This is the most common cause.
• Compression of your nerves, from problems such as a spinal cord injury or a pinched nerve in the neck or back
• Dehydration
• Low levels of electrolytes such as magnesium, potassium, or calcium
• Not enough blood getting to your muscles
• Pregnancy
• Certain medicines
• Getting dialysis

Sometimes the cause of muscle cramps is unknown.

Who is at risk for muscle cramps?

Anyone can get muscle cramps, but they are more common in some people:

• Older adults
• People who are overweight
• Athletes
• Pregnant women
• People with certain medical conditions, such as thyroid and nerve disorders

When do I need to see a health care provider for muscle cramps?

Muscle cramps are usually harmless, and they go away after a few minutes. But you should contact your health care provider if the cramps

• Are severe
• Happen frequently
• Don’t get better with stretching and drinking enough fluids
• Last a long time
• Are accompanied by swelling, redness, or a feeling of warmth
• Are accompanied by muscle weakness

What are the treatments for muscle cramps?

You usually don’t need treatment for muscle cramps. You may be able to find some relief from cramps by

• Stretching or gently massaging the muscle
• Applying heat when the muscle is tight and ice when the muscle is sore
• Getting more fluids if you are dehydrated

If another medical problem is causing the cramps, treating that problem will likely help. There are medicines that providers sometimes prescribe to prevent cramps, but they are not always effective and may cause side effects. Talk to your provider about the risks and benefits of medicines.

Can muscle cramps be prevented?

To prevent muscle cramps, you can

• Stretch your muscles, especially before exercising. If you often get leg cramps at night, stretch your leg muscles before bed.
• Drink plenty of liquids. If you do intense exercise or exercise in the heat, sports drinks can help you replace electrolytes.

BPJ 49: Nocturnal leg cramps

Nocturnal leg cramps are common, particularly in older people and in women who are pregnant. Is there an effective treatment? Unfortunately, treatment options are limited, but lifestyle modifications and gentle stretching may have some effect. Pharmacological treatment may be considered for people with frequent, severe leg cramps. Quinine is no longer recommended for leg cramps, however, it appears to still be used.

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Nocturnal leg cramps are common, particularly in older people and in women who are pregnant. The condition is characterised
by painful cramps in the legs or feet, that affect sleep quality. Is there an effective treatment? Unfortunately, treatment
options are limited, but lifestyle modifications and gentle stretching may have some effect. Pharmacological treatment
may be considered for people with frequent, severe leg cramps, however, quinine is no longer recommended.

What are nocturnal leg cramps?

A nocturnal leg cramp is a sudden contraction of muscles in the leg or foot during sleep. This painful tightening of
the muscle can last from a few seconds to several minutes. Cramps often cause waking, and although the cramps themselves
are benign, the affected muscle may be painful for some hours afterwards and the consequences of sleep impairment can
be considerable.

Severe nocturnal cramps are characterised by painful, incapacitating episodes, which last on average for nine minutes,
and recur intermittently throughout the night.¹ This can lead to secondary insomnia and impaired day-time
functioning. Approximately 20% of people who experience regular nocturnal cramps have symptoms severe enough to affect
sleep quality or require medical attention.¹

Nocturnal cramps are common, with a lifetime prevalence of between 50 – 60% in adults and approximately 7% in children.¹ Nocturnal
leg cramps, particularly calf cramps, are common in women who are pregnant, and are considered a normal part of pregnancy.²

The cause of nocturnal cramps for many people is unknown; however, dehydration, electrolyte and mineral imbalances,
muscle fatigue and reduced peripheral blood flow have been suggested as possible contributing factors.

Factors known to be associated with an increased risk of nocturnal cramping, include:¹

• Age over 50 years
• Pregnancy
• Exercise, particularly over-exertion
• Leg positioning, e.g. prolonged sitting with legs crossed, tight bed covers which cause the toes to point downwards
• Excessive consumption of alcohol
• Chronic dehydration
• Structural disorders, e.g. flat feet or other foot and ankle malformations
• Medicines, e.g. diuretics (especially thiazide and potassium-sparing diuretics), some anti-inflammatories (e.g. naproxen),
  long-acting beta-2 agonists, statins, opioids, raloxifene (used in osteoporosis) and lithium
• Co-morbidities, e.g. osteoarthritis, vascular diseases, cirrhosis, diabetes, Parkinson’s disease, hypo- and hyperthyroidism

Nocturnal cramps are diagnosed clinically

The patient’s description of their symptoms is usually sufficient to diagnose nocturnal leg cramps, e.g. the patient
may describe a sudden onset of painful cramping of the leg or foot muscles that wakes them from sleep.

The history (including a review of medicines) and a focussed physical examination can help to identify any underlying
conditions that may be causing or contributing to the leg cramps (Table 1). Examination should include blood pressure
measurement and neurological and vascular examination of the legs.¹

Laboratory investigations, such as electrolyte levels, are not routinely required, unless there are relevant findings
in the history and examination, e.g. investigation of serum calcium would be considered in a patient with numbness in
the feet and tetany (continuous involuntary muscle contractions).¹

Table 1: Important differential diagnoses of nocturnal leg cramps¹

For further information on restless leg syndrome,

see Managing Restless Legs Syndrome in Adults

Treatment of nocturnal leg cramps

The aim of treatment of nocturnal cramps is symptom control, unless an underlying cause has been identified and can
be managed. Lifestyle modifications to prevent the cramp from occurring can be trialled first. If the patient remains
symptomatic and symptoms are severe, pharmacological treatment may be considered. However, there is currently no pharmacological
treatment for leg cramps that has been proven to be both safe and significantly effective.¹

Acute management

Patients should be given advice on what to do when they experience a cramp. Physically stretching the muscle that is
cramping, e.g. for cramp in the calf, flexing the ankle by pulling the toes upward in the direction of the shin, is the
most effective way of stopping the cramp, but this can be painful.³ Passive stretching may also be effective
and is less painful: this involves relieving the tension on the affected muscle by massage and postural changes.³ Getting
out of bed and briefly walking may also provide relief.

There is no evidence of benefit of other acute management strategies, but patients may have their own methods that,
if safe, can be encouraged, e.g. having a hot shower or placing a wheat bag or an ice pack on the affected leg.

