Treatment of leg cramps in adults and children

Cramping of the lower limb muscles most often occurs suddenly and at the most inopportune moment. In most cases, the cramp cramps the calf muscles, often the thigh muscles are affected, the cramp can cramp the fingers or foot, and in some cases it spreads to the entire limb. The reasons for this are very different - from completely harmless positional to serious pathological. Accordingly, and the treatment of leg cramps can be different. Single cases usually do not require treatment, but regular cramps, especially night cramps, can be a symptom of a pathological process.

Feet are often cramped from physical overstrain, causing microtraumas of muscle and overexcitation of nerve tissue. A variant of increased stress on the legs is uncomfortable shoes - tight, narrow-nosed, with very high heels. Pregnant women are prone to leg cramps, they often bother in the second half of pregnancy, when the abdomen grows intensively and the load on the legs increases. A sudden change in temperature (cooling), for example, when swimming in an open body of water, leads to the appearance of cramps. There is nothing to treat in these cases, but there are many causes that require examination and treatment: disorders of water-electrolyte balance in the body, vitamin B deficiency, problems with cerebral and peripheral blood circulation or transmission of nerve impulses, tunnel neuropathies of the lower extremities, kidney pathologies and endocrine disorders, other diseases. Convulsions can be caused by drug treatment with certain drugs.

Whatever they were provoked by, you need to be able to give yourself first aid - to remove the cramp, because such a condition, in addition to discomfort associated with pain, fraught with temporary inability to make certain movements, which can lead to injury and even death, for example, while in the water.

What should I do if my leg cramps?

In the field, especially when swimming, you only have your own body, part of which has failed. You need to take immediate action. In any case, the tightened muscle should be relaxed and provide a rush of blood to it. How to relieve a cramp in the leg quickly and in an uncomfortable position?

If you are swimming (usually the calf muscle is affected in this case), try to pull the toe of the affected leg to the shin as much as possible, as if pulling the leg with the heel forward. By the way, when rowing with your legs, try not to pull the toe, it is in this position often appear cramps in the calf muscles. You can try to massage and even tingle in the place of tightening with one hand, rowing with the other, change the style of swimming. The main thing is not to panic and immediately turn to the shore.

On hard ground, relaxation and pinch massage (intensive kneading) are supplemented with the possibility to load the affected leg. For example, jump on the cramped leg, twist it, transfer the body weight from heel to toe and back, stand or walk on your heels, intensely but gently massage the tightened muscle, clenching and unclenching the toes. The direction of the massage should be towards the heart. The calf and posterior thigh muscles are stretched when the cramped leg is placed on the heel and, bending over, try to touch the toes with the appropriate hand.

If there is a support in the form of a wall nearby, on which you can lean with your hands, it is recommended to take your time and do push-ups from it, making sure that the heels of the feet do not come off the ground, the knees are straightened, and the forearms are tightly pressed against the wall. Starting position of the body - parallel to the wall at a distance of outstretched arms (palms resting on the wall, feet fully on the floor).

If a muscle in your leg is cramped when you were walking or standing, it is recommended to sit down and stretch forward the affected limb, then stroke, knead, pinch the place of stiffness and pain.

If the cramp is felt in the anterior thigh muscle, you can do the following exercise to stretch it: stand up and bend the affected leg backwards at the knee, putting your hand around its toe, holding on to a support with the other hand. Pull the heel toward the buttock until the thigh muscles are tense. You will feel the tension leave the muscle.

To stretch the gluteal muscle, sitting down, pull the affected leg up to the chest, holding it by the knee with one hand and the ankle with the other. Then take the toes of the affected leg with the appropriate hand and, without letting go, slowly and smoothly straighten the leg upwards at the knee, pressing the front part of the thigh to the chest with the other hand.

If the injured person is not alone, you can involve fellow first aiders. They can help massage or gently pull the affected limb by the foot. In this case, the patient is laid horizontally so that he or she rests the healthy leg on a solid support (wall, tree). Pull the affected leg smoothly and without fanaticism.

What to do at home?

All of the above exercises and massages can be done at home for cramps. You can also apply heat and cold therapy at home.

Heating helps to relax stiffened muscles. For this purpose, you can use a relaxing warm bath for the whole body or just for the legs, supplementing the procedure by massaging the affected leg with an intense shower spray. You can warm the muscles of the lower limb that have been cramped with a terry towel soaked in hot water, a warm heating pad, a bag of heated salt or sand, put a mustard patch or stick a pepper patch on.

Cold is also used to relax the muscles. For example, a bag of frozen food from the freezer is wrapped in a napkin and a stroking massage is performed on the sore spot.

You can walk barefoot on a cold floor - where there is no carpeting, on tile tiles, on the bottom of an empty metal bathtub. The colder the surface, the quicker the cramped muscles will relax.

If you have regular night cramps, you can put a needle applicator near the bed. When waking up at night from discomfort and pain, immediately take your feet off the bed, step on it and stomp on it if the foot cramps; press the applicator to the shin or thigh depending on the place where the discomfort is felt.

Even when the spasmed muscles are released, residual pain may persist for a long time. What to do in case of pain after leg cramps? It is recommended to rub the sore spot with something cold - a piece of ice, a wet cold cloth.

After a leg cramp, it is desirable to walk for a while to restore normal blood circulation in the limb. Warming the affected area also helps to get rid of pain after cramps.

It is also possible to relax the muscles and get rid of pain during and after a cramp by taking a tablet of a non-steroidal analgesic. So you can do this for a one-time elimination of pain syndrome, but for a long time to engage in medication self-treatment is not worth it. Analgesics for leg cramps are not particularly effective. With the help of massage and movement exercises to remove the spasm much faster. As long as the taken tablet will work, it will take at least 20-30 minutes. Therefore, it is worth using anesthetics in cases where cramps occur regularly, last for a long time and it is difficult to stop them with massage and exercises, and after them for a long time pain syndrome persists. Painkillers are most often prescribed to patients with unidentified origin of discomfort to relieve residual pain syndrome together with therapeutic exercises and a course of physiotherapy.

If leg cramps occur regularly, the disease that causes muscle spasms should be treated, and under the supervision of a doctor. It can fall under the competence of different specialists: neurologists, endocrinologists, urologists, traumatologists, vertebrologists and others. Therefore, treatment methods and medications may be prescribed in a variety of ways that do not have a direct anticonvulsant effect.

