Cramps

Conditions

Cramps are an unpleasant experience, characterized by the sudden and painful contraction of a muscle or group of muscles. These involuntary contractions may occur in any part of the body and can range in severity from mild to intense.

They should not be confused with myalgias (by muscle expression), myotonias (which are not painful) or other forms of cramps such as writer’s cramp which is a localized form of dystonia.

Night cramps in the elderly mainly affect the calf and are most commonly idiopathic, originating from metabolic, vascular, neurological, or iatrogenic disorders.

Origins Diseases
Endocrine and MetabolicDiabetes, Hypothyroidism, Adrenal insufficiency, Hypokalemia, Hyperkalemia, Hyponatremia, Hypocalcemia, Hypomagnesemia
VascularArteriopathy, Venous insufficiency
NeurologicalMononeuropathies, Polyneuropathies, Amyotrophic lateral sclerosis, Myopathies
Iatrogens (drugs)Diuretics (e.g. furosemide), Calcium blockers, Beta-stimulants, Phenothiazines, Corticosteroids, Morphine, Donepezil, Raloxifene, Tolcapone (anti-parkinsonian), Statins

Physical examination

To diagnose the cause of cramps, a doctor may perform an examination and ask detailed questions about the patient’s health history (anamnesis) to identify signs and symptoms. 

The examination will make it possible to identify the signs of dehydration, claudication of the lower limbs, neuropathy or poor medication intake. 

Measurement of magnesium, calcium, creatine, blood sugar or TSH levels should also be prescribed.

If there are symptoms similar to those seen in amyotrophic lateral sclerosis or myopathy, then a neurophysiological examination is necessary.


Treatment

Cramps, or muscle spasms, are painful contractions of the body’s muscle tissues that can be caused by a variety of reasons. To relieve cramping, massages and stretching of the affected muscles are recommended treatments.

Quinine sulphate does not seem to be effective and has side effects (e.g. tinnitus). 

This product is no longer recommended by the US Health Agency (FDA).