Treatment of leg cramps in adults and children

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

Legs often cramp from physical overexertion, causing microtrauma to muscles and overexcitation of nervous tissue. An option for increased load on the legs is uncomfortable shoes - tight, narrow-toed, with very high heels. Pregnant women are prone to leg cramps, they often bother them in the second half of pregnancy, when the belly grows intensively and the load on the legs increases. A sharp change in temperature (cooling), for example, when swimming in an open body of water, leads to cramps. There is nothing to treat in these cases, but there are many reasons that require examination and treatment: water-electrolyte imbalance in the body, deficiency of B vitamins, problems with cerebral and peripheral blood circulation or transmission of nerve impulses, tunnel neuropathies of the lower extremities, kidney pathologies and endocrine disorders, and other diseases. Cramps can be caused by drug treatment with certain drugs.

Whatever the cause, you need to be able to provide yourself with first aid - relieve the cramp, since such a condition, in addition to discomfort associated with pain, is fraught with a temporary inability to make certain movements, which can lead to injury and even death, for example, while in water.

What to do if your leg gets a cramp?

In the field, especially when swimming, you only have your own body, part of which has failed. You need to take urgent measures. In any case, the stiff muscle needs to be relaxed and provided with a blood flow. How to relieve a leg cramp quickly and in an uncomfortable position?

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

On firm ground, in addition to relaxation and pinching massage (intensive kneading), the possibility of loading the affected leg is added. For example, jumping on the cramped leg, twisting it, shifting the body weight from the heel to the toe and back, standing or walking on the heels, intensively but gently massaging the stiff muscle, squeezing and unclenching the toes. The direction of movement during the massage should be towards the heart. The gastrocnemius and posterior femoral muscles are stretched when the cramped leg is placed on the heel and, bending over, they try to touch its toes with the corresponding hand.

If there is a support wall nearby that you can lean your hands on, it is recommended to slowly do push-ups from it, making sure that your heels do not come off the ground, your knees are straight, and your forearms are pressed tightly against the wall. The starting position of the body is parallel to the wall at arm's length (palms resting on the wall, feet completely on the floor).

If a muscle in your leg cramps while you are walking or standing, it is recommended to sit down and stretch the affected limb forward, then stroke, knead, and pinch the area of stiffness and pain.

If the cramp is felt in the front thigh muscle, you can do the following exercise to stretch it: stand up and bend the affected leg back at the knee, grasping its toe with your hand, holding onto the support with the other hand. Pull the heel to the buttock until the thigh muscles are tense. You will feel the tension leaving the muscles.

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

If the victim is not alone, you can involve your comrades in providing first aid. They can help with a massage or gently pull the injured limb by the foot. In this case, the patient is laid horizontally so that his healthy leg rests on a solid support (wall, tree). The injured leg should be pulled smoothly and without fanaticism.

What to do at home?

All the exercises and massage described above can be done at home for cramps. In addition, at home you can also apply heat and cold effects.

Heating helps to relax the stiff muscles. To do this, you can use a relaxing warm bath for the whole body or just for the feet, supplementing the procedure with a massage of the affected leg with an intense stream of water from the shower. You can warm up the cramped muscles of the lower limb with a terry towel soaked in hot water, a warm heating pad, a bag of heated salt or sand, put a mustard plaster or stick a pepper plaster.

Cold is also used to relax 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 carpet, on ceramic tiles, on the bottom of an empty metal bathtub. The colder the surface, the faster the cramped muscles will relax.

If you have regular night cramps, you can put a needle applicator next to your bed. When you wake up at night from discomfort and pain, immediately lower your legs off the bed, step on it and trample if your foot cramps; press the applicator to your shin or thigh, depending on where you feel discomfort.

Even when the spasmodic muscles have subsided, residual pain may persist for quite a long time. What to do with pain after leg cramps? It is recommended to wipe the sore spot with something cold - a piece of ice, a wet cold napkin.

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

You can also relax your muscles and get rid of pain during and after a cramp with the help of medications by taking a non-steroidal analgesic pill. This can be done for a one-time relief of pain, but you should not self-medicate for a long time. Painkillers are not particularly effective for leg cramps. Massage and exercise can relieve the spasm much faster. It will take at least 20-30 minutes for the pill to take effect. Therefore, anesthetics should be used in cases where cramps occur regularly, last a long time and are difficult to stop with massage and exercise, and pain persists for a long time after them. Painkillers are most often prescribed to patients with an unknown origin of discomfort to relieve residual pain, along with therapeutic exercises and a course of physiotherapy.

