Muscle Cramps and Spasms

A muscle cramp is a sudden, sharp pain caused by involuntary muscle spasms. These spasms happen most often in the limbs, but they also occur in certain internal organs. Among the more common causes are:

• Inadequate flow of blood to muscles, often resulting from hardening of the arteries (arteriosclerosis).
• Exhaustion and cold, which cause the type of cramps suffered by swimmers.
• Minor muscle injuries that cause spasmodic contractions. Athletes are especially vulnerable.
• Poor posture that strains specific muscles. People who work at poorly designed computer work stations frequently experience muscle cramps in their hands, arms, neck, and shoulders.
• Chronic overuse of certain muscles, such as those of the hand that produce a writer's or tailor's cramp.
• Excessive loss of sodium and perhaps potassium and magnesium.
• Heat cramps caused by profuse sweating during vigorous exercise in hot, humid weather are the most common.
• Unaccustomed pressure on back and leg muscles during pregnancy.
• Pains may also be caused by spasms of the tiny muscles in internal organs. Examples include menstrual cramps, angina due to coronary artery spasms, and cramps related to a spastic colon.

Diagnostic Studies and Procedures

Muscle cramps are usually self-diagnosed, but if the cause is not apparent and the condition persists, a doctor should be consulted. A doctor's prompt evaluation is especially important if:

• Uterine cramps occur at any time during pregnancy.
• Muscle cramps in the lower back or legs impede movement.
• Abdominal cramps are accompanied by vomiting and diarrhea.

Medical Treatments

Drug Therapy. Most muscle cramps respond to self-treatment, but those that persist or are immobilizing may call for medication. The simplest, most common approach is the use of drugs that block prostaglandins, hormone-like chemicals that cause inflammation and muscle contractions. These include aspirin, ibuprofen, and other nonsteroidal anti-inflammatory drugs. Diphenhydramine, an ingredient in combination sleeping aids and painkillers for use at night, may alleviate muscle cramps that occur during sleep. An injection of cortisone or a local anesthetic may help bring relief from more severe cramps, such as those causing back or neck pain. Diazepam (Valium) or similar tranquilizers, which also relax muscles, can alleviate severe cramping in the back and neck.

Anticholinergic drugs, such as Librax or Donnatal, can relieve abdominal pain from colon spasms. Calcium-channel blockers such as verapamil (Calan) ease chest pains due to coronary spasms. Imbalances in body chemistry are treated with intravenous potassium, sodium, or other substances, depending upon the cause.

Surgical Treatment

Surgery to increase blood flow through arteries clogged by fatty plaque may be recommended for chronic leg cramps. Procedures include balloon angioplasty to flatten fatty deposits, bypass surgery to redirect blood flow around blockages, and laser surgery to destroy plaque.

Alternative Therapies

Alexander Technique. People who work at computers often benefit from sessions with an instructor of the Alexander technique, who can teach proper posture and suggest how to set up a work environment that minimizes this type of muscle tension.

Hydrotherapy. A whirlpool bath or underwater massage eases muscle cramps that occur from either overuse or tension.

Massage. Deep massage or rolling can help to alleviate muscle cramps in the legs and back. Other therapeutic techniques include acupressure and Shiatsu.

Nutrition Therapy. Leg cramps are said to be relieved by 300 to 400 l.U. of vitamin E each day. A 300-milligram calcium pill at night also may help.

Self-Treatment

Most cramps can be eased by gently massaging or compressing, and then extending and stretching the contracted muscle. If the cramp recurs, try an ice pack or heating pad. A contrast bath may help. Soak in hot water for 10 to 15 minutes, then stand under a cold shower for two or three minutes to prevent cramps while exercising, always warm up and cool down by stretching before and after workouts.

If nighttime leg cramps are a problem, do this calf stretching exercise before retiring: Stand two to three feet from a wall. Lean forward, extending your arms straight from the shoulders and placing your palms on the wall. Keeping your back and legs straight and your heels on the floor, slide one leg backwards until you feel a pulling sensation along calf muscles. Maintain this stretch for a slow count of 10. Relax and repeat with the other leg. Do three sets and follow by massaging.

Other Causes of Muscle Cramps

Muscle cramps are associated with tetanus, muscular dystrophy, multiple sclerosis and other neuromuscular disorders, and food poisoning and other poisoning emergencies.