Lifestyle interventions: diet, exercise and stretching

Encourage sufficient fluid intake during the day and avoidance of caffeine and alcohol, particularly later in the day.¹

There is mixed evidence as to whether brief stretching prior to sleep is beneficial, however it can be trialled. A randomised
controlled trial, found that the frequency of nocturnal leg cramps decreased significantly after six weeks in participants
who performed brief stretching before bed each night.⁴ However, a limitation of this study was that the control
group did not receive a placebo intervention. In another study where the control group performed sham exercises, calf-stretching
was not shown to be effective in reducing the frequency or severity of night cramps.⁵

Brief light exercise, such as walking or cycling on a stationary bike prior to bed time can be trialled, although evidence
of significant benefit is also lacking.¹

Pharmacological interventions and supplements

Mineral and vitamin supplements are unlikely to be beneficial for most people. Magnesium supplementation has no benefit
in the treatment of nocturnal cramps,⁶ although there is conflicting evidence that it may reduce nocturnal
cramps in women who are pregnant.² Supplementation with both vitamin E and calcium has been found to be no
more effective than placebo in reducing leg cramps.⁷

Over-the-counter “anti-cramp” formulations, such as Crampeze, contain some variation or combination of calcium, magnesium,
high-dose vitamin B6 or B12 and associated supplements. There is no evidence of benefit for these preparations, although
there is anecdotal evidence that they may be helpful for some people.

There is limited evidence that nortriptyline, diltiazem, orphenadrine, verapamil or gabapentin (not subsidised) may
be effective for night cramps, and can be considered in patients with severe symptoms.^1,6 Despite good evidence
that quinine is effective for the treatment of nocturnal cramps it is no longer recommended due to safety concerns.

If medicines are used, they should be initiated at the lowest possible dose and discontinued if no obvious benefit is
observed.

Quinine is not recommended as treatment

Quinine has traditionally been used at a low dose (200 – 300 mg/day) for nocturnal leg cramps, and is effective at reducing
the frequency and severity of cramps.⁸ However, it is no longer recommended for nocturnal leg cramps due to
concerns over its safety. In 2007, Medsafe issued a warning that the risk-benefit ratio of quinine for leg cramps no longer
supported its use, and manufacturers were required to remove leg cramps as an indication for quinine.^9,10

The main concern with quinine is the risk of potentially fatal thrombocytopenia. Quinine-related thrombocytopenia is
thought to be due to an idiosyncratic hypersensitivity reaction, and therefore can occur unpredictably, either immediately
or after years of treatment.⁸ Other hypersensitivity reactions associated with quinine include haemolytic uraemic
syndrome, disseminated intravascular coagulation and acute kidney injury.⁸ Quinine is significantly toxic at
high doses (causing cardiac arrhythmias, blindness and seizures), and has significant interactions with many other medicines.⁸ The
frequency of serious adverse effects has been estimated to be 2% – 4%.¹¹

Quinine is also contained in tonic water, and some people use this as a remedy for nocturnal leg cramps. However, Medsafe
has warned that even low doses of quinine, such as that found in 500 mL of tonic water, have been shown to cause severe
thrombocytopenia.¹⁰

ACKNOWLEDGEMENT: Thank you to Dr Alex Bartle, Sleep Physician, Director
Sleep Well Clinics, New Zealand for expert guidance in developing this article.

References

1. Allen R, Kirby K. Nocturnal leg cramps. Am Fam Physician 2012;86(4):350-5.
2. Young G, Jewell D. Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev 2002;(1):CD000121.
3. BMJ Best Practice. Muscle cramps. BMJ; 2011. Available from:
   
   http://bestpractice.bmj.com/best-practice/monograph/569.html (Accessed
   Dec, 2012).
4. Hallegraeff JM, van der Schans CP, de Ruiter R, de Greef MHG. Stretching before sleep reduces the frequency and severity
   of nocturnal leg cramps in older adults: a randomised trial. J Physio 2012;58(1):17-22.
5. Coppin R, Wicke D, Little P. Managing nocturnal leg cramps – calf-stretching exercises and cessation of quinine treatment:
   a factorial randomised controlled trial. Br J Gen Pract 2005;55(512):186-91.
6. Garrison S, Allen G, Sekhon R, et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev 2011;(9):CD009402.
7. Young G. Leg cramps. Clin Evidence 2009;3:1113.
8. El-Tawil S, Musa T, Valli H, et al. Quinine for muscle cramps. Cochrane Database Syst Rev 2010;(12):CD005044.
9. New Zealand Medicines and Medical Devices Safety Authority (Medsafe). Prescriber update: Quinine – not for leg cramps
   anymore. Medsafe; 2007. Available from: www.medsafe.govt.nz (Accessed
   Dec, 2012).
10. Food and Drug Administration (FDA). Quinine: important warning. FDA, USA; 2006. Available from:
    www.fda.gov/bbs/topics/news/2006/new01521 (Accessed
    Dec, 2012).
11. Katzberg H, Khan A, So Y. Assessment: Symptomatic treatment for muscle cramps (an evidence-based review). Neurology
    2010;74(8):691-6.

Leg Cramps (Aftercare Instructions) – What You Need to Know

This material must not be used for commercial purposes, or in any hospital or medical facility. Failure to comply may result in legal action.

WHAT YOU NEED TO KNOW:

A leg cramp is a sudden, painful squeeze in your calf (lower leg) or thigh (upper leg) muscles. The muscle may twitch under the skin or feel hard. Your leg may feel sore long after the muscles relax.

DISCHARGE INSTRUCTIONS:

To stretch your leg:

Warm up your muscles before you stretch. Take a short walk or run slowly in place. If you get leg cramps while you sleep, you may also want to stretch before bedtime. The following exercises stretch the calves and thighs to help stop or prevent leg cramps:

• To stretch your calf and heel:
  • Stand up and place the palms of your hands against a wall.
  • Lean into the wall, with one leg behind the other. Bend the front leg and keep the back leg straight.
  • Press the heel of your back leg into the floor.
  • Hold for 15 to 30 seconds, then switch sides.
• To stretch the back of your knee and thigh:
  • Sit on the floor with your legs straight in front of you. Do not point your toes.
  • Place the palms of your hands at your sides on the floor. Slide your hands past your hips toward your ankles.
  • Move toward your ankles until you feel a stretch in the back of your legs. Do not try to touch your head to your knees or round your back.
  • Hold for 30 seconds.

