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A cramp is a sudden, involuntary, painful skeletal muscle muscle contraction or overshortening associated with electrical activity. While generally temporary and non-damaging, they can cause significant pain and a paralysis-like immobility of the affected muscle. A cramp usually goes away on its own over several seconds or (sometimes) minutes. Cramps are common and tend to occur at rest, usually at night (nocturnal leg cramps). They are also often associated with pregnancy, physical exercise or overexertion, and age (common in older adults); in such cases, cramps are called idiopathic because there is no underlying pathology. In addition to those benign conditions cramps are also associated with many pathological conditions.
Cramp definition is narrower than the definition of muscle spasm: spasms include any involuntary abnormal muscle contractions, while cramps are sustained and painful. True cramps can be distinguished from other cramp-like conditions. Cramps are different from muscle contracture, which is also painful and involuntary, but which is electrically silent. The main distinguishing features of cramps from dystonia are suddenness with acute onset of pain, involvement of only one muscle, and spontaneous resolution of cramps or their resolution after stretching the affected muscle. Restless leg syndrome is not considered the same as muscle cramps and should not be confused with rest cramps.
Causes of cramping include Muscle Cramps Symptoms, Causes, Treatment – Do all muscle cramps fit into the above categories on MedicineNet . Medicinenet.com. Retrieved on 2011-02-13. hyperflexion, hypoxia, exposure to large changes in temperature, dehydration, or Hyponatremia. Muscle cramps can also be a symptom or complication of pregnancy; kidney disease; thyroid disease; hypokalemia, hypomagnesemia, or hypocalcaemia (as conditions); restless legs syndrome; varicose veins;Bergan J. The Vein Book, Hardcover text, Editor Bergan J, 2007. and multiple sclerosis. Muscle Cramps at WebMD
As early as 1965, researchers observed that leg cramps and restless legs syndrome can result from excess insulin, sometimes called hyperinsulinemia.
A lactic acid buildup around muscles can trigger cramps; however, they happen during anaerobic respiration when a person is exercising or engaging in an activity where the heartbeat rises. Medical conditions associated with leg cramps are cardiovascular disease, hemodialysis, cirrhosis, pregnancy, and lumbar canal stenosis. Differential diagnoses include restless legs syndrome, claudication, myositis, and peripheral neuropathy. All of them can be differentiated through careful history and physical examination.
Gentle stretching and massage, putting some pressure on the affected leg by walking or standing, or taking a warm bath or shower may help to end the cramp. If the cramp is in the calf muscle, dorsiflexing the foot (lifting the toes back toward the shins) will stretch the muscle and provide almost immediate relief. There is limited evidence supporting the use of magnesium, calcium channel blockers, carisoprodol, and vitamin B12.
Quinine is no longer recommended for the treatment of nocturnal leg cramps due to potential fatal hypersensitivity reactions and thrombocytopenia. Arrhythmias, cinchonism, and hemolytic uremic syndrome can also occur at higher dosages.
may sometimes cause myalgia and cramps among other possible side effects. Raloxifene (Evista) is a medication associated with a high incidence of leg cramps. Additional factors, that increase the probability of these side effects, are physical exercise, age, history of cramps, and hypothyroidism. Up to 80% of athletes using statins experience significant adverse muscular effects, including cramps; the rate appears to be approximately 10–25% in a typical statin-using population. In some cases, adverse effects disappear after switching to a different statin; however, they should not be ignored if they persist, as they can, in rare cases, develop into more serious problems. Coenzyme Q10 supplementation can help avoid some statin-related adverse effects, but currently, there is not enough evidence to prove its effectiveness in avoiding myopathy or myalgia.
Magnesium is commonly used to treat muscle cramps. Moderate-quality evidence indicates that magnesium is not effective for treating or preventing cramps in older adults. It is not known if magnesium helps with cramps due to pregnancy, liver cirrhosis, other medical conditions, or exercise. Oral magnesium treatment does not appear to have significant major side effects, however, it may be associated with diarrhea and nausea in 11–37% of people who use this medicine.
With exertional heat cramps due to electrolyte abnormalities (primarily potassium loss and not calcium, magnesium, and sodium), appropriate fluids and sufficient potassium improve symptoms. B vitamins, naftidrofuryl, lidocaine, and calcium channel blockers may be effective for muscle cramps.
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