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DESCRIPTION
You have over 600 muscles in your body. These muscles control everything you do, from breathing to putting food in your mouth to swallowing. Under normal conditions, when we use muscles that can be voluntarily controlled, such as those of our arms and legs, a muscle contracts (shortening muscle fibers) when it is used, then stretches out and relaxes (lengthening muscle fibers) when the motion is completed or another muscle moves in the opposite direction. The muscles alternately contract and relax as we move our limbs. Muscles that support our head, neck, and trunk contract in a similar, synchronized fashion to maintain our posture and this allows us to bend and move as needed. When a muscle (or even a few fibers of a muscle) that involuntarily (without consciously willing it) contracts, we call that movement a "spasm." If a spasming muscle contracts with great intensity and force without stretching out again, you feel the pain of a muscle cramp. Muscle cramping may be commonly referred to as a "charley horse".
When it comes to muscle cramps, the most commonly affected muscles are the muscles of your upper arms (triceps), the calf muscles (gastrocnemius), the muscles behind your thighs (hamstrings), and the muscles in the front of your thighs (quadriceps).
Many people experience muscle cramps during the night. This type of cramp generally affects the legs, especially the calf muscles, and the feet. They occur more frequently in older adults than in younger people. Children sometimes experience a type of crampy muscle and leg pain, often called "growing pains."
MUSCLE ANATOMY
Muscles are composed of many fibers bundled together; the bigger, more frequently used muscles have more fibers than the smaller, lesser used ones. Among the muscles are voluntary and involuntary muscles. Voluntary, or striated muscles are those that we move by choice (for example, the muscles in your arms and legs). These muscles are attached to bones by tendons, a sinewy type of tissue. Involuntary muscles, or smooth muscles, are the ones that move on their own (for example, the muscles that control your diaphragm and help you breathe). The muscles in your heart are called involuntary cardiac muscles.
SIGNS & SYMPTOMS
A muscle cramp is thus defined as an involuntarily and forcibly contracted muscle that does not relax. This causes a visible or palpable hardening of the involved muscle. Characteristically, a cramp is painful, often severely so. Usually, the sufferer must stop whatever activity is under way and seek relief from the cramp; the person is unable to use the affected muscle while it is cramping. Severe cramps may be associated with soreness and swelling, which can occasionally persist up to several days after the cramp has subsided. At the time of cramping, the knotted muscle will bulge, feel very firm, and may be tender.
A muscle cramp can last anywhere from a few seconds to several minutes or occasionally longer. It is not uncommon for a cramp to recur multiple times until it finally goes away. Most cramps resolve spontaneously within a few seconds.
The cramp may involve a part of a muscle, the entire muscle, or a group of several muscles that ordinarily move body parts in opposite directions and/or act together, such as those that flex adjacent fingers. The skeletal muscles (those over which we have voluntary control) are most prone to cramping. The skeletal muscles in the calf, thigh, and arch of the foot are most notorious sites of cramps.
Muscle cramps can be perceived as mild twitches or may be quite painful. Typically, cramps cause an abrupt intense pain in the involved muscle.
Cramps are extremely common. Almost everyone, possibly 95 percent of people, experience a cramp at some time in their lives. Cramps are common in adults and become increasingly frequent with aging. However, children also can experience cramps. Many children experience "growing pains", primarily in their legs and most often during growing spurts. low calcium level in blood (especially for adolescents where they need calcium for both blood and bone maturing
Involuntary muscles of the various organs (uterus and vaginal walls, blood vessel wall, intestinal tract, bile and urine passages, bronchial tree, etc.) are also subject to cramps. However, this article will focus on cramps of the skeletal muscles.
CAUSES
It is not known exactly why muscle cramps develop, however, muscle cramping is often caused by an imbalance in the body's levels of electrolytes. Electrolytes are minerals such as sodium, potassium, chloride, calcium, phosphate and magnesium found and carried in the blood and help regulate cellular function. These electrolytes can be out of balance due to illness or exercise.
A deficiency of vitamin E also may be involved. Another common cause is unaccustomed physical overexertion, overuse, or strain.
Other causes of muscle cramping include:
- Insufficient stretching before exercise.
- Sitting, standing, or lying for a long period of time in one position.
- Anemia.
- The use of tobacco products.
- Inactivity.
- Fibromyalgia.
- Hormone imbalances.
- Allergies.
- Arthritis.
- Arteriosclerosis.
- Dehydration.
- Heat stroke.
- Hypothyroidism.
- Varicose veins.
- More rarely, the early stages of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease).
- Some medications can cause muscle cramping as a side effect. The use of diuretic drugs for high blood pressure or heart disorders may lead to electrolyte imbalances, causing muscle cramp's.
- Poor circulation also contributes to leg cramps.
SIX BASIC CAUSES OF CRAMPING:
There are six basic causes of cramping:
- Hyperflexion.
- Inadequate oxygenation.
- Exposure to large changes in temperature.
- Dehydration.
- Low blood salt.
- Low blood calcium.
Muscle cramps may also be a symptom and/or complication of pregnancy, kidney disease, thyroid disease, hypokalemia or hypocalcemia (as conditions), restless legs syndrome, varicose veins, and multiple sclerosis.
ELECTROLYTE DISTURBANCE
Electrolyte disturbance may cause cramping and tetany of muscles, particularly hypokalemia (a low level of potassium) and hypocalcemia (a low level of calcium). This disturbance arises as the body loses large amounts of interstitial fluid through sweat. This interstitial fluid is composed mostly of water and table salt (NaCl). The loss of osmotically active particles outside muscle cells leads to a disturbance of the osmotic balance and swelling of muscle cells as these contain more osmotically active particles. This causes the calcium pump between the muscle lumen and sarcoplasmic reticulum to short circuit and the calcium ions remain bound to the troponin and the muscle contraction is continued. This may occur when the lactic acid is high in the cells.
IATROGENIC CAUSES
Statins are known to cause myalgia and cramps among other side effects. Additional factors increasing probability for these adverse side effects are physical exercise, age, female gender, history of cramps and hypothyroidism. Up to 80 percent of athletes using statins suffer significant muscular adverse effects including cramps, the rate appears to be approximately 10-25 percent in typical population using statins. In some cases these adverse effects will disappear after switching to a different statin, however they should not be ignored if they persist as they can rarely develop into a more serious problem.
Coenzyme Q10 supplementation can be helpful to avoid some statin related adverse effects but currently there is not enough evidence to prove effectiveness in avoiding myopathy or myalgia.
TYPES OF MUSCLE CRAMPS
Skeletal muscle cramps can be categorized into four major types. These include:
- "True" cramps.
- Tetany.
- Contractures.
- Dystonic cramps.
Cramps are categorized according to their different causes and the muscle groups they affect.
"TRUE" CRAMPS
"True" cramps involve part or all of a single muscle or a group of muscles that generally act together, such as the muscles that flex several adjacent fingers. Most authorities agree that "true" cramps are caused by hyper-excitability of the nerves that stimulate the muscles. They are overwhelmingly the most common type of skeletal muscle cramps. "True" cramps can occur in a variety of circumstances as follows:
- Injury: Persistent muscle spasm may occur as a protective mechanism following an injury, such as a broken bone. In this instance, the spasm tends to minimize movement and stabilize the area of injury. Injury of the muscle alone may cause the muscle to spasm.
- Vigorous Activity: "True" cramps are commonly associated with the vigorous use of muscles and muscle fatigue (in sports or with unaccustomed activities). Such cramps may come during the activity or later, sometimes many hours later. Likewise, muscle fatigue from sitting or lying for an extended period in an awkward position, or any repetitive use can cause cramps. Older adults are at risk for cramps when performing vigorous or strenuous physical activities.
- Rest Cramps: Cramps at rest are very common, especially in older adults, but may be experienced at any age, including childhood. Rest cramps often occur during the night. While not life-threatening, night cramps (commonly known as nocturnal cramps) can be painful, disruptive of sleep, and they can recur frequently (that is, many times a night, and/or many nights each week). The actual cause of night cramps is unknown. Sometimes, such cramps are initiated by making a movement that shortens the muscle. An example is pointing the toe down while lying in bed, which shortens the calf muscle, a common site of cramps.
- Dehydration: Sports and other vigorous activities can cause excessive fluid loss from perspiration. This kind of dehydration increases the likelihood of "true" cramps. These cramps are more likely in warm weather and can be an early sign of heat stroke. Chronic volume depletion of body fluids from diuretics (medicine that promote urination) and poor fluid intake may act similarly to predispose to cramps in seniors. Sodium depletion has also been associated with cramps. Loss of sodium, the most abundant chemical constituent of body fluids outside the cell, is usually a function of dehydration.
- Body Fluid Shifts: "True" cramps also may be experienced in other conditions that feature an unusual distribution of body fluids. An example is cirrhosis of the liver, with fluid in the abdominal cavity (ascites). Similarly, cramps are a relatively frequent complication of the rapid body fluid changes that occur during artificial kidney treatment (hemodialysis).
- Low Blood Calcium, Magnesium: Low blood levels of either calcium or magnesium directly increase the excitability of both the nerve endings and the muscles they stimulate. This may be a predisposing factor for the spontaneous "true" cramps experienced by many older adults, as well as for those that are commonly noted during pregnancy. Low levels of calcium and magnesium are common in a normal pregnancy unless these minerals are supplemented to the diet. Cramps are seen in any circumstance that decreases the availability of calcium or magnesium in body fluids, such as from diuretics, hyperventilation (overbreathing), excessive vomiting, inadequate calcium and/or magnesium in the diet, inadequate calcium absorption due to vitamin D deficiency, poor function of the parathyroid gland (a tiny gland in the neck that regulates calcium balance), and other conditions.
- Low Potassium: Low potassium levels occasionally cause muscle cramps, although it is more common for low potassium to be associated with muscle weakness.
TETANY
In tetany, all of the nerve cells in the body are activated, which then stimulate the muscles. This reaction causes spasms or cramps throughout the body. The name tetany is derived from the effect of the tetanus toxin on the nerves. However, the name is now commonly applied to muscle cramping from other conditions, such as low blood levels of calcium and magnesium. Low calcium and low magnesium, which increase the activity of nerve tissue non-specifically, also can produce tetanic cramps. Often, such cramps are accompanied by evidence of hyperactivity of other nerve functions in addition to muscle stimulation. For instance, low blood calcium not only causes spasm of the muscles of the hands and wrists, but it can also cause a sensation of numbness and tingling around the mouth and other areas.
Sometimes, tetanic cramps are indistinguishable from "true" cramps. The accompanying changes of sensation or other nerve functions that occurs with tetany may not be apparent because the cramp pain is masking or distracting from it.
CONTRACTURES
Contractures result when the muscles are unable to relax. The constant spasms are caused by a depletion of adenosine triphosphate (ATP), an energy chemical within the cell. This prevents muscle fiber relaxation. The nerves are inactive in this form of muscle spasm.
Contractures can be inherited (for example, McArdle's disease, which is a defect of the breakdown of glycogen to sugar within the muscle cell) or acquired (for example, hyperthyroid myopathy, which is a muscle disease that is associated with an overactive thyroid). Cramps of this category are uncommon.
DYSTONIC CRAMPS
The final category is dystonic cramps, in which muscles that are not needed for the intended movement are stimulated to contract. Muscles that are affected by this type of cramping include those that ordinarily work in the opposite direction of the intended movement, and/or others that exaggerate the movement. Some dystonic cramps usually affect small groups of muscles (eyelids, jaws, neck, larynx, etc.). The hands and arms may be affected during the performance of repetitive activities such as those associated with handwriting (writer's cramp), typing, playing certain musical instruments, and many others. Each of these repetitive activities may also produce "true" cramps from muscle fatigue. Dystonic cramps are not as common as "true" cramps.