Remedies for leg cramps

In most cases, the quickest way to relieve leg cramps is to use non-medication methods - developing and stretching the muscles. Skeletal musculature, which includes leg muscles, is most susceptible to so-called "true" cramps, which, according to most experts, arise due to overexcitability of nerves innervating muscle tissue. The main provoking factor is muscle fatigue associated with unusual or overactive physical activity, injuries, as well as - prolonged muscle inactivity (the need to lie or sit in one position). Cramps can appear not only directly during muscle tension, but also much later at rest. One-off situations can occur at any age and do not require treatment.

Regularly occurring leg cramps may indicate a disorder in the body - imbalance of biological fluids, loss of electrolytes, trace elements, dehydration. This can be associated with taking medications, such as diuretics, corticosteroids or birth control pills, venous insufficiency, chronic stress, thyroid disease. Obviously, completely different treatments will be required as well. Universal remedies for leg cramps are not available. Basically, treatment is applied, aimed at eliminating the causes of muscle cramping - replenishment of electrolyte deficiency, stabilization of the nervous system, vascular tone, the work of endocrine organs.

Anticonvulsant drugs for leg cramps belong to different pharmacological groups. Special antiepileptic drugs for true cramps in the muscles of the lower extremities are not used. They have a specific effect on the brain and a lot of side effects. Independently use them to relieve cramps in no case should not be used. If it does not help to relax the muscles with the help of drug-free manipulations, optimize nutrition and hydration of the body, it is necessary to be examined. Medication treatment must necessarily be prescribed and monitored by a doctor. Medications are prescribed in minimal doses and can be canceled or replaced by others in the absence of improvement. Treatment tactics may be reviewed and adjusted depending on the effectiveness of therapy.

Myorelaxants for leg cramps

Special drugs capable of reducing increased muscle tension - myorelaxants - are used to relax the muscles. Drugs of this group are prescribed not to all patients, but to those who suffer from chronic leg cramps, arising against the background of neurological, vascular or joint pathologies. Myorelaxants do not eliminate the cause of muscle hypertonus, but they relieve tension and can prevent the onset of cramps. These drugs are auxiliary and are used to eliminate acute discomfort. Sometimes, for example, in coxarthrosis, they are prescribed together with non-steroidal anti-inflammatory drugs that reduce inflammation and pain relief.

Nevertheless, if the cause of seizures is not identified, myorelaxants alone cannot be used. First, long-term use of these drugs is undesirable. In addition to the usual side effects - skin reactions, nausea, dyspepsia, they can cause hypotension, drowsiness, fainting, unsteady gait, speech, accommodation, breathing disorders. They relax not only the tightened muscles of the legs, but also the entire musculature of the body, therefore affecting all processes of vital activity. And exceeding the dose is fraught with respiratory depression and collapse. It is also possible to develop paradoxical effects, especially in cases of non-compliance with dosage recommendations.

In secondary seizures use myorelaxants of central action, that is, directly affecting the transmission of nerve impulses from the brain and spinal cord.

Pregnant women and nursing mothers should refrain from taking myorelaxants.

Baclosan (baclofen) may be prescribed to reduce muscle tone and prevent the development of leg cramps. The drug is a derivative of the inhibition mediator - γ-aminobutyric acid. Inhibition of excitation reflexes under the action of the drug is carried out at the level of the spinal cord, which makes it effective in cramps caused by problems with the spine (osteochondrosis, osteoarthritis, hernia, trauma). Spontaneous painful muscle contractions and skin hypersensitivity are reduced, but the transmission of neuromuscular impulses is virtually unchanged, the amplitude of tendon reflexes - also. This increases the patient's ability to move independently and accelerates rehabilitation. At the same time, blocking the release of mediators of excitation, glutamate and aspartate, activation of the mediator of inhibition leads to improved night sleep, reduced anxiety, but also some sluggishness of reactions. Baclofen is canceled in the appearance of allergy symptoms, not prescribed to patients with porphyria and exacerbation of peptic ulcer disease. The drug is taken starting with the lowest dose, gradually bringing it to therapeutically effective. The treatment regimen is prescribed individually. Treatment can be long and it can not be interrupted suddenly. The drug is canceled by a gradual reduction in dose. In persons with serious problems with the nervous system and psyche, schizophrenia, obsessive, depressive, manic disorders, parkinsonism, convulsive seizures, epilepsy and others, the use of Baclosan may cause exacerbation of the underlying disease.

Myorelaxant Midocalm in leg cramps of various origins can also be prescribed in acute and chronic cases. The active substance of the drug tolperisone hydrochloride inhibits the conduction of nerve impulses, relaxing the muscles and improving motor function. In addition, it has a specific affinity to the tissues of nerve fibers and chemical structure resembles anesthetic lidocaine, due to which effective analgesia is realized. The highest concentrations of the active ingredient are found in the cerebrospinal fluid and brain stem. Its pharmacological properties have not yet been fully elucidated, but it is established that Midocalm effectively reduces hyperexcitability of the spinal cord, stabilizes cell membranes of nervous tissue, improves peripheral blood circulation, and its main difference from other myorelaxants is the lack of pronounced sedation, which is important for long-term use of the drug. It does not cause lethargy and decreased concentration, as well as muscle weakness, so the patient who has to take Midocalm does not lose the ability to work and can lead a normal active life. Its effect on the processes of hematopoiesis is also minimal. It combines well with non-steroidal analgesics and in cases of their combined use allows to significantly reduce the dose of the latter, which minimizes the side effects of their use.

Midocalm can be used in seizures of alcoholic genesis, because its active substance is not an antagonist of alcohol. Because of its universal use, it is sometimes called "the ideal myorelaxant". However, there are contraindications to the use of the drug. It is not prescribed to infants, in pediatric practice only tablet forms are used. It can cause allergic reactions, like any other drug, although, in general, it is tolerated very well. It is not recommended to prescribe it to patients with diseases accompanied by muscle weakness. Teratogenic properties of tolperisone have not been identified, however, pregnant women are prescribed only for vital indications. During lactation, the safety of its use has not been confirmed and not refuted, so it is also better to refrain from taking it.

Adults are prescribed tablets in a single dose of 50mg, gradually increasing it to 100-150mg. Administration is two or three times. It is important to fill the stomach - bioavailability of the drug improves after a meal. Children are dosed depending on body weight.

