A Painful Night Visitor

It is not unusual to get a sudden spasm or cramp in a muscle, causing excruciating pain and a temporary inability to move. The condition, however, has an unusual colloquial name in the US and the UK — charley horse. This may be because the pain resembles the kick of a horse. The ailment is not confined to Western nations or horse riders. It affects 70 per cent of people over the age of 50 and 50 per cent of women during pregnancy.

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These leg cramps usually last less than a minute — though it may seem much longer as the pain is severe — but the contraction may take several minutes to subside. It may leave a residual dull ache. It can occur once — as a never-to-be-forgotten single incidence — or several times a month, or disturb the person’s sleep night after night.

Although any muscle can go into such cramps, it commonly occurs in bigger muscles that cross two joints, like the hamstrings and quadriceps which cross the knee and hip or calf muscles which cross the ankle and the knee. It can occur in the fingers and toes as well.

The exact reason for cramps is not known. Older people, especially post menopausal obese women, and smokers are more prone to them. Improper footwear while exercising aggravates the problem. Medications — such as statins (for high cholesterol), some drugs for high blood pressure, diuretics and steroids — may cause cramps. People of all ages can develop cramps, especially if they change their mode of exercise and suddenly increase its intensity, type and duration.

Cramps are a result of electrolyte imbalance in the body. This causes defective functioning of the muscle-nerve reflex arc. It is rather like traffic lights going out of sync and causing a jam. The electrolytes involved are sodium, potassium, magnesium, iron, zinc and calcium. Cramps occur if the ratio among these minerals changes. Proper functioning of the reflex arcs also requires biochemical reactions in the body, mediated by enzymes. The latter are affected by diseases like diabetes and malfunctioning of the thyroid gland. Deficiencies in the B group of vitamins, alcohol consumption, excessive caffeine intake and smoking also affect the enzymes.

If you have several attacks of leg cramps a month, consult your doctor. You need to tackle treatable conditions and change medication that may be aggravating it. If the cramps are due to pregnancy, they usually disappear once the baby is born.

If all the tests are normal, you may try a few simple measures:

* Try eating three to four helpings of fresh fruit and raw vegetables every day. It will correct any potassium and vitamin B deficiency.

* Eat a handful of nuts. It will take care of your requirements of magnesium and zinc.

* If you are anaemic, take iron and folic acid supplements.

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* Most people do not get enough calcium from their diet and this needs to be supplemented. Around 1,200 mg of calcium needs to be taken daily, preferably at bedtime.

* Keep yourself well hydrated. Drink at least three litres of water a day and at least 250 ml before going to bed.

* Finish all your exercise at least an hour before bedtime.

* Soak the legs in warm water for 10 minutes before bedtime, and place a pillow at the end of the bed so that you sleep with your feet propped up.

* Some stretches done morning and evening prevent cramps. Stand on the floor with your feet apart. Stretch your hands up over your head and rise up on to your toes. Holding this position, rock backwards and forwards on your feet for a minute.

* Always warm up and cool down before and after exercise.

* The stretches done as a part of yoga prevent cramps.

If you develop spasms despite all this, immediately try to push the foot upwards. Massage the affected leg and apply moist heat. Sometimes, stretching the unaffected leg helps.

Leg cramps occur specifically at night. That is what distinguishes them from pain that is due to nerve disorders or damage, slipped discs or blocked blood vessels which reduce blood circulation to the legs. These diseases cause pain all the time, day and night.

“Restless legs” are different from leg cramps. This is a peculiar condition where both the legs develop pins and needles and sometimes a creeping pain several times during the night. It wakes up the person, and relief can be obtained only by moving the leg or standing up. Sleep is disturbed and inadequate. This needs to be evaluated by a doctor and treated with medication.

Source: The Telegraph (Kolkata, India)

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