Whenever we use our muscles such as those of our arms and legs, they alternatively contract and relax as we move our limbs. Muscles that support our head, neck, and trunk contract similarly in a synchronized fashion to maintain our posture. A muscle that involuntarily contracts is called a muscle cramp. Muscle cramps can last anywhere from a few seconds to an hour, and occasionally longer in severe cases. The cramp may involve a part of a muscle, the entire muscle, or several muscles that usually act together, such as those that flex adjacent fingers.
Some cramps involve the simultaneous contraction of muscles that ordinarily move body parts in opposite directions. Muscle cramps are fairly common and become increasingly frequent with age. Any muscle under voluntary control (skeletal muscle) can cramp. The legs and feet, and particularly the calf (also known as a ‘charley horse’), are especially susceptible to muscle cramps.
Generally, there are three types of muscles in your body:
- Cardiac muscle makes up your heart.
- Smooth muscle cells line your blood vessels, gastrointestinal tract, and certain organs.
- Skeletal muscles attach to your bones and are used for voluntary movements of the body. Muscle spasms occur when a skeletal muscle contracts and does not relax, therefore muscle spasms are forceful and involuntary. A sustained muscle spasm is then called a muscle cramp. Leg muscles, especially the quadriceps, hamstrings, and gastrocnemius, are most likely to cramp, but any skeletal muscle in the body can cramp.
Causes & Symptoms
The cause of muscle cramp can be varied and not easy to pinpoint. When a healthcare provider cannot find a specific cause, the cramps are called ‘idiopathic’. Although, there are a variety of medical disorders that can lead to symptoms of a muscle cramp. Conditions and circumstances that may cause muscle cramps to include the following:
- Hypothyroidism – Having a thyroid gland that is less active than normal can lead to muscle cramps.
- Dehydration – Losing body fluids while exercising (primarily in hotter temperatures) can cause muscles to suddenly cramp.
- Low electrolyte levels – Low levels of substances such as calcium or potassium in the blood can cause muscle cramps to occur.
- Inadequate blood supply – Narrowing of the arteries that deliver blood to your legs can produce cramp-like pain in your legs and feet while you are exercising. These cramps usually go away soon after you stop exercising.
- Medication – Taking certain medicines, including pseudoephedrine (a type of medications that is used to treat nasal congestion) and statins (medication that treat high cholesterol), can lead to involuntary muscle cramps.
- Nerve disorders – In rare cases, issues such as a pinched nerve or spinal cord injury can cause nerve compression, which can then lead to muscle cramps.
- Strains – Overusing your muscles during exercises or strenuous activities can lead to cramps.
- Tightened muscles – Inactivity and not enough stretching can cause muscles to contract involuntarily.
Overall, muscle cramps can happen in any muscle of your body. They occur most often in the abdomen, arms, hands, feet, legs, and ribcage.
Who Gets Muscle Cramp?
Muscle cramps often occur in healthy people, usually in middle-aged and older people but sometimes in younger people as well. Cramps tend to occur during or after vigorous exercise, although they may sometimes occur during rest. Some patients also have painful leg cramps during their sleep. Sleep-related leg cramps normally affect the calf and foot muscles, causing the foot and toes to curl downward. Although painful, these cramps are usually not serious and are thus called benign leg cramps.
Other risk factors that might increase your risk of muscle cramps include:
- Pregnancy – Often, women who are pregnant experience leg cramps due to low electrolyte levels, circulation changes, and pressure on the nerves caused by the growing baby.
- Fatigue – Athletes are more prone to get muscle cramps in the preseason when the body is not conditioned and therefore more subject to fatigue. Muscle cramps often develop near the end of intense or prolonged exercise, or 4-6 hours later.
- Medical conditions – A patient might be at higher risk of muscles if he / she has diabetes, or nerve, liver, or thyroid disorders.
How Does It Affect You? How Serious Is It?
Some disorders can cause symptoms that resemble muscle cramps, such as:
- Dystonias – are involuntary muscle contractions, however, they typically last longer and occur more often than cramps. Also, they tend to affect other muscles and may affect many other muscles, including any limb muscles as well as those of the back and neck. In contrast, benign leg cramps and exercise-associated muscle cramping tend to affect the calf muscles.
- Tetany – is continuous or periodic spasms of muscles throughout the body. These spasms usually last much longer than muscle cramps and are much more widespread. Additionally, the muscles may also twitch constantly.
- Illusory muscle cramps – occur in some patients. These individuals feel as if they are having cramps, but no muscle contraction occurs.
- Hardening of the arteries in the legs – (also known as an arterial disease) may cause calf pain during physical activity such as walking. This pain is due to inadequate blood flow to muscles, not to muscle contraction as occurs with cramps.