In cases of severe secondary seizures accompanied by a pronounced pain syndrome, adult patients may be prescribed injections of Midocalm, intramuscular (100mg twice a day) or intravenous (slow trickle injection of 100mg once a day).

Cases of overdose are practically unknown, in children increased irritability was observed during treatment with high doses. Experimentally (on animals) it was established that in case of overdose paradoxical side effects - convulsive syndromes, as well as muscle weakness, respiratory function disorders up to paralysis - increase.

To eliminate leg cramps accompanied by acute pain, the drug Myorix (active substance - cyclobenzaprine hydrochloride) may be prescribed. This drug reduces or completely eliminates local hypertonus of skeletal muscles, without significantly affecting muscle function itself. Studies show that the drug mainly acts at the level of the brainstem rather than the spinal cord, as Baclosan does, dampening the excitation of motor peripheral motoneurons (α and γ). In seizures associated with diseases of the central nervous system, has not shown itself effective. Treatment with Myorix is symptomatic, prescribed in addition to therapeutic exercises and temporary (period of acute pain) restriction of motor activity. The course of treatment should not be longer than two to three weeks. It is taken once a day at approximately the same time, it can be taken at night, especially since Myorix provides a sedative effect.

There are other medications with myorelaxant effect. All of them are effective for spasms of skeletal muscles, but they are not harmless. Their main side effect is a decrease in motor activity up to complete immobilization and respiratory arrest. This, however, occurs, however, if the doctor's recommendations regarding the drug intake are not followed. Therefore, the right to choose the drug, dosage and duration of intake remains with the doctor. Self-medication with myorelaxants can be dangerous to health.

Magnesium preparations for leg cramps

One of the most important electrolytes, the deficiency of which causes the appearance of such a symptom as seizures, is magnesium. It prevents excess acetylcholine from accumulating in the synapse - it opens the channels of the presynaptic membrane, through which acetylcholine, which is not involved in the transmission of electrical impulses to myocytes, flows back to the end of the axon. Magnesium deficiency leads to the fact that the channels do not open, and neurotransmitter in excess accumulates in the synaptic gap. This leads to an increase in the frequency of electrical impulses that "order" the muscles to contract, i.e. To the development of convulsions.

The causes of magnesium deficiency can be many. Alimentary - limited diet, associated with diets, errors in nutrition; increased consumption during stress, pregnancy, rapid growth, intense exercise, treatment with diuretics, taking oral contraceptives, vomiting and diarrhea; disruption of absorption - pathologies of the intestine, endocrine organs, the use of incompatible products, etc. Magnesium deficiency has other symptoms, but cramps, and at first it is in the lower extremities, developing with minor loads, one of the main signs that should be focused on. Biochemical blood tests are not a diagnostic marker in this case. Even with a significant deficit in the blood, the level of magnesium will be maintained to the last due to its withdrawal from other tissues (muscle, bone).

Magnesium from leg cramps is replenished with the help of vitamin and mineral complex preparations and dietary correction. If a deficiency of this vital element is assumed, it will not be possible to "gain" it quickly.

The most well-known complex drug to compensate for magnesium deficiency is Magne-B6. It is produced by different manufacturers, in different dosages and forms (tablets, drinking ampoules). The combination of magnesium-B6 with leg cramps is very successful. The substances mutually potentiate the pharmacological action of each other and increase bioavailability.

Pyridoxine hydrochloride or vitamin B6 enhances the absorption of magnesium and potentiates its action. In turn, this vitamin also has anticonvulsant activity, which increases in the presence of magnesium cations.

The different compounds presented in the preparations are magnesium lactate dihydrate, magnesium citrate hydrochloride, with the second (organic) being considered more preferable and used in the forte version with prolonged absorption and intracellular distribution in tissues.

Children from the age of one year are often prescribed a drinking solution of Magne-B6 in ampoules, which are diluted in 100ml of water. The solution has a pleasant caramel flavor, it has a fairly concentrated content of magnesium. It is believed that in liquid form the active substance is absorbed faster and better, the level of magnesium in the body increases in two hours after taking it.

Magnesium deficiency in the body can be replenished with the help of similar drugs. Can be prescribed Magnelis-B6 for leg cramps - a synonym for the original French vitamin and mineral complex only of Russian manufacture, respectively, and the effect is exactly the same. It is available in tablets.

To eliminate magnesium deficiency, patients with vitamin B6 intolerance or deficiency of vitamin B6 can be prescribed a monopreparation Magnerot from leg cramps. The active substance is the magnesium salt of orotic acid. It is available in tablets containing 0.5 g of magnesium orotate.

Recommendations regarding the choice and regimen should be made by a physician depending on the level of perceived deficiency. If the symptoms of deficiency do not diminish after two to three weeks of administration, the prescribed drug should be reconsidered. Side effects are usually limited to cutaneous allergic reactions, and these are extremely rare. Digestive disorders may occur even more rarely.

Contraindications to taking magnesium preparations are also available. These are intolerance to the active and auxiliary components of the drug, magnesium deficiency, calcium deficiency, tendency to the formation of phosphate and calcium-magnesium stones in the urinary tract, severe renal dysfunction, atrioventricular blockade I-II degree and chronic marked slowing of the pulse.

Administration of magnesium preparations may be indicated for pregnant women, but its expediency is determined by a doctor. Magnesium penetrates into breast milk, so in case of a pronounced deficiency of magnesium and the need to take it, the question of interruption of breastfeeding is considered.

Magnesium preparations have a mild sedative and hypotensive effect and potentiate similar effects of other drugs, which should be taken into account when performing work requiring increased concentration.

Other electrolytes and restoring their balance

Potassium, calcium and sodium are no less important than magnesium. Their positively charged ions are involved in the conduction of nerve impulses to muscle cells. Normal muscle function requires a strictly defined balance between the ions of these substances both inside the cell and in the intercellular space. Violation of electrolyte balance leads to the fact that muscle contractions begin to occur from weak impulses, which in normal conditions would not excite myocytes. In addition, such impulses approach the cells much more often than full-fledged impulses, and due to a decrease in the threshold of excitability, the muscle is constantly in tone.