OTHER TYPES OF MUSCLE CRAMPS ASSOCIATED WITH DISEASE
Not all cramps are readily categorized in the preceding manner since these categories best apply to cramps that are the major muscle problem a patient has. Many cramps are a relatively minor part of nerve and muscle diseases; other muscle symptoms are usually more prominent in these diseases. Some examples include: amyotrophic lateral sclerosis (Lou Gehrig's disease) with weakness and muscle wasting; radiculopathy (spinal nerve irritation or compression from various causes) with pain, distortion or loss of sensation, and/or weakness; diseases of the peripheral nerves, such as diabetic neuropathy, with distorted and diminished sensation and weakness; and a number of primarily dystonic muscle diseases.
MEDICATION-CAUSED MUSCLE CRAMPS
Numerous medicines can cause cramps. Potent diuretic medications, such as furosemide (Lasix), or the vigorous removal of body fluids even with less potent diuretics can induce cramps by depleting body fluid and sodium. Simultaneously, diuretics often cause the loss of potassium, calcium, and magnesium, which can also cause cramps.
Medications such as donepezil (Aricept is used for Alzheimer's disease) and neostigmine (Prostigmine and others are used for myasthenia gravis) as well as raloxifene (Evista is used to prevent osteoporosis in postmenopausal women) have caused cramps. Tolcapone (Tasmar is used for Parkinson's disease) reportedly causes muscle cramps in at least 10% of patients. "True" cramps are reported with nifedipine (Procardia and others are used for angina, high blood pressure and other conditions) and the asthma drugs terbutaline (Brethine) and albuterol (Proventil, Ventolin, and others). Some medicines used to lower cholesterol, including clofibrate (Atromid-S) and lovastatin (Mevacor), can also lead to cramps.
Cramps are sometimes noted in addicted individuals during withdrawal from medications and substances that have sedative effects, including alcohol, barbiturates and other sedatives, anti-anxiety agents such as benzodiazepines (for example, Valium and Xanax), narcotics, and other drugs.
NUTRITIONAL DEFICIENCIES
Several vitamin deficiency states may directly or indirectly lead to muscle cramps. These include deficiencies of thiamine (B-1), pantothenic acid (B-5), and pyridoxine (B-6). The role of deficiency of these vitamins in causing cramps is unknown.
POOR CIRCULATION & MUSCLE CRAMPS Poor circulation to the legs, which results in inadequate oxygen to the muscle tissue, can cause severe pain in the muscle (sometimes known as claudication pain). This commonly occurs in the calf muscles. While the pain feels virtually identical to that of a severely cramped muscle, the pain does not seem to be a result of the actual muscle cramping. This pain may be due to accumulation of lactic acid and other chemicals in the muscle tissues. It's important to see your health care provider if you have pain like this.
CONCERNS FOR OLDER ADULTS
Older adults should have periodic magnesium blood levels taken if they use supplemental magnesium. Even a mild and otherwise not apparent degree of kidney dysfunction, which is often seen in this age group, may lead to toxic levels of magnesium with modest doses.
Recent studies have indicated that vitamin D (a vitamin required for the normal absorption of calcium from food) deficiency is common in some elderly individuals. Consequently, vitamin D replacement is important for these people, taking appropriate care to avoid excessive vitamin D levels, as these are toxic. An intake of 800 units of vitamin D daily is likely to be fully adequate; at least 400 units daily is generally recommended.
While the more potent diuretics are associated with an increased loss of calcium and magnesium, hydrochlorothiazide (Hydrodiuril) and related diuretics are associated with calcium and magnesium retention. Diuretics are commonly used for the treatment of hypertension and heart failure. If cramps (or osteoporosis) are also a problem, the patient and health care provider may consider using hydrochlorothiazide or another thiazide type of diuretic if otherwise feasible and appropriate.
Diuretics also cause sodium depletion and most also cause potassium depletion. Many patients who use diuretics are also on sodium restricted diets. Careful attention to the effects of diuretics on sodium and potassium, and replacement of these elements as needed, is always appropriate, even more so if cramps are a problem.
Older adults often do not hydrate themselves adequately, partly because the sense of thirst diminishes with age. This situation is exaggerated in those who are treated with diuretics. For some, simply increasing fluid intake to the generally recommended six to eight glasses a day will improve the cramps. However, drinks with caffeine should not be counted since they act on the kidneys to increase fluid loss. Individuals who are on restricted fluid intake should consult their health care provider on this issue and must not ignore their recommended fluid intake limits.
As for night cramps, the exact cause is often difficult to determine. The best prevention involves stretching regularly, adequate fluid intake, appropriate calcium and vitamin D intake, supplemental vitamin E, and possibly - with health care provider consultation - supplemental magnesium intake.
RISK FACTORS
Cramps can occur when you are resting, sleeping, or participating in sports or other daily activities. Anyone can develop a muscle cramp but infants, pregnant women, the elderly, the overweight and people involved with sport activities are at the greatest risk for muscle cramps.
Athletes are at greatest risk and most often develop muscle cramps at the beginning of a season when their body is not yet fully conditioned. Cramps in athletes can occur during or after periods of physical exertion.
PREVENTION
In athletics, you can also help prevent future muscle cramps by always warming up and stretching well (especially the muscle groups prone to cramping) before workouts and maintaining adequate hydration when exercising. Sports beverages rather than water may help prevent electrolyte imbalances such as low sodium levels (hyponatremia).
ACTIVITY
Health care providers, trainers and therapists recommend stretching before and after cramps that are caused by vigorous physical activity, along with an adequate warm-up and cool down. Good hydration before, during, and after the activity is important, especially if the duration exceeds one hour, and replacement of lost electrolytes (especially sodium and potassium, which are major components of perspiration) can also be helpful. Excessive fatigue, especially in warm weather, should be avoided.
HYDRATION GUIDELINES
Hydration guidelines should be individualized for each person. The goal is to prevent excessive weight loss (less than 2% of body weight). You should weigh yourself before and after exercise to see how much fluid you lose through sweat. One liter of water weighs 2.25 pounds. Depending on the amount of exercise, temperature and humidity, body weight, and other factors, you can lose anywhere from approximately 0.4 to 1.8 liters per hour.
Pre-Exercise Hydration (If Needed):1. 0.5 liters per hour for a 180-pound person several hours (three to four hours) prior to exercise.
2. Consuming beverages with sodium and/or small amounts of salted snacks or sodium-containing foods at meals will help to stimulate thirst and retain the consumed fluids.
During Exercise:1. Suggested starting points for marathon runners is 0.4 to 0.8 liters per hour, but again, it should be individualized based on body weight loss.
2. There should be no more than 10 percent carbohydrate in the beverage, and 7 percent has generally been considered close to optimal. Carbohydrate consumption is generally recommended only after one hour of exertion.
3. Electrolyte repletion (sodium and potassium) can help sustain electrolyte balance during exercise. Particularly when there is inadequate access to meals or meals are not eaten, physical activity exceeds four hours in duration, or during the initial days of hot weather. Under these conditions, adding modest amounts of salt (0.3 to 0.7 g/L) can offset salt loss in sweat and minimize medical events associated with electrolyte imbalances (for example, muscle cramps, hyponatremia).
Post-Exercise:1. Drink approximately 0.5 liters of water for every pound of body weight lost.
2. Consuming beverages and snacks with sodium will help expedite rapid and complete recovery by stimulating thirst and fluid retention.
PREGNANCY
Supplemental calcium and magnesium have each been shown to help prevent cramps associated with pregnancy. An adequate intake of both of these minerals during pregnancy is important for this and other reasons, but supervision by a midwife or qualified health professional is essential.
DYSTONIC CRAMPS
Cramps that are induced by repetitive non-vigorous activities can sometimes be prevented or minimized by careful attention to ergonomic factors such as wrist supports, avoiding high heels, adjusting chair position, activity breaks, and using comfortable positions and equipment while performing the activity. Learning to avoid excessive tension while executing problem activities can help. However, cramps can remain very troublesome for activities that are difficult to modify, such as playing a musical instrument.
REST CRAMPS
Night cramps and other rest cramps can often be prevented by regular stretching exercises, particularly if done before going to bed. Even the simple calf-stretching maneuver (described in the first paragraph of the section on treatment), if held for 10 to 15 seconds and repeated two or three times just before going to bed, can be a great help in preventing cramps. The maneuver can be repeated each time you get up to go to the bathroom during the night and also once or twice during the day. If nocturnal leg cramps are severe and recurrent, a foot board can be used to simulate walking even while recumbent and may prevent awkward positioning of the feet during sleep. Ask your health care provider about this remedy.
Another important aspect of prevention of night cramps is adequate calcium and magnesium. Blood levels may not be sensitive enough to accurately reflect what is happening at the tissue surfaces where the hyper-excitability of the nerve occurs. Calcium intake of at least 1 gram daily is reasonable, and 1.5 grams may be appropriate, particularly for women with osteoporosis. An extra dose of calcium at bedtime may help prevent cramps.
Supplemental magnesium may be very beneficial for some, particularly if the person has a magnesium deficiency. However, added magnesium can be very hazardous for people who have difficulty eliminating magnesium, as happens with kidney insufficiency. The vigorous use of diuretics usually increases magnesium loss, and high levels of calcium intake (and therefore of calcium excretion) tend to increase magnesium excretion. Magnesium is present in many foods (greens, grains, meat and fish, bananas, apricots, nuts, and soybeans) and some laxatives and antacids, but a supplemental dose of 50 to 100 milligrams of magnesium daily may be appropriate. Splitting the dose and taking a portion several times during the day minimizes the tendency to diarrhea that magnesium can cause.
Vitamin E has also been said to help minimize cramp occurrence. Scientific studies documenting this effect are lacking, but anecdotal reports are common and sometimes quite enthusiastic. Since vitamin E is thought to have other beneficial health effects and is not toxic in usual doses, taking 400 units of vitamin E daily is approved, recognizing that documentation on its effect on cramps is lacking.
A cramp is an involuntary and forcibly contracted muscle that does not relax. Cramps can affect any muscle under your voluntary control (skeletal muscle). Muscles that span two joints are most prone to cramping. Cramps can involve part or all of a muscle, or several muscles in a group. The most commonly affected muscle groups are:
- Back of lower leg/calf (gastrocnemius).
- Back of thigh (hamstrings).
- Front of thigh (quadriceps).
- Cramps in the feet, hands, arms, abdomen and along the rib cage are also very common. Muscle cramps range in intensity from a slight tic to agonizing pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away.
Although the exact cause of muscle cramps is unknown (idiopathic), some researchers believe inadequate stretching and muscle fatigue leads to abnormalities in mechanisms that control muscle contraction. Other factors may also be involved, including exercising or working in intense heat, dehydration and depletion of salt and minerals (electrolytes).
STRETCHING & MUSCLE FATIGUE
Muscles are bundles of fibers that contract and expand to produce movement. A regular program of stretching lengthens muscle fibers so they can contract and tighten more vigorously when you exercise. When your body is poorly conditioned, you are more likely to experience muscle fatigue, which can alter spinal neural reflex activity. Overexertion depletes a muscle's oxygen supply, leading to build up of waste product and spasm. When a cramp begins, the spinal cord stimulates the muscle to keep contracting.
Heat, Dehydration & Electrolyte Depletion: Muscle cramps are more likely when you exercise in hot weather because sweat drains your body's fluids, salt and minerals (i.e., potassium, magnesium and calcium). Loss of these nutrients may also cause a muscle to spasm.
Just about everyone will experience a muscle cramp sometime in life. It can happen while you play tennis or golf, bowl, swim or do any exercise. It can also happen while you sit, walk or even just sleep. Sometimes the slightest movement that shortens a muscle can trigger a cramp.
