Sometimes felt as a twitch, but other times an excruciating pain, leg cramps can rob you of sleep, make you stop whatever you are doing to seek relief. The classic cramp is the so-called "charley horse," an intense muscle cramp in the calf, but cramps can also strike the thighs and feet. Cramps can persist from a few seconds to much longer, and occur at any age.
Geriatrician Dr. Daniel Gornel, M.D., explains on MedicineNet.com that there are many causes of leg cramps. Injury; hyperexcitability of the nerves; vigorous activity; movement of a muscle during rest; depletion of potassium, sodium, calcium, chloride, magnesium or adenosine triphosphate; dehydration and poor circulation are among the known causes. Several prescription medications can trigger muscle cramps; for example, diuretics, prescribed for high blood pressure, can lead to depletion of body fluids (dehydration), sodium, potassium, calcium and magnesium. Deficiencies of vitamins B1, B5 and B6 can also lead to muscle cramps.
Many times a leg cramp will go away if the muscle is stretched. Gornel recommends standing up and walking around. For a calf muscle cramp, stand about 2 feet from a wall, leaning toward it with your forearms against the wall, knees and back straight, heels on the floor. A technique you can try while lying in bed is to keep the leg as straight as possible and flex the ankle by pulling the toes toward the head. Massaging the muscle or applying heat may help the muscle relax.
Most cramps subside quickly, before further treatment would have time to be effective. But there are steps you can take to help prevent cramps. Proper stretching before exercise and drinking plenty of water to ward off dehydration can reduce the likelihood of cramps. Gornel suggests drinking water before, during and after exercise. He also recommends 1 to 1.5 g of calcium daily, 50 to 100 mg of magnesium, and 800 units of Vitamin D to assist in proper absorption of calcium. Since vitamin E is believed to minimise muscle cramping, Gornel suggests 400 units of Vitamin E. He also recommends calcium and magnesium supplements during pregnancy.
Gornel notes that the only medication widely used in recent years to prevent and treat cramps is quinine, which works by reducing the excitability of muscles. Quinine, no longer available in tablet form in the United States, has been shown effective against muscle cramps in many studies, but also has been linked to birth defects, miscarriage, hypersensitivity reactions and deficiency of blood platelets. In the United States it is available only in tonic water sold in grocery stores, according to Gornel.
Although cramps are uncomfortable, they are usually benign, Gornel says. If cramps are frequent, persistent, severe, unresponsive to simple treatments or have no obvious cause, it's time to consult a doctor to determine if they are a manifestation of a medical condition. It's unlikely that cramping would be the first sign of a condition not already be known to the sufferer, Gornel notes. Problems with circulation, nerves, metabolism, hormones, medications and nutrition can all cause cramps.
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