How to cope with muscle spasms: causes, symptoms and ways of relief

Muscle spasm (muscle cramp) is a sharp and often painful contraction of muscles, associated with their overstrain, dehydration, deficiency of useful substances in the body and other reasons.This condition can occur involuntarily at different times of the day, spread to one muscle or a whole group of muscles, and sometimes, depending on the degree of severity, can even lead to temporary immobilization of a person.All 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, mostly foreign, can sometimes separate these concepts in meaning, calling:

• muscle cramp - an episodic involuntary painful muscle contraction;
• muscle spasm - a wider range of any involuntary muscle contractions, including their painless contractions, tremors, twitches (fascializations), etc.

In addition, the term “krampy” can be found in the medical literature - it also refers to cramps of skeletal muscles.

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 the 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 macroelements - primarily electrolytes (magnesium, calcium, potassium, sodium), about which we will certainly still talk further. Without a sufficient amount of electrolytes, the correct transmission of nerve impulses is impossible, which is what we see in the form of seizures;
• overcooling or overheating of the body. Important! Overheating, associated with any cause (heat, physical activity, high temperature) leads to increased sweating, and with sweat the body leaves and electrolytes - the muscles respond to this loss of the same spasms. Cramps associated with hypothermia, arise from a large difference in body temperature and the environment - often occurs during swimming, especially in cold water, when the temperature difference is added to the temperature difference and physical activity;
• 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 for the treatment of osteoporosis, angina pectoris, Alzheimer's disease and others;
• excessive use of alcohol, caffeine - in these cases, the body actively loses not only electrolytes, but also other substances necessary for normal neurological processes. First of all, these are B vitamins - “neurovitamins”;
• kidney disease, when the body loses the same valuable electrolytes with urine. In addition, muscle spasms often develop during dialysis, which is associated with rapid changes in biological fluids;
• excessive exercise or muscle strain;
• 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;
• intoxication - not only the already mentioned alcoholic, but any other;
• 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);
• cirrhosis of the liver (over 70% of cases). The key 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 diverse - that is 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 diagnostic measures, blood glucose and electrolyte levels, kidney function are examined, and sometimes ECG, MRI, ultrasound, etc. are prescribed.

Of course, if a disease is detected, which also provokes cramps - therapy focuses on it, and muscle spasms gradually disappear as they are cured.

Treatment of muscle spasms

For quick relief of the spasm, it may help to:

• stretching the spasmed muscle. For example, if a leg or foot muscle spasms, sometimes it helps to just stand up and walk around a bit and/or “roll” your foot from heel to toe and back again. If the calf muscle is cramped - it is recommended in a lying or sitting position to bend the ankle with the hand, pulling the foot toward you. If the hand is jammed “writing spasm” should press the hand against the wall, and the fingers should “look” down. By the way, hand and arm muscle spasms are often associated with calcium deficiency, and additional symptoms in this case - numbness / tingling of the skin on different parts of the body, including around the mouth;
• massage themuscle - massage it vigorously to ensure the fastest possible blood flow and relaxation. Massage movements are circular and strokes;
• rehydration - replenishment of fluid levels if the spasm is associated with dehydration (physical exertion, overheating, vomiting / diarrhea, etc.). In addition, restoration of electrolyte levels is also indicated in this case (1-2 liters of water with 2 tsp. 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 is not associated with hypothermia).

In some cases, alternating warm and cold compresses on the spasmed area of the body is recommended. The duration of the compress - 10 minutes, the interval between warm 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 if sodium deficiency is a rather rare situation (especially in people who consume a lot of table salt), magnesium and calcium deficiency is much more widespread and dangerous - it directly increases the excitability of nerve endings that innervate muscles.

As for potassium deficiency - it too can provoke muscle spasm, although more often hypokalemia provokes muscle weakness rather than cramps.

Mineral deficiency and muscle cramps are often associated - accordingly, magnesium and other electrolytes in various forms can be prescribed by a doctor as part of a comprehensive treatment of muscle cramps.

B vitamins. Deficiency of these “neurovitamins” may also well be directly or indirectly associated with muscle cramps. This is especially true for 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 provoke spasms, and if such spasms are directly related to neurovitamin deficiency.

Medication: painkillers, muscle relaxants.

In episodic spasms 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 in the form of patches, ointments, gels.

If muscle spasms annoy the patient often and accompanied by pain, as part of a comprehensive treatment may be prescribed muscle relaxants (myorelaxants) - for example, thiocolchicoside, tolperisone - but their effectiveness in this case is low.

Doctors may also use other drugs:

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

All of the above drugs are “serious” drugs and, of course, without medical advice to use them is strictly forbidden.

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

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

When are antispasmodics needed?

Antispasmodics - these are also drugs to eliminate muscle spasm, but they affect only smooth muscle, of which “built” vessels and hollow organs (stomach, intestines, gallbladder, urinary tract, uterus and others).

Spasms of smooth muscle, as well as skeletal muscle, are accompanied by pain - it is well known to us renal and hepatic colic, abdominal pain, heart attack, painful menstruation (dysmenorrhea) and painful spasticity in labor.

Spasmolytics are divided into subcategories:

• Neurotropic - the “older” drugs that block the M-cholinoreceptors responsible for muscle contraction. Such drugs include magnesium sulfate, diprofen, kellin, and others;
• myotropic - relax smooth muscle, relieve vascular spasm: papaverine, drotaverine, euphylline, dibasol, theobromine, etc.

In addition, nitrate and nitrite derivatives have 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), containing 80 mg of drotaverine in one tablet. The drug is used primarily to relieve spasms of smooth muscles of internal organs - biliary and urinary tract, gastrointestinal tract, uterus, tension headaches, etc.

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No-Spa 40 mg, 24 tablets, Sanofi

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No-Spa Forte, 80 mg, 24 film-coated tablets, Sanofi

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When is it absolutely necessary to go to the doctor?

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

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

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

Prevention: how to prevent muscle spasms

The approach to the prevention of muscle cramps should be the same as to their treatment - complex. Prevent muscle cramps or reduce the existing ones by following these recommendations:

• if you are prone to leg cramps, wear only comfortable shoes;
• do not avoid physical activity, but do not overdo it;
• perform gentle muscle stretching exercises before physical activity. In addition, such exercises are indicated if you are prone to night cramps or other resting cramps - in these cases, they are performed before bedtime;
• include in your diet foods containing electrolytes - lean meats, fermented milk products, nuts, bananas, apples, pears, citrus fruits, carrots. In general, the diet should be healthy and balanced - any strict diets can cause not only electrolyte imbalance, but also 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 daily number of cigarettes);
• if you are prone to muscle cramps, analyze the factors that usually provoke them, and then try to avoid these factors or exercise extra caution - for example, swimming in a body of water, do not swim alone and do not swim far from the shore. We do not want to scare the reader, but there are many cases of drowning caused by muscle cramps in the leg;
• when cramping in the legs, be sure to see a therapist (or immediately to a phlebologist) to exclude or confirm possible varicose veins. In case of such a diagnosis, carefully follow all the doctor's instructions;
• in consultation with a doctor, you can periodically take magnesium and calcium preparations, but in case of kidney problems you need to be very careful during their use. Vitamins B, D, E may also be prescribed. If by doctor's prescription you take diuretics, which activate the excretion of potassium from the body (loop or thiazide diuretics) - it is necessary to take additional potassium-containing drugs.

Quite often muscle spasms do not indicate serious problems and can be successfully treated simply. However, sometimes they are the body's request for help, that is, one of the primary symptoms of a serious disease. 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!