Some people are pre-disposed to muscle cramps and get them regularly with any physical exertion. Those at greatest risk for cramps and other ailments related to excess heat include infants and young children, people over age 65, and those who are ill, overweight, overexert during work or exercise, or take drugs or certain medications. Muscle cramps are very common among endurance athletes (i.e., marathon runners and triathletes) and older people who perform strenuous physical activities.
Athletes are more likely to get cramps in the preseason when the body is not conditioned and therefore more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or the night after. Older people are more susceptible to muscle cramps due to normal muscle loss (atrophy) that begins in the mid-40s and accelerates with inactivity. As you age, your muscles cannot work as hard or as quickly as they used to. The body also loses some of its sense of thirst and its ability to sense and respond to changes in temperature.
DIAGNOSIS
THE EXAMINATION
There are no special tests for cramps. Most people know what cramps are and when they have one. If present during a cramp, the health care provider, or any other bystander, can feel the tense, firm bulge of the cramped muscle. Generally, people know what they are experiencing when they have a muscle cramp so they do not seek medical help to find out what they are and what caused them. However, sometimes muscle cramps are more serious and they are frequent, lengthy, and unbearably painful. If they are caused by an illness, rather than overexertion, the reason for them will need to be found.
Your health care provider will first do a physical examination and take your medical history. Let your health care provider know if you have been ill recently with vomiting, diarrhea, or fever. Anything that may cause dehydration is important information and should be shared with the practitioner.
You will be asked when the cramps began, how long have you been having them, how long they last, and what are you usually doing when they start. Other questions, such as are you pregnant, taking any medications (including over-the-counter and natural or herbal remedies), do you smoke, and how much alcohol do you drink, will be asked. Your health care provider will also need to know how much and how often you exercise.
Your health care provider will want to know exactly where the cramping is occurring. Let your health care provider know if there are any other types of pain that happen at the same time. Your health care provider will want to know if the cramps are always in the same place or if they occur elsewhere.
BLOOD TESTS
Blood tests are usually first since muscle cramping may be caused by dehydration and depletion of salt and minerals (electrolytes). Since pregnant women can be more prone to muscle cramping, a pregnancy test may be ordered for women along with other blood tests. Additional blood tests may be ordered to check if your thyroid and kidneys are working properly. Your thyroid is a small gland that is just below your voice box and is responsible for making and distributing hormones.
If the blood tests are all within normal range and negative for pregnancy, there are more tests that may be ordered. A vascular Doppler ultrasound uses ultrasound waves to make images on a screen. Using the Doppler (small machine), your health care provider looks to see if there are any blockages in the blood vessels.
NEUROLOGICAL TESTS
If your health care provider thinks there may be a neurological (nervous system), disorder causing the cramping. One test that may be done is called an electromyography (EMG). To perform an EMG, your health care provider will insert a needle into the muscle that has been cramping. The needle has an electrode that will relay to a recording device any electrical activity from your muscle. After the needle has been inserted, you will be asked to contract (flex, tighten) your muscle and then relax it.
A magnetic resonance imaging (MRI) scan may also be done. The MRI is a radiological test that uses magnetic waves and a computer to create pictures of the parts of the spine. To perform this test, you must lie in a tube for about an hour. No needles or dye are usually required. The machine takes pictures of the spine one slice at a time. It can do this in multiple directions. It allows the health care provider to see the bones and soft tissues of the spine - including the nerves. Your health care provider will be looking for anything that may show an injured disc, pinched nerve, or injured nerve that could represent a cause for the cramping.
DIAGNOSING SPECIFIC TYPES OF CRAMPS
Smooth Muscle Cramps: Smooth muscle contractions lie at the heart of the cramping (or colicky) pain of internal organs. These include the intestine, uterus, ureter (in kidney stone pain), and various others.
Menstrual Cramps (Dysmenorrhea): Menstruation is also highly likely to cause cramps of varying severity in the abdomen that may radiate to the lower back and thighs. Menstrual cramps can be treated with ibuprofen, acetaminophen or paracetamol, stretching exercises, or the application of heat through such means as warm baths or heating pads. Menstrual cramps that do not respond to self-treatment can be a symptom of endometriosis or other health problems.
Skeletal Muscle Cramps: Skeletal muscles are muscles that can be voluntarily controlled. Of the skeletal muscles, those which cramp the most often are the calves, thighs, and arches of the foot. These cramps are seemingly associated with strenuous activity and can be intensely painful.
Nocturnal Leg Cramps: Nocturnal leg cramps are involuntary muscle contractions that occur in the calves, soles of the feet, or other muscles in the body during the night or (less commonly) while resting. The duration of nocturnal leg cramps is highly variable with cramps sometimes only lasting a few seconds and other times several minutes. Soreness in the muscles may remain for some time after the cramp ends. These cramps are more common in older people but may happen to anyone. They can happen quite frequently in teenagers and in some people while they are exercising at night. Nocturnal leg cramps can be very painful, especially if the person is dehydrated.
The precise cause of these cramps is unclear. Potential contributing factors are believed to include dehydration, low levels of certain minerals (magnesium, potassium, calcium, and sodium), and the reduced blood flow through the muscles attendant in prolonged sitting or lying down. Less common causes include more serious conditions or the use of drugs.
Nocturnal leg cramps may be relieved by stretching the affected leg straight out and pointing the toes upward. People report that quickly standing up and walking a few steps may also shorten the duration of a cramp.
Nocturnal leg cramps (almost exclusively calf cramps) are considered to be 'normal' during the late stages of pregnancy. They can however vary in intensity from mild to incredibly painful.
CONVENTIONAL MEDICAL TREATMENT
Cramps are inevitable, but if possible, it would be best to prevent them. Since exercise-associated muscle cramping occurs most often in healthy individuals, the important issue is to control cramping frequency and intensity. This can be done through preventative measures, such as proper preparation and stretching, and ensuring adequate fluid intake before undertaking physical exercise or activity.
Some people are pre-disposed to muscle cramps and get them regularly with any physical exertion. Those at greatest risk for cramps and other ailments related to excess heat include infants and young children, people over age 65, and those who are ill, overweight, overexert during work or exercise, or take drugs or certain medications. Muscle cramps are very common among endurance athletes (i.e., marathon runners and triathletes) and older people who perform strenuous physical activities.
Athletes are more likely to get cramps in the pre-season when the body is not conditioned and therefore more subject to fatigue. Cramps often develop near the end of intense or prolonged exercise, or the night after. Older people are more susceptible to muscle cramps due to normal muscle loss (atrophy) that begins in the mid-40s and accelerates with inactivity. As you age, your muscles cannot work as hard or as quickly as they used to. The body also loses some of its sense of thirst and its ability to sense and respond to changes in temperature.
MEDICATIONS
Medicines are not generally needed to treat an ordinary cramp that is active since most cramps subside spontaneously before enough medicine would be absorbed to even have an effect.
In recent times, the only medication that has been widely used to prevent, and sometimes also to treat, cramps is quinine. Quinine has been prescribed for the treatment of leg cramps. Quinine acts by decreasing the excitability of the muscles. It has also been shown to be effective in many, but not all, scientific studies. However, quinine also causes birth defects and miscarriages. It has also occasionally caused hypersensitivity reactions and a deficiency of platelets, which are the blood components responsible for clotting. Either of these reactions can be fatal. Quinine is also associated with a cluster of symptoms called cinchonism (nausea, vomiting, headaches, and deafness).
Additionally, vision and heart irregularities can occur. Consequently, quinine tablets are not available in the United States. Quinine is available in grocery stores in tonic water. You can also obtain homeopathic quinine. However, because of the drug's risks, the United States FDA has declared quinine tablets should not be used to prevent or treat leg cramps. Consult your health care provider before taking quinine for muscle cramps.
There are some cases where health care providers may use Botox® to stop cramping in certain muscles. This is decided on an individual basis and depends on the cause and the impact of the cramping. In recent years, injections of therapeutic doses of botulism toxin (Botox) have been used successfully for some dystonic muscle disorders that are localized to a limited group of muscles. A good response may last several months or more, and the injection may then be repeated.
TREATMENT OF UNDERLYING MEDICAL CONDITIONS
Cramps that are associated with specific medical conditions or caused by an illness, their frequency and intensity may be affected by the treatment for the illness. Treatment generally focuses on treating the underlying condition and the cramps should subside if treatment of the illness is successful.
Some muscle cramps can be caused as a side effect of certain medications. If side effects from medication are causing the cramps, this may be avoided by changing or adjusting medications, dosage, or medication combinations when possible. Ask your health care provider if a change in your prescription medication may help. Do not change any of your prescription drugs or stop taking them without your health care provider's knowledge and approval.
Medications are generally not recommended or used for muscle cramps because of their side effects. Most muscle cramps are short-lived. By the time the medication has started working the cramping has already stopped. Sometimes, additional medications specifically for cramps are prescribed with certain of these conditions.
Of course, if cramps are severe, frequent, persistent, respond poorly to simple treatments, or are not associated with an obvious cause, then the patient and the health care provider need to consider the possibility that more intensive treatment is indicated or that the cramps are a manifestation of another disease. As alluded to above, the possibilities are extremely varied and include problems with circulation, nerves, metabolism, hormones, medications, and nutrition. It is uncommon for muscle cramps to occur as the result of a medical condition without other obvious signs that the medical condition is present.
In the case of cramps caused by varicose veins, treatment of the affected veins with sclerotherapy, endovenous laser or surgery usually provides relief.
STRETCHING
Because muscle cramps come on so quickly and suddenly, usually resolving just as fast as they came, the best treatment is prevention. Anyone who is about to do something strenuous or athletic should warm-up and stretch their muscles first. If you are moving furniture, digging up a garden, painting, or doing general maintenance that you are not used to, the muscles you will be using can get fatigued. By stretching them, this should be prevented.
It is also important to stretch correctly. Do not stretch quickly. Stretch slowly and hold each stretch for 30 seconds. Any shorter than 30 seconds and there is no benefit. There is also no benefit for holding it longer than 30 seconds. Some experts suggest that athletes continue to stretch daily. This may keep the muscles flexible. Also remember to stretch after the activity to allow the muscles to cool down.
The type of treatments required for muscle cramps depends on what is causing them. If you are having occasional muscle cramps from physical activity or overusing certain muscles, you can usually take care of the cramps yourself. Simply stopping the activity will stop the cramping. If the cramps continue, stretching the cramping muscle - although painful - should release the tension of the muscle. For example, if it is your calf muscle that is cramping, stand facing a wall or solid object that you can hold on to for balance. Standing about two to two and a half feet from the wall (possibly farther for a tall person) and lean into the wall to place the forearms against the wall with the knees and back straight and the heels in contact with the floor. Keeping your heel of the sore leg as close to the floor as possible, tilt your body (slowly) to the wall or object, stretching the calf muscle. If you are lying in bed when the cramping starts, you can try pointing your toes straight up towards the ceiling, or grab hold of your toes and pull your foot up towards you.
For writer's cramp (contractures in the hand), pressing the hand on a wall with the fingers facing down will stretch the cramping finger flexor muscles.
Most cramps can be stopped if the muscle can be stretched. For many cramps of the feet and legs, this stretching can often be accomplished by standing up and walking around. Learn stretching exercises at a time when you do not have muscle cramp.
See further down on this page for some helpful stretching techniques.
MASSAGE
Massage may help as well, although it can be painful as the knot is being worked out. Muscle cramps can be treated by applying a soft massage on the cramped muscle, stretching your hands up above you and breathing in deeply through the mouth, stretching the muscle and applying heat or cold. Pounding on a cramped muscle can increase soreness.
MoonDragon's Health Therapy: Massage
HOT & COLD THERAPY
Some people find that using ice packs can help relax the tense muscles, others have better luck with heat such as from heating pads, warming packs, even warm towels. Heat improves superficial blood circulation and makes muscles more flexible, so some people find that heat is more soothing for muscle cramps.
