Muscle cramps

Muscle Cramps occur when a muscle contracts with great
intensity and stays contracted, without relaxing as normal. Muscle
Cramps are common and their effects range from mild discomfort to
considerable pain. Common areas of muscle cramping include the
calves (particularly at night), ‘stitches’ (pain in the side while
running) and foot cramps. The causes of cramping can vary
considerably, ranging from heat exhaustion and dehydration to
hormonal imbalances and mineral deficiencies.

DESCRIPTION

A Muscle Cramp is a painful and prolonged spasm in a muscle,
which refuses to stretch out again following contraction. Normally,
a muscle moves a limb by contracting (tightening to exert a pulling
force). It then stretches out when the movement is finished or when
another muscle exerts force in the opposite direction.

CAUSE

• Muscle contraction occurs in response to electrical signals
  from nerves. Transmission of these signals is dependent on minerals
  such as calcium, sodium and magnesium, which surround and permeate
  muscle cells. Any abnormality in the flow of electrical signals to
  the muscles can cause a cramp. This may be due to imbalances in
  those minerals, as well as in certain hormones, body fluids and
  chemicals, or malfunctions in the nervous system itself.
• People who work or exercise in conditions which overheat their
  bodies are prone to depleting fluids and minerals, which can lead
  to cramping. Inadequate fluid intake and physical exertion
  (particularly when the weather is hot) may cause heat cramps.
  Without adequate rehydration and temperature reduction (a rest in
  the shade), heat cramps can progress to heatstroke and heat
  exhaustion. 
• Diabetes and problems with the thyroid gland produce hormonal
  imbalances. This can interfere with the balance of minerals around
  the muscle and can also cause cramps.
• It is thought that a reduced oxygen supply in the blood may be
  important in the development of some cramps. This is more evident
  in smokers, where the blood oxygen levels are often lower than
  normal because of carbon monoxide inhaled while smoking. Smokers
  engaged in hard physical labour may find they experience cramps
  more often than non smokers. Severe cold may also induce Muscle
  Cramps.

SIGNS AND SYMPTOMS

Common signs and symptoms of muscle cramps
include: 

• A sharp, sudden and painful spasm, or tightening, of a muscle.
  It commonly occurs in the legs.
• The affected muscles may feel hard when touched. 
• The muscle may appear visibly distorted or there may be
  twitching under the skin. 
• Extremely severe cramps in the arms and legs, which may begin
  without warning. 
• Persistent cramping pains in lower abdominal muscles, which may
  occur with back pain or during menstruation. The abdominal muscles
  are commonly affected and may also indicate heat cramps.

TREATMENT OPTIONS

Always see your Doctor for diagnosis and advice. Seek medical
attention immediately. This information is in no way intended to
replace the advice of a medical practitioner. Persistent and severe
cramping may indicate a serious condition. Severe cramping in the
arms and chest region may indicate a heart attack.
 

The following may help relieve muscular cramps:

• Drink six to eight glasses of water every day. 
• Begin an exercise programme. Remember to be aware that fluid
  loss increases during warmer weather.
• Practise regular stretching exercises, such as yoga,
  particularly before bed.
• Smoking may also provoke Muscle Cramps. Ask your Pharmacist or
  Doctor for advice about quitting.

VITAMINS/MINERALS/HERBS

Muscle cramping is most commonly associated with an imbalance
in calcium, magnesium and potassium levels. The following
supplements may only be of assistance if dietary intake is
inadequate.

• Calcium – alterations in calcium levels may affect leg cramps,
  particularly during pregnancy. Calcium is required for normal
  muscle contraction. Calcium is particularly effective for Muscle
  Cramps which are active when resting.
• Magnesium plays an important role in neuromuscular
  contractions. Magnesium is involved in calcium function in the
  body. While calcium is necessary for correct muscle contraction,
  magnesium is necessary for muscle relaxation. It is therefore
  important to combine magnesium and calcium supplementation. The
  energy for smooth, skeletal, vascular and cardiac muscle
  contraction and relaxation is dependent on magnesium. Magnesium is
  particularly effective for Muscle Cramps which are active when
  pressure is applied or with exercise. 
• Vitamin E may eliminate nocturnal leg or foot cramps and
  restless leg syndrome in many people. Vitamin E may also reduce
  Muscle Cramps due to exercise. Vitamin E is also useful for muscle
  cramps caused by poor circulation and varicose veins.
• Potassium is necessary for correct calcium and magnesium
  metabolism and may help relieve Muscle Cramps. Potassium is
  responsible for stimulating nerve impulses for muscle contraction
  and relaxation.
• Passionflower may have an anti-spasmodic and relaxing
  action.
• Valerian may help relax muscles. It is believed to have an
  anti-spasmodic, carminative and mild sedative action.
• Ginger is particularly effective for Muscle Cramps caused by
  poor circulation. Ginger is believed to be a carminative and
  anti-spasmodic agent.

PHARMACIST’S ADVICE

Ask your Pharmacist for advice.

1. Ask your Pharmacist about Oral Rehydration Solutions (ORS).
   These help replace minerals and electrolytes lost from the body as
   a result of sweating or diarrhoea.
2. Ask your Pharmacist for suggestions to help you stop
   smoking.