Novosibirsk Doctors Explain Leg Cramps and Their Underlying Causes

Sometimes situations arise when legs are seized by cramps, and if it«s not about being in cold water, there can be many reasons. NGS journalist Maria Tishchenko learned from Novosibirsk doctors how this is related to vitamin deficiency in our body, how to distinguish such cramps from epileptic ones, and what treatment might be.

Difference from Epileptic Seizures

According to neurologist and expert doctor at the «Gemotest» laboratory, Yekaterina Demyanovskaya, sudden painful contractions of the calf muscles, often called cramps, represent a local transient muscle hypertonia and have no relation 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 in the level of consciousness with contraction of muscles in a specific area (for example, the neck or arm) or a generalized contraction of skeletal muscles.

Contraction of the calf muscle, however, is a disruption 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 reasons: a failure in signal transmission from the nerve to the muscle, impaired function of muscle cells, or an imbalance of substances necessary for proper contraction and relaxation of fibers.

Causes of Cramps

The main cause of painful involuntary contractions of the calf muscles (called crampi) 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.

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

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

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

Furthermore, noted Yekaterina Demyanovskaya, energy resources in the form of ATP molecules, necessary for relaxation, are depleted in the muscles, 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.

Yekaterina Demyanovskaya emphasized that vascular conditions should not be overlooked either. Chronic venous insufficiency or atherosclerosis of the abdominal aorta, its branches, and arteries of the lower extremities 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. The nerve signals that control the muscles become intermittent. This disrupts the well-established cycle of muscle contraction and relaxation, which can lead to a sudden painful contraction of the calf muscles.

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

She also noted that relatively well-known and more frequent causes of crampi—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 determine the cause.

What to Do

If you are bothered by cramps, you should first see a therapist. The doctor will examine the patient, collect a medical history, find out how often cramps occur, what they are associated with: whether the patient experiences high physical exertion, what their footwear is like, whether there has been a sudden change in weight, and what other symptoms are present.

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

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

Tatyana Tartynova, a neurologist at the «Zdraviitsa» family medicine center network, noted that if cramps have caused impaired blood circulation, you should see a vascular surgeon.

Earlier, Novosibirsk doctors told about the impact of heating on health in winter and first aid for the skin.