Cramps: That sudden, sharp pain

Let’s understand cramps, the little things that make our life miserable

man with leg crampSometimes when we stretch our hand or leg for something, we feel intense pain and are unable to move. It’s as if our muscles are jammed.

The pain sometimes lasts for just a few seconds and at other times many minutes, leaving us almost crying in pain—cramps can make life miserable.

What is a cramp?

When a contracted muscle is unable to relax we get a muscular cramp. This inability of the muscles to relax is also the cause of pain.

Cramps usually happen due to involuntary contraction of a specific muscle or a group of muscles. They can affect any part of the body—hands, feet, thighs, neck, calves, abdomen and chest are the commonly affected areas.

Almost everyone experiences muscular cramps. And their occurrence increases with age.

Are stomach cramps different?

Abdominal cramps sometimes happen not because of muscular contraction but because of accumulation of gas or bloating. If the pain is severe and continuous, the cramp may also be due to some problem with other organs like intestines, appendix or kidneys.

However, these cramps are often accompanied by other symptoms such as fever, diarrhoea or vomiting. If you experience such a cramp, get a thorough check up as soon as possible.

Which ones pain the most?

Cramps in the muscles between the ribs are one of the most painful ones. Usually, there is a sharp pain, which intensifies while taking a deep breath. You may experience such pain also because of an awkward sleeping posture, in which case you wake up with acute pain in ribs.

Sometimes other medical conditions including chronic cough, previous fractures/injuries of ribs, pneumonia, tuberculosis and infections too may give rise to pain in ribs.

Muscles surrounding the ribs may go into spasms and become tender thereby creating difficulty in even breathing or sleeping due to sharp and stabbing pain.

Another one that comes close in intensity is the leg cramp. They usually occur at night [hence are also called nocturnal cramps] when the legs are resting and lasts for a few minutes.

In most cases, the calves are affected and the severity causes disturbed sleep. It can be annoying if this becomes a frequent occurrence.

What causes cramps?

The reasons are varied. You can get a cramp because of vigorous activity, or if you don’t ensure enough fluid intake prior to exercise. You may also experience cramps due to poor circulation, lack of oxygen in the muscles, deficiency of certain vitamins and lack of essential minerals like calcium, magnesium and potassium.

In many cases even medication that drains out fluids from the body causes cramps. Sometimes cramps point to underlying neurological illnesses like radiculopathy, neuropathy, myelopathy or vasculopathy.

Is a diagnosis required?

It is fairly easy to identify a cramp. Usually the area of a cramp starts bulging and the muscles become tender. There is visible soreness around the firm or thickened part of the muscle. Sometimes the bulge disappears but the pain continues for a few days.

However, in case of a cramp in the abdominal region that persists for a few days, diagnosis may require ultra sonography or a CT scan of spine to rule out complications of organs like the kidneys, intestines and appendix.

Serum electrolytes, calcium levels, thyroid functions, vitamin D levels and EMG studies are also sometimes used to ensure correct diagnosis of cramps.

What to do in case of a cramp?

  • If you are doing something when you get the cramp, stop the activity immediately. Try to relax the contracted muscle by gently massaging the area with warm oil. You can even apply a cream or a gel at the area to reduce pain.
  • If the cramp is in the legs or calves muscles, perform mild stretching exercises as they help relax the muscle.
  • Consume fluids containing electrolytes like sodium and potassium to reduce recurrence. ? You can even treat the affected area with ice. Ice acts as a pain reliever and an anti-inflammatory agent. If you aren’t comfortable using ice, you can even use heat [heat pad, warm shower for instance] on the affected area as it enhances blood circulation in the area, relaxing the muscles.
  • If your cramps are due to an illness or medical condition like appendicitis or kidney disorder, they gradually subside with the treatment of the said disorders.
  • You can even use a muscle relaxant to ease the cramp.

In case of extreme cramps, medical professionals use Botox to relax the muscle and give it flexibility and movement.

Can cramps be prevented?

While minor cramps disappear without much trouble, serious cramps are really difficult to handle and they affect day-to-day life. Usually such cramps are due to vigorous activities such as sports, running or brisk walking.

To prevent such cramps, never miss your warm up and cooling down session. In fact, you should warm up before starting any vigorous and tough activity that requires excessive muscle movement.

In addition, drink enough fluids before and after such an activity. Maintaining proper electrolyte balance in body fluids is the key to muscle flexibility and it avoids contraction of the muscles thereby avoiding muscular cramps.

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    VINAY Chauhan

    Vinay Chauhan is a neurologist of the Lilavati Hospital and Research Centre.

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