Be careful when applying ice or heat to a sore part of your body. Ice should never be held directly on the skin. Ice should always be buffered with at least one layer of cloth. Heating pads can get very warm and can cause burns, so be sure to monitor the heat level and keep a layer of fabric between the heat and the skin.
Application of excessive heat or cold to sore muscles may bring on cramps.
HYDRATION & ELECTROLYTES
For athletes who experience a lot of cramping good nutrition is important. Adequate fluid and electrolytes may help limit the cramping. This could mean meeting with a dietitian to discuss diet and eating habits.
If the cramp is associated with fluid loss, as is often the case with vigorous physical activity, fluid and electrolyte replacement is essential and can be treated by drinking water and/or increasing salt intake. Staying hydrated by drinking enough fluids, such as sports drinks (be sure to read labels carefully), to keep your body's electrolytes from depleting (especially sodium and potassium) is necessary to balance fluid loss - but do not overdo the fluids either. Finally, do not overdo the exercising, especially in hot weather.
There is no scientific evidence to support the widely held claim by the sports nutrition industry that intake of specially composed electrolyte drinks has any advantage over intake of plain table salt (via drink or food) and water to counter these electrolyte disturbances and muscle cramps in people with a well-functioning renal system.
Eating foods high in potassium can help prevent muscle cramps.
OXYGENATION & BREATHING
In the case of inadequate oxygenation, excess lactic acid, produced by anaerobic respiration, builds up and stresses the muscle. In addition to the methods described above, cramps from poor oxygenation can be improved by rapid deep breathing.
ACUPRESSURE
One enthusiastic non-scientific recommendation has been to firmly pinch the tissues above the lip, just under the nose, and hold the pinch until the cramp stops (said to be within 15 minutes.) Of course, why this might be effective is uncertain, and no scientific study of this technique has been reported.
SELF-CARE FOR MUSCLE CRAMPS
If you experience a muscle cramp, stop doing whatever activity triggered the cramp.
Gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
Apply heat to tense/tight muscles, or cold to sore/tender muscles.
To avoid future cramps, work toward better overall fitness. Do regular flexibility exercises before and after you work out to stretch muscle groups most prone to cramping. Always warm up before stretching.
Warm ups and stretching should be completed before attempting any exercise to lose weight or gain fitness. Take the time to warm up thoroughly and you should have a more effective workout.
BASIC STRETCHING EXERCISES TO PREVENT MUSCLE CRAMPS
CALF MUSCLE STRETCH
The calf muscle stretch is a standing lunge with both feet pointed forward, straighten the rear leg. (Repeat with opposite leg.) Excessive tightness of the calf muscles can contribute to many foot problems and some knee problems. The Achilles tendon attaches the calf muscle to the back of the heel. As the calf muscle tightens up it limits the movement of the ankle joint. When there is not adequate range of motion at the ankle during walking or exercising the foot joints are forced to move in an abnormal fashion. The foot is forced to flatten and the forces generated into the ball of the foot are extreme in nature. Over time, this repeated strain results in a variety of foot problems. The calf muscle has a natural tendency to tighten, as we get older. Exercise also causes the muscle to tighten.
Calf muscle stretching is very useful in the treatment of many foot disorders and for the prevention of foot problems. The typical runners stretch, by leaning into a wall, is helpful. An alternative method of stretching is to stand approximately two feet from a wall. Facing the wall, turn your feet inward so you are pigeon toed. Lean forward into the wall keeping your heels on the floor and the knees extended. Also keep your back straight and do not bend at the hips. Hold the stretch for 10 seconds and do the stretch ten times in a row. Do the stretching three times each day. Always stretch the calf muscles following any form of exercise. If the stretching causes pain it should not be performed. The stretch should be felt in the body of the muscle not in the Achilles tendon or the back of the knee. If you are unable to perform the stretch properly consult with a health care provider or physical trainer.
HAMSTRING MUSCLE STRETCH
The goal with the hamstring stretch is not to be able to touch the toes, foot, or ankle, but to be able to feel a gentle stretch in the back of the leg while keeping the knee straight- if you do this stretch with your foot against a wall, it will help to stretch your calf muscle also.
The hamstring stretch targets the hamstring muscles which are located at the back of the thighs and is used to warm-up the upper legs. A hamstring stretch is particularly important if you intend to run to lose weight. If you start running three times per week then you will need to make sure you are warmed-up thoroughly before starting, for this reason you will definitely need to do lots of hamstring stretches. Another version of the hamstring stretch is one where you bend over to touch the toes, this is a much more common stretch. This version as it allows you to wiggle the foot around at the same time helping to loosen up the ankle joint.
Be careful not to over-stretch when warming up the hamstring muscles. Over-stretching can put too much stress on the back of the knee.
Sitting Hamstring Stretch: Sit with one leg folded in and the other straight out, foot upright and toes and ankle relaxed. Lean forward slightly, touch foot of straightened leg. (Repeat with opposite leg.)
Lying Down Hamstring Stretch: Start by lying on an exercise mat with your knees bent, your feet together and flat on the floor. Lift your right leg so that it is almost perpendicular to the floor. If possible try to slowly lock the knee joint at this point, if that is easy then reach up with both hands and hold the leg in position for 20 seconds. If that is also easy, slowly pull the leg an inch further towards your head and hold. Do this until you feel a slight stretch at the back of the hamstrings or knee joint then stop. As soon as you feel any stretch stop and hold for the count, unless you feel pain at any time, in this case stop the stretch immediately. After the right leg repeat the same technique for the left leg.
Standing Up Hamstring Stretch: Start by lifting leg into a 90 degree angle from the floor onto a stable support. Bend from lower back towards lifted leg, keeping the knee straight. This stretching exercise works the lower back and the hamstring.
QUADRICEPS MUSCLE STRETCH
The thigh stretch is a popular warm-up stretch for the thighs or quadriceps muscles of the upper legs. It also helps loosen up the knee joint increasing its range of motion. In fact this stretch is often used to help people with knee problems. The Quadriceps muscles are used heavily during weight-bearing exercise so the thigh stretch should be performed before any walking or jogging exercise to lose weight.
Stand near a wall or secure structure for support while performing this stretch. Stable yourself with the right hand while gently lifting the right foot behind your back towards the buttocks. Using the left hand reach and grab the right foot, hold the foot firmly. Stand straight with the thighs pointing down to the floor, and gently push the foot further towards the lower back until you feel the slight stretch in the quadriceps or thigh muscles of the upper right leg. Hold the stretch for 20 - 30 seconds, then release. Swap to the opposite side and repeat the thigh stretch for the left leg. If you struggle with this stretch then just try to hold the foot behind the back and do not push any further. This should be a fairly easy stretch but if it hurts at all stop doing it! Never stretch to the point of pain.
HIP STRETCH
You should start off stretching by only doing the basic, easy stretches. Once you have gained confidence, experience and lost weight then it may be the best time to try out more complex stretches like the hip stretch shown below.
Standing Hip Stretch: In a standing position, straighten the hip. The moment you tuck the bottom of the hip under to straighten the hip, you will feel the stretch move to the front of the hip. If you use the lunge for bending and leg exercise, keep the hip tucked and vertical as you lower and you will feel a far better stretch and strengthener. One way to do the hip tuck is to put your hands on each hip, thumbs in back, fingers in front. Roll your hip down in back so that your thumbs roll down in back. The front of the hip and upper leg will feel very good when you do this right. You will feel the large arch reduce and the front of the hip stretch. The front of the hip is an area often overly-maintained in bent and shortened position from hours of sitting, then exercising with the hip still bent, as in the top-left photos. Do not push the hip forward, just tilt the bottom under until vertical.
Hip Flexor Stretch: This is a very good stretch for the muscles around the hip area. The hip joint is involved in many different exercises and it's important that this area is fully warmed up and ready for any stress. This is a great stretch to do if you wish to perform squats in order to increase the metabolism to burn fat. Although it is a complicated stretch so you should perform this for the first time under the guidance of a qualified instructor.
The hip stretch should be performed with the shoulders flat on the ground. Bring one knee towards the shoulder of the same side and slowly place the flexed leg over the other leg, resting the inside of the leg on the thigh of the relaxed limb. Gently push down on the knee of the bent leg. This exercise isolates the upper hip flexor group. You will feel a gentle pull on the outside edge of the hip; if your entire body starts to twist and your shoulder or pelvis on the side that you are stretching comes off of the ground, you are stretching too far.
Hip Joint Stretch: From a standing point start this stretch by taking a long, single stride with your right leg. Slowly lower your upper body by using the right thigh to take most of the strain, place your hands on your right knee before lowering. As you lower keep the left leg lagged behind and feel for a slight stretch at the front above the quadriceps muscles. Once you feel the stretch hold the position for 10-20 seconds. Finish by drawing the left leg towards you so you can balance your body weight using both legs. Repeat the process to stretch the left hip side.
BUTTOCK STRETCH
This stretch loosens the buttocks, lower back muscles and hamstrings. It can be completed within a minute or two so it is fairly good to do if you are in a hurry. Do not strain during this stretch, and do not hold your breath. Try to relax all leg and back muscles and this stretch will feel easier.
Using a soft mat or carpet lie down on your back and gently pull your left leg towards your chest. Keep the right leg straight. Grasp your hands together and hold the knee in this position for 20 - 30 seconds. Repeat for the right leg.
LOWER BACK STRETCH
This is a sitting and leaning over stretch for the lower back, although it does help stretch all the other back muscles and the spine. Some may call it the spine stretch. It is a good stretch for warming up for the lower back when it's about to be put under strain; such as doing heavy weight exercises like squats or dead lifts. Some people may not even feel a stretch when doing this, however, it is still good for the circulation and to take the strain off the lower back.
Start by sitting on a strong, secure chair. Lift your arms up in front of you and slowly bend down and gradually reach for your feet. Try to feel for the stretch in the lower back area while holding this position for about 20 seconds. If this is easy you can try positioning the feet further away at the start of the stretch. Bending over with your feet further away will cause more stretch in the whole back.
Take care if you have problems with your back, if in doubt do not try this stretch!
Upper back lat stretch is another great stretch for the lat muscles of the back. This also helps loosen the shoulder joint preparing it for exercise. Another good point to this stretch is that the wrists get stretch a little as well. Good for when training the back muscles such as a rowing movement.
You can stand or sit to do this stretch. Start by interlacing your fingers, then turn the palms upward above your head as you slowly straighten your arms. It easier to arch the lower back slightly as the arms are nearly straight. Once you feel a slight stretch in the arms, shoulders or upper back the hold the position for 20 seconds. Again do not force anything and try not to hold your breath when stretching.
NECK STRETCH
The neck stretch and relax technique can be done before exercise but could also be done every day, especially if working on a computer all day. This stretch can help relieve everyday stresses and strains, and help through headaches. Although you should be careful if you have any neck problems at all.
Sit down on a comfortable chair and relax the shoulders. While breathing deeply let your head drop down slowly forwards until you feel the muscles in the back of the neck pull slightly. Hold this position for 10 seconds, then return back to the start. Push your head backwards slowly until you feel a slight stretch in the front of the neck, again hold for a count of 10. Return back to the start. Now repeat the process for the sides of the neck. Once completed you can try lowering the head again but this time roll the head around slowly three times, keep a straight back and breath deeply at all times.
Do not strain and be careful not to force the stretches in the neck, make sure this stretch is easy!
SHOULDER & TRICEPS STRETCH
The shoulder and triceps stretch is a great shoulder stretch that does two muscles at the same time. It stretches the posterior deltoid muscle (back head of shoulder), and the triceps muscles (back of the arm) together. This stretch will really loosen up the shoulder joint. It is ideal when doing heavy weight training for the upper body. This is much the reverse stretch to the chest stretch, which does the front shoulder head and the biceps. This one does the back shoulder and triceps. For this reason if you are pressed for time then they are probably going to be best for upper body warm up before exercising.