Drink plenty of liquids during exercise:

Water and other liquids help prevent cramps by replacing fluids lost in sweat. Drink more liquids when you are active in hot weather.

To stop a leg cramp if it happens again:

• Stretch and massage your muscle to stop the cramp.
• Apply heat or ice packs to the cramp. A heating pad or hot pack may help relieve tight muscles. An ice pack or crushed ice in a bag, wrapped in a towel can soothe tender or sore muscles.

Take your medicine as directed:

Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are taking any vitamins, herbs, or other medicines. Keep a list of the medicines you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits.

Follow up with your healthcare provider as directed:

Write down any questions you have so you remember to ask them in your follow-up visits.

Contact your healthcare provider if:

• Your leg cramps get worse or happen more often.
• Your leg feels numb.
• Your leg cramps do not go away with stretching or massage.
• You feel dizzy, lightheaded, or confused when you exercise in hot weather. You may have a headache or blurred vision.

© Copyright IBM Corporation 2021 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Leg Cramps (Aftercare Instructions)

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Leg Cramps at Night: Leg Cramp Causes and Remedies

Eeow! Startled from a deep sleep, you suddenly come to with a shriek, as your calf, thigh, or maybe the arch of your foot contracts in violent pain. Commonly called a “Charley horse,” this is a common and painful occurrence. Discover what causes leg cramps at night, as well as how you can prevent and relieve them.

Emerging groggily from the edge of sleep or from a deep sleep, you struggle to straighten your leg, pull your toes forward, perhaps kneading the knotted muscles with your thumbs. After the spasms subside, you may get up and try to hobble around a bit to loosen up the painful area a little more.

By now you’re completely awake, and you may not return to sleep. The cramped muscles may remain tender for hours or even days.*

The nighttime “Charley horse” is an age-old, global problem. Other languages use terms that translate into phrases like muscle hangover, wooden leg, thigh hen, thigh cookie, donkey bite, old woman, and water buffalo.

What Causes Leg Cramps at Night?

Sixty percent of adults say they’ve experienced nocturnal leg or foot cramps at some time in their lives.

Pregnant women and older people tend to suffer nighttime leg cramps more often than other groups, but medical experts say there’s often no clear explanation of why these nighttime leg cramps occur, listing many conditions that might bring one on, including:

• Hard exercise during the day
• Electrolyte imbalance 
• Dehydration
• Neurological, neuromuscular, or endocrine disorders
• Lumbar stenosis
• Standing for long periods on concrete floors
• Sitting all day in a cramped position
• A side effect of some drugs

Leg Cramp Remedies

When a cramp startles you from sleep, here are 5 tips to manage the problem:

1. Take a few breaths and try to stay calm. Panicking may cause you to tighten the affected muscles even further and prolong or intensify the cramp.
2. If the cramp is in your arch or calf muscles, forcefully extend your toes toward your head and hold the stretch until the cramp subsides. This will release the tension so that the muscles can relax. You may need to sit up, bend over, and pull your toes forward with your hands.
3. If the cramp is in the back of your thigh, roll out of bed, bend at the waist, supporting yourself on your forearms, and keep bending forward until you feel the cramped muscles stretching out. Hold the stretch until the cramp abates.
4. I’ve had good luck using a towel or a woven stretching strap to help straighten out especially vicious hamstring cramps.
5. When the acute pain subsides, get up and walk around a bit to bring oxygen to the cramped muscles. A cold pack or hot pack may help. I like the long, rectangular “beanbags” (cloth sheaths filled with beans or other seeds) heated for a couple of minutes in the microwave and wrapped around sore muscles. (Great for arthritic joints, too.)

How to Prevent Leg Cramps

If you’re prone to leg cramps at night, these 6 tips can help to stop cramps from happening again:

1. A lot of uphill walking/running or stair-climbing shortens the back muscles and the muscles and tendons at the back of the legs, making them more likely to cramp later. Focus attention on stretching these muscle groups after a hilly workout.
2. Go for a deep-tissue therapeutic massage with an experienced practitioner. Ask her/him to teach you the techniques for the muscle groups in the legs and feet, so that you can work the knots out before they become disabling cramps.
3. Loosen the bedcovers so that they don’t press your feet down and shorten the muscles of your arches, encouraging them to cramp.
4. Drink when you feel thirsty, especially after exercise. Don’t overdo it. Tea, coffee, smoothies, fruit, and vegetables all contribute to your daily fluid needs.
5. Eat a variety of potassium- and magnesium-rich foods every day. Good choices: black beans, kidney beans, nuts and seeds, potatoes, sweet potatoes, leafy greens (especially beet greens), bananas, and other fruit.
6. Stay flexible with a regular stretching. Here are two common stretches:

Basic calf stretch

Here’s how to do it:

Towel stretch

Do this stretch while you sit:

• Keep legs outstretched in front of you
• Point the toes of your affected foot at the ceiling so that the leg is engaged
• Take a towel or neck tie and wrap it around your foot, holding it with both hands
• Lift the leg slightly until you feel a good stretch

Just stretching the affected muscles three times a week will help immensely. Hold stretch for at least 10 seconds, working up to 30 seconds. And perform each stretch 3 to 5 times. 

(Find more stretches here. Clicking the “Exercise Search” box on the right side.)

The drug quinine, once prescribed to prevent night cramps, is now rarely prescribed for this use, because the possibility of severe adverse reactions outweighs the benefits of its use.

If you start having far more frequent or severe attacks of night cramps, see your doctor for an evaluation to rule out a more serious medical condition.

Restless Leg Syndrome

Don’t confuse nighttime leg cramps with restless leg syndrome (RLS). RLS is annoying and may cause an aching sensation, but it’s not usually painful and doesn’t cause cramping. See home remedies for restless leg syndrome.

*Note: If your calf or thigh is swollen, warm to the touch, or discolored; if your pain gets worse when you get up and walk around and doesn’t subside after a minute or two, seek immediate medical help. Don’t knead or massage a swollen muscle. These symptoms could signal a serious, potentially life-threatening condition called a deep vein thrombosis, a blood clot in a deep vein that can travel to a lung, where it can block blood flow.

