How to cope with muscle spasms: causes, symptoms and ways to relieve them

Muscle spasm (muscle cramp) is a sudden and often painful contraction of the muscles, associated with overuse, dehydration, lack of useful substances in the body and other reasons. This condition can occur involuntarily at different times of the day, it can spread to a muscle or an entire group of muscles, and sometimes, depending on the degree of severity, it can even lead to temporary immobilization of a person.Everything about the causes of muscle spasms, their treatment and prevention, as well as particularly dangerous symptoms that require immediate medical attention - read in our material.

To begin with, let's agree that in this article we say "spasm" - we mean "cramp" (and vice versa). In a broad sense, these terms denote the same thing, although some doctors, mainly foreigners, can sometimes separate these concepts in meaning, calling:

• muscle cramp - an episodic painful involuntary painful muscle contraction ;
• Muscle spasm - a broader range of any involuntary muscle contractions, including painless muscle twitching, tremors, twitches (fasciculations), etc.

In addition, the term "krumpy" can be found in medical literature - it also refers to skeletal muscle cramps.

So what is muscle spasm by its nature and how does it occur? The mechanism of its occurrence consists of four stages:

1. A nerve impulse is formed.
2. The impulse affects muscle tissue.
3. There is a persistent involuntary contraction of the muscle, which can last from a few seconds to several minutes.
4. The muscle relaxes.

Causes of muscle spasms

What causes muscle cramps is difficult to determine "offhand". Cramps can be associated with a large number of factors, mostly internal, including

• violation of water and salt metabolism, deficiency of certain micro- and macro-elements - primarily electrolytes (magnesium, calcium, potassium, sodium), which we will certainly talk more about later. Without sufficient electrolytes, proper transmission of nerve impulses is impossible, which we see in the form of seizures;
• excessive cooling or overheating of the body. Important! Overheating associated with any cause (heat, physical exertion, high temperature) leads to increased sweating, and along with sweating the body leaves electrolytes - the muscles react to this loss with the same spasms. Cramps associated with hypothermia, occur due to a large difference between body and ambient temperature - they often occur during swimming, especially in cold water, when the temperature difference is compounded by the temperature difference and physical exertion;
• dehydration, especially severe dehydration. Dehydration = loss of electrolytes;
• taking certain medications - diuretics (diuretics, which again increase the removal of electrolytes from the body), antidepressants, drugs to treat osteoporosis, angina, Alzheimer's disease, etc;
• excessive consumption of alcohol, caffeine - in these cases, the body actively loses not only electrolytes, but also other substances necessary for normal neurological processes. In the first place, these are the B vitamins - "neurovitamins";
• kidney disease, when the body loses the same valuable electrolytes with urine. In addition, muscle spasms often occur during dialysis, which is associated with rapid changes in biological fluids;
• excessive exercise or muscle exertion;
• high blood pressure (hypertension), other cardiovascular diseases;
• certain autoimmune diseases - systemic lupus erythematosus (SLE), rheumatism, etc;
• increased blood glucose levels: muscle spasms are common in diabetes;
• impaired blood circulation and blood flow to the muscles, which often occurs with atherosclerosis, peripheral arterial disease, thrombosis, varicose veins, smoking, etc;
• prolonged immobility of the body;
• severe fatigue, lack of sleep, psychological stress, especially prolonged psychological stress;
• intoxication - not only the alcohol intoxication already mentioned, but also any other intoxication;
• pinched nerves (radiculopathy);
• certain infections, especially chronic infections;
• pregnancy and other specific conditions and diseases in which the hormonal background changes (endocrine diseases - e.g. hypothyroidism, diabetes)
• liver cirrhosis (over 70% of cases). The main cause of muscle cramps in cirrhosis is ascites, an accumulation of fluid in the abdominal cavity: this 'unusual' distribution of fluid is the reason for the cramps.

As you can see, the causes of muscle spasms are extremely varied - that's why it is not difficult to diagnose muscle cramps, but sometimes the doctor has to work very hard to find the real cause. As part of the diagnostic measures, blood glucose and electrolyte levels, kidney function, sometimes ECG, MRI, ultrasound, etc. are investigated.