Start by lifting your right arm up in the air but keep the biceps close to the side of your head. Gently bend the right arm until your hand is comfortably touching the back of the neck. Using your left hand, hold the elbow of your right arm and gently pull the elbow backwards, pretend you are trying to get the elbow behind the head but you only want to pull a tiny bit. Stop pulling as soon as you feel the stretch in the shoulder or arms, hold this position for 20 - 30 seconds. Now repeat for the left arm.
This is a complicated and tough stretch so you should perform this stretch under the guidance of a qualified instructor. If you are not very flexible in the shoulders and struggle to get in the starting position the do the other shoulder stretch instead.
CHEST STRETCH
The chest stretch with hands behind the back is a great stretch for the chest, front shoulder and bicep muscles. It can help warm up most of the upper body in one, thus if short on time then the chest stretch is one with should be performed more than any other upper body stretch. Use this stretch as part of a warm-up routine rather than trying to increase flexibility.
You should not try to push this stretch too far, too soon. Start off with the hands closer to the buttocks, as it becomes easier over the weeks you can slowly try to move the hands up a little at a time. Remember though, always remain within a comfortable stretch area for the chest stretch.
Start in a seated or standing position. Using both hands reach around to your back until the hands meet in the middle. Grasp both hands together by interlocking the fingers, at this point the elbows should be unlocked. Now slowly push the shoulders back and straighten the arms until the elbows lock out - stop the stretch completely if you feel pain at any time! You should feel it pull slightly in the chest and maybe the arms. Hold the stretch for 20-30 seconds. Now gently unlock the elbows before releasing the hands.
If this stretch is easy then try to gently lift the hands upwards until you feel a slight stretch in the chest, shoulders or arms. The chest stretch can be tough so I would advise you perform this one under the guidance of a qualified instructor.
ANKLE STRETCH
This is less of a stretch and more of a movement to help loosen up the ankle joint during warm-up. The ankle joint is subjected to a large number of impacts during many weight-bearing exercises, therefore this warm up technique is ideal if you intend to run or jog for an aerobic or cardio workout.
Sit down on a comfortable, sturdy chair and lift the right leg up with the knee pointing outwards. Grab hold of your leg with your right hand just above the ankle joint. Using your left hand hold the bottom of your right foot firmly. Now pull the foot slowly towards your stomach area while relaxing the right ankle joint and foot, hold for 5 seconds. Now gently push the foot the opposite way, again hold for 5 seconds. Now rotate the ankle around clockwise in a slow and gentle manner. Repeat for the left ankle joint.
GROIN STRETCH
The groin stretch is an easy stretch exercise to do for warming-up the groin area before any weight loss exercise. It can be done in front of the TV at home and will take less than a minute to complete. The groin is one area many people forget to warm up before exercising. It is important to warm up this area thoroughly before exercise as any injury to the groin can be fairly painful, and may cause you to stop training resulting in less calories burned.
Sit comfortably on a soft exercise mat or carpet. With your knees pointing outwards put the soles of your feet together and hold onto your toes. Rest your elbows around the shin area in line with the lower legs and make sure you feel stable. Gently pull yourself forward, bending from the hips until you feel a little stretch in the groin area. Do not bounce to stretch and try to keep the back straight at all times. Hold the stretch for 30 seconds.
If you find it difficult or painful just to put your soles together then do not do this groin stretch.
STRETCHING & HYDRATION
To prevent cramps, you should also keep your body adequately hydrated. Children especially often do not drink enough liquids to replenish fluid lost during exercise. Some tips:
- Drink water at regular intervals, before you get thirsty.
- Drink more than your thirst requires.
- Drink fruit juice or a sports beverage if you are working in heat or sweating for more than an hour.
Always consult a health care provider prior to starting any type of exercise or activity program. The stretches given above are only a few of the many exercises that are available. Warming-up and stretching is important to prevent injuries during any type of athletic activity. When beginning a activity program, learn to do these stretching exercises from a qualified professional to prevent injury.
PROGNOSIS
Medical considerations aside and although cramps can be a great nuisance, most muscle cramps are not serious and are considered a benign condition, but they are a real pain. Cramps usually go away on their own without seeing a health care provider. Their importance is limited to the discomfort and inconvenience they cause, or to the diseases associated with them. Careful attention to the preceding conventional and following holistic recommendations will greatly diminish the problem of cramps for most individuals. Those with persistent or severe muscle cramps should seek medical attention.
SEEKING MEDICAL ADVICE
Although most muscle cramps are benign, sometimes they can indicate a serious medical condition. Check with your health care provider if you have frequent or unusually severe muscle cramps that do not appear to be associated with exercise or do not improve with stretching and massage. Muscle cramps in the legs that come on with exercise can be a sign of a more serious condition called intermittent claudication due to poor circulation of blood to the legs, problems with nerves, metabolism, hormones, medications or nutrition. Muscle cramps may be a minor part of many conditions such as Lou Gehrig's disease (amyotrophic lateral sclerosis), spinal nerve irritation or compression (radiculopathy), hardening of the arteries, narrowing of the spinal canal (stenosis), thyroid disease, chronic infections and cirrhosis of the liver.
HOLISTIC, NUTRITIONAL & HERBAL RECOMMENDATIONS
CONSIDERATIONS
Using creatine, actually creating monohydrate, a popular supplement with athletes and body builders, may increase the likelihood of muscle cramps. Caution: Using creatine along with cimetidine (Tagamet), NSAIDs such as ibuprofen, and/or diuretics also can cause kidney damage.
Hydrotherapy (the therapeutic use of water, steam and ice) or massage therapy (manipulation of muscles and other soft tissue) may be helpful in controlling muscle cramps.
Gabapentin (Neurontin), a drug that is used for the treatment of epilepsy, and may be used for bipolar mood disorder by some health care providers, is under study for its ability to relieve muscle cramps. Oddly, however, documented side effects of this drug can include muscle ache or pain (in addition to blurred or double vision; dizziness, drowsiness; swelling of hands, feet, or lower legs; trembling or shaking; and unusual tiredness or weakness). Until the results are known, it is generally recommended to avoid this drug.
Acute muscle spasms in the back are oftentimes triggered as a result of injuries, but chronic attacks can also result from curvature of the spine (scoliosis), age-related degenerative disk disease, and/or spinal alignment problems. Osteopathic / chiropractic adjustments, physiotherapy, muscle relaxants, needle acupuncture, needle-less electro-acupuncture or electro therapy are common treatment options, depending on the type of medical system one is most comfortable with.
Nutritional imbalances, such as abnormal mineral ratios, are also capable of affecting spinal alignment, or they can even lead to scoliosis over time (and subsequent muscle cramps and spasms), in which case drug therapy or frequent visits to a chiropractor, physiotherapist, or acupuncturist can become frustrating, since the therapy will not last. However, once a nutritional balance is re-established, the spine is less likely to go out of alignment and trigger muscle spasms, cramps, and/or other health problems.
"Sleep Starts" (myoclonic or hypnagogic jerks) describes a type of involuntary muscle jerking that takes place just before drifting off to sleep. While felt by most people at some point in their lives, these sudden muscle twitches or jolts do not generally interfere with someone's sleep unless they occur on a regular, nightly basis. When they start to take place seconds apart, they will seriously affect a person's ability to fall, or remain asleep. Some individuals experience shorter bouts that only last a few weeks, however other people are less fortunate and may suffer "sleep starts" for several months, or on an ongoing basis.
There are some known medical conditions associated with myoclonus, including brain or spinal cord injury, Parkinson's disease, Tourette syndrome, multiple sclerosis, stroke, epilepsy, drug or chemical poisoning, organ damage, and others, however "sleep starts" is considered to be a type of 'Periodic Limb Movement Disorder' that as of yet lacks a specific medical cause or has a known relationship to a specific medical condition, although females are affected more than males, partly due to monthly hormonal fluctuations that seem to aggravate this condition around the time of their menstrual cycle.
Standard treatments for "sleep starts" consist of clonazepam therapy (a benzodiazepine type of tranquilizer), which - while able to help the symptoms, invites the usual long-term dependency this class of drugs is known for. Some patients require additional drugs or drug combinations that may include barbiturates, sodium valproate, phenytoin, or primidone.
Unfortunately, nutritional approaches that are helpful for conventional muscle spasms and cramps do not offer any benefits for most types of myoclonus, however Taurine in the dosage of 1,500 mg to 2,000 mg plus per day range is found to be somewhat helpful for "sleep starts," provided reasonable care is taken at the same time to avoid stimulants such as alcohol, caffeine, and excessive intake of white sugar, which are known to worsen symptoms.
MENSTRUAL CRAMPS
Cramps are also present in that ever-trying menstrual period in women. During the time when hormones fluctuate, the uterus contracts, and there is increased activity in the uterine muscles, both in terms of the frequency of contractions and contractility. Like normal cramps, there are certain things women can do to ease or get rid of their menstrual cramps during their menstruation cycle. Get an over-the-counter pain reliever. Pain relievers with ibuprofen or aspirin can help in relieving the pain of menstrual cramps. There are also medicines specifically made for menstrual cramps, such as Midol or Pamprin. Be sure that you only get the correct dosage, though; when in doubt, consult your health care provider. Taking more than the recommended dose can cause damage to your liver and stomach lining.
Raise your endorphin levels: exercise. Do not engage in anything serious or hectic, though. Just light exercises will do. Yoga stretching or a light cardio exercise can get the blood pumping and stretch out your tense muscles. The activities will also cause your body to release endorphins, which are usually associated with pain relievers.
You can also do an exercise to stretch your pelvic muscles. Stand with your legs spread far apart, beyond the shoulder width, forming a triangle. Bend sideways to reach your ankle with the corresponding hand while holding your other arm up in the air. Continue doing this several times.
Drink herbal teas and water. As mentioned before, proper hydration will keep your muscles from cramping easily. Hydration will also keep you feeling well, even if bloated. The tea also has herbal elements that can help relieve some of the menstrual pain you are feeling, along with the satisfying warmth of the liquid itself.
Apply heat compress. Usually, the parts of the body that are most affected by menstrual cramps are the lower back and the abdomen. Applying a heat compress directly on them will help you deal with the pain. Saunas as well as a hot bath are also effective methods.
As always, it is better to just prevent cramps from developing (unless it's the menstrual kind, in which case, you will get it no matter what you do). Keep yourself properly hydrated, but most important of all, do some stretching before you engage in any strenuous or unaccustomed physical activity. The key is to condition your muscles, preventing them from being caught unawares.
DIETARY & LIFESTYLE RECOMMENDATIONS
Eat Alfalfa, Brewer's Yeast, plenty of dark green and leafy vegetables, cornmeal, and Kelp.
Herbal Remedies: Alfalfa Information
Herbal Remedies: Alfalfa Supplements & Products
Herbal Remedies: Kelp Information
Herbal Remedies: Kelp Supplements & Products
Herbal Remedies: Brewer's Yeast Information
Herbal Remedies: Brewer's Yeast Supplements & Products
Drink plenty of fluids such as quality water, fresh juices, herbal teas and vegetable broths to prevent dehydration, replenish lost water and electrolytes and flush the symptom clean. Drinking plenty of fluids (the recommended eight glasses of quality water per day is a minimum for most people) will help replenish any fluid you may have lost if the cramp is due to dehydration. Take a large glass of quality water to flush out toxins stored in the muscles. Do this every 3 hours throughout the day. Fluids will help your muscles relax and will keep the cells hydrated. You may also need to drink a solution that contains electrolytes, as electrolytes are not found in water.
