Muscle Cramps: Symptoms, Types, Cures, Treatment and Home Remedies

A muscle cramp is an involuntary and violently contracted muscle that does not relax. Will muscle cramps occur in any muscle? foot and leg muscles are very common. Almost everyone is experiencing muscle cramp sometime in their lives.

There are several types and causes of muscle cramps. Muscle cramps may occur during exercise, at rest or night, depending on the exact cause. Dehydration is a common cause of muscle cramps. Many drugs can cause muscle cramps. Most muscle cramps can be stopped if the muscle can stretch.

Muscle cramps can often be prevented by measures such as adequate nutrition and hydration, attention to exercise safety and attention to ergonomic factors.

What are muscle cramps?

A muscle cramp is an involuntary and violently contracted muscle that does not relax. When we use the muscles that can be controlled voluntarily, like those of our hands and feet, they alternate alternately and relax as we move our limbs.

 The muscles that support the head, neck and torso contribute in a similar way at the same time to maintain our attitude. A muscle (or even a few fibers of a muscle) that inadvertently (without conscious intention) is in a "spasm". If the spasm is strong and preserved, it cracks. Muscle cramps often cause visible or palpable hardening of the involved muscle.

Muscle cramps may take from a few seconds to a quarter of an hour or occasionally longer. It is not unusual for a cramp to repeat many times until it is finally resolved. The cramp can include a part of a muscle, the entire muscle or several muscles that usually act together, such as those that bend adjacent fingers. Some cramps involve the simultaneous contraction of muscles that usually move parts of the body in opposite directions.

Muscle cramps are extremely common. Almost everyone (an estimate is about 95%) is experiencing a cramp sometime in their lives. Muscle cramps are common in adults and are becoming more common with aging. However, children also experience muscle cramps.

Any of the muscles under voluntary control (skeletal muscles) may be cramped. Tip cramps, especially feet and legs (including night foot cramps), and in particular calves (the classic "charley" horse), are very common.

Involuntary muscles of the different organs (uterus, blood vessel wall, intestines, bile and urinary passages, bronchial tree, etc.) are also subjected to cramps. Cramps of involuntary muscles will not be considered further in this review. This article focuses on skeletal muscle cramps.

The types and causes of muscle cramps?

Skeletal muscle cramps can be categorized into four main types. These include "true" cramps, tetania, symptoms and dystonic cramps. Cramps are categorized according to their various causes and the muscular groups that affect them.

Types of muscle cramps: True cramps

True cramps involve some or all of a single muscle or a group of muscles that generally work together, such as muscles that bend in many nearby fingers or leg muscles. Most authorities agree that the actual cramps are due to the hypersecretion of the muscles that stimulate the nerves. It is overwhelmingly the most common type of skeletal muscle cramps. Actual cramps can occur in several cases as follows.

• Damage and intense muscle cramping activity

• Injury: Continuous muscle spasm can appear as a protective mechanism after injury, such as broken bone. In this case, the spasm tends to minimize movement and stabilize the area of ​​the injury. Only the injury to the muscle can cause the spasm of the muscle.

• Active activity: True cramps are usually associated with intense muscle use and muscle fatigue (in sports or unusual activities). Such cramps may come during the activity or later, sometimes several hours later. Similarly, fatigue of the muscles of sitting or lying for a long time in a difficult position or any recurrent use can cause cramps. Older adults are at risk of cramping when performing intense or intense physical activity.

• Restrain cramps and muscle cramps of dehydration Cramps: Cramps in a resting state are very common, especially in elderly adults, but may be experienced at any age, including childhood. Complicated muscle cramps occur frequently at night. Although they are not life-threatening, night cramps (also known as night cramps) can be painful, sleep disturbed and often repeated (that is, several times a night and / or several nights a week). 

The real cause of night cramps is unknown. Sometimes, such cramps begin by making a move that shortens the muscle. An example shows the finger down while lying on the bed, which shortens the muscle of the leg, a common area of ​​muscle cramps.

• Dehydration: Athletic and other vigorous activities, including the activities of endurance athletes, can cause excessive loss of sweat fluids. This type of dehydration increases the likelihood of real cramps. These cramps are more likely to occur in hot weather and may be an early sign of heat stroke.

 Reducing the chronic volume of body fluids from diuretics (urinary promoting medicines) and low fluid intake leads to dehydration and may also act as a predisposition to cramps, especially in the elderly. Sodium depletion has also been associated with cramps. The loss of sodium, the most abundant chemical component of bodily fluids out of the cell, is usually a function of dehydration.