In people who are experiencing muscle cramps, the following symptoms and characteristics are of particular concern:
- Muscle twitching
- Pain or loss of sensation unless they occur at the same time as the cramping
Recommended Treatment & Rehabilitation
Muscle cramps are normally harmless and often do not require immediate medical attention as they will disappear on their own in most cases. However, you should consult a doctor if your cramps cause severe discomfort for prolonged periods of time, are associated with leg swelling, redness, or other skin changes, muscle weakness, or are not the result of any obvious cause such as strenuous exercise.
To properly assess the cause of your muscle cramp, your doctor will perform a physical examination and ask you questions about your current condition. These questions will likely inquire about the frequency of the cramps, the affected muscles, whether you drink alcohol or exercise regularly, take any medications, or drink enough fluids. You may also be asked to provide a blood sample to check your levels of potassium and calcium, as well as your kidney and thyroid function to rule out any underlying medical conditions. In some cases, if you are a female patient, you may be asked to take a pregnancy test as well.
During the process of a physical examination, your doctor may also order an EMG or electromyography which will measure your muscle activity and check for any abnormalities. An MRI may also be requested, as it can create an accurate picture of your spinal cord.
The treatment for alleviating muscle cramps is determining the cause of the cramp and then trying to prevent the conditions that cause the cramp in the first place. A physiotherapist will first outline a specific treatment plan depending on the condition of the cramps and on your physical body. He / she may ask you to perform gentle stretching exercises prior to engaging in activity to prevent future muscle cramps. If the spasm is a result of an injury, the injury should be treated to prevent muscle knots from forming. Muscle knots are more painful and harder to cure. Therapeutic massage may be used as a treatment method for treating muscle knots or trigger points, which may also include physiotherapy exercises, heat and cold therapy, ultrasound, electrical stimulation, and trigger point injections.
Generally, most muscle cramps may resolve themselves quickly and cause no lasting pain or damage.
As for exercises that can help reduce further pain due to muscle cramps, here are a few stretches for common muscle cramps that may help you over time:
Crossover arm stretch
While standing, relax your shoulders and gently pull one arm across your chest, holding your upper arm. Stay in the stretch for 30 seconds and repeat on the opposite side before repeating three sets on each side a day.
Supine hamstring stretch
Lie on the floor on your back with both knees bent and feet flat on the floor. Wrap your hands around the back of your right thigh and straighten your knee until you feel a stretch in the back of your leg. Hold the position for 30-60 seconds before returning to the starting position. Switch legs and repeat three sets on each side a day.
Supine piriformis stretch
Begin on your back on the floor, crossing the leg of the affected sciatica side over the other so that you form a figure four, ankle on the opposite knee. Next, pull your knee toward your body, hold for 30 seconds, and repeat. Complete three sets on each side a day.
Start on your back on the floor with your knees bent, feet flat on the floor, and arms out to the side with your palms facing down. Afterward, turn your knees out to the right until you feel a gentle stretch in your lower back. Hold this position for 15-30 seconds, then repeat on the opposite side with three sets on each side a day.
For foot cramps, try to perform a towel stretch. Firstly, sit down with your legs outstretched in front of you, and flex your painful foot so the toes are pointed towards the ceiling. Then, take a towel and wrap it under the ball of your foot with both hands and lift the leg slightly. Finally, hold for 30 seconds, then repeat for three sets on each side.
If you have a muscle cramp in your calf, stand with your palms placed against a wall, arms stretched out. Step back with the affected leg, while leaning forward on the other leg and pushing against the wall. Hold for 30 seconds before repeating three sets a day.
Alternative & Homeopathic Treatment
There are many ways to treat muscle cramps from home, including steps that you can take to prevent them from occurring in the first place. Here are some home remedies that can help your feel better and get back to your regular activities:
After stretching, you should consider massaging the muscle cramp for relief. Using a roller or simply your hands, gently massage the muscles to loosen them up.
Along with stretching, another of the important muscle cramp remedies is heat application. Applying heat soon after spasms stats can help soothe the pain that comes with muscle cramps since it helps the muscle loosen up. To do this, you can either take a warm bath or shower. You can also apply a heating pad or a warm towel directly to the tense muscle.
Applying cold is another great way to treat muscle cramps. Once the pain subsides a little after heat application, you can grab an ice pack and put it on the cramping muscle. You can also try massaging the cramp with the ice pack to loosen up the muscle.
If your muscle cramp is in an area that you can elevate, like your leg or foot, prop the affected area upwards. Keep it positioned this way until the cramp starts to subside.
Drink enough water
A way to get relief from muscle cramps before they even begin is to drink enough water. Dehydration often plays a part in muscle cramps, so drinking enough water throughout the day can help keep them at bay. Drinking enough fluids while you have a cramp helps the muscles contract and relax.
If your muscle cramp continues and requires more than tropical home remedies, it is recommended to take a painkiller like ibuprofen or paracetamol.