What to do with Muscle Spasms

Coping with Muscle Spasms – Symptoms and Signs

As a practicing physician, I suffer from muscle spasms. I have had nocturnal cramps and exercise induced cramps. My right thigh muscle can spasm so intensely that I fall to the ground in pain. I will tell you how I relieved the pain later in this article.

So little is known about muscle spasms and the treatments are not well defined. Textbooks of medicine hardly talk about the subject. I will attempt to help you because this problem is quite common at all ages. My passion is being fueled by my own past frustration with this subject, so let’s get started. After all, this is indeed personal.

Causes of Muscle Spasms

It is always important to determine the causes of Muscle Spasms.

These can include:

  • thyroid disorders

  • calcium

  • magnesium and potassium imbalances

  • dehydration

  • hot temperatures

  • drugs such as diuretics

  • beta blockers and especially statins.

  • Neurologic diseases like MS, Parkinson’s

  • back and neck disorders; and

  • spinal cord and brain injuries can cause muscle spasms as well.

Many times patients get nocturnal cramps that awaken them without any precipitant whatsoever.

Besides treating the underlying cause, what can we do to both prevent and treat muscle spasms?

Prevention of Muscle Spams

  • Drink six to eight glasses of water daily. This may help to prevent dehydration, which may possibly play a role in the cramping.

  • Stretch the calves or affected muscle regularly throughout the day and at night.

  • Ride a stationary bicycle for a few minutes before bedtime or before exercise. This keeps the muscles warmer and may prevent spasms.

  • Keep blankets loose at the foot of the bed to prevent your feet and toes from pointing downward while sleeping

  • Do aquatic therapy regularly to help stretch and relax the muscles.

  • Wear appropriate foot gear.

Certain medicines may be helpful which I will address shortly.

Treatment of Muscle Spasms

As you know, there are many different types of muscle spasms and we don’t know if the different categories are treated the same. For instance are exercise induced cramps treated the same as nocturnal cramps? Feel free to do therapeutic trials with any of these options to see if they work for you as long as you review the treatments with your health provider.

  • Calf stretches or stretching the affected muscle. Consult with an exercise trainer or physical therapist for specific exercises to both prevent and treat muscle spasms. Walking may relieve leg or thigh cramps quickly.

  • Hydration with electrolytes may be particularly useful for exercise induced spasms. Gatorade is one example of an electrolyte drink.

  • Ice packs can be applied to the specific muscle. I keep a large pack in the freezer and use it when a muscle cramps up and it helps. Frozen vegetables will also work when no ice packs are available. Heat may also work if ice doesn’t.

  • Pain killers such as ibuprofen, acetaminophen or tramadol may be helpful in treating spasms but take time to work.

  • Cyclobenzaprine (Flexeril), a muscle relaxant, has shown efficacy in treating neck and back related spasms.This drug can cause drowsiness but an extended release preparation, Amrix, causes less fatigue. Chiropractors, physical therapists, accupuncturists, massage therapists and exercise trainers might also be helpful.

  • Vitamin E 400 units daily plus vitamin C 250 mg daily helped to relieve muscle cramps in dialysis patients.

  • Some studies show that B vitamins, calcium and magnesium might be effective.

  • Baclofen and or clonazepam (like Valium) might be useful for spasms related to neurologic disease.

  • Quinine is the 800 pound gorilla! I found this drug very effective for leg cramps but it was taken off the market due to heart rhythm disturbances and the reduction of platelets, although both side effects are uncommon. Now it is only approved for malaria as Qualaquin at 5 bucks a pill and it is not recommended for leg cramps since the risks outweigh the benefits. Hyland Leg Cramps and tonic water are likely too low in quinine to be effective although either product may be tried.

  • Hot Shot drink. This is an OTC drink developed by a Nobel Prize winner, Dr Rob MacKinnon. He postulates that cramps occur due to excessive nerve input into the muscle. Apparently spicy food in the mouth and esophagus slows down the neuronal discharge. The drink contains ginger, cinnamon and capsicum (made from chili peppers) and retails for $35 per 6-pack ($5.83 per 1.7oz serving). The duration is likely 2-4 hours and can be used before exercise or as soon as a cramp begins. Spicy foods might also reduce the incidence of heart disease.

  • Vitamin D and coenzyme Q-10 might work for spasms due to a statin drug (treats high cholesterol). Often going off the drug for a month or trying another statin can help. Livalo probably causes the least spasms out of all the statins. Finally aim for a vit D level of around 50 to help decrease statin induced muscle cramps.

So what did I do for my awful thigh spasm? I applied cold packs and took an eighth of a teaspoon of cayenne pepper as that was the only spice that I had available. My mouth was on fire but the cramp dissipated in under a minute.

Dr’s. Rx: Muscle spasms have a wide variety of causes and there is no simple solution. A targeted approach can be taken depending on the associated disease. If there is no apparent cause, then any of the above remedies can be tried with the help of your PCP.

About the Author:

Evan L. Lipkis, M.D., is a successful practicing internist who has been in the field of medicine for more than 25 years. He trained at Northwestern University Medical School and presently practices at Glenbrook Hospital in Illinois. He has served as the president of the American Cancer Society (locally), hosted Medical Insight on WTMX radio, and lectured nationally with Dr. C. Everett Koop, the former surgeon general. He now serves as the medical consultant for WGN radio. Dr. Lipkis also is an editor for Prescriber’s Letter, a national newsletter for physicians.


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