• Fluid shifts in the body, low blood calcium and muscle cramps in the potassium. Body Fluid Shifts: Real cramps can also occur in other situations characterized by an abnormal distribution of body fluids. An example is cirrhosis of the liver, which leads to the accumulation of fluid in the abdominal cavity (ascites). Similarly, cramps are a relatively frequent complication of rapid body fluid changes occurring during hemodialysis for renal insufficiency.

• Low calcium or magnesium in the blood: Low levels of calcium or magnesium in the blood directly increase the stimulation of both the nerve endings and the muscles that stimulate. This may be a predisposing factor for spontaneous actual cramps experienced by many older adults as well as for those muscle cramps that are usually noted during pregnancy. 

Low levels of calcium and magnesium are common in pregnant women, unless these minerals are supplemented in the diet. Cramps are observed in any conditions which will reduce the availability of calcium or magnesium in body fluids, such as diuretic, overbreathing, excessive vomiting, deficient calcium and / or magnesium in the diet, insufficient calcium absorption due to vitamin D deficiency, poor functioning of the parathyroid glands (microscopic glands in the neck

Do all muscle cramps fit into the above categories?

No. Not all cramps are readily categorised in the preceding manner since these categories best apply to cramps that make up an individual's major muscle problem. Many cramps are a relatively minor part of nerve and muscle diseases; other muscle symptoms are usually more prominent in these diseases.

Some examples of cramps include amyotrophic lateral sclerosis (Lou Gehrig's disease) with weakness and muscle wasting; radiculopathy (spinal nerve irritation or compression from various causes) with pain, distortion or loss of sensation, and/or weakness; diseases of the peripheral nerves, such as diabetic neuropathy, with distorted and diminished sensation and weakness; and a number of primarily dystonic muscle diseases.

Can medications cause muscle cramps?

Numerous medicines can cause cramps. Potent diuretic medications, such as furosemide (Lasix), or the vigorous removal of body fluids, even with less potent diuretics, can induce cramps by depleting body fluid and sodium. Simultaneously, diuretics often cause the loss of potassium, calcium, and magnesium, which can also cause cramps.

Medications such as donepezil (Aricept, that is used for Alzheimer's disease) and neostigmine (Prostigmine and others, used for myasthenia gravis) as well as raloxifene (Evista, used to prevent osteoporosis in postmenopausal women) can cause cramps.

 Tolcapone (Tasmar, used for Parkinson's disease) reportedly causes muscle cramps in at least 10% of patients. True cramps have been reported with nifedipine (Procardia and others, used for angina, high blood pressure and other conditions) and the asthma drugs terbutaline (Brethine) and albuterol (Proventil, Ventolin, and others).

Some of the medicines used to lower cholesterol, such as lovastatin (Mevacor), can also lead to cramps.

Cramps are sometimes noted in addicted individuals during withdrawal from medications and substances that have sedative effects, including alcohol, barbiturates and other sedatives, anti-anxiety agents such as benzodiazepines (for example, diazepam [Valium] and alprazolam [Xanax]), narcotics, and other drugs.

Can vitamin deficiencies cause muscle cramps?

Several vitamin deficiency states may directly or indirectly lead to muscle cramps. These include deficiencies of thiamine (B1), pantothenic acid (B5), and pyridoxine (B6). The precise role of deficiency of these vitamins in causing cramps is unknown.

Can poor circulation cause muscle cramps?

Poor circulation to the leg muscles, which results in inadequate oxygen to the muscle tissue, can cause severe pain in the leg muscle (sometimes known as claudication pain or intermittent claudication) that occurs with walking or exercise. This commonly occurs in the calf muscles.

 While the pain feels virtually identical to that of a severely cramped muscle, the pain does not seem to be a result of the actual muscle cramping. This pain may be due to accumulation of lactic acid and other chemicals in the muscle tissues. It's important to see your doctor if you have pain like this.

What are the symptoms of common muscle cramps? How muscle cramps diagnosed?

Characteristically, a cramp is painful, often severely so. Usually, the sufferer must stop whatever activity is under way and seek relief from the cramp; the person is unable to use the affected muscle while it is cramping. Severe cramps may be associated with soreness and swelling, which can occasionally persist up to several days after the cramp has subsided. At the time of cramping, the knotted muscle will bulge, feel very firm, and may be tender.