Potassium is located in the intracellular space in the form of ions and unstable compounds with phosphorus, proteins and carbohydrates. In norm it is about 98% there, in the intercellular space contains a very small part (about 2%) of ionized potassium. This ratio is necessary to maintain the electrical potential of myocyte membranes and ensures normal muscle function. Intensive output of ions from the cell occurs when it experiences hypoxia, protein compounds are destroyed, glycogen decays. This occurs both with significant physical exertion, and hypodynamia, pathological metabolism due to disease, dehydration, errors in nutrition. This leads to an imbalance of potassium ions inside and outside the cell and is affected by a decrease in resting potential. Myocytes become excited by the smallest impulses, and tonic spasms occur.

Potassium preparations are able in such cases to help restore the disturbed balance and relieve leg cramps. Hypokalemia is diagnosed in cases where the serum potassium content does not reach 3.5 mmol/L. To stabilize its level in the body, Kali-Normin tablets can be prescribed. Potassium losses are possible with vomiting and diarrhea, therapy with corticosteroids, taking diuretics and laxatives. Deficiency of this chemical element appears with excessive production of endogenous corticosteroid hormone.

Potassium preparations are contraindicated in sensitized patients, during the exacerbation of peptic ulcer disease, with dehydration of the body, extensive traumatic injuries of the skin surface, pronounced symptoms of renal insufficiency - urinary disorders, metabolic acidosis. Not prescribed for patients with congenital muscle weakness.

For the treatment of potassium deficiency, the dose is determined by the degree of potassium deficiency. It may be prescribed to take from one to six tablets per day. Overdose is fraught with hyperkalemia, which is manifested by muscle weakness and paresis, cardiac dysfunction, loss of sensation, decreased blood pressure, depression and apathy.

However, much more often the body loses potassium and magnesium at the same time. To eliminate the deficiency of these electrolytes, Asparkam can be prescribed for leg cramps. This is a complex drug containing potassium and magnesium in the form of asparginate. Asparginic acid is present in all living organisms in free form and as part of proteins, due to the connection with it, potassium and magnesium ions in the form of complex salts penetrate well into the intracellular space and are included in the mechanism of muscle contraction at the molecular level. The full synonym of the drug is Panangin, which can also be recommended for replenishing the deficit of potassium and magnesium in leg cramps. It is taken one or two tablets three times a day. Caution in the appointment of potassium-magnesium therapy should be observed when the patient suffers from dehydration, he has impaired kidney function or extensive trauma with violation of skin integrity. In this contingent of patients during treatment it is necessary to monitor the content of electrolytes, since the probability of hyperkalemia is quite high. In addition to hypersensitivity to drug components, severe renal failure, hypocorticism, blood pressure below 90 mmHg and atrioventricular blockade are contraindications.

Calcium in leg cramps also plays one of the main roles, and spasmodic muscle contractions are one of the main symptoms of both calcium deficiency and excess. Violation of the balance of cations of this substance in the extracellular space and inside the myocyte in either direction leads to its excitation up to the development of tetany. And also with calcium deficiency the sensitivity of sodium channels increases, which leads in addition to the imbalance of this electrolyte. The concentration of ionized calcium tends to change during the day. It reaches the highest values in the extracellular medium at night, at about 2-4 o'clock, which leads to an increase in membrane potential and the development of nocturnal convulsions. This time coincides with the physiologic decrease in blood glucose levels, which is an additional risk factor for their occurrence.

Calcium preparations help to replenish the deficiency of this element and restore the electrolyte balance in the body. One of the cheapest and long-known preparations is calcium gluconate. It is the calcium salt of gluconic acid. It is most often used in tablets. It is prescribed as a mineral supplement for calcium deficiency in the body. Calcium gluconate in leg cramps helps to normalize the transmission of nerve impulses, contractile activity of muscles of all kinds, improve hematopoiesis and blood circulation. Indicated for deficiency and increased loss of calcium, disorders of vitamin D metabolism. This drug can be taken by pregnant women and young children. It penetrates into breast milk, so breastfeeding mothers are prescribed by indication.

However, excess calcium also leads to undesirable effects. Hypercalcemia is manifested by poor health (weakness, drowsiness), digestive disorders, neurological symptoms (irritability, depressed mood), heart disorders. Calcium salts can be deposited in the body, the blood becomes too thick - blood clots appear. Therefore, people prone to nephrourolithiasis and thrombosis, calcium preparations are contraindicated. Do not prescribe them to patients with severe heart and kidney damage. Do not combine with the reception of antibiotics quinolone and tetracycline series, iron preparations, fluoride, foxglove. Against the background of vitamin D intake, calcium absorption improves, so without special indications high doses of both drugs are not prescribed simultaneously.

When taking calcium, it should be taken into account that its absorption improves the presence of protein and fats in the food. In case of magnesium deficiency, the elimination of calcium from the body is accelerated, so magnesium deficiency should also be compensated.

The daily dose for adults can be up to six tablets per administration depending on the degree of deficiency, children are prescribed according to their body weight. Elderly people are not prescribed more than four tablets per day.

Calcium chloride from leg cramps has not lost its relevance. It is available in a solution for oral intake, and many believe that in the liquid form of calcium assimilation is better. Indications for use and contraindications are similar. Calcium chloride has a more pronounced local irritant effect - the solution is bitter, gluconate is more inert (tasteless). Adults take twice or three times a day a tablespoon of solution, children - one or two teaspoons.

Nowadays there are many other calcium preparations, the manufacturers of which position them as more revolutionary in the sense of assimilation. For example, it is known that calcium is very well assimilated when taken in the form of citrate, that is, calcium salt of citric or ascorbic acid, which promotes excellent dissolution and absorption in the intestine. This is not to say that this is not true, however, such chemical forms are important for people with low acidity (hypoacid, atrophic gastritis). They have a chance that the tablet will get into the intestine in an unchanged form. In this case, the formula of the compound matters.

For all other patients, this does not play a significant role. After all, before entering the intestines, the tablet first enters the stomach. In a person with normal or increased acidity, any calcium compound reacting with hydrochloric acid immediately turns into calcium chloride, immediately decomposing into ions. In the basic intestinal environment, calcium ions react with fatty acids from the food eaten, again forming hard-to-solubilize compounds.

More modern calcium preparations: balanced complexes with vitamin D3 (Calcium D3 Nicomed, Calcemin in various versions, Calcium D3 citrate), Calcium-osteovit - contains two forms of calcium (citrate and hydrophosphate) and, in addition to vitamin D3, ascorbinka, retinol, pyridoxine. Solgar Complex - a nutritional supplement in the form of syrup or tablets may also be prescribed. It contains calcium, magnesium in the form of citrates and vitamin D3.