90,000 Limb cramps – symptoms, causes, treatment, first aid, what to do in case of convulsions

Seizures are familiar to most people, an unpleasant sensation that is caused by involuntary muscle contraction. As a rule, it does not last long, but it brings a lot of negative emotions.

What are seizures?

This is a sharp muscle contraction that is beyond the control of a simple relaxing effort. The spasm is accompanied by pain, it can last from several seconds to ten minutes.With a strong muscle contraction, a large amount of decay products are released, this is the biological mechanism of convulsions.

What are the causes of seizures

This condition can occur both in sick people and in completely healthy people. Muscle contraction can be localized or generalized when entire muscle groups are affected. In children, such seizures occur at high temperatures, and in adults, a similar condition is a sign of a serious illness of the nervous system.

Among the causes of seizures:

• Deficiency of certain vitamins and minerals, most often calcium or magnesium;
• Sedentary lifestyle or too intense stress;
• Pregnancy and related changes in the female body;
• Taking certain medications that remove potassium salts from the body;
• Various diseases, including diabetes mellitus, varicose veins, overweight and flat feet.

If you are worried about frequent cramps in the limbs, contact a specialist who will find out the cause of the unpleasant phenomena.

What to do in case of night cramps?

If the muscle has cramped, it will be impossible to consciously relax it. The only way is to use physical force: straighten the toes with your hands or pull the toe towards you. After the cramp has passed, the limb can be massaged to help restore normal circulation.

How to prevent seizures?

Prevention of seizures exists if you understand the risk of their occurrence and the cause that may lead to it. For example, with flat feet, it is important to choose the right shoes and use orthopedic insoles. With varicose veins – avoid excessive physical exertion. During pregnancy, observe the regimen and take the necessary vitamins. In any case, if you want to avoid night cramps, you need to adjust your diet to include foods rich in potassium, calcium and magnesium.Instead of sweets, give preference to dried apricots and dates.

Diagnosis of the cause of seizures

In case of an unpleasant condition, it is first of all recommended to contact a therapist who will prescribe a number of tests and carry out the necessary diagnostics. These are blood and urine tests, which will show the presence of concomitant pathologies, as well as ultrasound of the veins of the lower extremities. After the cause of the seizures is found, the patient is recommended to be examined by a specialized narrow specialist or take vitamins and a diet that can help with a banal lack of trace elements.

Treatment of night cramps

Seizures can be a sign of the development of serious diseases, it is extremely important to diagnose them in a timely manner. Depending on the cause, appropriate treatment is also selected. In any case, you can reduce the risk of painful leg cramps by practicing a daily contrast shower. It is also important to change your diet. Include foods rich in potassium, calcium and magnesium, and reduce the amount of carbohydrates and fats that interfere with the absorption of beneficial micronutrients.

In most cases, frequent calf cramps subside if you balance your diet and begin to engage in moderate physical activity.

You can consult about the causes of seizures and make an appointment with a specialist by calling our clinic or through the form on the website.

SEE PRICES

90,000 Use of magnesium preparations in patients with nocturnal leg cramps

Relevance

Nocturnal leg cramps are painful, unintended contractions or spasms of the muscles of the lower extremities.Usually the calf muscles are involved, but sometimes the muscles of the feet are also involved.

The risk of nocturnal seizures increases with age and during pregnancy. The risk of developing seizures increases in patients with chronic kidney disease, diabetic neuropathy, and hyperthyroidism. According to some publications, the incidence is increased in people taking diuretics, although a direct connection between the events has not been established. Antihypertensive drugs, statins, and oral contraceptives are also medicinal causes of nocturnal leg cramps.

Magnesium supplements are widely advertised for the prevention of nocturnal lower limb cramps, despite the lack of significant beneficial effects.

The aim of of this randomized trial was to determine whether magnesium oxide is superior to placebo in the prevention of this condition.

Methods

Patients from Israel were included in a randomized, double-blind, placebo-controlled study (from February to October 2013).Patients received therapy for 4 weeks (placebo or magnesium oxide once a day in the evening). All subjects included in the analysis were ≥21 years old and had 4 or more documented episodes of nocturnal leg cramps within 2 weeks of screening.

The intention-to-treat analysis was performed from March 2014 to April 2016.

The primary endpoint of the study was the difference in the number of episodes of nocturnal seizures per week after therapy. Secondary endpoints were severity and duration of seizures, patient quality of life, and sleep quality.

Results

Of the 166 patients, 94 people were included in the final analysis (39% men, mean age 69 ± 11.1 years). Of these, 48 received magnesium oxide and 46 received placebo.

• The average change in the number of nocturnal seizures was −3.41 (4.05) (from 7.84 [5.68] to 4.44 [5.66]) and −3.03 (4.53) (from 8.51 [5.20] to 5.48 [4.93]) per week in the magnesium group and placebo, respectively. Difference between groups 0.38 (P = 0.67 in intention-to-treat analysis).
• No statistically significant differences were found between the groups in severity and duration of seizures, indicators of quality of life and sleep.

Conclusion

Magnesium oxide is not superior to placebo in patients with nocturnal leg cramps.

The decrease in seizure episodes per week in both groups is most likely associated with the placebo effect, which may explain the widespread use of magnesium in these patients.

Source: Noga Roguin Maor, Mordechai Alperin, Elena Shturman, et al. JAMA Intern Med. February 2017

.

Leg cramps in the elderly

These manifestations can occur suddenly and be episodic or recur regularly.Let’s try to figure out why leg cramps occur and how to avoid this pathology.

Reasons

The appearance of leg cramps can be both the first symptom and a sign of an existing ailment. Most often, the pathology is caused by the following reasons:

• Varicose veins.
• Diseases and disorders of the nervous system.
• Atherosclerosis.
• Hypertensive crisis.
• Dehydration.
• Endocrinological disorders.
• Infectious diseases.
• Metabolic disorders.
• Intoxication of the body.
• Diseases of the liver and kidneys.
• Prolonged use of certain medications.
• Pregnancy.
• Past diseases.
• Muscle fatigue due to long walking, exercise or swimming.

