DO YOU GET CRAMPS IN YOUR LEGS?

 

Leg muscle cramps can wake you up in the middle of the night and disturb your sleep. They are sudden, involuntary, intense muscle pains usually in your calf, foot or thigh. There may present as sudden pain and tightness in a muscle, typically in your calf or there can be a temporary hard lump or twitching under the skin. Muscle cramps happen when a muscle involuntarily contracts on its own and you have no control on it. Usually, you feel a hard lump at the point of pain and that’s the contracted muscle.

Sometimes, the cramp may cause your leg to spasm — to tighten uncontrollably. Although painful to live with, cramps in your legs are generally harmless. 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. Alternatively, athletes may have cramps in their muscles while performing or exercising, and particularly when they return after a long gap in practice they are most vulnerable.

Incidence

Night leg cramps (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. Approximately 40% of people will experience leg cramps during pregnancy. Healthcare providers believe that’s because the extra weight of pregnancy strains your muscles. This problem tends to increase during the warmer part of the year.

The muscles in your legs are made up of bundles of fibers that alternately contract and expand to produce movement. A cramp is a sudden, involuntary contraction (tightening) of one of these muscles, typically in your calf. Cramps can last anywhere from a few seconds to several minutes. They can be mild, or intense enough to wake you out of a sound sleep. A sudden, painful muscle spasm in the leg is called a charley horse, which legend has it is named after baseball player Charlie "Hoss" Radbourn, who reportedly suffered from frequent cramps back in the 1880s.

Causes

Some leg cramps happen for no known reason. These are called “idiopathic” cramps. Possible causes of these leg cramps include:

• Involuntary nerve discharges.
• Part of your leg muscle isn’t getting enough blood.
• Stress.
• Too much high-intensity exercise.

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

• Sitting for long periods of time (like at a desk job).
• Overusing your muscles.
• Standing or working on concrete floors.
• Having poor posture during the day.
• Kidney failure, diabetic nerve damage, mineral deficits and issues with blood flow.

 

Dehydration and electrolyte loss: There can be many causes of leg cramps but most of the time this is caused by dehydration and the loss of electrolytes from the body. That is why when we sweat profusely in summers or when we lose fluids because of repeated vomiting or lose motions we get leg cramps. Toxins from smoking and heavy alcohol consumption can also affect the balance of electrolytes in your body and increase the likelihood of cramping.

A deficiency of electrolytes such as magnesium or potassium in your diet can lead to more frequent cramping, by preventing your muscles from fully relaxing. Age is another factor, with cramps becoming more frequent in middle age and beyond. Older muscles tire more easily, and they become increasingly sensitive to lower fluid volumes in the body.

Exercise and muscle fatigue: This terrible pain associated with leg cramps can also occur due to muscle fatigue or mechanical stress on the muscles, especially if you stand for long periods or walk on hard surfaces. Exercise is a common trigger, especially after you've exercised for a long period of time or in the heat. Muscles that are tired or dehydrated become irritated and are more likely to cramp up.

Drug induced: Sometimes the cramping is triggered by medication such as diuretics, statins, which are used to treat high cholesterol, Diuretics, clonazepam, gabapentin, pregabalin, naproxen, fluoxetine, celecoxib, beta-blockers are other drugs that can cause leg cramps. Cancer treatments like chemotherapy can cause nerve damage, which may also cause leg cramps. Your doctor can prescribe you alternate medicines if you bring it to his/her notice.

Pregnancy: Two factors play their respective roles – mechanical and hormonal. Mechanically, the centre of gravity moves forward and the calf muscles have to work harder to maintain and balance the erect posture. Hormonal changes during pregnancy make the body retain more water and dilute the electrolytes.

 

Secondary causes: “Secondary” leg cramps are a symptom or complication of a more serious health condition. Leg cramps can be a sign of serious conditions, including:

·         ALS (amyotrophic lateral sclerosis/Lou Gehrig’s disease): Progressive neuromuscular disease.

·         Congestive heart failure: When your heart can’t pump blood well enough to give your body a normal supply.

·         Cirrhosis of the liver: Scarring of your liver.

·         Diabetes: A disease that prevents your body from properly using the energy from the food you eat.

