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Cramp

Cramps are unpleasant, often painful, sensations caused by contraction or over shortening of muscles. It usually occurs in one of the calf muscles, below and behind the knee. The small muscles of the feet are sometimes affected. A cramp pain typically lasts a few minutes. In some cases it lasts just seconds, but in some cases it can last up to 10 minutes. The severity of the pain varies. The muscle may remain tender for up to 24 hours after a leg cramp.

Leg cramps usually occur when you are resting - most commonly at night when in bed. (They are often called night cramps). They may wake you from sleep. It can become a distressing condition if your sleep is regularly disturbed. In most cases the cause is not known. One theory is that cramps occur when a muscle that is already in a shortened position is stimulated to contract. As the muscle is already shortened, to contract further may cause the muscle to go into spasm.

This commonly happens at night in bed as the natural position we lie in is with knees slightly bent (flexed), and with the feet pointing slightly downwards. In this position the calf muscle is relatively shortened and prone to cramps. This theory explains why stretching exercises may cure the problem. In some cases, the cramps may be a symptom of another condition or problem.

Causes

     •     Some medicines can cause cramps as a side-effect, or make cramps occur more often. Including diuretics ‘(water tablets)’, nifedipene, cimetidine, salbutamol, terbutaline, lithium,clofibrate, penicillamine, phenothiazines and nicotinic acid.

     •     Over-exertion of muscles

     •     Dehydration

     •     Conditions that cause alterations in the balance of salts in the bloodstream (such as a high or low sodium or potassium level).

     •     Pregnancy - usually in the later stages

     •     An un-treated underactive thyroid gland.

     •     Peripheral vascular disease (narrowing of the leg arteries which cause poor circulation).

     •     Excess alcohol

Avoidance and Treatment

Make sure bed clothes are not too heavy or tight, restricting movement of your legs and feet.

Stretch the affected muscles daily. eg. for calf muscles, stand about 2 feet away from the wall and lean forwards against the wall keeping your heels on the ground to feel a stretch down the back of your leg. Hold for 20 seconds, repeat 10 times.

Consult your GP about your medication if you think that may be a factor.

Tonic water contains quinine and this may help. Take a glass (250 mls) each night.

If you take a lot of exercise and sweat a lot, especially if you follow a very healthy diet, you may be low in salt. Try adding salt to cooking water and/or to your food.

Magnesium is important for relaxation, including muscle relaxation. Magnesium is found in vegetables, apples and nuts. It is also easy to take a supplement.

Eating foods high in potassium can help prevent muscle cramps. Foods with high sources of potassium include, in order from highest to lowest:- Brussels sprouts, Avocados, Bananas, Broccoli, Soybeans and Apricots. It is also common in most fruits, vegetables and meats.

Leg cramps may also be due to vitamin D deficiency (also needed for calcium absorption).