Leg Cramps – Causes, Complications, and Treatment.

What are leg cramps?

 

Leg cramps are abrupt, unconscious, excruciating muscle pains that typically occur in the calf, foot, or thigh.

They are also sometimes referred to as "charley horses."

Your leg may occasionally spasm, or stiffen up uncontrollably, as a result of the cramp.

Although uncomfortable, cramps are typically not harmful.

A leg cramp feels like a muscle that has been clenched, constricted, and knotted.

It might even be intolerably painful or uncomfortable.

Your muscles in the area might hurt for hours after the cramp goes away.

 

Pathophysiology.

Leg cramps, on the other hand, typically result from a disruption in energy generation in muscle cells and are most frequently caused by metabolic myopathies that are linked to problems with glycogen, lipid, or mitochondrial metabolism. Low ATP levels are a result of metabolic myopathies.Actin and myosin chains do not separate during muscle relaxation since this is an adenosine triphosphate (ATP)-dependent active activity, which results in an electrically silent cramp (ie, contracture).Additionally to ATP deficiency, the metabolic failure may result in the buildup of potentially hazardous metabolites.

 

What causes leg cramps.

Leg cramps can have an unknown origin (idiopathic).

In other situations, there might be an underlying issue or another clearly recognizable cause.

 

Idiopathic leg cramps

There are numerous opinions concerning what could cause idiopathic leg cramps, despite the fact that the etiology is unclear.

 

These include:

Abnormal nerve activity when you sleep causes your leg muscles to cramp

Leg muscles may occasionally cramp as a result of excessive strain, such as that caused by exercise.

Rapid reduction in the flow of blood to the impacted muscles.

Additionally, as a person ages, tendons naturally shorten, which could account for why leg cramps afflict older people more than younger people.

Tendons are strong tissue bands that attach muscles to bones.

Your muscles that are attached to your tendons may cramp up if they get too short.

 

Secondary leg cramps

An underlying disease or another clearly defined cause is the cause of secondary leg cramps.

These consist of:

Pregnancy: The additional weight associated with pregnancy may put tension on the leg muscles, increasing their susceptibility to cramping

Exercise: Leg cramps are frequently felt after exercise when resting

 

The following neurological diseases can impair the nerves that control your leg muscles:

For instance, peripheral neuropathy or motor neuron illness

Liver disease: If your liver isn't functioning properly, toxins will accumulate in your blood and cause your muscles to spasm.

Infection: Some bacterial infections, like tetanus, can result in cramps and spasms in the muscles.

Leg cramps can sometimes be brought on by excessive blood levels of toxic (poisonous) chemicals like lead or mercury.

Dehydration: In some individuals, a lack of water in the body can cause your salt levels to drop, which can cause muscle cramps.

 

Who is at risk for muscle cramps?

Muscle cramps can happen to anyone, however some persons are more likely to experience them:

Older people

People who are overweight

Expecting mothers

Individuals suffering from illnesses including thyroid and nerve issues.

 

Symptoms of leg cramps

Leg cramp signs and symptoms include:

A sudden leg muscle ache brought on by an uncontrollable contraction (shortening) of the leg muscle

Most often, they affect the calf muscles. Less frequently, they affect the foot and thighs.

Leg cramps typically stay the longest, lasting anywhere from a few seconds to 10 minutes.

Cramping causes the affected muscles to tighten and hurt, and it also causes the feet and toes to become rigid.

You can experience discomfort and tenderness in your legs for several hours following the cramps.

 

What possible side effects could leg cramps have?

 

Leg cramps can be caused by serious disorders, therefore if they are not cured by self-care techniques, it is important to seek medical attention. Doing so can prevent major complications and lasting harm.

Following the treatment strategy you and your healthcare provider create especially for you after the underlying cause has been identified will help to lower your risk of future problems, such as: 

Reduced mobility

Nonrestorative sleep

Overuse illnesses

Progressive symptoms

Skin alterations

 

Diagnosis of leg cramps

Leg cramp evaluation focuses on identifying what is curable.

A condition that causes cramps is frequently previously known to exist or produces symptoms that are more distressing than cramps.

It is important to distinguish cramps from claudication and dystonias; a clinical evaluation is typically sufficient.

 

History

A description of the cramps, including their duration, frequency, location, apparent triggers, and any accompanying symptoms, should be obtained from the patient's past medical history.

Muscle stiffness, weakness, discomfort, and loss of sensation are some signs that neurologic or muscular problems may be present.

The following factors are noted: pregnancy, recent dialysis, use of diuretics, strenuous activity, vomiting, diarrhea, and electrolyte or bodily fluid imbalances.

 

Review of systems should seek symptoms of possible causes, including the following:

Amenorrhea or irregular menstruation:

Leg pains attributed to pregnancy

Skin changes and weight increase along with cold intolerance:

Hypothyroidism

 

Weakness:

Neurological conditions

Loss of sensation or discomfort

Radiculopathies or peripheral neuropathies

Any conditions that can induce cramps should be included in the past medical history.