Have a balanced diet. If you are lacking calcium, magnesium, or potassium, eating or taking foods rich in them will ensure that you are getting your daily recommended dietary allowance for the said minerals. Calcium is present in milk, while beans and spinach are rich in magnesium. Apricots, bananas, and raisins can supply you with your potassium needs.
If you are on diuretic medication for high blood pressure or a heart disorder, be sure to take supplemental potassium daily. Note: Do not take supplemental potassium if you are taking a potassium-sparing diuretic. Discuss this with your health care provider.
NUTRITIONAL IMBALANCE & SUPPLEMENTS
Provided there are no neurological or neurodegenerative causes such as multiple sclerosis, cerebral palsy, stroke, or spinal cord injury - extra Calcium is usually the solution for muscle spasms or muscle cramps in many nocturnal cases. The extra requirements for calcium may be a result of high protein or phosphate levels (kidney disease, poor diet), hormonal diseases or imbalances, nutritional imbalances (high magnesium (Mg)/calcium (Ca) ratio, low pantothenic acid), celiac disease or other intestinal conditions that interfere with calcium absorption, prescribed medications that promote calcium loss, random self-supplementation of the wrong vitamins and minerals, and others. Since calcium is quite low in ratio to magnesium, supplementing 500 mg of elemental calcium per day quickly resolved the problem - but only symptomatically.
When High Calcium is suspected but no resources are available to measure cellular calcium levels (serum calcium cannot be used for that purpose), an acidifying approach may be tried such as taking a very large amount of Vitamin C for a few days. If the muscle spasms or cramps get worse, then at least one can assume that calcium was likely on the low side, and one needs to increase its dietary intake, and/or use calcium supplementation.
If on the other hand the muscle cramps or spasms improve, then calcium is likely too high and requires co-factors to make it more bioavailable by supplementing either Magnesium, or a phosphorus source such as Lecithin, a higher daily intake of Vitamin C, or one could increase one's protein intake as another option.
The right strategy of course was to raise Sodium, since continuing to supplement calcium would in time only lead to a greater increase in cellular magnesium (unless potassium is very high also), which in turn would lower sodium even more and result in all sorts of additional medical problems. While using extra salt would work in some individuals, it will generally not work with low-aldosterone types (whose sodium levels are chronically low - even with high sodium intake), so supplements such as Choline Bitartrate are indicated instead to raise sodium levels, which in time will lower magnesium and thus normalize an individual's Ca/Mg ratio also. In the above case, silicon / silica (which also inhibits magnesium), was another very important addition.
Sodium Carbonate (baking soda) or Sodium Citrate ("Eno") can be helpful for low sodium-related muscle cramps and spasms as well. They, or similar buffering agents are used by some athletes to combat muscle fatigue and to increase performance by raising muscle and plasma pH, however when increasing recommended amounts from 0.3 g per kg of body mass to what some trainers consider to be an optimal intake of 0.6 g per kg, the risk increases to induce muscle spasms, stomach cramps, and/or a variety of other side effects.
Once it is established that calcium and/or magnesium are needed, then the mineral type should be matched to stomach acid levels. If they are high, then calcium / magnesium "carbonate" is preferable, and when low, "citrate" is better. Carbonate is also generally better with a tendency for diarrhea, and citrate is generally better with a tendency for constipation.
Since low calcium and/or low magnesium-induced muscle spasms or cramps go hand in hand with disturbances of bone mineral metabolism, it may be worthwhile to consult a medical practitioner and be evaluated for other possible medical problems such as Osteopenia or Osteoporosis, whereby additional supplements such as Vitamin D, or other dietary adjustments may be indicated.
Those suffering from leg cramps that are due to insufficient potassium intake should be aware of - or at least use their symptoms as a warning sign - that ongoing low potassium levels increase the risk for Cardiovascular Disease and/or Stroke.
One-sided leg cramps or spasms can help with the decision of what to supplement, whereby the left side is usually indicative of calcium, while the right side is generally an indication of magnesium being needed, although some individuals require a calcium / magnesium combination for relief as a result of both being low. If right-sided muscle cramps respond to calcium (rather than to magnesium or other acidifying strategies), then dehydration is suspect, and extra sodium may be additionally required.
While electrolyte or other nutritional imbalances can be a cause or contributing factor for toe spasms or cramping of one's toes also, if one never experiences spasms or cramps in other parts of the body, then they may occur as a result of poor circulation, wearing tight shoes, or sitting in a particular position (car, plane, theater) for longer periods of time. Briefly exercising one's toes, or taking a short walk usually provides relief and resolves the problem.
LACTIC ACID
Consuming foods or beverages containing Lactic Acid is another acidifying strategy to reduce muscle cramps when working out, despite the buildup of lactic acid in muscle tissue during strenuous exercise being actually a common cause of muscle spasms or cramps. This happens from insufficient oxygen not being able to oxidize lactic acid, which would otherwise get rid of it from muscle. Inosine and Creatine supplements also help to reduce the buildup of lactic acid in muscle.
As exercise tolerance increases from repeated training, it takes increasingly longer before lactic acid is produced in muscle, so there is less of a chance of muscle cramps to develop. Lactic acid is found in a number of foods and beverages, and it is also commercially added to increase their acidity (such as olives, sauerkraut, cheese, beer, soft drinks, pickles). Lactic acid-containing drinks can serve as a valuable fluid replacement for athletes before, during, and after competitive training and exercise.
If poor circulation causes muscle cramps, Vitamin E might be a good choice for its blood-thinning and vasodilating properties. (See Nutrients further down on this page for recommended dosages).
Gingko Biloba also provides a blood-thinning effect and may be considered.
Herbal Remedies: Ginkgo Information
Herbal Remedies: Ginkgo Supplements & Products
Warm up before intense exercise, and cool down and stretch afterward. Avoid overworking your muscles.
Before going to bed, gently stretch the muscles that tend to cramp during the night.
Massage cramping muscles and use heat to relieve pain. Rub pure, unprocessed Olive or Flaxseed Oil into your muscles before and after strenuous exercise. Add 25 drops of oil to a hot bath and soak. Canola Oil is also good for this purpose.
Herbal Remedies: Flaxseed Oil Supplements & Products
Apply a warm or cold compress. If the cramp is due to muscle overuse or from a sports injury, then apply a cold compress on the area around the cramp, not on it. A warm compress after the swelling has subsided will promote the circulation of blood in the muscles and ease the pain. Use hot towels, hot water bottles, and ice packs with caution.
Take a hot bath using minerals salts before bedtime to increase blood flow during the night.
Herbal Remedies: Epsom Salts - Bath Salts Supplements & Products
If you have cramps during the day, while you are active, consult with a health care provider. This can be a sign of impaired circulation or arteriosclerosis.
If cramping occurs after walking and is relieved when you stop, suspect impaired circulation. See the link below and take the Artery Function Self-Test.
HERBAL RECOMMENDATIONS
Alfalfa, Bayberry, Blessed Thistle, Cayenne, Dong Quai, Echinacea, Elder Flower, Elderberry Extract, Garlic, Ginkgo Biloba, Horsetail and Saffron are good for circulation.
Horsetail, Meadowsweet, Valerian, and Skullcap help to relieve muscle cramps.
Rubbing Lobelia extract on the affected area helps to relieve muscle cramps. Homemade Lobelia Extract can be made by taking 4 ounces of dried Lobelia and putting it in a glass jar and cover with 100 proof vodka. Tightly seal with lid. Store in dark cool place and shake daily for 6 weeks. Strain and store in brown glass bottles and use as necessary.
Taking Valerian root at bedtime helps to relax the muscles. You can purchase the capsules or you can make your own using dried root, ground fine using a pestle and mortar or a hand held coffee grinder and make your own capsules by using empty gelatin caps. Store prepared capsules in a tightly sealed glass bottle in a cool, dark place or make a tincture using the recipe above for the lobelia. It is easy and much less expensive than purchasing them ready made.
Herbal Remedies: Alfalfa Supplements & Products
Herbal Remedies: Bayberry Supplements & Products
Herbal Remedies: Blessed Thistle Supplements & Products
Herbal Remedies: Cayenne Supplements & Products
Herbal Remedies: Dong Quai Supplements & Products
Herbal Remedies: Echinacea Supplements & Products
Herbal Remedies: Elderberry Supplements & Products
Herbal Remedies: Garlic Supplements & Products
Herbal Remedies: Ginkgo Supplements & Products
Herbal Remedies: Horsetail Supplements & Products
Herbal Remedies: Lobelia Supplements & Products
Herbal Remedies: Meadowsweet Supplements & Products
Herbal Remedies: Saffron Supplements & Products
Herbal Remedies: Skullcap Supplements & Products
Herbal Remedies: Valerian Supplements & Products
NUTRITIONAL SUPPLEMENT RECOMMENDATIONS
The following nutrients are important for healing once appropriate local treatment has been administered. Unless otherwise specified, the following recommended doses are for those over the age of 18. For a child between 12 and 17 years old, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended amount.
MUSCLE CRAMP SUPPLEMENTS & PRODUCTS
Information, supplements and products for muscle cramps, the pain that occurs when a muscle contracts but does not extend back into its normal position after use.
Alive! Whole Food Energizer, Multi-Vitamin & Mineral With Naturally Occurring Iron (No Iron Added), Nature's Way, 90 Tabs
No other supplement contains more life-giving nutrients than Nature's Way Alive Multi-Vitamin. Alive Multi-Vitamin is better absorbed into your blood stream because its tablets disintegrate up to 5X faster than other leading brands.Angelica Root Tincture, 2 fl. oz.
Angelica Root is generally used as a stimulating herbal expectorant.Arth-X Platinum, Natural Arthritis Supplement For Bone & Joint Pain & Stiffness, Trace Minerals, 90 Tabs
Arth-X Platinum is the most complete and effective dietary supplement and may be a good Natural Arthritis Treatment for you to support and aid in the relief of bone and joint pain and stiffness.Ashwagandha, Promotes Vitality & Strength, Banyan Botanicals, 90 Tablets
Ashwagandha is one of the most highly regarded and commonly used adaptogens in the Ayurvedic pharmacopoeia. Maximizing the bodies ability to resist stress, it enables the body to reserve and sustain vital energy throughout the day while promoting sound, restful sleep at night.Blessed Thistle Tincture, 2 fl. oz.
Helps nursing mothers by stimulating the mammary glands and helps to increase breast milk supply.Blue Skullcap (Scutellaria Lateriflora), Standardized, Nature's Way, 100 mg, 60 VCaps
Skullcap is most commonly used as a sedative and it can take the edge off anxiety and promote sleep for those who struggle with insomnia.Blue Vervain Tincture, 2 fl. oz.
Blue Vervain is used to treat jaundice, asthma, congestion, bronchitis, colds, fever, and flu.Butcher's Broom Root, Nature's Way, 470 mg, 100 Caps
Popular in Europe for improving circulation in the legs, Butcher's Broom Root contains a mixture of steroidal saponins which produce a vasoconstrictive effect.Calcium Ionic Mineral Supplement, Fully Absorbable, 700 +/- ppm, 16 fl. oz.
WaterOz Ionic Calcium is a pure liquid Calcium supplement. Calcium is one of the most essential of the major biochemical elements needed in human nutrition. It is needed in every organ of the body, including the brain. Calcium is called the "knitter" because it promotes healing or knitting everywhere in the body. It is valuable for tone, power, strength, longevity, vitality, and endurance, healing of wounds, counter-acting acids, and helping regulate metabolism.Cal-Mag Pre-Chelated Calcium & Magnesium, Vital Earth, 240 GelCaps
Cal-Mag is pre-chelated to boost absorbability by 40% to 50%. Also this formula contains the 3 most absorbable forms of calcium: Aminoate, Glycinate, and Citrate/Malate, plus the additional components necessary to create essential co-factor reactions for maximum uptake, utilization, and assimilation. 240 Gelcaps-one month supply.Calming Tea With Organic Chamomile, For Daily Stress Relief, Yogi Tea, Caffeine Free, Certified Organic, 16 Tea Bags
Calming tea by Yogi Tea is a safe and time-tested Ayurvedic formula designed to ease stress and tension, encouraging a state of relaxed alertness without drowsiness.Catnip Oil, 2 fl. oz.
