Leg Cramps

Leg cramps are painful and sometimes scary since it can feel like your body is literally trying to rip its own muscles.  If you do enough research you will find that the cause of leg cramps is not precisely known.  The good news is that so many people are affected by this condition that practically everything has been tried and some treatments and therapies seem to work better than others.

During the Day

If you are not already drinking an above average amount of water, this is definitely the place to start. To achieve real hydration you will need to drink more water than you think you need. You will certainly need to drink when you are not thirsty.  Merely satisfying your thirst will not give your body enough extra fluid to ward off leg cramps.  Although it is a good idea to drink before going to bed, you will really need to increase water consumption throughout the day to make a noticeable difference.  Don’t despair – it gets easier to drink more after you get into the habit.  In fact, your body will begin to enjoy and crave fluids after you have developed the habit.

Potassium deficiency may also be the cause of your cramps. Try eating a banana a day and see whether the frequency of cramps decreases.  A little extra potassium may take you a long way

Before Going to Bed

You may not need to do anything additional at all if you find that water intake and extra potassium are doing the trick for you.

Increasing blood flow to your calf muscles should be part of the strategy.  Stretch the leg muscles by facing the wall, planting the foot of leg firmly and flatly against the floor and then leaning forward to stretch the hamstring and calf muscles. Make sure to keep your leg straight and knee locked. Do this for each leg.

If you routinely exercise you might try scheduling the exercise during an evening time slot and following it up with a stretching routine that emphasizes muscles prone to cramping.

Another good technique is to gently massage the muscles that are most often involved in the cramps. Some doctors recommend a warm bath with dissolved epsom salt.

Leg position can be difficult to control after you go to sleep. But starting out in a position that does not contort or stress any part of the leg can be important. Sometimes cramps come on when you wake in the night and stretch your legs just a bit farther than your body is comfortable with. Your legs may respond with a painful contraction.

Leg cramps and menses

Leg cramps occur due to a wide variety of causes. One important cause is menstruation. During menses, women lose a significant amount of blood. This results in loss of iron (from hemoglobin) and other minerals like potassium and magnesium.

During heavy or prolonged menses (polymenorrhoea), this loss is even greater. Depletion of these vital minerals causes increased irritability of the skeletal muscles of the calf and lower limbs, precipitating painful spasms of the muscles. Leg cramps can occur for 3 to 7 days during the menstrual phase and is more so if the patient is dehydrated or has heavy physical exertion.

Prevention of cramps lies in controlling the risk factors or precipitating causes of this condition. One important precaution is to prevent dehydration by increasing fluid intake. Women should also increase the intake of crucial electrolytes like potassium and magnesium during and after this phase.

The cramped muscle is painful to the touch (tender) and is usually harder than normal muscles. At the onset of cramps it is best to cease all physical activity and gently massage the affected areas. It is also advisable to lie on your back with your leg raised. Next, gently flex the knee. This position and flexing causes relaxation of the muscles. Then attempt to straighten the knee, while continuing the gentle massage.  Prevent dehydration by consuming 5 to 8 glasses of water or other liquids daily. During acute attacks themselves it is also a good idea to drink plenty of water. This can be followed by a warm water bath. Some physicians advocate the adding of Epsom salt to the bath water though this isn’t strictly necessary.

Along with these methods, women who are prone to leg cramps during menses should consume foods rich in potassium like bananas, mollusks, white fish and avocadoes. Foods rich in calcium, like milk and cheese, as well as curd are advisable. Magnesium rich foods like black beans, barley and artichokes are help to restore magnesium levels. Various home remedies are also used to treat leg cramps. Add chamomile tea to warm water and then wash the affected (cramped) muscle in it for 15 to 20 minutes. Some advocate adding sea salt and baking soda to a tub of warm water and soaking the cramped leg in it for 10 minutes. Another home remedy is to orally consume a cup of yogurt every morning. Use of pumpkin seeds as a preventive measure has also been tried to some positive effect. Once the menses begin, eat one or two bananas during every meal. These supply much needed potassium to the diet. Herbal tea using a combination of lemon and ginger can also be very useful. Drinking a cup of this tea is often very helpful in preventing leg cramps. Often it is not any single remedy but a combination of several of these that make an effective defense against muscle cramps during menses.