Thus, involuntary muscle contraction is only a symptom indicating the presence of pathology.It is possible to eliminate seizures only if it is possible to determine the exact cause of their occurrence.

Are seizures dangerous?

As a rule, seizures in older people are not a serious threat. However, there are a number of conditions in which involuntary muscle contraction is dangerous and requires medical intervention.

Specialist help is needed when seizures are caused by the following conditions:

• Epilepsy accompanied by severe headache, irritability, insomnia.
• Meningitis.
• CNS damage, lack of oxygen.
• Micronutrient deficiency (magnesium, potassium).
• Violation of water and electrolyte metabolism due to the presence of infectious diseases.
• Hypoglycemia (a sharp decrease in blood glucose levels).
• Discoloration of the skin, edema, redness.
• Muscle contraction accompanied by dizziness and high body temperature.

In addition, severe muscle pain with spasms for several days is an alarming symptom.If an elderly person has such manifestations, you should immediately seek medical help.

First aid

In most cases, seizures occur at night. What to do if an unpleasant condition causes discomfort?

Experts recommend the following measures aimed at relaxing the spasmodic muscle:

• Massage the leg with rubbing movements.
• Pat the muscle with a piece of ice.
• Place your feet in warm water.
• Grasp the spasmodic sore spot with your fingers and pull it towards you.
• Inject the muscle with a sterile needle.

Important! Using these simple techniques, you can prevent involuntary muscle contraction if it is of an episodic nature. With convulsions caused by serious pathologies, specialist help is required.

When urgent medical attention is needed

Most often, the contraction of the leg muscles lasts no more than a few minutes.However, in some cases, seizures indicate a serious medical condition that requires intensive treatment.

A medical emergency is required when leg cramps are accompanied by the following conditions:

• Strong twitching of the legs.
• Sudden squint or other visual disturbances.
• The appearance of foam on the lips, profuse salivation.
• Loss of consciousness.
• Sudden muscle hypertonia.

These symptoms are typical for such dangerous diseases as stroke and epilepsy. Timely seeking medical help will help prevent these pathologies and avoid complications caused by their presence.

Diagnostics

With the timely treatment of the patient to the doctor, seizures are successfully treated. Before the specialist prescribes the correct therapy, a complete examination of the elderly person is carried out using modern techniques. The course of treatment is prescribed only after determining the cause of the symptom.

Diagnosis of pathology includes the following activities:

• Consultation of a therapist, phlebologist.
• Delivery of blood tests (general, biochemical) and urine tests.
• MRI.
• EEG.

After the studies carried out, the exact cause of the pathology is established and complex treatment is prescribed.

Treatment

It is possible to get rid of leg cramps only when the cause of their occurrence is eliminated. After the diagnosis, the attending physician prescribes treatment.In most cases, involuntary muscle contraction occurs against a background of mineral deficiencies, neurological disorders, and a history of chronic disease. Therefore, therapy includes taking medications of the muscle relaxant group, performing gymnastics, adhering to a diet and using effective folk remedies.

Medicines

For the treatment of involuntary contraction of the leg muscles, anticonvulsants are prescribed, which help to weaken the excitation of nerve fibers and stimulate processes in the central nervous system.

Treatment of seizures is accompanied by the intake of the following drugs:

• “Magnerot”, “Magne B6”, “Magnelis B6” – magnesium preparations.
• “Amantadine”, “Carbamazepine”, “Dopamine”, “Diphenin” are effective anticonvulsants.
• Panangin, Potassium Chloride, Asparkam – preparations with a high potassium content.
• “Sirdalud”, “Mivacurium”, “Midocalm”, “Pancuronium”, “Tolperisone-OBL” – drugs that reduce neuromuscular transmission.
• Vitamin and mineral complexes.

Important! All anticonvulsants are prescribed by a specialist. The use of drugs of the muscle relaxant group without a prescription from the attending physician can lead to muscle atony and immobilization of a person.

Power mode

The diet of an elderly person should be complete and include trace elements and vitamins necessary for the body. Low protein diets should be avoided and the following foods should be consumed regularly:

• Fish (mackerel, salmon, trout, cod).
• Meat (chicken, turkey).
• Cottage cheese, fermented baked milk, milk, kefir.
• Nuts.
• Porridge.
• Vegetables, fruits.
• Cabbage, dill, parsley.

In addition, you need to keep the water balance. Elderly people are advised to drink at least 1.5 liters of water per day.

Gymnastic exercises

Physical activity is one of the auxiliary methods of treating leg cramps, since moderate exertion has a beneficial effect on blood circulation in the lower extremities and promotes the conduction of nerve impulses to the muscles.

In case of involuntary muscle contraction, simple gymnastic exercises should be performed for 10 minutes. Daily morning exercises and gymnastics are the prevention of leg cramps in the elderly.

Folk remedies

Proven folk remedies in combination with pharmacotherapy relieve pain and help to eliminate leg cramps. The following recipes are most effective:

• Compressor. Mix 1 tsp. mustard powder and 2 tbsp.l. warm vegetable oil. Apply the prepared product in a thin layer on the legs every day half an hour before bedtime.
• Ointment. Mix celandine juice with cosmetic petroleum jelly in proportions 1: 2. Apply the prepared mass to the area of ​​painful muscles one hour before bedtime.
• Lime blossom decoction. Pour 1.5 tbsp. l. dry raw materials 200 ml of boiling water. Boil over a fire for 2-3 minutes, strain, take 50 ml 4 times a day before meals.

Important! Healing compresses and infusions of some medicinal herbs have contraindications, so they can only be used after consulting a doctor.

Prevention of seizures

With age, the human body has a hard time coping with various pathologies, so the best way to prevent them is to take preventive measures.

To avoid involuntary muscle contraction, you need to follow some rules:

• Eat a balanced diet.
• Wear comfortable shoes.
• Perform exercises to improve blood circulation in the legs.
• Avoid excess body weight.
• Daily light massage of the calf muscles and feet.
• Give up bad habits.
• Drink at least 1.5–2 liters of liquid per day.
• Replenish the deficiency of minerals with the help of special vitamin and mineral complexes.
• Follow the daily routine.

Leg cramps are not an independent disease, but a symptom of any pathology. Therefore, with repeated involuntary muscle contractions, you need to consult a specialist for diagnosis, establishment of the cause and purpose of complex treatment.

