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. For a calf muscle cramp, the person can stand about 2 to 2.5 feet from a 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. (It is best to learn this maneuver at a time when you don't have the cramp.) Another technique involves flexing the ankle by pulling the toes up toward the head while still lying in bed with the leg as straight as possible. 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.
Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak. If the cramp is associated with fluid loss, as is often the case with vigorous physical activity, fluid and electrolyte (especially sodium and potassium) replacement is essential. 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 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.
The treatment of cramps that are associated with specific medical conditions generally focuses on treating the underlying condition. 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 doctor need to consider the possibility that more intensive treatment is indicated or that the cramps are a manifestation of another disease. As described 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.
Cramps are inevitable, but if possible, it would be best to prevent them.
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Archived: March 20, 2014
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