Of course, if a disease is detected, which also causes cramping - therapy focuses on this, and the muscle spasms gradually disappear as they are cured.

Treatment of muscle spasms

For rapid spasm relief, it may be helpful to:

• Stretching the spasmed muscle. For example, if a leg or foot muscle spasms, sometimes it may help just to stand up and walk around a little and/or "rolling" the foot from heel to toe and vice versa. If the calf muscle is cramped - it is recommended in the lying or sitting position to bend the ankle with the hand, pulling the foot towards you. If the hand is stuck "writing spasm" should press the hand against the wall, and the fingers should "look" down. By the way, muscle spasms in the arms and hands are often associated with calcium deficiency, and additional symptoms in this case - numbness / tingling of the skin on various parts of the body, including around the mouth;
• massage the muscle - massage vigorously to ensure the fastest possible blood flow and relaxation. Massage movements are circular and stroke;
• rehydration - replenish fluid levels if spasm is associated with dehydration (physical exertion, overheating, vomiting/diarrhea, etc.) In addition, replenishing electrolyte levels is also indicated in this case (1-2 liters of water with 2 teaspoons of salt, special electrolyte drinks for rehydration sold in pharmacies and sports nutrition stores, etc.)
• application of heat (if the muscle is simply tense - warm compress, warm bath/shower - or cold (if the spasm is accompanied by pain but not related to hypothermia).

In some cases, alternating hot and cold compresses on the spastic area of the body is recommended. Duration of compress - 10 minutes, interval between hot and cold - 15 minutes.

Minerals and vitamins

Electrolytes. In the list of causes of muscle spasms electrolyte disorders are not without reason in the first place. The main electrolytes are magnesium, calcium, potassium and sodium: they ensure proper transmission of nerve impulses. And while sodium deficiency is quite rare (especially in people who eat a lot of table salt), magnesium and calcium deficiency is much more common and more dangerous - it directly increases the excitability of nerve endings that innervate muscles.

As for potassium deficiency - this too can cause muscle spasms, although more often hypokalemia causes muscle weakness rather than cramps.

Mineral deficiency and muscle cramps are often linked - consequently, magnesium and other electrolytes in various forms may be prescribed by your doctor as part of a complete muscle cramp treatment.

B vitamins. Deficiency of these "neurovitamins" may also be well associated directly or indirectly with muscle cramps. This is particularly true of vitamins B1 (thiamine), B5 (pantothenic acid) and B6 (pyridoxine). Preparations containing these nutrients are widely used in the treatment of neurological diseases, including those that cause spasms, and if these spasms are directly related to neurovitamin deficiency.

Medications: analgesics, muscle relaxants.

In episodic spasms that are not associated with a serious disease, mineral and vitamin therapy may be sufficient, sometimes with the temporary use of non-steroidal anti-inflammatory drugs (NSAIDs), including patches, ointments, gels.

If muscle spasms often bother the patient and are accompanied by pain, muscle relaxants (myorelaxants) - e.g. thiocolchicoside, tolperison - may be prescribed as part of a comprehensive treatment, but their effectiveness in this case is low.

Doctors may also use other drugs:

• gabapentin;
• baclofen;
• calcium channel blockers (with caution, as they can lower blood pressure). However, the well-studied representative of this group, nifedipine , is not currently used because one of its side effects is the occurrence of skeletal muscle cramps, krampy;
• verapamil, diltiazem;
• benzodiazepines.

All the above drugs are "serious" drugs and, of course, without consulting a doctor their use is strictly forbidden.

Also as part of a complex therapy, the doctor may recommend changes in the regime/intensity of physical activity, certain "corrections" in diet and lifestyle in general, use of vasodilators.

Among physiotherapeutic methods in the treatment of cramps, electro- and ultrasound therapy, high-frequency wave thermotherapy, magnetic laser therapy are used.

When are antispasmodics necessary?