90,000 Leg cramps: what to do, how to treat

What is a cramps?

A cramp is a sudden contraction of a muscle that a person cannot relax. It can be long or short, but it is always painful. It is caused by a large amount of decay products that are released during strong muscle contraction.

What are the causes of leg cramps at night with varicose veins?

There may be several of them. The root cause of seizures in varicose veins is stagnation of blood in the veins, which is inevitable in this disease.The blood stagnates, the pressure in the veins rises, and water is released into the surrounding tissues. But along with it, microelements are released that are needed for normal muscle contraction – potassium, calcium and sodium. As a result, the muscles begin to contract spontaneously, and this is the cramps. It is impossible to get rid of this at home: only a doctor can cure varicose veins. That is why, if you are concerned about leg cramps at night, we recommend that you seek advice from a phlebologist.

Secondly, with varicose veins, blood flow in the veins is difficult, and at night it becomes especially slow.Muscles can begin to contract with impulses to “push” blood through the vessels.

And thirdly, there is one more, slightly more complex mechanism. It’s not only that the muscle contracts, but also that it doesn’t relax. Relaxation of muscles is also an energy-consuming process, therefore ATP molecules are needed for it – the universal “fuel” of a living cell. When the blood in the veins stagnates, the production of ATP decreases, and the mechanism that “relaxes” the muscle fails.

What are the causes of leg cramps during pregnancy?

Waiting for a baby is certainly a happy, but at the same time, difficult time.It was during this period that, as a result of weight gain, hormonal changes, and decreased activity, many expectant mothers develop varicose veins. Which becomes one of the causes of night cramps.

Please note: cramps, swelling of the legs during pregnancy is an alarming symptom. It may indicate a lack of trace elements, may be the result of large fluid losses (for example, during toxicosis), seizures occur if the growing uterus compresses the inferior vena cava, etc. The expectant mother should certainly consult a doctor who will accurately determine the causes of seizures.

How to get rid of night leg cramps?

If you woke up at night from a sudden convulsion, then your first desire is to rub your sore leg. Unfortunately, this does not always help relieve pain.

While lying down, you can do the following: pull on the foot of the sore leg, while simultaneously squeezing and unclenching the calf muscle with your palms (after all, it is usually it that reduces). This will help to quickly relieve the attack. After that, work with the feet of both legs, make circular movements or alternately pull them towards you.This will activate blood circulation and the pain will go away.

Some people advise, in case of very intense cramping, to try to remove it by pricking the leg with a pin or needle. We doubt that you will have it at your fingertips during your night’s sleep. But it is possible to pinch yourself on the lower leg several times, although it can be difficult if the cramp is very strong.

Also, if your leg is bridged, you can stand on the bare cool floor (but not on the carpet, the effect will not be the same) and try to walk. And when the muscle relaxes, still standing on the floor, shift from toe to heel for a minute.This simple exercise will help improve blood circulation.

I would not like to face pains at night. Is there any kind of prevention in case of leg cramps with varicose veins?

Prevention of seizures with varicose veins helps:

• Choosing the right footwear – preferably with low heels and tight ankle support.
• lack of excessive physical activity.
• dietary adjustment. Include foods rich in potassium, calcium and magnesium in your daily menu.Eat more dairy products, legumes, cereals, give preference not to chocolate, but to dates, prunes and dried apricots. And do not forget that smoking, as well as drinking a lot of coffee and strong tea, can provoke cramps.

The editors would like to thank the Phlebology Center for help in preparing the material.

Sources

• Luo L., Zhou K., Zhang J., Xu L., Yin W. Interventions for leg cramps in pregnancy. // Cochrane Database Syst Rev – 2020 – Vol12 – NNULL – p.CD010655; PMID: 33275278
• Crisponi G., Nurchi VM., Cappai R., Zoroddu MA., Gerosa C., Piras M., Faa G., Fanni D. The Potential Clinical Properties of Magnesium. // Curr Med Chem – 2020 – Vol – NNULL – p .; PMID: 33200694
• Lorenzo M., Schaeffer M., Haller DM., Maisonneuve H. Treatment of nocturnal leg cramps by primary care patients over the age of 60. // Fam Pract – 2018 – Vol35 – N1 – p.29-33; PMID: 28985304
• Roguin Maor N., Alperin M., Shturman E., Khairaldeen H., Friedman M., Karkabi K., Milman U. Effect of Magnesium Oxide Supplementation on Nocturnal Leg Cramps: A Randomized Clinical Trial. // JAMA Intern Med – 2017 – Vol177 – N5 – p.617-623; PMID: 28241153
• Kakkos SK., Allaert FA. Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. // Int Angiol – 2017 – Vol36 – N2 – p.93-106; PMID: 28225220
• Martinez-Zapata MJ., Vernooij RW., Uriona Tuma SM., Stein AT., Moreno RM., Vargas E., Capellà D., Bonfill Cosp X. Phlebotonics for venous insufficiency. // Cochrane Database Syst Rev – 2016 – Vol4 – NNULL – p.CD003229; PMID: 27048768
• Zhou K., West HM., Zhang J., Xu L., Li W. Interventions for leg cramps in pregnancy. // Cochrane Database Syst Rev – 2015 – Vol – N8 – p.CD010655; PMID: 26262909
• Orlin JR., Øen J., Andersen JR. Changes in leg pain after bilateral fasciotomy to treat chronic compartment syndrome: a case series study.// J Orthop Surg Res – 2013 – Vol8 – NNULL – p.6; PMID: 23561303
• Allen RE., Kirby KA. Nocturnal leg cramps. // Am Fam Physician – 2012 – Vol86 – N4 – p. 350-5; PMID: 22963024
• Hallegraeff JM., Van der Schans CP., De Ruiter R, de Greef MH. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomized trial. // J Physiother – 2012 – Vol58 – N1 – p.17-22; PMID: 22341378

My leg cramped: is it true that the lack of salt in the body is to blame?

• Claudia Hammond
• BBC Future

September 28, 2017

Photo author, iStock

When your leg cracks and your muscles are constrained by unbearable pain, after all, the best remedy is not salt, I am convinced columnist BBC Future .Why are there convulsions?

