Hand and leg cramps

Unpleasant sensations such as cramps in the arms and legs can occur as a result of prolonged muscle tension, due to vascular problems, or due to a lack of certain vitamin and mineral substances. There are other pathological causes of this problem. Should I try to get rid of cramps on my own, or do I still need to visit a doctor? [1]

Causes of the hand and leg cramps

There is no single cause that precedes the appearance of cramps in the arms and legs: there can be many factors, and all of them must be taken into account when making a diagnosis. After all, they treat not just convulsions, but eliminate the cause of the pathological condition.

As experts point out, most often the root cause is ordinary muscle fatigue - such cramps go away on their own after 1-2 days. Other causes are classified as pathological, since their appearance is associated with individual pathologies.

• Dehydration.

The lack of moisture in the tissues is a fairly common cause of convulsive muscle contraction. The fact is that in a state of dehydration, the muscles lose their ability to adequately contract. In this case, the terminal sections of the nerve fibers become more sensitive, and the muscles spasm. The condition is aggravated against the background of high ambient temperature (for example, in the heat of summer) or during intense sports. [2]

• Deficiency of certain micronutrients.

Insufficient intake of certain microelements into the body causes various problems on the part of tissues and organs. Specifically, the body needs calcium, potassium, magnesium, and sodium for proper muscle function. Deficiency of these substances can be caused not only by a poor or monotonous diet, but also by a violation of the absorption of trace elements.

• Diabetes.

In diabetes, various disorders of tissue innervation occur, both the vascular and nervous networks are affected. Therefore, muscle spasms, which are manifested by cramps in the arms and legs, are often disturbing with this diagnosis. [3]

• Venous insufficiency, varicose veins.

Convulsions against the background of swelling of the lower extremities, pain and fatigue in the legs are sure signs of varicose veins. Such symptoms are caused, first of all, by a violation of blood flow in the affected vessels, stagnation of blood, and a violation of trophism. 

• Hormonal imbalance.

Changes and restructuring of hormonal balance often cause periodic seizures. For example, this can be observed in adolescence, as well as in women during periods of pregnancy or menopause, or before the start of a new monthly cycle. [4]

• Alcohol abuse, smoking.

Both alcohol and smoking over time cause irreversible changes in the vessels, as well as disrupt the absorption of some important trace elements and disrupt the function of the peripheral nervous system. This, in turn, can provoke a convulsive syndrome. [5], [6]

• Medicines.

Convulsive muscle spasms often occur with improper or prolonged use of diuretics, analgesics, hormonal drugs.

• Increased body temperature.

The so-called febrile convulsions are one of the side symptoms of elevated body temperature. Especially often this can be observed in young children with an unstable thermoregulation system. As a rule, such muscle twitching disappears as body temperature returns to normal. [7]

Small muscle twitches of the arms and legs occur when there is a shortage of iron and folic acid in the tissues. Against the background of the normalization of nutrition, such symptoms, as a rule, disappear on their own. If convulsions are found not only on the limbs, but throughout the body, then we can talk about serious problems with the central nervous system.

Risk factors

There are certain risk groups: people belonging to these groups are more prone to the appearance of cramps in the arms and legs:

• athletes, heavyweights, bodybuilders, etc.;
• children under three years old, as well as adolescents;
• women during periods of strong hormonal changes (pregnancy, menopause, the initial period of menstruation);
• people who, due to their professional activities, are forced to stand for a long time or stay in an uncomfortable position;
• people who abuse alcohol and smoke;
• people who often follow strict or monotonous diets, practice prolonged fasting, or those who have serious problems with the absorption of certain food components;
• patients suffering from thyroid diseases, vascular diseases, diabetes mellitus, oncology;
• people suffering from chronic intoxication, as well as those who consume insufficient amounts of fluid daily.

Pathogenesis

Hand and leg cramps can be provoked by various acute and chronic pathologies and disorders in the brain (neuroinfectious diseases, trauma, tumor processes, hemorrhages, dysgenesis), genetic and chromosomal disorders (failure of metabolic processes of amino acids, lipids, carbohydrates), brain intoxication (toxic infections, exogenous intoxication with chemicals and medicines).

Seizures often appear against the background of endocrine and electrolyte disorders - for example, with diabetes mellitus, hypoparathyroidism, spasmophilia, hypomagnesemia, impaired sodium metabolism, etc. In addition, we can talk about psychogenic factors.

