THE CARDIOVASCULAR INSTITUTE

LEG CRAMPS

Leg cramps are a very common occurrence. Most often, they are just minor and temporary -- easily alleviated with a few simple techniques. In other instances, leg cramps may be a sign of serious illness and warrant consultation with your physician.

WHAT ARE SOME COMMON TYPES OF LEG CRAMPS?

• Cramps that occur most often at night while resting. These are the most common and usually not a problem.
  
• Cramps that occur as a result of strenuous exercise and are usually not a problem.
  
• Cramps that occur during exercise. These are more important and may be a sign of a serious condition

WHAT CAUSES NIGHTTIME LEG CRAMPS?

These cramps occur when a muscle goes into intense contraction and then does not relax normally. This can be a quick squeeze/release in seconds -- a jolt that's called a spasm -- or a tightening for as long as a minute or two that interferes with function, such as in your calf muscle. These leg cramps are most commonly due to pulled, strained, or overused muscles. Many patients refer to these cramps as "Charley Horse" cramps. Often these types of cramps affect elderly people or people whose muscles are not usually exercised. These cramps commonly affect the calves, but may also affect the thighs, feet and toes.

WHAT CAN HELP PREVENT NIGHTTIME LEG CRAMPS?

Stretching gently before bedtime may help alleviate leg cramps during the night. Some physicians recommend stretching twice daily to prevent further attacks of night cramps. Although many types of medications have been tried to prevent nocturnal cramps, Quinine is the only drug that has been shown to be effective in treating night leg cramps. However, your doctor must prescribe it and there are risks associated with this type of therapy.

HOW CAN POST-EXERCISE CRAMPS BE PREVENTED?

When these leg or foot cramps occur, the muscle knots up and you can feel it tense and harden with your hand. If left alone, the muscle will eventually relax. But that can mean minutes of suffering, which can feel like hours. For faster relief, immediately stretch the muscle gently in the opposite direction of the contraction. For example:

• If the cramp is in the calf, with the ankle being forced down into a ballerina's point, flex the foot upwards or stand up.
• If the cramp is in the sole of your foot and your toes are curling under, take hold of them and gradually stretch them back up.
• If the cramp is in the front of the thigh, bend your knees and squat.
• If it's in the back of the thigh, sit on the floor with your feet straight out in front of you and stretch your arms out toward your toes.

WHAT CAUSES CRAMPS DURING EXERCISE?

Leg cramps during exercise also may be due to fatigue but are more likely to be due to one of the following conditions:

• Claudication -- Also called angina of the leg, this is decreased leg blood artery circulation. It can cause unbearable cramps, heaviness, tightness or aching in the calf, thigh, and buttocks with walking or exercise, completely resolving with rest. Often caused by arteriosclerosis (hardening of the arteries), it can be a symptom of serious arterial disease which, in certain situations, can lead to gangrene. Medication, balloon angioplasty, or even surgery, may be needed to improve circulation.
• Varicose Veins -- This pain usually is more noticeable after standing for a long time. Generally, limb discomfort from varicose veins improves with walking or leg elevation. Elastic support hose may be helpful or, sometimes, the enlarged veins may be removed surgically or treated with an outpatient laser procedure.
• Phlebitis -- An inflammation of the veins, phlebitis can create additional problems if you also have varicose veins. Most episodes of phlebitis of a varicose vein are easily treated with medication, compression, topical heat, and leg elevation. However, more serious blood clots may occur in deep veins, which require blood thinners. Again, hospitalization may be necessary, together with medication to prevent potentially life-threatening blood clots.

If you have severe or frequent cramps during exercise, see your physician promptly.