Cramp: Types, Causes and Remedies

An ever-tightening band around your calf muscle, a squeezing and knotting pain, getting tighter until you can’t imagine how to make it release its grip. But what is it and why does it suddenly assault you?

What is Cramp?

It can strike in any part of the body where there is muscle tissue. Cramp is a sudden spasm, an involuntary, and usually painful, contraction of the muscle. Muscular contractions are the result of a normal process where the brain communicates with the spinal cord and the muscles. Chemicals and proteins are also responsible for shortening and relaxing of muscle fibres.

Cramp can also be the result of muscles not able to relax or when they are irritated by a surplus of lactic acid which builds up when you don’t rest your muscles sufficiently after strenuous exercise.

The brain is responsible for signalling for muscles to contract via a process of electrical signals and chemicals which travel through the spinal cord to the muscles. The chemicals, together with proteins, interact within the muscles and prompt tensing or relaxing movements.

When this process is interrupted for any reason then muscular contractions, spasms and cramping can occur. Usually, the pain from these events tends to ease off quite quickly.

Symptoms of Cramp

The most common first sign of cramp is the sudden tightening of the muscle, often it’s in the leg and usually in the calf muscle, but it may also be in the thigh or in the feet. With the tightening sensation comes a sharp pain. It’s quite common to feel a hard mass of muscle tissue in the affected area.

Muscular cramps don’t often last very long and ease off without treatment. There are a few instances where you should seek medical help, and these are:

• When there is swelling and redness in the area
• If the cramp follows a period of muscular weakness
• When the spasm lasts for a significantly longer time than usual
• If bouts of cramp happen frequently

What Causes Cramp?

There are several main triggers to the muscular spasm known as cramp. Often it is simply down to the over straining of a muscle or being in a fixed position for a long time. It can be caused by standing for too long on a hard surface or by wearing uncomfortable footwear such as high-heeled shoes.

Cramp Caused by Medication

Certain prescribed drugs may cause cramp as a side effect.

Diuretics

These are often prescribed to treat high blood pressure, heart failure and oedema. They hasten the process of eliminating excess fluid by moving it into the urine. The reason these drugs can cause cramp is that they also remove electrolytes such as sodium (salt), chloride and potassium. When you have low levels of these electrolytes you may feel very fatigued and suffer with muscle weakness as well as having pain in your joints, bones, and muscles. If this seems to be a problem for you, it’s important to speak with your doctor to see if you can change to a different kind of diuretic. Some cause less risk of electrolyte elimination.

Beta-blockers

These are drugs which are usually prescribed to treat high blood pressure and arrhythmias. They slow the heart rate and lower blood pressure by blocking adrenaline. They are also prescribed to treat angina, migraines, certain kinds of anxiety and they may sometimes be given in eye-drop form to treat glaucoma.

Beta-blockers can cause leg cramps, but the exact cause is still unclear. However, studies have found that they may cause the arteries in the legs to narrow, causing a reduced blood flow. This is called peripheral vasoconstriction and results in cold hands and feet.

Statins

Prescribed to lower cholesterol. They can cause leg cramps as they have been found in research studies to inhibit the production of certain cells in the muscle, and this impacts upon muscle growth.

Some research studies have found that statins can have an impact at cellular level to cause reduced energy. Weakness in muscles and aches throughout the body can be brought on by statin-induced rhabdomyolysis. This is when there is a breakdown of muscle that allows muscle fibre to be released into the bloodstream which can also cause damage to the kidneys.

Senior adults who take statins are at greater risk of developing a condition known as sarcopenia which is the wasting away of skeletal muscle and strength. Sarcopenia is associated with ageing, but statins may bring it on.

If you are among the many senior adults who do not have heart disease but have been prescribed statins to help lower slightly elevated cholesterol levels, you could have a discussion with your doctor. It may be helpful to ask for advice on changing your diet to lower your cholesterol, or perhaps switching to daily vitamin B12, folic acid and vitamin B6 supplement instead of relying on statins.

