Disease, Illness and Condition Library
Leg Cramps
- It was early morning when my uneventful nights sleep was
interrupted by a sharp, shooting, and excruciating pain in my lower leg.
My calf muscle has suddenly cramped, apparently when I stretched my leg
while sleeping. The muscle was drawn into a hard, tight cramp that refused
to relax or ease on its own. It was as if my calf muscle has a mind of its own.
I rolled over, suffering in pain. I tried to rub the muscle, but little relief was
apparent. I then tried a full blown message which produced little benefit.
Finally, all else having failed, I sat up, put my feet on the floor, and stood
up, placing my weight on the cramped leg and foot.
Almost immediately the muscle began to relax. Taking a few steps further
relieved the cramp within seconds, the pain which only minutes before had
virtually crippled me as gone. My attitude immediately improved, and in a
short time I was asleep.
Common but Allusive
Occasionally leg cramps, afflict millions of people worldwide, although no one
knows exactly how often or why they occur. They may result from overexertion,
certain medical conditions such as diabetes, or a reaction to medication, among
other causes. Because leg cramps are not usually symptoms of a disease or
medical condition and rarely lead to more serious problems, little research has
been done on them.
Consequently doctors do not know the precise physiological cause of muscle
cramps, why they seem to occur more often in one leg than other muscles, or
why particular medications, most used primarily for other medical conditions,
and home remedies seem to relieve them.
Maybe the biggest mystery of all is why cramped muscles fail to relax. Why
someone who lifts weight and keep the muscles contracted for a substantial
time doesn’t suffer a cramp or pain is at the heart of this medical mystery.
What is known is that leg cramps seem to occur most commonly in athletes and
others, who exercise strenuously, in people who have reached middle age and
beyond, and in those who suffer circulatory problems. They occur most often at
night or when resting. Also, people who stand for long periods of time are prone
to be afflicted with leg cramps. However, painful at the moment, most leg cramps
last no more than a few minutes, and they don not interfere with daily functioning.
In a few cases, however, leg cramps can cause a persistent, severe pain that
could prevent sleeping, walking, or other activities.
How Do Muscles Cramp?
Most leg cramps seem to occur for no apparent reason. One noted cardiologist
and vascular specialist explains that the general process of leg cramps by
likening the body’s cells to electric batteries. Both function, he says, by passing
electrical charges across their surfaces.
Muscles contract when electrical impulses travel from the brain along the
nerves and are transferred to muscle cells by special transmitters operating at
the nerve muscle junction. Most muscle contractions are voluntary, organized,
and controllable. A cramp or spasm occurs when the electrical impulses from
the brain occur very rapidly, causing the muscle to contract in a sudden
disorganized, and uncontrollable fashion.
In these cases, muscular activity is somehow related to changes in the balance
of various body chemicals called electrolytes. Of these, calcium, potassium, and
sodium have the most effect on muscle and nerve activity. Sweating a lot can
alter the body’s chemistry by decreasing sodium and potassium levels and total
body fluids. An altered chemical balance can prevent the transmitters from
functioning properly, perhaps preventing the muscles from relaxing after
contracting.
Some cramps may be a product of over exercising or failing to properly stretch
muscles before exerting them. Athletes normally prepare their muscles before
running or competing vigorously. Cramps are particularly common among older
people or weekend warriors, who are less active and less likely to warm up first.
But athletes are not the only ones who overexert muscles. It can happen to
other people too, especially normally inactive individuals. People who spend
more time than normal in the garden, for example, may exercise their muscles
more than they are used to and suffer leg cramps later. Again, those who are
middle aged or older are more likely to experience such cramps.
Weight can be a complicated factor. Being overweight can change body posture
in ways that place extra pressure on leg muscles, leading to cramps. Also, the
enlarging uterus in the late months of pregnancy can impede blood flow from
the lower legs. Swelling in the legs, varicose veins, and frequent leg cramps
are not uncommon. Pregnant women are often advised to wear elastic
stockings to reduce swelling and cramping.
Drugs and Cramps
Certain medications can alter chemical and fluid balances, leading to leg
cramps. Patients taking diuretic drugs to control heart, blood pressure, and
kidney disorder can suffer cramps. The reason is that diuretic drugs remove
electrolytes from the body, taking with them fluids needed for proper body
function. The only way to stop these types of leg cramps is to reduce the
dosage of electrolyte affecting drugs or add additional medications to
prevent the cramping.
Home Remedies
There are many simple home remedies that relieve leg cramps. Standing on
the cramped leg or foot and walking around works by forcing the muscle in
the direction against the cramp, which relieves it. Home health manuals often
advise people to pull their toes forcefully yet smoothly up towards the knee,
which similarly forces the muscle against the cramp.
Other home remedies include massaging the cramped muscle, applying heat to
it, and wearing loose fitting clothing to bed. Heating the muscle with a hot water
bottle or electric blanket, for example, increases blood flow to the leg, thus
improving the electrolyte and other chemical balances needed for muscles to
function properly. One physician recommends putting a spongy matt on the
floor to the cushion the legs for individuals whose work forcing them to stand
for hours on end. He also suggests an occasional flexing of the muscles by
simply moving about.
When It Gets Serious
Sadly, not all leg cramps are so easily treated. Some, in fact, result from serious
medical conditions and can themselves make normal functioning difficult. In
some cases medical treatment, beyond medications and home remedies will
be required.
In the mid 90’s one study in Israel linked muscle cramps with liver disorders.
By comparing healthy people with patients who had cirrhosis of the liver,
researchers found that 88 percent of the latter had painful muscle cramps
compared to 21 percent of healthy subjects. The authors of the study concluded
that painful muscle cramps might be regarded as a symptom of liver cirrhosis.
A more common cause of leg cramps is varicose veins. Varicose or abnormally
swollen veins affect the interchange of fluids between the veins and muscles.
Also, damaged valves in the veins can let blood leak back down the leg and
into the muscle, causing cramps.
Other circulatory ailments, such as arteriosclerosis and arteritis, can likewise
cause leg cramps. They result in narrowed leg arteries, thereby preventing an
adequate supply of blood from reaching the muscles. People with these
conditions often cannot walk long distances or for sustained periods of time
without suffering pain or a cramp or both. Such symptoms known collectively
as intermittent claudication, are usually associated with cigarette smoking and
high blood cholesterol levels.
Other Causes
While intermittent claudication involves only large arteries, leg cramps can be
caused by blockages of smaller ones, too. Diabetes, for example, can cause
small arteries to become constricted, thereby cutting the blood flow through them.
Yet another medical condition can cause leg cramps. Patients suffering from low
calcium levels can cause leg cramps, as can patients with on hemodialysis for
end stage renal disease. Patients with chronic kidney disorders who undergo
dialysis may have leg cramps near the end of the dialysis session. Medical
studies have shown this to be related to fluid and salt depletion occurring during
the dialysis and can be relieved by giving the patients intravenous salt and sugar
solutions.
It should be pointed out that most people who suffer from arterial disorders,
diabetes, and other medical conditions linked to leg cramps do not get leg
cramps, or get them only occasionally. Similarly, only about 1 or 2 percent of
people using diuretics actually get leg cramps. This is a very small percentage
but when you add up the millions taking these drugs it comes out to be a very
large number.
Because of their unpredictable nature and the fact that so little is known about
them, leg cramps continue to be a perplexing problem.
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