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A cramp is an involuntary and forcibly contracted
muscle that does not relax. Cramps can affect any muscle under
your voluntary control (skeletal muscle). Muscles that span two
joints are most prone to cramping. Cramps can involve part or
all of a muscle, or several muscles in a group.
Just about everyone will experience a muscle cramp
sometime in life. It can happen while you play tennis or golf,
bowl, swim or do any exercise. It can also happen while you sit,
walk or even just sleep. Sometimes the slightest movement that
shortens a muscle can trigger a cramp.
Some people are pre-disposed to muscle cramps and
get them regularly with any physical exertion. Those at greatest
risk for cramps and other ailments related to excess heat include
infants and young children, people over age 65, and those who
are ill, overweight, overexert during work or exercise, or take
drugs or certain medications. Muscle cramps are very common among
endurance athletes (i.e., marathon runners and triathletes) and
older people who perform strenuous physical activities.
· Athletes are more likely to get cramps in the preseason
when the body is not conditioned and therefore more subject to
fatigue. Cramps often develop near the end of intense or prolonged
exercise, or the night after.
· Older people are more susceptible to muscle
cramps due to normal muscle loss (atrophy) that begins in the
mid-40s and accelerates with inactivity. As you age, your muscles
cannot work as hard or as quickly as they used to. The body also
loses some of its sense of thirst and its ability to sense and
respond to changes in temperature.
Cause of Muscle cramps
Although the exact cause of muscle cramps is unknown (idiopathic),
some researchers believe inadequate stretching and muscle fatigue
leads to abnormalities in mechanisms that control muscle contraction.
Other factors may also be involved, including exercising or working
in intense heat, dehydration and depletion of salt and minerals
(electrolytes). See details below:
· Stretching and muscle
fatigue: Muscles are bundles of fibers that contract and
expand to produce movement. A regular program of stretching lengthens
muscle fibers so they can contract and tighten more vigorously
when you exercise. When your body is poorly conditioned, you are
more likely to experience muscle fatigue, which can alter spinal
neural reflex activity. Overexertion depletes a muscle’s
oxygen supply, leading to build up of waste product and spasm.
When a cramp begins, the spinal cord stimulates the muscle to
keep contracting.
· Heat, dehydration
and electrolyte depletion: Muscle cramps are more likely
when you exercise in hot weather because sweat drains your body’s
fluids, salt and minerals (i.e., potassium, magnesium and calcium).
Loss of these nutrients may also cause a muscle to spasm.
· Calcium deficiency:
Muscle spasms can be due to lack of calcium in your food or malabsorption
of calcium as calcium is vital in relaxing muscles.
Muscle cramps may be brought on by a number of conditions:
· Activity without proper stretching
· Claudication (Leg
Cramps) from Peripheral Vascular Disease. Leg cramps may
be caused by decreased blood flow to the legs.
· Claudication from
Spinal Stenosis. Claudication, cramps when walking, may
NOT be caused by disease of the arteries to the legs, but by pressure
on the nerves to the legs from spinal stenosis. This is called
neurogenic claudication.
· Parkinson Disease.
In PD the most common cause of muscle cramps, called dystonia,
is a relative lack of dopamine stimulation in the brain. Such
cramps usually occur at night, when you are resting, when your
drug levels of levodopa, dopamine agonists (Mirapex, Requip) are
low or “off.”
Drugs, other than drugs for PD, that can cause muscle
cramps include: Water pills (diuretics), antipsychotic medications,
such as chlorpromazine (Thorazine) or haloperidol (Haldol), estrogens,
alcohol, drugs called calcium channel blockers that are used to
treat high blood pressure, lithium. Muscle cramps may also occur
when you suddenly stop taking some drugs such as steroids or opiates.
· Other Nervous System
Diseases. Leg and arm cramps may occur in multiple sclerosis,
amyotrophic lateral sclerosis (ALS), spinal stenosis, peripheral
nerve disease, muscular dystrophy, muscle injury, poliomyelitis
or post polio syndrome. The cramps in these disorders, unlike
in PD, usually but not always occur during activity and are relieved
by rest.
· Medical Conditions.
Hyperthyroidism (an over active thyroid), hypothyroidism
(an under active thyroid), increased blood calcium, decreased
blood calcium, decreased blood magnesium (from starvation or dehydration),
diabetes, hypoglycemia, liver disease with cirrhosis (scarring
of the liver), and kidney disease with or without dialysis (resulting
in fluid and electrolyte imbalance) may all result in leg cramps.
· Toxins. Toxins including
tetanus (lockjaw), a bacterial infection that can be caused from
a dirty wound and the venom from a black widow spider bite may
result in cramps.
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