Muscle Cramps

Muscle Cramps

Put Them at Ease--For Good

They seem to come out of nowhere. One minute you're lying in bed reading quietly. The next, you're sitting up, clutching your leg, rocking back and forth and swearing at an intense muscle cramp shooting through your calf.

You know the feeling. That's because muscle cramps, which are involuntary muscle contractions that can occur anywhere in the body, are very common. A whopping 95 percent of college students questioned in a survey said they had experienced muscle cramps. And a survey of patients at a health clinic found that 50 percent had suffered at least one leg cramp in the previous month.

An Unsolved Mystery

The most common type of muscle cramp occurs at night in the legs, says Baltimore physical therapist Z. Annette Iglarsh, Ph.D., vice-president of Theraphysics, a rehabilitation managed-care corporation, and president of the Orthopedic Section of the American Physical Therapy Association. These cramps can be extremely painful and can even rouse you from a deep sleep. Daytime cramps are also possible in muscles throughout the body, including the thighs, back, hands and arms.

Doctors suspect that muscle cramps are often related to mineral deficiencies, says Dr. Iglarsh. Magnesium and calcium in particular are believed to play central roles in muscle contraction and relaxation, so a lack of them may bring about cramps. So might shortages of potassium and sodium, which also trigger the contraction and relaxation of muscles.

Exercise can reduce the body's mineral reserves because potassium and sodium are lost in sweat. Dehydration is also thought to cause cramps.

People who are out of shape run an increased risk of getting cramps because poorly conditioned muscles get fatigued more easily, says Paul Davidson, M.D., associate clinical professor of medicine at the University of California in Greenbrae and medical director of the Fibromyalgia Clinic at Kentfield Rehabilitation Hospital in Kentfield, California.

Changes in circulation--such as swelling in the feet and ankles, which many pregnant women experience--can lead to cramps, says Dr. Iglarsh. That's because swelling deprives the calf muscles of the nutrients they need. Also during pregnancy, the fetus draws on the mother's mineral stores, which may lead to depletion, she says.

Your sleeping position may also be the culprit. When blankets press down on your foot, forcing it into a pointed position, your calf and foot muscles are shortened and a cramp can result.

Medications can trigger muscle cramps. Diuretics, for example, which are used to treat kidney disease and high blood pressure, cause frequent urination. Because you lose minerals when you urinate, mineral balances in the body are altered.

Muscle cramps can also be due to diseases, including hypothyroidism, in which the thyroid gland produces too little hormone. Peripheral vascular disease, in which the small blood vessels in the extremities deteriorate, and atherosclerosis, in which the walls of small blood vessels thicken, both cause circulatory problems and possibly cramps.

Don't Cramp Your Style

Lots of people get muscle cramps, and usually they are not a sign of anything serious, says Dr. Davidson. There are some things you can do to lower your chances of getting one, however, and to get relief when one strikes.

Stay active. Do your best to participate in an exercise program on a regular basis, says Dr. Iglarsh. This may help prevent leg cramps by keeping your muscles in shape. Any kind of aerobic exercise, such as walking, running or biking for at least 20 minutes three times a week, is generally sufficient to maintain muscle fitness.

Quit smoking. Smoking decreases the size of the arteries that supply blood to your muscles, says Dr. Davidson. This improper blood flow can cause cramps, so do your best to cut back or quit.

Prepare for sleep time. Slowly unwind at least one hour before you go to sleep, says Dr. Iglarsh. Too often we rush around all day, exercise after work, race home to prepare dinner and do some chores, then jump right into bed without a relaxation period, she says. Taking time to calm down may reduce the likelihood of cramps because you won't be placing great demands on your muscles and then stopping suddenly.

Stretch it out. To deter leg cramps, do calf stretches before you go to bed or when you wake up, says Dr. Iglarsh.

Stretching can also help if you get a cramp, she says. The aim is to stretch the cramping muscle, whether it's in your calf, foot, thigh or hand, in the opposite direction. For example, if you have a cramp in your calf, sit on the floor with the cramped leg extended straight in front of you. Pull your toes back toward your kneecap. You may want to pull back gently on your toes with your hand to assist the stretch.

Stand up. If you're in too much pain to sit down and do a calf stretch, standing will also provide a prolonged, moderate stretch, says Dr. Iglarsh. In fact, one of the best things for foot and calf cramps is weight-bearing, she says. So if you get a cramp, stand on the affected leg. Be careful not to lose your balance, warns Dr. Iglarsh.

Drink up. Muscle cramps that occur during exercise are often from dehydration, so drink water. Drink six eight-ounce glasses each day, and drink as much as you can in the hour after you exercise. A recommendation is to drink 8 to 12 ounces of water for every 20 to 30 minutes that you exercise, says Margot Putukian, M.D., team physician at Pennsylvania State University in University Park and assistant professor of orthopedic surgery and internal medicine at Pennsylvania State University/Milton S. Hershey Medical Center in Hershey.

Get enough potassium. Since muscle cramps may be due to insufficient potassium, give your body what it needs. The Daily Value (DV) for potassium is 3,500 milligrams. Foods high in it include bananas, orange juice, oranges, prune juice, broccoli, baked potato with the skin and red snapper.

Load up on other minerals. Calcium, magnesium and sodium are also important. The DV for calcium is 1,000 milligrams; good food sources include milk, yogurt, canned pink salmon, Swiss cheese and broccoli.

The DV for magnesium is 400 milligrams. Halibut, long-grain brown rice and spinach are magnesium-rich.

Most Americans get enough sodium, but if you use very little salt and exercise a lot, add a dash to your food.

Get it checked. If your cramps persist or are painful and frequent enough to disrupt your lifestyle, talk to your doctor about them, says Dr. Iglarsh.

Ask about quinine. People who regularly have nocturnal leg cramps may find relief with the nonprescription drug quinine, says Dr. Davidson. A study of 27 male veterans conducted at the Veterans Affairs Medical Center in White River Junction, Vermont, found that 13 of the patients had a 50 percent reduction in the number of nocturnal cramps while taking quinine sulfate. Other studies, however, have found quinine to be no more effective than a placebo. Ask your doctor about it; quinine's side effects can include dizziness, nausea and ringing in the ears.