The sodium cations in the extracellular medium must also have a certain concentration. As soon as it becomes less than the intracellular concentration, water begins to enter the cells, diluting the potassium concentration, and this leads to a decrease in cellular resting potential and convulsions. This most often occurs when there is a deficiency of adenosine triphosphate (ATP), the main chemical transporter of energy. This substance is synthesized by cellular mitochondria and maintains its vitality. In this case, injections of Sodium Adenosine Triphosphate may be prescribed. Intramuscularly they are administered as an outpatient 1ml once a day for the first two or three days of treatment, then the dose is increased to 2ml and administered once or twice a day for another two weeks. Intravenous injections of ATP are given only in hospital.

No-shepherd for leg cramps

The popular antispasmodics Drotaverine or No-shpa can have a certain positive effect on leg cramps, but it is not the drug of choice. The drug effectively relieves spasms of smooth muscle, that is, that which is lined with internal organs and blood vessels. On the bones of the skeleton are located transverse striated muscles. And if smooth contract and relax spontaneously, without external impulses, then skeletal - only on the signals coming from the central nervous system, that is, it is necessary to influence directly on the brain or spinal cord. Direct effect on transverse striated muscles No-shpa does not have, but it is able to dilate blood vessels and improve blood flow to various tissues. Therefore, in cramps in the lower extremities caused by insufficient peripheral blood circulation due to vasoconstriction, for example, after hypothermia, No-shpa can dilate these vessels and, providing blood flow, eliminate the cramp.

The active substance of the drug inhibits the enzymatic activity of phosphodiesterase type IV, and its increased activity is observed in many diseases and inflammatory processes. Therefore, No-shpa, blocking the activity of this enzyme, may have an indirect anticonvulsant effect.

The drug does not eliminate the cause of cramps, but it can be used as an emergency remedy simultaneously with physical action on the tightened muscle - rubbing, warm compresses. With No-shpa should be careful hypotensive people, people with heart and kidney disease.

Wobenzyme

People with diseases of the musculoskeletal system are familiar with cramps. Degenerative-dystrophic processes of vertebral structures, joint pathologies, injuries predispose to unnatural redistribution of the load on the legs, which leads to excessive muscle tension and the occurrence of cramps.

Chronic venous insufficiency, recurrent phlebitis, thrombangiitis, varicose veins are also quite common, leading to venous blood stasis and muscle hypertonus. Symptoms of varicose veins are: swelling of the lower extremities, which is especially noticeable in the evening, accompanied by feelings of heaviness, pain and itching. The appearance of the legs also changes - vascular stars appear on the skin, later joining into a bluish mesh, thick twisted veins appear under the skin.

The complex enzyme preparation Wobenzyme, according to its manufacturers, has the ability to strengthen the immune system, reduce swelling and pain, as well as - not only to thin the blood, but also to break up existing blood clots. Various enzymes included in Wobenzyme freely penetrate into the circulatory system and are carried with the blood flow to virtually all tissues and organs, thus affecting all biochemical processes in the body.

The tablet has a shell that does not dissolve in the acidic environment of the stomach. Its destruction and absorption of the contents occurs in the intestine, through the wall of which the enzymes immediately enter the systemic bloodstream.

The drug contains pancreatin (a mixture of pancreatic enzymes of animal origin). These are proteases that break down protein molecules, amylases that break down starch molecules, amylases that promote digestion of fats by converting them into fatty acids and triglycerides, and lipases.

The preparation also contains plant enzymes papain (from papaya) and bromelain (from pineapple), which also break down proteins. Their effect has not yet been studied reliably.

Plant glycoside rutin (rutoside) strengthens the walls of blood vessels, has a pronounced anti-inflammatory and anti-edema effect, prevents sticking of red blood cells and increases their elasticity. Angioprotector reduces congestion in the veins and promotes the outflow of lymph, soothing pain and itching, swelling and cramps in venous insufficiency.

The proteolytic enzymes trypsin and chymotrypsin, are similar in action and jointly catalyze the reaction of hydrolysis of proteins and peptones to low molecular weight peptides.

Vobenzyme is recommended to be included in the complex treatment of many diseases of almost all organs, however, the action of the drug is not sufficiently studied, so not all experts believe in its effectiveness. It is known how each component of the drug acts on its own, but their joint effects are practically not established, there are no authoritative studies of the drug's action. At least, take pills to get a noticeable result for a long time - three times a day from three to ten tablets. First, two to three weeks take a therapeutic dose, then two to three months twice as small, supporting. Tablets are swallowed whole before eating, drinking enough water, then after half an hour take a meal.

Vobenzyme is a blood thinner, so it should not be taken by people prone to bleeding. It is also contraindicated in kidney diseases that require hemodialysis. The drug is tolerated very well, there are no reports of undesirable effects of overdoses or addiction. Rare side effects are limited to rash, the appearance of feces may change. There are reports that at the beginning of treatment may worsen the symptoms of the disease. This is a normal phenomenon that does not require withdrawal of treatment, which quickly passes. For pregnant and lactating women, the drug is prescribed only by a doctor.

No clinically significant negative interactions with other drugs have been identified. It can reduce the side effects of antibiotics (dysbacteriosis) and enhance their effect. Also against its background, treatment with glucocorticosteroids and cytostatics is easier to tolerate.

Shots for leg cramps

In severe cases of severe pain during or after seizures, if oral forms are ineffective, injectable forms of drugs - analgesics, anti-inflammatory, vitamins - are used. Many patients and doctors believe that injections help to get rid of discomfort faster, and the bioavailability of the active substance delivered parenterally is higher. In fact, this is the case with intravenous injections. In this case, the drug enters directly into the bloodstream and its effect comes instantly. But intravenous injections are usually administered to patients in hospital conditions, where their condition can be constantly monitored.

Intramuscular injections, which are performed on an outpatient basis, are not considered by modern medicine to be much more effective than tablets. The therapeutic effect of the drug delivered by the latter two methods occurs almost simultaneously (if the instructions for administration are followed), and side effects usually develop to the same extent. Moreover, oral dosage forms are currently recommended in preference.