Often, cramps in the arms and legs begin to disturb at elevated temperatures (the so-called febrile convulsions).

This pathological condition is polyetiological, but most often it is associated with one common point. This refers to a violation of the central hemodynamics, which leads to oxygen deficiency, acidosis and other metabolic failures in the central nervous system. As a result of these processes, the energy brain balance changes, enzyme systems lose their activity, which stimulates the convulsive readiness of the body.

Epidemiology

Most often, cramps occur in the lower extremities - especially in the calf muscles. This is due to the fact that the predominant load during the day falls on the legs. In addition, the lower extremities are more distant from the heart, and blood circulation in them may be slowed down.

Most often, convulsive muscle contractions are found in middle-aged and elderly patients. It is believed that the loss of muscle mass increases after reaching the age of 40. At the same time, if a person does not maintain his physical activity, then his chances of such a problem are significantly increased.

According to statistics, 55% of the adult world population and 7% of children periodically experience seizures.

Symptoms

Cramps of the arms and legs are weak, barely noticeable, or pronounced, painful and prolonged. The mild form is characterized by such first signs as tingling, short-term muscle spasm, mild muscle pain, twitching of the limb. In severe form, the convulsive syndrome is pronounced, spasms can capture the entire limb, they are long and painful. Even after the spasm releases, the pain may remain for a long time.

Cramps of the fingers and toes usually occur due to impaired peripheral circulation. The intensity and duration of the attack in all patients is different, depending on the severity of the underlying pathology.

With chronic venous insufficiency, varicose veins, the following symptoms are characteristic: in the second half of the day, swelling of the ankles and feet appears, cramps of the arms and legs occur at night, fatigue often worries. Upon closer examination, spider veins, protruding veins, and hematomas can be seen on the skin.

Sometimes it happens that one side of the body is affected - for example, cramps appear in the left leg and arm, or the entire opposite part of the body. This happens when the spine is damaged, when the activity of the central nervous system is disturbed, when the activity of the muscle fibers themselves changes. It is possible to accurately determine the cause only through a thorough diagnosis, since one study of the clinical picture is not enough here.

Cramps of the right arm and leg, or the opposite half of the body, can occur with infectious pathologies, damage to the central nervous system, vascular diseases, intoxication, traumatic brain injury, and tumor processes. With such disorders, symptoms of the underlying pathological process are usually present, which is taken into account when making a diagnosis.

Frequent leg and arm cramps are always involuntary, they can affect both one muscle and entire muscle groups, setting the entire limb in motion. With frequent attacks, patients may complain of the appearance of a prolonged pain syndrome: pain may increase when trying to move the affected leg or arm, or straighten the limb. Sometimes the patient manages to choose a certain position in which the pain subsides, even if the muscle continues to be in a spasmodic state.

Gradually, the spasm passes, sometimes the arms and legs go numb, the convulsions stop, but temporarily the patient is haunted by the feeling that with the slightest movement or extension of the limb, the problem will return again.

Constant leg and arm cramps cause an enduring sensation of pain, as a state of hypoxia is formed in spasmodic muscle tissues, there is a lack of oxygen and nutrients, intoxication processes begin due to stagnation of metabolic products. As a result, the nerve endings are constantly irritated, a prolonged pain syndrome appears.

Cramps in the arms and legs of a child

Seizures in children can appear at any age. However, experts clarify that most often such disorders are found in babies of the first 3 years of life.

The reasons for this pathology may be as follows:

• birth trauma, cerebral hypoxia, intracranial hemorrhage, intrauterine infectious diseases;
• inflammation of the meninges, brain abscess;
• mechanical damage, head injury;
• metabolic disorders, deficiency of sodium, calcium, magnesium, hypoglycemia, renal failure;
• high temperature, fever;
• epilepsy, congenital disorders in the central nervous system, neoplastic brain processes.

Convulsions in childhood can be tonic, clonic, mixed, myoclonic, infantile. But in some cases in infants, such single disorders can be transient, not requiring treatment. Repeated episodes should be carefully diagnosed and treated, under the supervision of specialists - a pediatrician and a neurologist.

Diagnostics of the hand and leg cramps

Singular seizures are not regarded as a sign of any disease. An indication for diagnosis is the presence of several recurring or persistent seizures that are not due to any objective cause.