Leg cramps and diabetes

What is the relationship between diabetes and cramps in the lower limbs? Plenty! Diabetes is a condition caused by an increase in blood sugar (blood glucose). This results in increased urine output for the diabetic patient, also called polyuria in medical parlance. A substantial amount of electrolytes like sodium, potassium and magnesium are excreted in this increased urine loss. This causes an imbalance in the diabetic patient’s electrolyte levels in the blood. Hypokalemia or reduced potassium levels triggers increased irritability of the skeletal muscle fibers with resultant muscle spasms and leg cramps. Perhaps, another cause of leg cramps in diabetic patients is diabetic neuropathy. Long term diabetes causes substantial damage to the peripheral nerves, making the nerve fibers susceptible to being increasingly irritable which results in leg cramps. It is also believed that arteriopathy, damage to the arteries to the lower limbs, also contributes to the process of leg cramps.  It is not one factor alone, but a combination of all these pathologies that contributes to increased incidence of painful muscle spasms in diabetics. Low calcium levels are also believed to play a role in such patients. In children, diabetes may increase the tendency for leg cramps along with what is called as growing pains.

What are the main complaints of diabetic patients related to leg cramps?

Usually the diabetic complains of getting painful cramps that awaken him or her during sleep. Theses are called nocturnal cramps and can cause severe sleep loss for the patient. In advanced and long term diabetes, the pain element might be absent due destruction of the pain fibers of the neurons or nerve cells.

How does one prevent leg cramps in diabetes?

Much thought and research has gone into this field. Experts say that the best way is to increase consumption of food rich in potassium such as oranges, cantaloupes, sweet potatoes, and fruits. In fact, the most common and cheapest source of potassium may be bananas. In addition, regular checking of the blood electrolyte levels may serve as advance warning to the patient of leg cramps.

Regular use of potassium supplements may be required as well as changes in diet. Many doctors recommend the intake of about 3 doses of liquid potassium supplements per day. It is also advisable to use Morton Salt Substitute as an emergency medicine to be taken during cramps. The dose advisable in patients is 1/8 teaspoon of Morton’s salt substitute with plenty of water. One test for low potassium levels is as follows: take 1/8th teaspoon of Morton’s salt substitute with a large amount of water. If the patient feels better within 20 minutes of taking this dose, then he/she is suffering from low potassium levels (hypokalemia). Such patients may benefit from 2 to 3 doses of liquid potassium daily. Never consume more than 1/8th teaspoon of Morton’s salt. However it must be emphasized that self medication is not advisable. Any medicine must be taken after proper medical consultation with a doctor or physician.

Leg cramps in children

Like adults, children too tend to have leg cramps. These are also called “charley horses”, especially when the muscles spasm follows prolonged exercise. This term is derived from popular American slang for painful cramps in the lower limbs, usually involving the quadriceps and calf muscles.

The Main Causes

Children are usually very active and often do not know the limits and risks of prolonged and strenuous physical exercise or activity. This is the commonest cause of leg cramps in children. There is excessive build up of certain chemicals like lactic acid in the skeletal muscles of the thigh and the calf. This causes what is called in medical terminology, ERMC (exercise related muscle cramps). These can last from a few seconds up till a few minutes. Recent studies suggest that rather than the build up of chemicals in the muscle, cramps are the result of central nervous system fatigue. We all know that the brain via the spinal cord and the nerves extending from here, control the skeletal muscles (muscles of the limbs). Normally, there is always a mechanism of feedback whereby the skeletal muscles are inhibited from becoming overactive during muscle contraction. Prolonged exercise is believed to alter this inhibitory system resulting in hyperactive muscles and consequent muscle cramps. Perhaps it is both of these mechanisms (accumulation of harmful substances and loss of inhibition) that cause painful spasms of muscles. In addition, children (and indeed adults also) often sit or stand in awkward postures for extended periods of time precipitating muscle cramps. Other factors include improper footwear and obesity. Obesity is now becoming an increasingly common factor in both adults and in children. This has a lot to do with current lifestyles with emphasis on fast food and long hours of television viewing. Other causes of cramps in children include electrolyte imbalances, specifically potassium and magnesium deficiency. Exercise can also cause dehydration with loss of electrolytes and fluids in sweat, resulting in cramps. More ominously, serious illnesses like leukemia can also cause painful cramps in children. A pinched nerve due to awkward positions while sleeping can also cause cramps.

Treatment of Cramps in Children

If cramps are caused by painful contractions of the affected muscles, the remedy lies in stretching the muscle. Thus, the first thing to be done if a child suffers from spasms of the calf muscles is this: gently hold the toes and bend the foot from the ankle, upwards and towards the shin of the leg, thus stretching the calf muscles. Hold this position for some time till the cramps subside. The other remedy is to gently massage the affected calf muscles preferably with warm water or oils. One might also use one of the many medicated pain relieving creams or ointments, available over the counter at a pharmacy. Other things that can help include taking preventive measures like increasing the dietary consumption of green vegetables and fruits to supply sufficient electrolytes and vitamins. Also, it is important to rest after exercise, and to gradually increase the capacity for exercise. Proper hydration is also very important.