However, there are times when injections are necessary. Painkiller injections may be prescribed for leg cramps. Usually resort to drugs from the group of NSAIDs, for example, ketorolac (ketanov). The injection of this drug relieves pain in about a quarter to half an hour, the average duration of analgesic action is from four to six hours.

In diseases and injuries of the musculoskeletal system can be prescribed Midocalm in injections. In addition to analgesic, this drug also has a central myorelaxing effect. The analgesic effect of tolperisone is complemented by lidocaine, which is the second component of the injectable solution. It is a good conductor of the main active component, potentiates the analgesic effect and makes the injection itself less painful. Midocalm injections can be given both intramuscularly and intravenously.

With significant electrolyte deficiency may be prescribed intravenous administration of mineral preparations: calcium gluconate or chloride, potassium chloride, magnesium preparations. Injections are made slowly, sometimes prescribe drip infusions. Intravenous injections are administered in situations requiring rapid relief of insufficiency and symptoms associated with it, in particular, spasmodic muscle tone.

Injectable forms are intended for rapid replenishment of electrolyte deficiency in case of its insufficient intake or increased consumption and convulsions caused by this condition. This is possible in hyperexcitability of the nervous system in epileptics, after stroke, trauma and intoxication, ventricular arrhythmias, in pregnant women with preeclampsia, eclampsia, threat of premature delivery, in other cases. The need for injectable elimination of electrolyte deficiency is determined by a doctor, he also prescribes doses and methods of therapy.

Magnesia for leg cramps, administered intravenously, provides almost instant anticonvulsant, as well as - soothing and vasodilating effect. However, it does not last long - about 30 minutes. An intramuscular injection of the drug acts in about an hour, but the duration of action is at least four hours.

In addition to all of the above actions, magnesia has an emollient, choleretic and moderate diuretic effect.

Magnesia in solution is pure magnesium sulfate without any additional components. Magnesia is most often administered intramuscularly, the dose is calculated so that 500mg of magnesia per kilogram of the patient's weight. Injections are painful, but this method is considered optimal.

Intravenous administration is practiced only in cases of acute need, drip or very slow trickle. Almost always magnesium sulfate is diluted with glucose or sodium chloride solutions. The introduction of the drug directly into the blood gives an immediate effect, but the side effects also do not make you wait. And they are manifested by depression of the heart and central nervous system up to the development of coma and death.

Milgamma vitamin complex is considered by modern medicine not so much as a compensatory remedy for vitamin-deficient conditions, but rather as a drug that relieves pain and night cramps in the legs in various types of chronic neuropathies and manifestations of dystrophic changes in the spinal column, as well as in acute conditions (trauma, postoperative conditions, stress). Its action is not yet fully explained, however, the effects are undoubted and, perhaps, it is the saturation of the body with vitamins B1, B6 and B12 contributes to the cessation of seizures. An ampoule of injectable solution contains 100mg of the first two vitamins and 1mg of vitamin B12. The compatibility of these components provides potassium hexacyanoferrate. In liquid form there is dissociation of this component into potassium ions and ions of complex iron cyanide, which prevents the breakdown of vitamin B1 under the action of metabolic products of B6 and B12. The injectable solution also contains lidocaine hydrochloride (20mg), which provides anesthesia at the time of injection and faster delivery of the active substance into the systemic bloodstream (conductive effect). In acute conditions, daily intramuscular injections of one ampoule are usually prescribed. The course is usually ten days. In cases of chronic seizures, such as diabetic polyneuropathy or spinal prolapse, treatment courses are periodically repeated.

Injections of antispasmodics may be prescribed, such as No-Sprax or ATP, a decrease in the concentration of which can also cause seizures. The appropriateness of injection therapy should be determined by a doctor. Modern medicine considers injections as a last resort, giving preference to more gentle methods of treatment.

External remedies for leg cramps

Ointments and gels for leg cramps help by improving local blood circulation. First, when the patient rubs the drugs into the skin of the legs, he does it with massage movements. Secondly, external remedies have a thermal effect, warming or cooling.

Various ointments and gels are used for leg cramps. For example, Troxevasin gel. It is prescribed for cramping contractions of the calf muscles of unspecified genesis, as well as patients with venous insufficiency, different stages of varicose veins and thrombophlebitis, with injuries. The drug improves microvascular perfusion, activates blood circulation, has an antioxidant effect. It is a mixture of bioflavonoids. It is allowed to be used by pregnant and lactating women. It can cause allergic reactions and is not recommended for long-term use by patients with renal pathologies. It is not applied on the damaged skin surface.

The gel is applied in a thin layer in the morning and before going to bed in places where cramps occur and rubbed until completely absorbed.

Similar action has a similar effect Phleboton, Troxegel, Troxerutin.

You can also use warming ointments and creams for leg cramps:

• Apizatron: the main component of the ointment - bee venom obtained from live insects, which is well absorbed through the surface of the skin and acts multifaceted (warms, reduces inflammation, improves blood circulation and detoxification, eliminates hypoxia), the effects are enhanced by other components - NSAIDs methyl salicylate and allysothiocyanate;
• Zivokost cream: contains comfrey extract combined with various components - bee venom, chondroitin, bear bile, bischofit, etc.;
• Cream Shark oil from leg cramps - it can be with different additives, choose the appropriate main pathology (Shark oil and ginger or with leeches - directly from cramps associated with muscle strain, with acacia - with varicose veins and venous insufficiency, with glucosamine and chondroitin - with osteoarthritis and so on);
• Ointment Kapsikam with turpentine oil and many others.

There are many reviews that ordinary drugstore glycerin helps well with leg cramps. It is simply rubbed on the places that are cramped and they say that they go away. Official medicine does not explain this method of treatment. Perhaps the effect of foot massage with glycerin just works. Perhaps this method is more from the category of folk recipes using ready-made remedies that can be bought in any pharmacy.

You can also use a band-aid for leg cramps. For example, you can stick a pepper or mustard patch on the cramped surface of the leg. In addition, some people use a regular mustard patch to relieve discomfort.

Vitamins for leg cramps

Leg cramps can appear from avitaminosis and anemia. Such conditions are often caused by a deficiency of B vitamins, the role of which in hematopoiesis and the nervous system is difficult to overestimate. Basically, these are vitamins B1, B6, B12. They can be injected each separately (this method is considered the most effective). Injections are made once a day, each day - one vitamin. You can inject a complex solution, in particular, Milgamma, which was discussed above. But such treatment should be prescribed by a doctor after examination.

