What is Muscle Cramps?
Muscle cramps cause an unwanted, painful tightening of an entire group of muscles, a single muscle, or even just certain muscle fibers. They can last anywhere from seconds to minutes, and you might be able to feel a hard bump in the muscle area where the cramp is. This can happen in both healthy individuals and those with underlying health issues.
Muscle cramps that happen because of exercise are the most common reason people need medical help during sports activities. Even though they’re quite common, doctors and researchers don’t fully understand why they happen. Different causes are possible depending on the individual person’s health status and circumstances. It’s worth noting that just because a cramp is happening in a specific body area, doesn’t mean the cause is in that same area.
In fact, a cramp is generally not a local effect. It involves complex interactions within the whole body system, including both physical and emotional aspects.
What Causes Muscle Cramps?
The reason you get a cramp can vary based on the circumstances. It’s not possible to list down all the causes, and it’s important to note that cramps can occur in different physiological or pathological situations.
One common type of cramp is muscle cramping due to heat, which is often seen during sports or intense physical activities. This usually happens when you lose a lot of sweat and important minerals (electrolytes) from your body, and is believed to be the root cause of these cramps.
Risk Factors and Frequency for Muscle Cramps
Understanding the occurrence and characteristics of muscle cramps can be difficult due the variation in causes and situations where they occur. This also depends on several factors like the individual’s health condition, sporting environment, and type of sport. Here are some important points to note about muscle cramps:
- Many elderly people in France, typically those aged 65 to 69 years old, experience cramps.
- Sex does not seem to affect the likelihood of having cramps and the calf is often the most affected area, constituting 80% of instances.
- About 6% of Americans suffer from leg cramps at night, which might be connected to heart issues and depression.
- Pregnant women in China experience cramps in the calf area at a rate of 32.9%, with the percentage differing across pregnancy trimesters: 11.6% during first trimester, 28.2% in the second trimester, and 50.2% in the third trimester.
- Pregnant Indian women experience the most muscle cramps during their third trimester, particularly in the calf (64.6%).
- It was reported in an American study that 46% of patients with chronic obstructive pulmonary disease (COPD) suffer from muscle cramps and this is often the main source of their pain.
- Another American study showed that 74% of cramps occur in athletes, particularly in extreme heat conditions.
- In Australia, 32% of children with Charcot-Marie-Tooth disease type 1A suffer from calf cramps and this increases with age.
Signs and Symptoms of Muscle Cramps
Cramps have been present throughout human history. However, it’s difficult to pinpoint exactly when they were first defined as a medical condition. When diagnosing cramps, doctors often observe a patient’s posture and how they move. They also feel the muscles to ensure there is uniformity on both sides of the body. Doctors might ask patients to apply pressure to the area where cramps typically occur to understand if repeated stress triggers them. A cramp brought on by a passive stretch might indicate a symptom of a more severe condition.
There are many health issues that can cause muscle cramps. Here are some common ones:
- Nocturnal Leg Cramps: These cramps mostly affect the calf and disturb sleep quality. They are common in people over 60 in America. The exact reason for this phenomenon is unknown. Some underlying factors could include standing a lot during the day, or significant physical exertion, electrolyte imbalances, neurological conditions, hormonal and metabolic issues, nerve root compression, or blood vessel compression.
- Leg Cramps in Pregnant Women: Very common during the later stages of pregnancy and often occur at night. Several causes like weight gain, nerve compressions, poor blood flow to muscles, and increased muscular work are considered.
- Exercise-Associated Muscle Cramp: These types of cramps usually occur during or after physical activities. The cause could be due to dehydration, electrolyte imbalance, or a neurological disorder.
- Writer’s Cramp: A specific form of hand dystonia that usually affects those between 30 and 50 years of age.
- Cramp-Fasciculation Syndrome: This syndrome is linked to the hyperactivity of the peripheral nervous system and often leads to persistent muscle cramps or fasciculations.
- End-Stage Renal Disease: Patients undergoing dialysis often suffer from muscle cramps, particularly in the lower limbs.
- Amyotrophic Lateral Sclerosis (ALS): Almost 95% of patients with ALS report cramps. The frequency and intensity of these cramps are not related to the severity of the disease.
- Cirrhosis: Muscle cramps are a common occurrence in patients with cirrhosis.
- Anti-Myelin-Associated Glycoprotein Antibody (Anti-MAG) Neuropathy: About 60% of patients experience cramps, particularly in the lower limbs.
- Diabetes: Cramps in diabetic patients are often related to neuropathy — a condition that affects the nerves.
- Fibromyalgia: Cramps are a common occurrence in patients with fibromyalgia and are linked with the severity of the disease.
Currently, there are no adequate treatments to completely prevent the incidence of cramps in these situations.