Beta2-agonists

These are bronchodilators to help relax the smooth muscles surrounding the bronchial tubes, making breathing easier. They may be prescribed to help symptoms of chronic obstructive pulmonary disease (COPD). They are mostly used with an inhaler, giving a mist of the drug but may also be given as a pill to those who can’t use inhalers.

Beta2-agonists can cause leg cramps, but the reason has not yet been discovered.

ACE inhibitors

Prescribed to treat high blood pressure, congestive heart failure and other conditions, they help relax blood vessels by blocking the production of a hormone called angiotensin II. This is a hormone which causes blood vessels to narrow leading to high blood pressure.

Ace inhibitors can cause potassium to collect in the body and this can result in leg cramps and aching joints as well as muscular pain.

Antipsychotic drugs

Used to treat schizophrenia, bipolar disorder, and other serious psychiatric conditions. Antipsychotic drugs are sometimes prescribed to treat agitation and depression.

These drugs have a powerfully depressant effect on the central nervous system. Studies have found that their side effects include fatigue, lethargy, and general weakness. Because they lower dopamine levels which cause drowsiness, they can also lead to muscle stiffness and cramp. Dopamine reduction caused by long-term use of antipsychotics can also cause muscle rigidity and movement disorders.

If you suffer from painful leg cramps and you suspect this may be caused by your medication, it is important to talk with your doctor before changing your medication routine.

Is Cramp a Serious Condition?

Generally, muscle cramps are not serious although some may prove to be caused by other medical issues, for example:

• If you have a compressed spinal nerve this may bring on pain which feels like cramp in your legs and makes walking difficult.
• When arteries that bring blood to your legs become narrowed this produces cramp-like pain and this is made worse during exercise. This is a condition known as arteriosclerosis of the extremities. Once you rest after exercise the pain usually disappears.
• When there is a shortage of potassium, calcium, or magnesium in your diet, this can be one of the causes of leg cramps. If you are taking medication to treat high blood pressure, it’s possible that one of them may be a diuretic which leads of fluid loss, and this can also lead to a deficiency of minerals in the body.

Risk Factors for Cramp

Certain conditions may mean you are at a higher risk of muscle cramps:

• Dehydration – prolonged exercise or taking part in sport during warm weather can sometimes result in attacks of muscular cramps. This is due to losing body fluid through perspiration and fatigue.
• Medical Conditions - diabetes or nerve, liver or thyroid issues are all conditions that can predispose you to cramps.
• Pregnancy - it is very common to experience cramp during pregnancy.
• Older age groups - tend to suffer with cramps due to losing muscle mass. This leads to remaining muscles being overstressed.

Measures to Prevent Cramp

One of the best tips to help avoid cramp is to stretch your muscles before exercise. If leg cramps during the night are a problem, try doing some stretching exercises before bedtime.

Avoid being dehydrated so make sure you drink plenty of fluids, particularly water, every day. Drinks with caffeine can also make you dehydrated, as can alcohol. If you are doing exercise you need to have even more water.

Causes of Different Types of Cramp

As well as the muscular cramps in legs, there are other kinds of cramp:

1. Period Pains

Women may have various causes of abdominal pain but when it concerns cramp or spasm-type pain it is most often caused by the monthly menstrual cycle.

This pain is often a dull, dragging ache which begins in the middle of the lower abdomen and can spread into the lower back. It can build into a tight spasm that causes a desire to double up. It is usually possible to manage these monthly pains with paracetamol and a comforting hot water bottle on the tummy, but there may be certain instances where the pain is unbearable and may have other symptoms and if this is the case you should consult your GP to rule out other complications.

2. Muscle Spasms in Stomach

Cramps and spasms in the stomach are due to abdominal muscles (often known as abs), contracting. The pain can also come from your intestines and may feel as though muscles are twitching.

Usually, these spasms are not serious but if they persist, they may be an indication of an underlying condition. It’s best to check with a doctor to find out what may be going on.