B vitamins, along with vitamins A, D and E, magnesium, potassium, calcium and other useful substances contain different vitamin and mineral complexes, some of them mentioned above. In case of leg cramps, the doctor will help to choose the right one based on the results of the examination.

Vitamin B3 or nicotinic acid for leg cramps can also be prescribed, since its deficiency often leads to their occurrence. Deficiency of this vitamin is reflected in the condition of the skin, nervous system and gastrointestinal tract. Significant deficiency is manifested by the "disease of the three D's" (dermatitis, diarrhea, dementia) - pellagra. Dermatitis in this case is provoked by sunlight. In addition, the patient usually sleeps poorly, gets tired quickly, his appetite worsens and constantly has liquid stools, as well as - he becomes irritable, aggressive and very forgetful. In addition to high doses of nicotinic acid, other B vitamins - B1, B6, B9, B12 - are also prescribed. This disease most often affects chronic alcoholics, people with diseases of the digestive tract or undergoing prolonged therapy with drugs that prevent the absorption of these vitamins, hard working physically and poorly nourished at the same time. Contraindications to the appointment of nicotinic acid is its intolerance, decompensated hypertension, glaucoma.

Ascorutin for leg cramps helps to strengthen the walls of blood vessels, eliminate their fragility and prevent the formation of blood clots, significantly improving blood circulation in the lower extremities. Taking this drug, containing rutin and vitamin C, helps to get rid of numbness and cramps at night in the development of chronic venous insufficiency and in the initial stages of superficial thrombophlebitis. Ascorutin helps to get rid of leg cramps provoked by wearing uncomfortable shoes, in particular, on stilettos. In addition to cramps, it is possible to get rid of swelling, heaviness and pain in the legs. Vitamin preparation is not recommended to take with increased blood clotting, reduced potassium, increased - calcium, the formation of oxalate concretions, gout. Prolonged treatment and high doses of the drug can be taken only by doctor's prescription.

Physiotherapeutic treatment

Physiological effects on the body can be a valuable complement to drug treatment, optimized nutrition and hydration. Depending on the patient's state of health, a very wide range of physiological treatments can be offered using direct and alternating electric current, electromagnetic vibrations, heat treatments, laser equipment.

Massage for leg cramps helps to get rid of the cramps themselves and prevent their further occurrence. People who do not have permanent contraindications, i.e. Mental disorders that make it impossible to fulfill certain behavioral requirements, and pronounced symptoms of thrombophlebitis and varicose veins, can resort to various types of professional massage, relaxing or toning. Regular visits to a specialist will help to normalize blood circulation in the lower extremities, improve the flow of lymph and eliminate swelling, develop the supporting muscles and joint and ligament apparatus and improve their mobility. With the help of massage you can correct the consequences of injuries, flat feet, improve the well-being of arthritis, osteoarthritis, venous insufficiency.

Temporary contraindications to massage are exacerbations of chronic diseases, damage to skin integrity, increased bleeding, menstruation in women. Massage is not performed on patients with acute symptoms, such as high body temperature or blood pressure, in the presence of neoplasms.

Acupressure for leg cramps can also help. With its help, you can get rid of the underlying disease. There are many receptors on the surface of the feet, affecting which causes reflex reactions of all organs. By stimulating certain points, a good specialist in the field of reflexology can achieve a real improvement in the patient's health and get rid of leg cramps. Acupressure foot massage normalizes hormonal status, improves the immune system and internal organs.

Therapeutic exercise helps to get rid of excess weight, hypodynamia, to cope with cramps and prevent their occurrence in the future. Under the guidance of an instructor, you can learn some exercises for leg cramps, then practice them on your own at the end of the day to relax the muscles and relieve daytime tension caused by prolonged sitting, standing, walking in uncomfortable shoes.

Gymnastics for leg cramps is one of the main directions of their prevention. Together with a nutritious diet and drinking the necessary amount of fluid, it can relieve the patient of discomfort without the use of drugs, if its appearance is not associated with a serious systemic disease. True, in this case, you will have to make certain efforts. And drug treatment alone, without physical action on the musculature of the body, will not get rid of the problem for a long time.

Folk treatment

It is quite possible to get rid of cramps that do not arise due to disease with the help of centuries of ancestral experience. Folk recipes for leg cramps are often very simple. Sometimes it is not quite clear how the folk remedy works, but nevertheless, each of them has many fans who claim that with its help they managed to forget about cramps forever.

The simplest and healthily skepticism-inducing recipe concerns the use of a fragrant bar of toilet soap. It is recommended to put it under the blanket at night in the area of the location of the lower extremities. And that's it! The connoisseurs of this method claim that you will forget about discomfort. Only the soap must necessarily be fragrant. What kind of odor it should emit is not specified. Apparently, it's all the same. Specialists believe that soap from leg cramps acts as a placebo. The patient is worried, waiting for a cramp, and put a piece of soap, calmed down, believed and calmly fell asleep.

Moreover, a piece of soap in bed (sometimes in socks) helps with other pains - bursitis, arthritis, osteoarthritis, restless legs syndrome. It's hard to believe, but it's easy to try.

If a cramp seizes your leg during the day, you can put a bar of soap on the sore spot. It is said to go away. Another folk method of first aid is to clasp a metal object in the appropriate hand.

A copper wire bracelet can be worn at all times on the leg that is prone to muscle spasms.

Other recipes for leg cramps are more complicated. At least you need to get the ingredients, there is always soap in the household.

For example, collect onion husks and make tea from them every morning. Onion husks help from leg cramps not immediately, but about two months after the start of therapy (persistent effect). People who have tried this method of treatment, managed to normalize blood pressure, stabilize vision. Within a year of such therapy disappears vascular mesh on the calves. Many people note the strengthening of immunity - became less sick, passed chronic cough, stabilized the work of the heart and digestion.

Lemon also helps from leg cramps. It is used as an external remedy. Recipes are slightly different. The simplest - every day for ten days, laying in bed, you need to carefully lubricate a piece of lemon on both heels from the bottom and side to the ossicle. Let dry the juice applied the first time, then repeat the procedure and leave so until morning. In some sources it is recommended to smear the place of cramping - calves, thigh, feet.

Similarly, you can use heated liquid honey (after application, wrap your feet), mustard oil, 6% apple cider vinegar.

