Doctors explain causes of leg cramps in Arkhangelsk region

Residents of the Arkhangelsk region sometimes experience situations where their legs cramp, and if it«s not due to being in cold water, there can be many reasons. JournalistMaria Tishchenko of NGS.RU found out from Novosibirsk doctors how this is related to vitamin deficiencies in the body, how to distinguish such cramps from epileptic seizures, and what treatment may be available.

Difference from epileptic seizures

According to neurologist Ekaterina Demyanovskaya, an expert doctor at the Gemotest laboratory, sudden painful contractions of the calf muscles, often called cramps, represent a local transient muscle hypertonus and are not related to epilepsy. These conditions are fundamentally different in their mechanism of occurrence.

Epilepsy is the result of a sort of «short circuit» in the cerebral cortex, when many nerve cells activate simultaneously. This can lead to loss or reduction of consciousness with muscle contraction in a specific area (for example, the neck or arm) or a generalized contraction of skeletal muscles.

A calf muscle contraction, however, is a disturbance at the level of the peripheral nervous system or in the muscle tissue itself without a change in the level of consciousness. There can be several causes: a failure in signal transmission from the nerve to the muscle, impaired function of muscle cells, or an imbalance of substances necessary for the proper contraction and relaxation of fibers.

Causes of cramps

The main cause of painful involuntary contractions of the calf muscles (called cramps) is considered to be an electrolyte imbalance: a deficiency of magnesium, potassium, calcium, or vitamin D.

These micronutrients are critically important for the process of muscle contraction and relaxation.

«Magnium acts as a natural muscle relaxant and stabilizer of nervous excitability. Its deficiency leads to the muscle being unable to fully relax,» explained Ekaterina Demyanovskaya. «Significant losses of magnesium are possible with excessive sweating, taking diuretics, pregnancy, or an unbalanced diet.»

Vera Semashko, a top-category neurologist at the Smitra clinic, also added that cramps can be a symptom of diseases of the endocrine system, namely the parathyroid glands, including after thyroid surgery. Sometimes cramps can also be of psychosomatic origin.

Another significant factor is muscle overload. When muscles work for a long time and actively, for example, during a long walk, an unusual workout, or standing work, metabolic products, including lactic acid, accumulate in them.

Furthermore, noted Ekaterina Demyanovskaya, the energy resources in the muscles in the form of ATP molecules, necessary for relaxation, become depleted, as this is also an energy-consuming process. Because of this, the muscle may remain in a compressed, tense state, which is felt as a cramp.

The condition of peripheral nerves also plays an important role. For example, with polyneuropathy, which occurs in people with diabetes, the transmission of nerve impulses to the muscles is impaired, which can manifest as painful spasms.

Ekaterina Demyanovskaya emphasized that the condition of blood vessels should not be discounted either. Chronic venous insufficiency or atherosclerosis of the abdominal aorta, its branches, and arteries of the lower limbs impair venous outflow and blood supply to the leg muscles, which, accordingly, leads to the accumulation of metabolic products and reduced blood supply. This provokes painful spasms, especially at rest.

In some neurological diseases, for example, multiple sclerosis or damage to nerve roots in the lumbar region, the normal connection between motor neurons and muscles is disrupted. Nerve signals that control the muscles become intermittent. Because of this, the well-established cycle of muscle contraction and relaxation is disrupted, which can lead to a sudden painful contraction of the calf muscles.

«It is important to distinguish simple cramps from symptoms of more serious conditions. For example, Parkinson»s disease, amyotrophic lateral sclerosis (ALS), or dystonic syndromes can also include muscle spasms, but they will be accompanied by other characteristic neurological symptoms: tremor, muscle weakness, changes in gait,« said Ekaterina Demyanovskaya.

She also noted that relatively well-known and more frequent causes of cramps—varicose veins, magnesium deficiency, carbohydrate metabolism disorders—can progress and lead to serious complications. Therefore, if painful contractions of the calf muscles become frequent, are not relieved by simple muscle stretching, or begin to affect other muscle groups, this is a valid reason to consult a doctor to find out the cause.

What to do

If you are bothered by cramps, you should first consult a general practitioner. The doctor will examine the patient, take a history, find out how often the cramps occur and what they are associated with: whether the patient experiences high physical exertion, what kind of shoes they wear, whether there has been a sudden change in weight, and what other symptoms are present.

The doctor will order primary diagnostics for iron levels, thyroid hormones, and parathyroid hormone, based on the results of which they will prescribe treatment or refer the patient to a specialist—a neurologist or endocrinologist.

«You should not independently get tested for vitamins, especially vitamin D,» emphasized Vera Semashko.

Tatyana Tartyonova, a neurologist at the Zdoravitsa network of family medicine centers, noted that if cramps have caused impaired blood circulation, you should consult a vascular surgeon.