Catnip oil was recently found to be an effective insect repellent when used on the skin. Some people use the leaves in tea, as a meat tenderizer and even as a folk treatment for fevers, colds, cramps and migraines.Celery Seed Tincture, 2 fl. oz.
Celery seed, an arthritis herbal remedy, also has an ancient reputation for treating muscle spasms, high blood pressure, gout, sleeplessness, depression, and anxiety.Chamomile Tea, Caffeine Free, Yogi Tea, Certified Organic, 16 Tea Bags
Organic Chamomile tea by Yogi Tea with its subtle fragrance and flavor, is a great way to ease your daily tensions.Chamomile Tincture, 100% Organic, 2 fl. oz.
Chamomile is a gentle relaxer that soothes upset stomachs and gas pain.Chaparral Tincture, 2 fl. oz.
Chaparral protects against the harmful effects of radiation, sun exposure, and the formation of tumors and cancer cells.Chlorofresh Chlorophyll Supplement, Nature's Way, 50 mg, 90 Softgels
Chlorofresh, Chlorophyll Supplement, is used chiefly as an aid to reduce odor from a colostomy or ileostomy and to reduce fecal odor due to incontinence.Chlorofresh Liquid Chlorophyll, Mint, Nature's Way, 16 fl. oz.
Chlorofresh is a special liquid chlorophyll complex, derived from premium alfalfa leaves.Chlorofresh Liquid Chlorophyll, Natural, Nature's Way, 16 fl. oz.
Chlorofresh is a special liquid chlorophyll complex, derived from premium alfalfa leaves. Chlorofresh is used chiefly as an aid to reduce odor from a colostomy or ileostomy and to reduce fecal odor due to incontinence.Cinnamon Tincture, 100% Organic, 1 fl. oz.
Cinnamon bark is warming to the body, an analgesic, carminative, antiseptic, and antibacterial.Colon & Liver Cleanser, Truman's CAC Tea, Loose Leaf, 1/2 lb.
Use of this cleansing tea has many additional benefits: improves overall digestion; strengthens the immunity; helps to prevent cancer; makes the skin more emollient and flexible: clears the eyes; and provides an overall tonic effect on the body.Comfrey Leaf Powder, 4 oz. Bulk
One of the most well-known healing plants, especially for its ability to heal tissue and bone.Comfrey Leaf Tincture, 2 fl. oz.
Comfrey contains allantoin, which promotes the growth of connective tissue, bone, cartilage, and is easily absorbed through the skin.Coral Calcium (Okinawa) Plus With Magnesium & Vitamin D, 100% Natural, NOW Foods, 500 mg, 100 VCaps
Okinawa Coral Calcium Plus with Magnesium, Vitamin D and 70 other trace minerals provides essential minerals, restores body alkalinity, supports the immune system, and is bio available for better absorption.Cranberry Extract Standardized, Vegetarian Supplement, 400 mg, 120 VCaps
Cranberry Extract with Ester is primarily useful those with chronic or recurrent urinary tract infections by inhibiting the adhesion of E. coli bacteria to the lining of the bladder.Cranberry Extract Standardized, Vegetarian, Nature's Way, 400 mg, 120 Tabs
When you take Nature's Way cranberry extract, you can enjoy the benefits of cranberry without the added calories or sugar of a fruit juice.Dandelion Root (Taraxacum Officinal) Powder, 4 oz. Bulk
Dandelion root is known as a Blood purifier used for liver and kidney disorders. Dandelion root also contains nutritive salts to build up the blood.Digestion Essentials, Ultimate Digestion Formula, Peter Gillham's Natural Vitality, 120 Tabs
Digestion Essentials is a superior formulation of digestive enzymes along with digestive acids. Digestion is a vital process necessary for the breakdown and absorption of nutrients needed for basic health.Dong Quai (Tangui Ladys), Organic Herbal Tea, 20 Tea Bags
For maintaining normal gynecological functions, to regulate female hormone, cycles, alleviate cramps and mid-life hot flashes, and to prevent hair loss.Dong Quai Root (Angelica Sinensis) Powder, 4 oz. Bulk
Dong Quai root (Angelica sinensis), referred to as the 'female ginseng', is rich in vitamins and minerals and is one of the most widely used herbs in traditional Chinese medicine. It is effective for female disorders such as menstrual disturbances, PMS and hot flashes due to its anti-inflammatory, analgesic, antiseptic, bactericidal and vasodilative effects. The herb is also used to regulate menstrual cycles, relieve menstrual cramps and alleviate symptoms related to PMS.Dong Quai Root Tincture, 100% Organic, 2 fl. oz.
Dong Quai root is often used in the treatment of menstrual cramps, or dysmenorrhea and PMS, hot flashes, and other menopausal symptoms.Echinacea Herb, Nature's Way, 400 mg, 180 Caps
Echinacea herb supports the Immune System and promotes general well-being in cold and flu season.Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Cranberry, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Lemon Lime, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Orange, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Raspberry, NOW Foods, 1000 mg, 36 0.3 oz Packets
Effer-C Instant Fizzy Vitamin C Drink Mix Powder, Punch Flavor, NOW Foods, 1000 mg, 36 0.3 oz Packets
This excellent tasting fizzy Vitamin C drink mix is for Energy & Immune System Support, select orange, raspberry, punch or cranberry flavor.Elderberry Juice Concentrate, 12.5 fl. oz.
Elderberry Juice Concentrate is a Non-Alcoholic source for the health benefits of Elderberries. A medically proven strong anti-viral and immune system enhancer, elderberry is recommended as part of a health maintenance program.Electrolyte Stamina Power Pak, Lemon Lime, Trace Minerals, 32 Packs
Electrolyte Stamina Power Pak is an easy-to-fix high performance energy electrolyte drink with no caffeine, artificial stimulants or artificial ingredients.Electrolyte Stamina Power Pak, Orange, Trace Minerals, 32 Packs
Electrolyte Stamina Power Pak is an easy-to-fix high performance energy electrolyte drink with no caffeine, artificial stimulants or artificial ingredients.Electrolyte Stamina Tablets, Trace Mineral Research, 90 Tabs
Electrolyte Stamina Tablets are a high performance energy nutritional supplement, developed specifically for athletes or other people who experience a lot of fluid loss.Female Balance, NOW Foods, 90 Caps
Scientifically engineered to support the normal hormone function of today's active female with Wild Yam, Borage Oil, Dong Quai and folic acid, this perfectly balanced blend of potent herbal extracts and essential fatty acids (omega-3 and 6) may encourage normal menstruation, reduce the severity of cramps and support a healthy positive mood.40,000 Volts Electrolyte Concentrate, Trace Minerals, 8 fl. oz.
40,000 Volts Electrolyte Concentrate is a Dietary Supplement, the Only Liquid Electrolyte Made with Concentrace Ionic.Ginger Tea, Yogi Tea, Organic Digestive Aid, 16 Tea Bags
Our 100% Organic Ginger tea by Yogi Tea has something to offer to anyone who wants to get or stay healthy.Guarana Seed Powder (Paullinia Cupana), Alternative Health & Herbs, 4 oz.
Guarana is a creeping shrub native to the Amazon (and particularly the regions of Manaus and Parintins). In the lushness of the Brazilian Amazon where it originates, it often grows to 12 m high. The fruit is small, round, bright-red in color, and grows in clusters. As it ripens, the fruit splits and a black seed emerges - giving it the appearance of an "eye" about which Indians tell legends.Hawthornia, 100% Natural, 500 mg, 60 Gel Caps
This is a 100% natural herbal remedy that may relieve (non-hiatal) hernia symptoms. Relieves strain-related lower abdominal discomfort, pain and cramps.Heather's Tummy Fiber, Organic, Acacia, Powder, Heather's Tummy Care, 1 lb.
Heather's Tummy Fiber Supplement Acacia is a natural, pure, certified organic, soluble dietary fiber produced from the gum of the Acacia tree (also known as gum arabic). Acacia is a natural plant water-soluble fiber that has been harvested for millennia in Africa; its recorded dietary use dates back to the Egyptian pharaohs.Horsetail Herb Grass, Nature's Way, 440 mg, 100 Caps
Horsetail herb contains approximately 22 milligrams of Silica per capsule or 4.94% and Nature's Way Horsetail Grass is certified organically processed by Oregon tilth.Heather's Tummy Tea, Organic, Peppermint, Heather's Tummy Care, 36 Tea Bags
Peppermint is a cooling, calming herb that, through dietary management, helps relieve the symptoms of IBS. Clinical studies have shown that peppermint is exceptionally beneficial for IBS abdominal pain and spasms, diarrhea, and urgency (it will not cause or worsen constipation).Hot & Cold Gel Pack With 18 Inch Strap, Packaged In Plastic Bag, CorPak, 9X16 Inch, 1 Each
Hot & Cold Gel Pack With 18 Inch Strap, Packaged In Plastic Bag, CorPak, 6X10 Inch, 1 Each
Hot & Cold Gel Pack, CorPak, 3X5 Inch, 1 Each
Hot & Cold Gel Pack, CorPak, 6X10 Inch, 1 Each
Hot & Cold Gel Pack, CorPak Soft, 10X13 Inch, 1 Each
Hot & Cold Gel Pack, CorPak Soft, 6X20 Inch, 1 Each
Treat your strains, sprains, tendinitis and other injuries with a CorPak Soft Hot & Cold Pack.Hyland's Leg Cramps With Quinine Homeopathic Formula, 100 Tabs
Hyland's Leg Cramps with Quinine is a traditional homeopathic formula for the relief of symptoms of cramps and pains in lower back and legs often made worse by damp weather.Kava Tea Stress Relief, Natural Anxiety Relief, Certified Organic, 16 Tea Bags
Kava Tea Stress Relief tea helps you calm down as it relieves stress, anxiety and minor pain, as well as lending gentle support to the digestion and the kidneys.Kidney Rejuvenator, Peter Gillham's Natural Vitality, 90 Tabs
Kidney Rejuvenator is a proprietary blend of powerful herbs that support the kidneys' vital functions.Kombucha 2000, Concentrated Kombucha, 30 Caps
Concentrated Kombucha Capsules are new to the market, but Kombucha 2000 is one of the very first successful kombucha tea producers in the United States.Kombucha Tea, 100% Organic, Original Flavor, Ready To Drink, 12 fl. oz., Case of 24
Kombucha Tea, 100% Organic, Original Flavor, Ready To Drink, 25.4 fl. oz., Case of 12
Kombucha Tea, 100% Organic, Original Flavor, Ready To Drink, 64 fl. oz., Case of 6
Kombucha Tea Extract Tincture, Certified 100% Organic, Case of 12, 1 fl. oz.
Kombucha's benefits to the physical body vary widely. It is said to enhance the immune system. By detoxifying the body, kombucha makes it unlikely for disease causing bacteria and viruses to find a suitable growth environment. This results in a healthier physical body.
People from all over the world claim drinking Kombucha Tea provides relief from many physical ailments. Kombucha Tea Extract drops are very convenient and portable. Take them anytime, anyplace; work, traveling or at home.Lemon Balm (Melissa Officinalis) Powder, 4 oz. Bulk
Lemon Balm tea is recommended to relieve fever due to cold and flu, and to ease menstrual cramps, insomnia, headaches and nervousness.Lemon Balm Tincture, 100% Organic, 2 fl. oz.