Apple cider vinegar from leg cramps is also taken internally. It helps to eliminate potassium deficiency, prevents dehydration. The drink is prepared simply: a tablespoon of natural apple cider vinegar is diluted in a glass of warm boiled water. Drink such a drink every evening before going to bed. As a variant of the drink: dilute one teaspoon of apple cider vinegar and honey in a glass of warm water with a tablespoon of calcium lactic acid (food additive E327).

B vitamins are fully represented in brewer's yeast. You can get them in liquid natural form at breweries and private breweries, the pharmacy sells beer yeast in capsules without additives and with additives, in particular, with minerals and vitamins. In some cases, a course of beer yeast can help with leg cramps.

Any folk medicine does not bypass its attention treatment with herbs. Phytotherapy uses in the fight against cramps sedative herbs and collections, if it is implied that they arose against the background of stress. These are melissa, mint, thyme, peony, motherwort, valerian root.

In venous insufficiency use a tincture of horse chestnut fruit. It is made with vodka or apple cider vinegar and used externally, for rubbing in places of spasm before going to bed. Rub without fanaticism, from bottom to top. Preparation of tincture: mature chestnut fruit split, crushed into several pieces and poured to half of a three-liter jar. Pour any of the two liquids to the edges of the jar and insist in a dark place at room temperature for two weeks.

Make an ointment of celandine juice with petroleum jelly in a ratio of 1:2. It is rubbed into the cramp-prone areas before going to bed. The course of treatment - two weeks.

Drink from leg cramps linden tea with honey, infusion of birch buds, chamomile, tatarnik.

Homeopathy

Since seizures are caused by different reasons, so for their elimination is used almost the entire arsenal of homeopathic remedies, with treatment aimed at eliminating the underlying pathology. Although sometimes in acute cases, symptomatic help is also provided.

Agaricus (Red fly agaricus), Calcarea carbonica (Carbonic acid lime), Hyoscyamus (Black bilberry), Nux vomica (Vomiting nut), Sulfur (Sulphur) are used for night cramps if the feet, toes and soles are cramped; Ambra (Sperm whale gut contents), Arsenicum album (Arsenicum white), Kali carbonicum (Potassium carbonicum), Sepia (Black cuttlefish bag contents) - thigh muscles; Lycopodium (White Sycamore), Pulsatilla (Sleep-grass), Strontiana carbonica (Strontium carbonicum) calf muscles.

When prescribing treatment, it is not only the localization of the cramps that is important, but also the time of onset, the severity of the pain, other symptoms and patient characteristics. If the drug is prescribed correctly, it is usually possible to get rid not only of the distressing symptom, but also to normalize the work of the whole body.

Surgical treatment

Surgery is used only in extreme cases, if the cramps are very painful, cannot be treated conservatively and cannot be controlled. Surgery is not performed directly on the muscles cramped, but surgically removes the cause of this condition - a neoplasm, spinal hernia, prosthesis of a destroyed and unrecoverable joint.

Surgical treatment is performed for ischemia of the lower limbs - the volume and type of surgery is determined by the nature of the lesions of the venous system. Usually the treatment consists of removing varicose veins through pinholes. In more severe cases, special endoscopic equipment is used.

Nutrition for leg cramps

Adjustment of the daily menu to increase the amount of foods rich in magnesium, potassium, calcium, vitamins B and D can help to eliminate the deficiency of essential electrolytes caused by nutritional reasons. Optimize the diet is also recommended in cramps caused by chronic pathologies. It is best to consume vitamins and trace elements from foods. Hypervitaminosis is not earned this way, the body will simply remove excess.

You should eat more green leafy vegetables. They almost always contain all the necessary electrolytes (magnesium, potassium, calcium), at least two of them, as well as vitamin B6, which is necessary for magnesium absorption. Most of them contain a lot of iron, folic acid, vitamin C. Leg cramps do not threaten fans of green salads dressed with vegetable oil (vitamin E). All kinds of cabbage, spinach, lettuces, green onions, parsley, dill are not rare and scarce for our zone. Salads are perfectly combined with a piece of meat, liver, sea fish, which also have a lot of anticonvulsant components.

Rich in essential minerals and vitamins are carrots, tomatoes, cherries, currants, apples, apricots, watermelon, legumes, nuts, seeds and dried fruits, dark chocolate and natural cocoa powder.

Dairy products, not skimmed but whole, are a source of easily digestible calcium and protein. They also contain potassium. Dairy products prevent the development of dysbacteriosis, improve the intestinal microflora and improve the absorption of useful anticonvulsant components from all the food eaten.

Vitamin D, which promotes calcium absorption, is found in egg yolks, cod liver, butter. The endogenous vitamin is produced in the body under the influence of sunlight, and you do not need to be in the sun for a long time. Ten minutes a day is enough.

The list of products can be continued indefinitely, however, it is individual. It is necessary to take into account the tolerance - there are allergic reactions to foodstuffs, and some products are forbidden in certain diseases. Nevertheless, it is possible in any case to find a suitable diet. Professional nutritionists can help with this.

At the same time, it is necessary to avoid dehydration of the organism, i.e. To drink enough clean non-carbonated water. On hot days and during physical activity, the amount of water drunk should be increased. For each organism this indicator is also individual, you need to listen to your desires and satisfy them.

Increases electrolyte consumption by drinking coffee, alcohol, taking diuretics and laxatives, it should be taken into account when preparing the menu for each day.

Prevention

Eat a varied diet and make sure that the daily diet contains foods rich in magnesium, potassium, calcium, vitamins.

Drink enough fluids, increase daily dose in hot weather, replenishing losses.

Keep your body weight normal, do sports, but without fanaticism, give your body a feasible load.

Daily wear comfortable shoes, but if you have to walk during the day in narrow shoes or high heels, in the evening you need to take care of tired feet - make a light massage, a bath with an infusion of herbs, simple exercises. Then there is every reason to hope that the night will pass peacefully.

Give up bad habits, do not abuse coffee and tea.

Monitor your health and consult a doctor if you have any symptoms of ill health.

Forecast

Cramps are unpleasant, but not fatal in most cases. They are also generally not difficult to get rid of with the help of massage and relaxation exercises. Regular cramps can be a symptom of pathological changes in the body, but with timely medical attention, most of the causes of such a symptom are completely eliminated or controlled.