Antispasmodics - these are also drugs to eliminate muscle spasms, but they affect only smooth muscles, from which "built" vessels and hollow organs (stomach, intestines, gallbladder, urinary tract, uterus and others).

Spasms of the smooth muscles, as well as skeletal muscles, are accompanied by pain - renal and hepatic colic, abdominal cramps, infarction, painful menstruation (dysmenorrhea) and painful spasticity in childbirth are well known to us.

Antispasmodics are divided into subcategories:

• Neurotropics - "older" drugs that block the M-cholinoreceptors responsible for muscle contraction. Such drugs include magnesium sulfate, diprofen, kellin and others;
• myotropics - relax smooth muscle, relieve vascular spasm: papaverine, drotaverine, eufylline, dibazol, theobromine and others.

In addition, nitrate and nitrite derivatives have an antispasmodic effect. In addition to the direct myotropic effect, they depress the activity of the vasomotor center in the medulla oblongata.

Most often, in the fight against muscle spasms, myotropic antispasmodics are used, including the popular drug No-shpa Forte (Sanofi), which contains 80 mg of drotaverine in one tablet. The drug is mainly used to relieve spasms of the smooth muscles of internal organs - biliary and urinary tract, gastrointestinal tract, uterus, tension headaches, etc.

When should I go to the doctor?

In fact, you should go to the doctor even if muscle spasms, especially painful ones, occur more than 2-3 times a month. But you should not just go, but run immediately (if you still can, and if you can't - call a doctor at home) should be at:

• spasm frequency up to 5-10 times a day;
• duration of spasms longer than 3 days;
• pain after muscle relaxation and/or intensification of pain after taking analgesics/anti-spaspasmodics;
• difficulty in limb movement, spasticity in the back;
• swelling in the area of spasm;
• increasing weakness, numbness of limbs, nausea;
• cramps at night (especially more often 1-2 times a night);
• marked muscle weakness.

If these symptoms occur, the first thing to do is to consult a GP or family doctor. If necessary, he or she will refer the patient to specialized specialists - neurologist, endocrinologist, surgeon, phlebologist, etc.

Prevention: how to prevent muscle spasms

The approach to preventing muscle cramps should be the same as treating them - comprehensive. Prevent or reduce muscle cramps by following the recommendations below:

• if you are prone to leg cramps, wear only comfortable shoes;
• don't avoid physical activity, but don't overdo it;
• Do light muscle stretching exercises before physical activity. In addition, such exercises are indicated if you are prone to night cramps or other rest cramps - in these cases, they are performed before going to bed;
• include in your diet foods that contain electrolytes - lean meats, fermented dairy products, nuts, bananas, apples, pears, citrus fruits, carrots. In general, your diet should be healthy and balanced - any strict diet can cause not only electrolyte imbalance, but many other serious health problems;
• follow a proper drinking regimen and remember that coffee, black tea and any alcoholic beverages actively remove electrolytes from the body;
• if you smoke, quit (or at least reduce the number of cigarettes you smoke each day);
• if you are prone to muscle cramps, analyze the factors that usually cause them and then try to avoid these factors or exercise extra caution - for example, when swimming in a body of water, don't swim alone and don't swim far from the shore. We don't want to scare the reader, but there are many cases of drowning caused by leg muscle cramps;
• in case of leg cramps, always consult a general practitioner (or immediately a phlebologist) to rule out or confirm possible varicose veins. In the event of such a diagnosis, follow all your doctor's instructions carefully;
• after consulting your doctor, you can take magnesium and calcium preparations periodically, but in the case of kidney problems, extra caution should be exercised when using them. Vitamins B, D, E may also be prescribed. If you are prescribed diuretics, which activate the excretion of potassium from the body (loop or thiazide diuretics) - it is necessary to take additional potassium-containing medicines.

Quite often muscle spasms do not indicate serious problems and can be successfully treated simply. However, sometimes they are the body's cry for help, i.e. one of the primary symptoms of a serious illness. Therefore, muscle cramps, which occur frequently and are accompanied by severe pain, should never be ignored.

The Liki24 team wishes you good health and strong muscles!