Lemon Balm is a sedative that elevates the mood an antidepressant.Magnesium Ionic Mineral Supplement, Fully Absorbable, Magnesium Water, 350 +/- ppm, 16 fl. oz.
WaterOz Ionic Magnesium is a pure liquid Magnesium supplement. Magnesium is a natural tranquilizer. Called the "anti-stress mineral," it aids in relaxing nerves, relieving tension, assisting digestion, activating enzymes important for protein and carbohydrate metabolism.Magnesium Malate, 150 mg, 120 VCaps
Magnesium is an essential mineral that is required by every cell in the human body and is important for helping to maintain normal cardiovascular, muscle, nerve, bone and cellular function.Manganese Ionic Mineral Supplement, Fully Absorbable, 30 +/- ppm, 16 fl. oz.
WaterOz Ionic Manganese is a pure liquid Manganese supplement. Manganese, also called the "brain mineral," is important in the utilization of all mental facilities/functions.Meta C Vitamin C Supplement, 1000 mg, 100 Tabs
Meta C Vitamin C Supplement is a unique form of vitamin C that is absorbed faster than regular vitamin C and maintains higher serum levels for longer period of time with no intestinal discomfort.Muira Puama (Ptychopetalum Olacoides) Powder, 4 oz. Bulk
Muira puama has been gaining popularity in the United States where herbalists and health care practitioners are using muira puama for impotency, menstrual cramps and PMS, neurasthenia and central nervous system disorders.Muscle Relaxation Wellness Oil, 2 fl. oz.
After working out, hiking, or doing anything physically exhausting, apply this oil to overworked muscles to promote relaxation and to avoid muscle cramping.Natural Aspirin Alternative, White Willow Bark Extract, 390 mg, 60 Tabs
Used to treat bursitis, tendonitis, headaches, osteoarthritis, dysmenorrhea, rheumatoid arthritis, back pain, toothache, and menstrual cramps, White Willow is being used by more people as a safer, natural alternative to aspirin.Ola Loa, All Natural Hydrating Sports Drink, Mango Tangerine, 30 Packets
Ola Loa, All Natural Hydrating Sports Drink, Mixed Berry, 30 Packets
Ola Loa Sport is an all natural thirst-quenching, hydrating drink created for people who want to lead healthy, active lives.Ola-Loa Children's Multi-Vitamin Drink Mix, Cran-Raspberry, 30 Packets
Better your kids health by introducing them to this Child Multi-Vitamin based upon the most up-to-date studies on nutrition and child development and is 100% all-natural.Organic Rooibos Tea, Caffeine Free Herb Tea, 25 Tea Bags
Rooibos is a red tea indigenous to South Africa, Wisdom Herbs Organic Rooibos Tea is caffeine free and tastes great.Pain Free 1-2-3, A Proven Program For Eliminating Chronic Pain Now, By Jacob Teiltelbaum, M.D., Paperback
Conquer pain and Take your life back NOW, Dr. Jacob Teitelbaum gives several Chronic Pain Coping Technique 's in his proven step-by-step program, Pain Free 1-2-3. His First hand knowledge and 30 years experience as a pain specialist, lecturer, and researcher give him rare insight in the challenge posed by persistent, nagging chronic pain.Pepogest Peppermint Oil, Enteric Coated, Nature's Way, 60 Softgels
Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort. Pepogest peppermint oil is a targeted release peppermint oil supplement that provides natural gastrointestinal comfort.Peppermint Leaf (Mentha X Piperita) Powder, 4 oz. Bulk
Peppermint leaf calms the muscles of the stomach and improves the flow of bile, which the body uses to digest fats. As a result, food passes through the stomach more quickly.Peppermint Stomach Soother Tea, Yogi Tea, Caffeine Free, Certified Organic, 16 Tea Bags
Organic Peppermint tea from Yogi Tea is the perfect way to lift your spirits and quiet your stomach; with a fresh flavor and aroma you'll want to enjoy everyday.Peter Gillham's Liquid Organic Life Vitamins, 32 fl. oz.
Organic Life Vitamins is a power-packed premium formulation that supplies the body with the essential nutrients it requires-missing as a result of deficient diets and the stresses of today's busy lifestyles. It is easy to take and tastes great!Polari Tea, Herbal Detox Tea, Caffeine & Tannin Free, 20 Tea Bags
Polari Herbal Detox Tea is a South African produced herbal tea remedy.Potassium Chelate, 100% Natural, Nature's Way, 99 mg, 100 Caps
Nature's Way Potassium Chelate is 100% natural for superior absorption. Potassium is a key nutrient in maintaining the electrolyte balance which regulates heart and muscle contraction.Potassium Ionic Mineral Supplement, Fully Absorbable, 340 +/- ppm, 16 fl. oz.
WaterOz Ionic Potassium is a pure liquid Potassium supplement. Potassium aids rheumatic or arthritic conditions and is vital for the elimination of wastes.Procaine Ultra GH9 (Ultimate 9), Procaine HCl, 100 mg, 60 Caps
Procaine Ultra GH9 is the most trusted Anti-Aging TherapGH9 with its patented PBN will put that "ump" back into your cells, catapulting your wellness or sports program to a multi-quantum level!RedBush Chai Tea, Yogi Tea, Certified Organic, 16 Tea Bags
The total experience of our Organic Caffeine Free Redbush Chai by Yogi Tea is taken to an exciting new level with the addition of Organic Rooibos Leaf, an African leaf that is sweet and earthy.Red Raspberry Tincture, Red Raspberry Supplement Liquid, 100% Organic, 2 fl. oz.
Red Raspberry supplement is said to be good for common female problems, but it's healing properties for other uses are sometimes overlooked.Sea Minerals With Silver & Sea Greens, Dynamic Health, 32 fl. oz.
This unique formulation has dynamic ingredients that work together synergistically to bring your cells to an optimum performance level.St. John's Wort Supplement, 350 mg, 180 Caps
St. John's Wort Supplement can be helpful in support of depression, menopause, cramps, and insomnia. Nature's Way St. John's Wort extract standardized to .3% Hypericin, then synergistically blended with the whole St. John's Wort herb in the perfect balance to ensure consistent hypericin content in each capsule.Stop Bleeding Menstrual Regulation Remedy, TCM Formula, Sangi Zhixie, 100% Natural, 400 mg, 60 Caps
Made of extracts from notoginseng, baked fossilized bone, Frankincense, myrrh, purple gromwell root, dragonis blood, pearl, deer horn glue, mentha, catechu, astragalus and corydalis, this time-honored formula is used in Chinese medicine to stop bleeding and pain and promote natural menstrual cycle.Thyme Tincture, 100% Organic, Herbal Remedies USA, 2 fl. oz.
Thyme is used to clear respiratory congestion, whooping cough, laryngitis, catarrh, and sore throat. This herb also can be used to treat stomach cramps, diarrhea, heartburn, chronic gastritis, flatulence, colic, and diminished appetite.Tiger Balm Ointment, Extra Strength, Red Sports Rub, 0.63 oz.
Tiger Balm Red has successfully been used to relieve sore and achy muscles, ease back pain, soothe headaches and clear sinuses. Tiger Balm Red helps increase blood circulation as well.Tiger Balm Patch, 5 (4 X 2.74 Inch) Patches
The Tiger Balm Patch uses a new delivery technology to deliver it's well known pain-relieving formula to where it hurts.Tiger Balm, Regular Strength, White Sports Rub
Tiger Balm White has a higher concentration of mint oil than the red balm which help relieve muscular aches and pains, increase circulation in arthritic joints and ease soreness after a working out.Tiger Balm, Ultra Strength, Non-Staining sports Rub, Natural Pain Relief, 1.7 oz.
Tiger Balm Ultra sports rub for sore muscles and overexertion.U O Clear (Ovarian Cyst & Fibroid Support), 500 mg, 60 Caps
The herbs work synergistically to strengthen the body's natural capability of female systems self-cleaning functions, especially for uterus and ovary.Unker's Medicated Salve, 3.5 oz.
Unker's For the temporary relief of pain and itching associated with minor cuts, scrapes, minor burns, sunburns or minor skin irritations.Unker's Medicated Salve, 7 oz.
Unker's Medicated Salve has been providing healing and relief for over 60 years. It works great for arthritis, sore muscles and joints, cuts, burns, bruises, throat congestion, sinus problems, psoriasis, and much more.Unker's Natu-Rub, All Natural Liquid Medicated Salve, 1 fl. oz. (Up to 200 Applications)
This all natural liquid version of Unker's medicated salve absorbs into the skin quickly.Vitamin C Liquid For Baby & Children, 4 fl. oz.
Vitamin C is known as a principal anti-oxidant, the need for which is greatly increased in infants and children due to today's elevated environmental stresses and pollution.Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 VCaps
Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.Vitamin C 500 With Rosehips, Nature's Way, 100% Natural, 500 mg, 250 Caps
Nature's Way Vitamin C with Rosehips offers a rich whole plant source of vitamin C.Vitamin E, Natural D-Alpha-Tocopherol, 400 IU, 100 Softgels
Vitamin E has potent antioxidant activity, supplies oxygen to the blood, aids in strengthening capillary walls, and plays a beneficial role in cancer and cardiovascular disease prevention, anti-aging benefits, circulation, wound-healing, immune function, nervous system function, PMS, hot flushes, diabetes, vascular disease, eye health, tissue repair, athletic performance, leg cramps, skin and hair health, and alleviating fatigue.Woman's Moon Cycle Tea With Dong Quai, Yogi Tea, Certified Organic, 16 Tea Bags
Organic Woman's Moon Cycle Tea with Dong Quai is an organic way to regulate mood swings, cramps and other minor symptoms of premenstrual discomfort.Woman's Raspberry Leaf, Female Support, 16 Tea Bags
Our Organic Woman's Raspberry Leaf is a gentle and organic way to support the special needs of a woman's reproductive system.
FOR A COMPLETE LIST OF MUSCLE CRAMP SUPPLEMENTS & PRODUCTS:
Herbal Remedies: Muscle Cramp Information
Herbal Remedies: Muscle Cramp Supplements & Products
Herbal Remedies: Pregnancy / Pregnancy-Related Problem Supplements & Products
RELATED LINKS
Muscle Cramp (American Academy of Orthopedic Surgeons)
Muscle Cramp (Mayo Foundation for Medical Education and Research)
Heat Cramps: First Aid (Mayo Foundation for Medical Education and Research)
Night Leg Cramps: What Causes Them? (Mayo Foundation for Medical Education and Research)
Stiffness, Cramps and Twitching (Muscular Dystrophy Association)
Muscles (Patient Education Institute) - Requires Flash Player
Also available in Spanish
Muscles (Patient Education Institute) - Requires Flash Player
Also available in Spanish
ClinicalTrials.gov: Muscle Cramp (National Institutes of Health)
Article: Perceived physical strain in paid and unpaid work
Article: Are there alternatives to the use of quinine
Article: Tarui disease and distal glycogenoses: clinical and genetic update.
Muscle Cramps -- More Articles
Muscle Cramps - Medline
American Academy of Orthopedic Surgeons
National Institute of Arthritis and Musculoskeletal and Skin Diseases
Also available in Spanish
Children - Your Muscles (Nemours Foundation)
Also available in Spanish
Medline Plus: Dystonia
Medline Plus: Muscle Disorders
Medline Plus: Sports Injuries
Medline Plus: Bones, Joints and Muscles
National Institute of Arthritis and Musculoskeletal and Skin Diseases
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HELPFUL PRODUCTS & FURTHER EDUCATION
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 2nd Edition
Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
-- by Phyllis A. Balch, James F. Balch - 4th Edition
Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
-- by Phyllis A. Balch
The Complete Guide to Natural Healing
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Educational materials and health products are available through Amazon.com. Use the search box provided below to search for a particular item.
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Mountain Rose Bulk Herbs
Mountain Rose Aromatherapy Oils
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