You wake up in the middle of the night and writhe in pain. Your calf muscle seems to be living its own life. She was so brought together that the back of her leg ached unbearably.

You try to find a comfortable, more relaxed position for your leg, hoping it will ease the pain, but to no avail. This is a seizure, and this type is very common – for example, in the later stages of pregnancy.

The older you get, the more you encounter this.Those overweight are also susceptible to seizures. But in principle, this can happen to anyone – either after training or in the middle of the night.

Low salt levels in the body, or more specifically, low sodium levels, are often cited as the cause of seizures.

In such cases, it is suggested to eat a little salt to ease the pain. However, as I will discuss later, there is an easier, salt-free way.

What’s the salt?

Cramps most commonly occur in the calf muscle in the back of the leg below the knee, in the hamstring, or in the quadriceps in the front of the thigh.

Sometimes they are associated with more serious health problems, such as lameness resulting from a lack of oxygen in the muscles. Or, in rare cases, seizures are due to low calcium levels due to malfunctioning of the parathyroid gland.

Author of the photo, iStock

Caption to the photo,

My leg has come together. Very painful!

But as Raymond Playford, professor at the London School of Medicine and Dentistry, points out, in most cases, seizures are not related to your body’s need for salt or a lack of salt in your diet.

The stoker’s convulsions

What is the cause of such convulsions? This is still a mystery. More than 100 years ago, it was noticed that those who supported the fire in the stoves of steamers often suffered from them, the phenomenon was even called that – the stoker’s convulsions.

This led to the birth of the following theory: the lack of salt is to blame. It was explained as follows: the heat of the stove and hard work make a person sweat profusely and thus lose sodium.

So, they concluded then, eat more salty, and you will not have seizures.

Photo author, iStock

Photo caption,

A fireman’s work is hard work

A biological explanation could be that a lack of salt together with dehydration of the body causes the space between muscle cells to shrink. This, in turn, increases the pressure on the nerve endings, which gives rise to pain.

However – here’s the bad luck – there is no reliable evidence of this.

Light electroshock

To be fair, it must be said that this is a difficult topic for research, since the occurrence of seizures is unpredictable.And if you collect test subjects in the laboratory in the hope that some of them will lose their legs, you will have to wait a long time.

All that remains is to watch for cramps in real life – as in a study that found that American football players tend to bend their legs more often during hot weather. Which would seem to support the theory of sweating and salt loss.

The only problem is that athletes living in countries with cold climates also suffer from seizures.

And when the sodium level was measured in the athletes who took part in the Super Marathon in Cape Town (South Africa), it turned out that the difference between those who experienced convulsions and those who did not (with a similar sodium loss) is so negligible that it can be neglected …

In another experiment, they tried to artificially induce convulsions by subjecting volunteers to a light electric shock.

The reasoning was this: if the problem is really a lack of sodium, then a weaker discharge will be needed to cause convulsions in a person whose body is partially dehydrated (and, accordingly, desalinated).

Photo author, iStock

Photo caption,

On the football field, this happens in almost every match

However, Kevin Miller and colleagues from the University of North Dakota (USA) did not find any effect of sodium loss on the onset of seizures.However, they noted, it is not known whether more severe fluid loss will bring the “seizure threshold” closer.

Follow the example of football players

So, if you are looking for a method that will quickly help you in a situation with a flattened leg, then look at how, for example, football players deal with it ( see photo above ). After all, they do not run across the field with a salt shaker in store just in case.

When this unbearable pain comes to you, the best remedy is not salt, but stretching the muscles.

Grab your toes firmly and slowly pull your foot towards you. The muscle contracted by the spasm will stretch, and the pain should gradually go away.

And you don’t need to swallow salt.

Legal information. This article is for general information only and should not be construed as a substitute for the advice of a physician or other healthcare professional. The BBC is not responsible for any diagnosis made by the reader based on the materials of the site.The BBC is not responsible for the content of other sites, links to which are present on this page, and also does not recommend commercial products or services mentioned on these sites. If you are concerned about your health condition, see your doctor.

To read the original of this article in English, visit BBC Future .

Potassium and magnesium deficiency

Microelements have their “friends” and their “opponents”.

The main antagonist of potassium is sodium. Potassium accumulates in the cells of the human body to perform its useful functions. As soon as he “gives up his position”, i.e. when its reserves are depleted – the place of potassium is immediately taken by sodium.

This pair has directly opposite tasks: if potassium removes water from the body, then sodium retains it. Therefore, rushing to the place of potassium , sodium fills the cells with water, i.e.e. puffiness develops. In this state, the cells and tissues of the body begin to perform their functions worse. First of all, the heart suffers, tk. cardiac muscle – myocardium – consists of cardiomyocyte cells, very sensitive to the loss of potassium .

The most common cardiac diseases that arise or are significantly aggravated by a deficiency of potassium : ischemic heart disease and various types of rhythm disturbances.

The work of the myocardium is restored as soon as the required amount of potassium returns to its cells.Usually sodium does not withstand the onslaught of its rival and gives up the occupied place without unnecessary resistance.

What about “friends”? Potassium has an excellent relationship with magnesium . Potassium is poorly absorbed from food when magnesium is deficient. Conversely, it fully manifests its beneficial properties if magnesium is contained in sufficient quantities. Therefore, you need to consume these two micronutrients together. Fortunately, they are often found in the same foods (vegetables, herbs, fruits), and in the composition of mineral preparations, a combination of potassium and magnesium is easy to find.

60% magnesium is found in human bones, the rest – in the cells of the heart and brain, as well as in soft muscle tissues. With a shortage of magnesium , its physiological antagonist, calcium, comes to the fore. Like sodium, it occupies a deserted territory. Working in excess, calcium causes strong or abnormal muscle contractions. Muscle cramps and pain can be felt throughout the body, most often in the calves and feet. For such seizures against the background of micronutrient deficiencies, it is characteristic of the occurrence at night.With an excess of potassium / lack of magnesium, the myocardium also suffers: heart rhythm disturbances occur, increased vascular tone develops, which negatively affects blood pressure (a tendency to increase), metabolic processes in the myocardium are disrupted.

So, with a deficiency of potassium and / or magnesium, the heart muscle (myocardium) feeds and contracts incorrectly and, one might say, does not “rest” normally.