A thorough drug history is obtained, including alcohol use.

 

Physical examination

The skin should be examined thoroughly for signs of alcoholism, nonpitting edema, hair loss on the brows (which could indicate hypothyroidism), and changes in skin moisture or turgor.

A neurologic examination is performed, including testing for deep tendon reflexes.

All of the extremities' blood pressure should be checked, along with their pulses.

Ischemia may be indicated by a weak pulse or a low ankle-to-brachial blood pressure ratio in the affected leg.

 

Test

There are no routine tests for diagnosing leg cramps. Instead, doctors order tests to rule out or confirm an underlying condition. This could include a variety of tests, such as:

Tests on blood or urine to determine hormone levels, nutritional status, kidney, liver, and liver function as well as electrolyte values.

A blood vessel could be the source of the leg cramps, according to vascular imaging.

Leg cramp-like symptoms could be caused by venous insufficiency or peripheral artery disease.

If your doctor suspects a nerve or muscle condition may be to blame, nerve conduction testing may also be helpful.

These tests indicate to your doctor whether the muscles themselves or the nerves that govern them are the issue.

Your physician might recommend electromyography (EMG).

This test monitors muscular activity and looks for anomalies in the muscles.

An MRI scan could also be beneficial.

An image of your spinal cord is produced with this imaging device.

Occasionally, a myelogram, also known as a myelography, or another imaging test, may be beneficial.

If you feel weak, in pain, or lose sensation, let your doctor know.

These indicators of a nerve problem may be present.

 

Treatment

Leg cramps are unlikely to be prevented by medicine.

An over-the-counter (OTC) pain reliever may be helpful if a strong cramp leaves a muscle feeling sore.

Quinine was utilized in the past.

The Food and Drug Administration (FDA) warns against using this, however, as there could be harmful interactions and negative effects.

There is some evidence that calcium channel blockers, carisoprodol, stretching, and vitamin B-12 may be beneficial.

Taking multivitamins while pregnant may be beneficial.

Calcium, potassium, and nonsteroidal anti-inflammatory medications (NSAIDs) have no proven health benefits.

 

Exercises and stretches

Leg cramps should go away on their own if no underlying reason is present.

Stretching the muscles and releasing a cramp might be achieved by tiptoe walking.

Exercises that involve stretching might be beneficial.

Try the following stretches if the cramp is in the calf muscle:

 

Hamstring muscle stretch

Sit on the ground with your legs extended in front of you.

In order to stretch the calf muscle, lift the toes toward the knee.

Hold for a minute.

 

Calf muscle stretch

Put both of your feet level on the ground and stand about one meter away from a wall.

Lean forward against the wall with your palms flat on the surface and your arms extended.

Keep your heels firmly planted.

Hold for 10 seconds, then gradually raise your body back up.

5–10 times, then stop.

 

Quadriceps muscle stretch

Holding onto a chair or wall for support as needed, stand up straight.

Grab the ankle of one foot and lift it up toward the buttocks, keeping it as near to the body as you can.

30 seconds should be spent holding, then switch to the other foot.

 

These exercises might be used to treat or prevent cramps.

They may also be used to warm up before physical activity.

 

What medications could ease leg cramps?

There isn't a medication on the market right now that can completely stop leg cramps.

However, there is some evidence that certain prescription drugs can prevent leg cramps.

Under your healthcare provider’s watchful eye, you might want to try the following:

Carisoprodol (Soma): A muscle relaxant.

Diltiazem (Cartia ): A calcium-channel blocker.

Orphenadrine (Norflex): Treats muscle spasms and relieves pain and stiffness in muscles.

A calcium channel blocker is verapamil.

 

Home remedies

To relieve cramping,these  recommendations are suggested:

Stop doing whatever produced the cramp.

Massage and stretching the muscle.

Hold the stretched leg there until the cramp subsides.

Heat should be applied to tense or tight muscles.

On painful muscles, apply cold compresses.

 

For the purpose of easing muscle cramps, some people use supplements like magnesium.

Although research is scarce, stretching before night may be beneficial.

How to avoid leg cramps

Stretching your lower leg muscles on a daily basis can help avoid leg cramps or lessen their frequency if you suffer from them frequently.

Stretching your calves each night before bed may be beneficial for you (see stretching advice above or try this post-exercise calf stretch).

 

The following nighttime suggestions could be helpful:

Make sure your toes point upwards if you are lying on your back. You may aid maintain this posture by placing a pillow on its side at the foot of your bed and leaning your feet against it.

Hang your feet over the end of the bed if you are lying on your front; this will keep your feet relaxed and prevent the muscles in your calves from tensing and constricting.

Keep blankets and sheets loose.

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