·         Flat feet: The absence of a supportive arch in your foot.

·         Hypokalemia: Low potassium levels in your blood.

·         Kidney failure: A condition in which one or both of your kidneys no longer work correctly.

·         Osteoarthritis: The corrosion of the cartilage that protects your bones.

·         Parkinson’s disease: A neurological movement disorder.

·         Peripheral artery disease: Narrowing of the arteries in your legs or arms.

·         Peripheral neuropathy: A group of nerve diseases that can cause a range of symptoms, including cramps and pain.

 

 

Treating muscle cramps

You want to get rid of a leg cramp the moment it strikes. You might be finishing up an exercise routine, or a cramp might wake you up in the middle of the night. In moments like that, unfortunately, there aren’t any 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 toward your shin to stretch the muscles. Stretch the cramped muscle, and gently rub. For a thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself.

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.      Take pain medications: Take ibuprofen or acetaminophen to help with the pain.

8.      Elevate: Prop up your leg after the cramp starts to feel better.

 

Most cramps will go away on their own within minutes. Massaging or gently stretching the muscle will help it relax. Heat is soothing to tense muscles. Apply a heating pad or warm wet washcloth to help loosen up the muscle. If the pain worsens and the problem continues to the point of debilitation, it’s best to consult with your physician as the condition could indicate a more serious problem.

To avoid leg cramps in the future, drink plenty of fluids before and during exercise. Muscles need fluid to contract and relax properly. Prevent tightness by warming up your leg muscles before you work out with some walking in place or a slow jog. After each workout, stretch out your leg muscles for a few minutes. Do another set of stretches before bed if you tend to get cramps while you sleep.

 If you have a leg cramp, rest and gentle stretching may help relax the muscle. Other practices, like staying hydrated and changing up your diet, may help prevent leg cramps.

Preventing leg cramps

Ideas for prevention 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 your healthcare provider prescribes them.
• 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.

 

There aren’t many medicines prescribed for leg cramps – a topical muscle relaxant like Move or Volini gel, a calcium channel blocker, magnesium and Vitamin B-complex are sometimes prescribed.

 

1. Drink water or electrolyte solution before bed - Heavy exercise and low fluid intake can cause dehydration. Doctors recommend drinking water or electrolyte filled drinks like Gatorade before retiring to sleep. Water naturally relieves cramps and hydrates the muscles, while the mineral filled drinks ensure your electrolytes, such as sodium, potassium, and calcium are not depleted.

 

2. Potassium and magnesium When your body has a mineral deficiency, it makes it difficult for the heart to push enough blood down to your legs. Magnesium regulates the muscle and nerve functions, blood pressure and blood sugar levels; while potassium has a similar function but also plays a part in water regulation. Combined together, these two minerals can encourage effective prevention against cramping and certain foods are rich in one or the other. Bananas are an easy and healthy source of potassium while magnesium can be found in nuts, lentils, and quinoa. It should be noted that if you have kidney problems, extra magnesium can exacerbate the condition.

 

3. Stretching exercises - You don’t need to do a whole workout before bed, but three minutes of stretching can prevent mid-sleep leg cramp disturbances. You can try a standing calf stretch. Place one leg in front of the other and bend the knee while extending the back leg. You should feel a relieving pull in the muscle. If you are prone to cramping in the upper leg, try a hamstring stretch. Put your feet together and do a standing forward bend at the hips. Hold this pose for 20 seconds.

Try the following to prevent leg cramps in your calves:

1.      Stand about 3 feet (1 meter) away from a wall.

2.      Lean forward. Touch the wall with your arms outstretched while keeping your feet flat.

3.      Count to five before you stop, and do it over and over again for at least five minutes.

4.      Repeat three times per day.

 

Leg cramps can be unpredictable and agonizing. They are painful, involuntary muscle contractions that can last seconds or minutes. They affect your sleep, exercise routine and general quality of life. They’re common, very normal and, fortunately, temporary. Some conditions and drugs can cause them, and there are risk factors you’ll want to avoid. When a cramp happens, try flexing the muscle, applying heat or ice and massaging the area.If you’re concerned about the severity and duration of your leg cramps, or think a serious condition may be causing them, don’t hesitate to contact your healthcare provider.