Here are some of the most frequent causes of stomach cramps:

• Dehydration
  • When electrolytes have been eliminated due to perspiration, sickness, or diarrhoea, this can lead to muscle spasms, particularly in the abdominal area. This is because muscles need electrolytes such as calcium, potassium, and magnesium to function well. If you notice that you feel very thirsty, your urine in very dark or if you have a headache, these are all signs that you are dehydrated.
• After exercise
  • If you notice cramping pains or muscular spasms particularly after strenuous exercise or workout, particularly if you have been doing sit-ups, crunches etc. then you have may have strained a muscle.
• Inflammatory bowel disease
  • All of these conditions, such as Crohn’s Disease, ulcerative colitis, gastritis, gastroenteritis, diverticulitis can cause cramping pains due to inflammation of the colon. In the case of gastritis, inflammation extends to the intestines.
• Irritable bowel syndrome (IBS)
  • This is a condition that impacts upon the large intestine that can produce painful stomach cramping pains. Many people with IBS notice that a flare up coincides with a period of stress. Anti-spasmodic medication may be beneficial in the short term but dietary changes and relaxation strategies are usually needed for a more long-term solution.
  • Soluble fibre such as vegetables, and plenty of fluids are very helpful, but beware of harsh fibre such as bran cereals as they can sometimes aggravate. Limiting alcohol and staying hydrated will help greatly as will reducing fatty and spicy foods.

3. Hand Cramp

There are several frequent causes of cramp in hands, and these may include:

• Repetitive strain or overuse injury
  • These types of injury are caused by excessive use of the muscles that are used for fine motor movement. Sometimes known as ‘writer’s cramp’, they can include writing, typing, or using a keyboard for long periods of time. Also playing guitar, piano and other musical instruments or actions that need you to grip things such as pens, tools, and cooking utensils for prolonged periods of time. Even excessive use of a smart phone can cause hand cramps, particularly when sending lengthy or frequent text messages, e-mails, or social media postings.
• Diabetic stiff hand syndrome
  • If you have either type 1 or 2 diabetes you could possibly get this syndrome. It limits finger movement due to weakened hand joints.
    Managing blood sugar levels may help prevent this condition but treatment may include physical therapy and stretching exercises.
• Rheumatoid arthritis
  • A form of arthritis where the body attacks its own healthy cells. This causes pain that affects the joints, including the hands. Treatments may include medication known as antirheumatic drugs. There are also low-impact exercises which help such as swimming, walking, and cycling.
• Imbalance of electrolytes
  • These are needed for normal bodily functions such as nerve and muscle use, hydration, controlling blood pH and blood pressure as well as maintaining healthy tissue. Muscles need a balance of electrolytes for optimal function so when this harmony is out of kilter it can lead to muscle contractions and hand cramps.

To help yourself alleviate hand cramps try stretching muscles, applying heat and cold alternately, increasing fluid intake, consider vitamin supplements. It is always advisable to have your condition evaluated by a doctor and if any underlying causes are found you will receive a medical recommendation for treatment.

Usually, hand cramp causes are minor but there may be some cases where they are due to something more serious such as Lou Gehrig’s Disease, and this needs specialist medical treatment.

4. Toe and Foot Cramp

These are spasms that can take you completely by surprise and they may be extremely incapacitating. Cramp in the toes, or in the whole foot, can be just a slight and fleeting event or it could be a full-on and very painful spasm.