Testing for Muscle Cramps
When your doctor first checks you, they might feel a strong tightness in your muscles. This could be over a large area or just a small spot. This is done through a physical check or “palpation”.
Another way your doctor can assess your condition is through electromyography. This is a type of test that measures the electrical activity in your muscles to identify any abnormal discharge of motor units. This is important as it can help diagnose a neurological problem that may not be related to the disease you are being checked for.
Finally, an echocardiograph, another type of test, can be used to spot any abnormalities in your heart’s structure. This could reveal potential issues that may be causing muscle cramps. These various tests will help your doctor understand your condition better and determine the right way to treat it.
Treatment Options for Muscle Cramps
For healthy individuals and patients, the simplest non-invasive treatment often involves stretching the affected muscle or getting deep massages. These methods help in providing relief from discomfort.
In terms of preventing muscle cramps, individuals can make sure they warm up properly before engaging in physical activities and stay well-hydrated. However, when it comes to various conditions that also involve muscle cramps, unfortunately, there are no commonly accepted treatment guidelines about using medicines to manage these situations.
What else can Muscle Cramps be?
A cramp is a sharp, painful muscle tightness that happens briefly. It’s different from other types of muscle contractions. Dystonia, for example, is a non-painful contraction coming from the central nervous system, while myotonia is an extended non-painful contraction seen in conditions like myotonic dystrophy and Thomsen’s dystrophy.
The pain from tetany can be similar to a cramp, but usually affects more than one muscle area. Conditions like Camurati-Engelmann disease, anorexia nervosa (Russell sign), and low calcium levels (hypocalcemia) often feature this. On the other hand, myalgias are muscle pains that don’t necessarily come with contractions. They are often caused by things like vitamin D deficiency, drug misuse, or spastic hypertonia from damage to the central nervous system.
Lower limb muscle pain during activities like walking or intermittent claudication can sometimes be a sign of peripheral vascular stenosis. Cramps may appear if the person continues to strain the affected muscle. There’s also Restless Leg Syndrome, in which involuntary contractions affect the lower extremities. However, this condition does not lead to cramps – instead causing discomfort and muscle fatigue. In certain cases, similar contractions could also be a symptom of Parkinson’s disease.
It’s also important to note that a cramp isn’t the same as a trigger point, which can be immediate or not-so-obvious. The pain from a trigger point often spreads out within a small area. It’s not always painful, it can also cause feelings like tingling, a dull ache, or a burning sensation within the affected area.
In order to tell the difference between a normal cramp and one linked to an health issue, doctors might use tests like electromyography, which can also detect muscle contractions. More extensive tests such as MRI or CT scans can be used to identify any neurological problems.
Another way to tell if a cramp is harmless is to see if the muscle it affects has changed in size (hypertrophy or atrophy). If the muscle also feels weak, this could suggest that the cramp is a symptom of a bigger issue. On some occasions, something as light as the wind could trigger further muscle contractions.
If uncertainty remains, blood tests can look for myoglobinuria. Extremely high potassium levels (hyperkalemia) could also point towards an underlying issue. Tests like muscle biopsy can show any cell changes, such as atrophy or phenotypic changes.
In the case of Nocturnal Leg Cramps (NLC), it’s marked by a few distinguishing features, including:
- Severe pain
- Cramps lasting no longer than 10 minutes
- Mostly affects areas like the calf or foot; less often the thigh muscles
- Muscle discomfort even after the cramp has disappeared
- Disturbed sleep cycles
- Increased stress
These differences allow for better identification and treatment of sleep-related diseases against NLC.
What to expect with Muscle Cramps
In healthy individuals, the outlook for the occurrence of cramps is always good.
Possible Complications When Diagnosed with Muscle Cramps
Current research does not report any negative effects after experiencing harmless muscle cramps.
Recovery from Muscle Cramps
In various diseases that affect metabolism, the nervous system, or internal organs, and have muscle cramps as one of the symptoms, it’s common practice in rehabilitation treatments to include stretching exercises. The idea behind this is to keep the affected muscle or group of muscles flexible, maintaining its natural length.
Muscles have a tendency to shorten when in a contracted or tense state for an extended period. The most extreme part of these muscle cells, known as sarcomeres, tend to vanish, leading to an increase in fat and connective tissue. As a result, the muscle becomes tighter, further impacting its electrical activity measured through a test called an electromyogram. When a muscle is constantly shortened, it can lead to electrical disturbances, making it harder for the nerve’s electrical signals to properly stimulate the muscle fiber.
Preventing Muscle Cramps
After thoroughly examining a patient, both visually and using medical instruments, and ruling out the chances of any neurological or other symptom, it might be possible for the doctor to provide some advice. This guidance might include the correction of poor posture, the suggestion of routine stretching exercises, and the importance of staying hydrated if the patient’s work or recreational activities occur in hot and humid atmospheres. All this advice is given to improve the overall health and well-being of the patient.
