What is crumpy
Cramps are not epileptic convulsions, but a local spasm of an individual muscle or group of muscles. It is believed to occur due to increased excitability of the motor nerve endings in the muscle, especially when it is in a shortened position. At night, the foot is often extended, the calf muscle is contracted, and a small movement is enough to trigger a spasm. The muscle becomes hard, the foot or fingers bend involuntarily, and sharp pain occurs. The episode goes away on its own or after a muscle strain, but may recur the same night.
- Idiopathic night cramps - without an identified cause
- Crumpy during physical activity
- Crumpy during pregnancy
- Symptomatic - for diseases of metabolism, kidneys, nerves
- Medicinal - while taking certain medications
Possible reasons
As we age, muscles and tendons shorten and the number of motor neurons decreases, so nighttime cramps are especially common in older people. In athletes, spasm is caused by muscle fatigue and fluid loss through sweat. During pregnancy, cramps are associated with stress on the legs and changes in mineral metabolism. Decreased levels of potassium, magnesium, calcium, sodium, dehydration, diabetes mellitus, hypothyroidism, chronic kidney disease, and cirrhosis of the liver predispose to seizures. A common cause is medications: diuretics, statins, some drugs for blood pressure and bronchial asthma.
- Age over 50
- Pregnancy
- Intense exercise, dehydration
- Deficiency of potassium, magnesium, calcium
- Diabetes mellitus and polyneuropathy
- Hypothyroidism, kidney and liver diseases
- Diuretics and statins
- Prolonged sitting or standing
Associated symptoms
Ordinary cramps occur sporadically and do not show themselves in any way between attacks. The doctor is alarmed if cramps are combined with weakness, muscle loss, and small twitching under the skin - this may indicate motor neuron or nerve disease. Numbness and burning in the feet are characteristic of polyneuropathy. Pain in the calves that appears when walking and goes away with rest indicates a narrowing of the arteries in the legs. Unpleasant sensations in the legs with an irresistible urge to move them in the evening are a sign of restless legs syndrome, not cramps.
- Hard, painful muscle during spasm
- Muscle soreness after an attack
- Numbness and burning in the feet
- Swelling and heaviness in the legs
- Thirst, dry mouth, frequent urination
- Weakness and muscle twitching
What examinations are needed
For rare seizures in a healthy person, testing is usually not required. If the attacks are frequent, interfere with sleep, or appear after starting a new medication, the doctor prescribes tests: electrolytes, glucose, creatinine, TSH, and, if necessary, liver function tests and creatine kinase. The list of medications taken must be discussed. If there is numbness and weakness, the neurologist will refer you for electroneuromyography. If there is pain when walking, swelling or dilated veins, an ultrasound examination of the vessels of the legs is performed. For pregnant women, an obstetrician-gynecologist prescribes an examination.
- Potassium, sodium, chlorine
- Magnesium and calcium
- Blood glucose
- Creatinine
- TSH
- Creatine kinase - according to indications
- Electroneuromyography
- Dopplerography of the vessels of the lower extremities
What to do if you have seizures and how to prevent them
During a spasm, you need to stretch the muscle: straighten your leg and pull the toe of your foot towards you, you can stand on the floor and walk. Light massage and warmth help. For prevention, stretching the calf muscles before bed, drinking enough water, comfortable shoes, and avoiding excess alcohol and caffeine are used. If an electrolyte deficiency is detected, it is corrected as prescribed by the doctor. In case of drug-induced seizures, the doctor may change the drug. Magnesium without a confirmed deficiency is ineffective for ordinary night cramps, and any supplements for pregnant women are prescribed by an obstetrician-gynecologist.
- If there is a spasm, pull the toe towards you and straighten your leg
- Stand up and shift your weight to your lowered leg
- Calf stretch before bed
- Do not tuck the blanket tightly so that the foot does not stretch
- Drink enough water, especially in hot weather and when exercising
- Do not discontinue medications on your own - discuss with your doctor