There are no special tests for cramps. Nevertheless, the diagnosis of muscle cramps is relatively easy. Most people know what cramps are and when they have one. If present during a cramp, the doctor, or any other bystander, can feel the tense, firm bulge of the cramped muscle.

What types of doctors treat muscle cramps?

Because there are so many different causes and types of muscle cramps, many different medical specialists may be involved in their treatment. Most commonly, patients would consult their primary-care provider, including specialists in internal medicine or family medicine. If the cramps are the result of a sudden injury or illness, emergency-medicine specialists would treat the patient.

Cramps due to specific medical conditions may be treated by different specialists, including neurologists, orthopedists, nephrologists, endocrinologists, cardiologists, sports-medicine specialists, physiatrists, or surgeons.

What are treatments and home remedies for skeletal muscle cramps?

Most cramps can be stopped if the muscle can be stretched. For many cramps of the feet and legs, this stretching can often be accomplished by standing up and walking around. For a calf muscle cramp, the person can stand about 2 to 2.5 feet from a wall (possibly farther for a tall person) and lean into the wall to place the forearms against the wall with the knees and back straight and the heels in contact with the floor. It is best to learn this maneuver at a time when you don't have the cramp.

Another technique involves flexing the ankle by pulling the toes up toward the head while still lying in bed with the leg as straight as possible. For writer's cramp (contractures in the hand), pressing the hand on a wall with the fingers facing down will stretch the cramping finger flexor muscles.

Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak. If the cramp is associated with fluid loss, as is often the case with vigorous physical activity, fluid and electrolyte (especially sodium and potassium) replacement is essential. Medicines generally are not needed to treat an ordinary cramp that is active since most cramps subside spontaneously before enough medicine would be absorbed to even have an effect.

Medical treatment for muscle cramps

Muscle relaxant medications may be used over the short-term in certain situations to relax muscle cramps due to an injury or other temporary event. These medications include cyclobenzaprine (Flexeril), orphenadrine (Norflex), and baclofen (Lioresal).

In recent years, injections of therapeutic doses of botulism toxin (Botox) have been used successfully for some dystonic muscle disorders that are localized to a limited group of muscles. A good response may last several months or more, and the injection may then be repeated.

The treatment of cramps that are associated with specific medical conditions generally focuses on treating the underlying condition. Sometimes, additional medications specifically for cramps are prescribed with certain of these conditions.

Of course, if cramps are severe, frequent, persistent, respond poorly to simple treatments, or are not associated with an obvious cause, then the patient and the doctor need to consider the possibility that more intensive treatment is indicated or that the cramps are a manifestation of another disease.

 As described above, the possibilities are extremely varied and include problems with circulation, nerves, metabolism, hormones, medications, and nutrition. It is uncommon for muscle cramps to occur as the result of a medical condition without other obvious signs that the medical condition is present.

Cramps are inevitable, but if possible, it would be best to prevent them.

How can muscle cramps be prevented during activity?

During activity: Authorities recommend stretching before and after exercise or sports, along with an adequate warm-up and cooldown, to prevent cramps that are caused by vigorous physical activity.

Good hydration before, during, and after the activity is important, especially if the duration exceeds one hour, and replacement of lost electrolytes (especially sodium and potassium, which are major components of perspiration) can also be helpful. Excessive fatigue, especially in warm weather, should be avoided.

Are there medications to prevent muscle cramps?

In recent times, the only medication that has been widely used to prevent, and sometimes also to treat, cramps is quinine. Quinine has been used for years in the treatment of malaria. Quinine acts by decreasing the excitability of the muscles. It has also been shown to be effective in many, but not all, scientific studies.

However, quinine also causes birth defects and miscarriages as well as serious side effects. It has also occasionally caused hypersensitivity reactions and a deficiency of platelets, which are the blood components responsible for clotting. Either of these reactions can be fatal. Quinine is also associated with a cluster of symptoms called cinchonism (nausea, vomiting, headaches, and deafness).

Also, vision and heart irregularities can occur. Consequently, quinine tablets are not available in the United States. Quinine is available in grocery stores in tonic water. The U.S. FDA does not recommend or endorse the use of quinine to treat or prevent muscle cramps.

Nevertheless, quinine is sometimes recommended as quinine water (tonic water) prior to bedtime to prevent night muscle cramps. Always consult your health care professional before taking quinine for cramps.