These are the most common causes:

• Dehydration
  • When you are not drinking enough water to prevent muscles in your feet and toes from working efficiently. Staying well hydrated helps prevent electrolyte imbalance and keeps a healthy fluid content in your muscle tissue. It is recommended that drinking about eight glasses of water per day is a suitable goal.
• Magnesium deficiency
  • A major cause of toe cramps and muscular twitches. It’s a good idea to get your GP to do blood tests to check your nutrient levels.
• Bad circulation
  • When you spend most of your day sitting in one place, such as at your computer, this can result in cramping in your lower legs, feet, and toes. If you are unable to take regular breaks to walk around, then at least remember to wiggle your toes quite often to help keep blood flowing.
• Badly fitting shoes
  • Where pressure is put on the front and sides of your feet this can cause cramp symptoms. It is also not a good idea to wear soft, unsupportive footwear for long periods of time.
• Cold weather and cold water
  • Because poor circulation leads to toe cramps, when the weather is cold the muscles lose heat. This loss of heat causes muscle contraction, and this creates tension at the joint. This means that the joint needs to work harder, and this can lead to cramping. The same applies to swimming in cold water. It is very common for swimmers to get foot cramp.
• Tight muscles
  • Not doing some stretching exercises before a workout can result in muscle cramping, and this includes your toes. Too much of the same movement can also cause cramp to develop, including repetitive exercises that stress the toe joints. Remember to do some gently stretching exercises both before and after exercise.
• Nerve damage
  • Some medical conditions can cause toe cramps due to nerve damage. Diabetic neuropathy is one of the most usual of these conditions and it is very important to be alert to the fact that neuropathy causes a deterioration of nerves in the extremities.

To help alleviate foot and toe cramps you can spend some time gently massaging the toe joint and stretching the toes by flexing up and down. It can also help to rotate the foot in both directions. Taking over-the-counter medication such as ibuprofen can also help.

There are instances when seeing your doctor is the best thing to do and this is when the cramps are persistent and don’t respond to rest and massage. If you notice any swelling, bruising, numbness, or an increase in skin heat, (such as a feeling of fever in your toe), or if the cramping in your foot or toe is so bad that you are struggling to walk, then you should certainly see a doctor.

Supplement For Muscle Cramp

Many people find relief from the various forms of cramp by using traditional herbal extracts or by supplementing with magnesium and B complex vitamins which have been clinically proven to relieve spasms and cramps. We recommend the following natural products:

Cramp Bark Tincture

A high strength, organic bark fluid extract from the bark of the guelder rose, a member of the viburnum genus. Cramp Bark Tincture is a traditional and natural supplement for easing cramps, spasms, and menstrual cramps. It should not be taken when pregnant or breast feeding.

Magnesium Malate

A form of magnesium that is easily assimilated by the body. It has the additional benefit of malic acid, and is gentle on the digestive system. Magnesium Malate may have a laxative effect so if you are already taking laxatives, antibiotics, or antacids you may wish to check with your doctor before adding it to your diet.

Magnesium Muscle Body Spray

For topical use, Magnesium Oil Body Spray is quickly absorbed and to be applied directly to the skin. It is blended with lemon oil, arnica and capsicum designed for tired, aching muscles.

This product has the advantage of magnesium’s beneficial effect to alleviate cramps, but it by-passes the digestive system. Magnesium Oil Body Spray works much more quickly than capsules. It also helps manage blood sugar levels. This is a very useful feature as many people with diabetes also have a magnesium deficiency.

‘Harmony’ from Holly Botanic

A tisane with a blend of herbs that help balance hormones for women’s health. A great and very soothing way to help alleviate menstrual cramps and menopausal symptoms, Harmony includes extract from Ladies Mantle (the Alchemilla mollis plant which is a member of the rosacea family and is noted for its power to alleviate pain associated with cramps and heavy bleeding, fibroids and endometriosis). It also has extracts from raspberry leaf, rose petals, raspberries, damiana and red clover.

Harmony should not be taken when pregnant.

Vitamin B Complex

Taking a B vitamin Complex can be helpful in easing pain and cramps associated with periods. Thiamine (vitamin B1) and niacin (vitamin B3) have been found to be particularly effective

Evidence has also been found that taking a B complex vitamin supplement may help alleviate general cramps.

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If you would like to discuss any aspect of using natural supplements, or would find advice helpful, please feel free to contact us on 01297 553932.