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Muscle Cramps

Overview

Muscle cramps are a fairly common condition characterized by involuntary contraction or shortening of muscles. Any group of muscles can be affected, but the more commonly affected group of muscles include the arm, legs, and abdominal muscles. They occur for a short period but can be painful and reduce mobility until it resolves. The most common group of people to get muscle cramps are athletes. However, they may occur at any age to a person of any gender, race, or profession. Several remedies are available to lessen muscle cramps and improve the normal functioning of the affected muscles.

Causes

Muscle cramps can occur due to various causes. It also depends on the group of muscles involved. Skeletal muscle cramps frequently occur in athletes or those who perform a lot of physical activity within a day. Commonly affected skeletal muscles include thighs, calves, foot arch, biceps, and triceps. Females experience skeletal muscle cramps during pregnancy. Skeletal muscle cramps can also occur due to severe dehydration or electrolyte imbalance.

Nocturnal leg cramps are another type that is usually involuntary and occur during sleep or rest. They typically affect the calves and soles of feet, although any skeletal muscle may get targeted. It is considered multifactorial, and the causes may include dehydration, electrolyte imbalance, reduced blood flow, or iron deficiency. Certain medications, such as naproxen, conjugated estrogen, raloxifene, etc., may also cause nocturnal leg cramps. 

Smooth muscles present in our digestive, urinary, and other systems can also suffer from cramps. A typical example of smooth muscle cramps is menstrual cramps which occur due to contractions of the uterine muscles. Intestinal cramps, ureter cramps, and cramps of smooth muscles of the inner systems are other examples.
Other causes of muscle cramps include anemia, hypoglycemia, anaphylaxis, hypothyroidism, metabolic acidosis, liver failure, chronic renal failure, deep vein thrombosis, varicose veins, diabetes, dialysis, tetanus, uremia, heatstroke, skeletomuscular genetic disorders, etc.

Risk Factors And Epidemiology

Multiple risk factors can predispose a person to the development of muscle cramps. Some of these risk factors include dehydration, hyponatremia, hyperkalemia, imbalance of other electrolytes such as calcium, magnesium, etc., profuse sweating, weak or inflexible muscles, nutritional deficiency, constant exertion of muscles, decreased blood supply, wearing high heels for a long time, systematic diseases, genetic predisposition to skeletomuscular disorders, etc.

Muscle cramps have been noticed more frequently in elders over 60 years of age, although they may occur at any age due to physiological or pathological causes. Skeletal muscle cramps are more common in males, especially in a strenuous work. Smooth muscle cramps are common among females, such as those experienced during menses.

Signs And Symptoms

The most common symptom for muscle camps is sudden, intense pain as the muscle contracts involuntary. This pain can last from 2 to 15 minutes in most cases. It may be accompanied by a muscle or tissue bulge that can be felt upon palpation. Skeletal muscle cramps can reduce the affected muscles’ mobility until it is resolved. Nocturnal leg cramps can result in sleep disturbance, intolerable pain, and irritability. Smooth muscle cramps can be present with other symptoms if an underlying disease involves endometriosis, stone in the ureter, etc.

Diagnosis

The clinical presentation of cramps is enough for its diagnosis in most cases. A history and clinical examination are required in persistent or long-standing cramps. If your doctor suspects electrolyte imbalance, a blood sample may be taken to check for levels of sodium, potassium, magnesium, and other electrolytes.

Electromyography (EMG) may be done in some cases to check for abnormal muscular activity. In case of any other suspected systemic or genetic disorders, relevant imaging and diagnostic tests would be necessary to identify the primary cause of muscle cramps and associated symptoms.

Differential Diagnosis

Since muscle cramps can occur due to various systemic, metabolical, environmental, pathologic, genetic, or idiopathic causes, it is necessary to look out for the intensity, time of occurrence, duration, the persistence of cramps, and other associated symptoms to differentiate them from regular muscle cramps.

Treatment

Treatment of muscle cramps depends upon their cause and the group of muscles affected. Typically, in the case of skeletal muscle cramps or nocturnal leg cramps, massaging the affected area, stretching the muscle, or applying heat can reduce the pain and soreness. The important point is to restore the oxygen and blood supply to the affected area. An increase in the frequency of water intake and a decrease in the frequency of alcohol intake are suggested. Nutritional deficiencies should be treated with adequate food and dietary supplements. Smooth muscle cramps may be relieved by a heating pad over the affected area. Severe pain may require intake of oral analgesics to reduce the severity.

Medication

Supportive care alone is often enough to reduce muscle cramps, and medicines are not required in most cases. If there is severe pain, oral analgesics such as naproxen, diclofenac sodium, etc., may be effective. Antimalarial drug quinine was considered an effective medication for muscle cramps, but it has been discontinued due to its severe side effects. Intake of oral magnesium supplements has been deemed effective in some cases.

Prognosis

The prognosis of skeletal muscle cramps is good, especially in young adults. Elders may experience long-lasting or persistent cramps due to the age factor. Muscle cramps associated with other disorders will have to be tested and treated for their primary cause.

Prevention

The prevention of muscle cramps can be done by frequent water intake, consuming food high in necessary electrolytes, stretching exercises of muscles, avoiding strenuous work for long hours, lowering intake of alcohol and caffeinated drinks, and performing deep breathing exercises regularly. If you have any genetic or systemic disease that makes you prone to muscle cramps, get it treated immediately to avoid the occurrence of this condition.

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