Muscle cramps

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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