Main causes of potassium and magnesium deficiency:

• 1

  increased sweating (sports, hot climate, work in hot workshops, frequent baths or saunas)

• 2

  diarrhea or use of laxatives

• 3

  the use of diuretics (except for potassium-sparing)

• 4

  hormonal treatment, including contraception

• 5

  diabetes

• 6

  diseases of the gastrointestinal tract (gastritis, ulcers, diseases of the gallbladder and pancreas)

• 7

  chronic stress and depressive conditions

• 8

  regular consumption of coffee and / or alcohol

• 9

  cardiovascular diseases

What are the signs of low potassium levels?

• 1

  drowsiness, apathy

• 2

  muscle weakness and pain

• 3

  swelling

• 4

  persistent constipation

• 5

  fluctuations in blood pressure

• 6

  irregular heart rate

• 7

  difficulty breathing

• 8

  dryness, loss and / or dullness of hair

What are some signs of low magnesium levels?

• 1

  increased nervous irritability, irritability

• 2

  decreased performance, severe fatigue

• 3

  dizziness

• 4

  hearing loss

• 5

  muscle cramps, twitching of the eyelids

• 6

  numbness in the fingers and / or toes

• 7

  drops in blood pressure

• 8

  heartache

• 9

  tendency to constipation or diarrhea

• 10

  thin, brittle nails and / or hair loss

Fortunately, it is not difficult to restore the deficiency of potassium and magnesium : you need to enrich the diet with foods high in potassium and magnesium, or you can normalize / increase the level of beneficial trace elements by taking special complexes with potassium and magnesium in organic form (such preparations will be best absorbed by the body person).

90,000 RULES OF CONDUCT ON WATER. HELP FOR DROWNERS.

May is on the calendar, summer is coming, warm weather. Wanting to get rid of the heat, people tend to be closer to water bodies, and they pose an increased danger to humans. One of the dangers to the life of a person in water is hypothermia of the body, as a result of which irreversible processes begin in it, and a person dies even in shallow water.

It is recommended to swim at a water temperature not lower than +18 C, and an air temperature of +20 C.You can swim no more than 3-5 times in a row for 10-15 minutes. It is not recommended to swim earlier than 1.5-2 hours after eating.

Bathing of children should be carried out only under the supervision of adults!

Have you accidentally sipped some water? Stop, raise your head above the water and clear your throat. Vigorous movements of your arms and legs will help you stay upright in the water, and then swim to the shore.

Once in the whirlpool, draw more air into your lungs. Immerse yourself in the water and make a strong dash to the side with the current, float to the surface.Entangled in algae, do not make sudden movements and jerks. Lie on your back, and try to swim out in the direction from which you sailed with soft, calm movements. If this does not help, you need to pull your legs up to your stomach and gently free yourself of the algae with your hands.

Once in a strong current, do not get lost, do not swim against the stream. Go with the flow, gradually moving towards the shore. The main thing in self-rescue is not to panic, control yourself, calmly take the necessary measures to get out of this situation.The main reasons for the death of people on the water are a gross violation of the rules of safe behavior on the water, swimming in unidentified places, as well as drunk bathing.

Never swim alone! There should always be someone by your side to help if needed.

WATER RULES:

The main rule says: if you don’t know the ford, don’t go into the water!

– Once in the whirlpool, do not panic – take in more air in your lungs, plunge deeper into the water and, sharply raking with your hands and feet, swim away from the funnel;

– do not try to swim across rivers, lakes on a bet – you can bet;

– do not bathe in cold water for a long time;

– never leave young children unattended near open water! They can drown instantly! Even in shallow water, always be with them!

– If you do not know how to swim, you should not overly trust yourself with air mattresses, car cameras and other improvised watercraft.First, at the most inopportune moment, they can burst. Secondly, the current and wind can carry you far from the coast.

SEASONS:

Did you have convulsions in the water, did your arms or legs cramp? Do not get lost, try to stay on the surface of the water, swimming on your back. Rub the contracted muscle vigorously. If there are people on the shore, do not hesitate to call them for help.

Usually, seizures occur with general hypothermia and fatigue of the same muscle groups (for example, when swimming only with breaststroke).Most often cramping muscles of the legs and toes. Sharp movements and excessive muscle tension increase the likelihood of seizures. Therefore, when in the water for a long time, try to change your swimming style more often and do not try to swim fast so as not to overload the muscles.

In case of convulsions of the fingers, straighten them with the other hand and relax the muscles. In case of leg cramps, it is necessary, for a moment, plunging into the water and straightening the leg, strongly pull the foot over the big toe.There are other options for “anticonvulsant” first aid. For example, forcefully pinch, bite, or stab the affected muscle several times.

DROWNER ASSISTANCE:

If, in order to get closer to a drowning man, you use a boat or he sinks near the shore, you can use a lifebuoy or throwing lines to rescue him, ideally Aleksandrov’s rescue line, which consists of equipping small boats.

Without floating craft – swim up from behind and grab a drowning person by the hair or wrap his left hand around his neck, raise his face above the water and drag him to the shore.If the drowning man managed to grab your arms, neck or clothes and pulled you to the bottom, do not hesitate, hit him harder to regain his sanity, or, better, breathe in more air and submerge a few meters into the water. The instinct for self-preservation will make him let go of you.

Having pulled the victim out of the water, it is necessary to quickly cleanse his oral cavity, putting his stomach on his knee, squeeze the water out of his lungs and start resuscitation measures.

A person can be brought back to life after a five-minute stay in water, and in cold water – even after twenty minutes.

They must be continued until the ambulance arrives.

Do not neglect the rules, take care of yourself!

REMEMBER! Following these recommendations will provide you with a safe rest on the water.

Unified rescue phone: “01” (when dialing from a mobile phone – “112”). Call it if you witness a fire, traffic accident or other incident when the help of rescuers is required. Helpline of the Main Directorate of the Ministry of Emergency Situations of Russia in the Kaliningrad region: 79-99-99.

Sincerely, FKU “GIMS Center EMERCOM of Russia in the Kaliningrad Region”

Inspection department of Pionersky.

Administration of the municipal formation “Pionersky urban district”

Department of Civil Defense and Emergency Situations of the Pionersky City District Administration

.