To find out the causes of the problem, the doctor will carefully collect information about the medical history, prescribe laboratory and instrumental examinations.

In addition to the usual complete blood count, other tests will be prescribed, for example:

• determination of the level of potassium in the blood;
• determination of the level of calcium in the blood;
• assessment of the level of magnesium in the blood;
• prick test (use of a glucometer) to diagnose hyper or hypoglycemia;
• determination of the level of urea and electrolytes.

Instrumental diagnostics may include the following methods and activities:

• Neurological examination.
• Diagnosis of the vascular network, angiography, bicycle ergometry.
• Electroencephalography (determines the electrical activity of different brain regions).
• Computed tomography of the brain (visualizes brain structures, diagnoses tumor processes, cysts, hemorrhages, which can cause seizures).
• Magnetic resonance and positron emission tomography (as additional measures).
• Single photon emission computed tomography (used if the cause of seizures could not be determined by other methods).

Differential diagnosis

Differential diagnosis is carried out with the most common causes of convulsive conditions:

• with hypocalcemic (hypomagnesmic, hypokalemic) convulsions;
• with hypoglycemia;
• with hyperbilirubinemia;
• with vascular diseases (for example, varicose veins);
• with neurocutaneous pathologies;
• with inflammatory diseases, infections;
• with post-vaccination complications (relevant for early childhood);
• with diseases of the central nervous system.

Treatment of the hand and leg cramps

If cramps of the arms and legs appear systematically, then it is necessary to visit a therapist who will conduct a preliminary examination and refer the patient to a specialist of the appropriate profile - for example, to a phlebologist, vascular surgeon, neurologist, etc. Treatment is prescribed after the final diagnosis is made.

Immediately I would like to dwell in more detail on vascular diseases, since varicose veins and chronic venous insufficiency are the most common causes of limb cramps. Stagnation of venous circulation is one of the consequences of a disturbed vascular lumen and leads to disruption of metabolic and trophic processes in tissues. For example, the stability of the intake of potassium and calcium ions into cellular structures is disrupted, and the quality of muscle contraction largely depends on their intake. As a result, muscle fibers begin to contract spastically, the possibility of their relaxation is lost, and convulsions occur.

A logical question arises: on what grounds can varicose veins be suspected? First of all, this is the appearance on the legs of protruding venous vessels, spider veins. But these symptoms may not be detected both at first and with damage to the deep veins. Additional signs may be swelling in the legs (especially in the evening), fatigue and discomfort in the lower extremities, itching and burning, heaviness (especially after prolonged standing or walking).

If such symptoms are present, then you need to visit a specialized doctor - a phlebologist.

Complications and consequences

Most often, cramps in the arms and legs go away without any negative consequences for the body. But if they are caused by a serious pathology, then a special treatment regimen is required, which is selected individually for each patient.

With generalized convulsions, respiratory function disorders, as well as circulatory disorders, water and electrolyte balance may develop - in such situations, infusion therapy is indicated.

In addition, severe generalized convulsions can lead to injuries, cerebral edema, and disruption of the functional ability of internal organs.

Prevention

How to make a diet correctly, and what to do additionally to prevent the appearance of cramps in the arms and legs?

For quality prevention, several rules are important:

• a properly built diet enriched with vegetables, herbs, nuts, seeds, seafood;
• the use of sufficient volumes of water (one and a half to two liters per day);
• regular exercise, morning exercises;
• the right choice of clothes and shoes (correspondence to size, exclusion of synthetic materials, quality, convenience);
• timely rest for the limbs and the whole body, water procedures, relaxing massage;
• the right choice of bedding, ensuring the comfort of sleep and rest.

When cramps of the arms and legs appear, you should not immediately pick up a first-aid kit and self-medicate. First you need to figure it out: perhaps the problem is caused by a relatively banal reason. For example, you slept in an uncomfortable position, or overtrained the day before, or took diuretics. If unpleasant convulsive sensations bother you often, or even constantly, then you must definitely consult a doctor. A therapist or family doctor, as well as a vascular surgeon or phlebologist can help.

Forecast

The quality of the prognosis depends on the underlying cause of the disease state. Single episodes of seizures, as a rule, should not cause concern, since they are the result of a transient local circulatory disorder caused by various factors.

If cramps in the arms and legs occur constantly or often, then it is necessary to provide an integrated approach to solving the problem. Only full and regular treatment can guarantee a positive prognosis.