Muscle cramps or muscle spasms occur as a result of involuntary contraction of skeletal muscles without relaxation. It is uncontrollable and can be a very painful experience. Any muscle group can be affected, but calf muscles and forefoot muscles are the commonest. Muscle cramps are so common even among healthy people, these especially occur after strenuous exercise and/or reduction of body water and salt content. In older people muscle cramps can occur after minimal exercise or even at rest. Muscle cramps commonly lasts for few seconds but in extreme cases this can be hours. Most of the time cramps are harmless isolated incidents, but sometimes these can be a presenting symptom of an underlying disease as well.
Proper first aid training offers a confident and systematic approach to this very common condition, thereby reducing the suffering of the victim.
Causes and risk factors for muscle cramps:
• Dehydration – even not drinking water for few hours can trigger muscle cramps.
• Electrolyte imbalance – electrolytes play a major role in contracting and relaxing muscles, so alteration of body electrolyte levels – even slightly may lead to muscle cramps.
• Excess sweating.
• Hot and humid environment.
• Nerve injury to muscles – spinal cord compression can cause pain and cramps in leg muscles.
• Vitamin deficiencies like vitamin B1, B5, and B6.
• Drugs and medications like furosemide, donepezil, neostigmine, nifedepine, and terbutaline.
• Associated medical conditions- diabetes mellitus, atherosclerosis, and sciatica.
• Injury to muscles.
• Physical over-exertion – e.g. athletes
• Inadequate diet.
• Tight inflexible muscles in some conditions.
• Poor physical health condition.
• Reduction of blood supply (ischemia) to muscles – when exercising energy consumption by muscles will be increased. Therefore, muscles need more blood supply to achieve the demand. When blood vessels get narrowed (e.g. due to atherosclerosis) blood supply to that muscle will be insufficient and this causes cramps and pain.
• Age- older people with less muscle mass will have more risk of getting muscle cramps.
Symptoms of muscle cramps
• Sudden sensation of uncontrollable pain
• Muscle twitching
• Transient distortion of fingers and/or toes.
• Leg swelling
• Muscle weakness
First aid treatment
• Muscle cramps usually resolve spontaneously.
• First relax, calm down and take a deep breath.
• Gently massage the affected muscle.
• Some ice can be applied on the muscle to relieve pain.
• A local analgesic cream/ointment can be applied over the muscle.
• In the same time; give a salt containing drink to the patient. To make such at home, put ½ teaspoonful of table salt to a glass of drinking water and dissolve well. Some glucose can be added if available.
• Then give adequate amount of water to drink.
• During athletic games or exercising in hot/humid environment, remember to keep drinking adequate amount of water (with some salt) or drink rehydration solutions.
When to seek medical advice
• Recurrent muscle cramps with unbearable pain.
• Cramps not resolving with first aid therapies.
• Do warm up exercises before and after proper exercise or athletics.
• Consume foods and juices with high potassium.
• Do not smoke or take excessive caffeine before exercise.
• Stretch leg muscles by standing with toes.
• Increase the level of physical fitness.
• Drink plenty of water/rehydration solutions before and during exercise.
• Regularly massage muscles to reduce muscle tension.
• Avoid high heel shoes as much as possible.