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

Leg cramp remedies

In most cases, the fastest way to stop leg cramps is non-drug methods - muscle development and stretching. Skeletal muscles, which include leg muscles, are most susceptible to so-called "true" cramps, which, according to most experts, occur due to overexcitability of the nerves that innervate muscle tissue. The main provoking factor is muscle fatigue associated with unusual or too active 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 in a state of rest. One-time situations can occur at any age, they do not require treatment.

Regular leg cramps may indicate a problem in the body - an imbalance of biological fluids, loss of electrolytes, trace elements, dehydration. This may be due to taking medications, such as diuretics, corticosteroids or birth control pills, venous insufficiency, chronic stress, thyroid disease. Obviously, the treatment will also be completely different. There are no universal remedies for leg cramps. Basically, treatment is used aimed at eliminating the causes of muscle cramps - replenishment of electrolyte deficiency, stabilization of the nervous system, vascular tone, and endocrine function.

Anticonvulsants for leg cramps belong to different pharmacological groups. Special antiepileptic drugs are not used for true cramps in the muscles of the lower extremities. They have a specific effect on the brain and a lot of side effects. In no case should you use them on your own to relieve cramps. If muscle relaxation with the help of non-drug manipulations, optimization of nutrition and hydration of the body does not help, you need to get examined. Drug treatment must be prescribed and monitored by a doctor. Medicines are prescribed in minimal doses and can be canceled or replaced with others if there is no improvement. Treatment tactics can be reviewed and adjusted depending on the effectiveness of the therapy.

Muscle relaxants for leg cramps

To relax the muscles, special drugs are used that can reduce increased muscle tension - muscle relaxants. Medicines of this group are prescribed not to all patients, but to those who suffer from chronic leg cramps that have arisen against the background of neurological, vascular or joint pathologies. Muscle relaxants do not eliminate the cause of muscle hypertonicity, 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, with coxarthrosis, they are prescribed together with non-steroidal anti-inflammatory drugs, which reduce the inflammatory process and relieve pain.

However, if the cause of the cramps is not identified, muscle relaxants alone cannot do. Firstly, 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 disorders, accommodation, breathing. They relax not only the stiffened muscles of the legs, but also the entire musculature of the body, therefore, affect all life processes. And exceeding the dose is fraught with respiratory depression and collapse. The development of paradoxical effects is also possible, especially in cases of non-compliance with dosage recommendations.

For secondary seizures, centrally acting muscle relaxants are used, that is, those that directly affect the transmission of nerve impulses from the brain and spinal cord.

Pregnant and nursing women should refrain from taking muscle relaxants.

Baclosan (baclofen) can be prescribed to reduce muscle tone and prevent the development of leg cramps. The drug is a derivative of the inhibitory mediator, γ-aminobutyric acid. The drug inhibits excitation reflexes at the spinal cord level, which makes it effective for cramps caused by problems with the spine (osteochondrosis, osteoarthrosis, hernia, injuries). Spontaneous painful muscle contractions and skin hypersensitivity are reduced, but the transmission of neuromuscular impulses remains virtually unchanged, as does the amplitude of tendon reflexes. This expands the patient's ability to move independently and accelerates rehabilitation. At the same time, blocking the release of excitation mediators, glutamate and aspartate, activating the inhibitory mediator leads to improved night sleep, reduced anxiety, but also some inhibition of reactions. Baclofen is discontinued if allergy symptoms appear and is not prescribed to patients with porphyria and exacerbation of peptic ulcer disease. The medicine is taken starting with the lowest dose, gradually increasing it to a therapeutically effective one. The treatment regimen is prescribed individually. The treatment can be long-term and cannot be interrupted suddenly. The drug is discontinued by gradually reducing the dose. In people with serious problems with the nervous system and psyche, schizophrenia, obsessive, depressive, manic disorders, Parkinsonism, seizures, epilepsy and others, the use of Baclosan can cause an exacerbation of the underlying disease.

The muscle relaxant Mydocalm for 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 exhibits a specific affinity for nerve fiber tissues and is similar in chemical structure to the anesthetic lidocaine, due to which effective pain relief is realized. The highest concentrations of the active ingredient are found in the cerebrospinal fluid and brainstem. Its pharmacological properties have not yet been fully clarified, but it has been established that Mydocalm effectively reduces the hyperexcitability of the spinal cord, stabilizes the membranes of nerve cells, improves peripheral circulation, and its main difference from other muscle relaxants is the absence of pronounced sedation, which is important for long-term use of the drug. It does not cause inhibition and decreased concentration, as well as muscle weakness, so the patient forced to take Mydocalm does not lose the ability to work and can lead a normal active life. Its effect on 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 from their use.

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

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

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

Cases of overdose are practically unknown, increased irritability was observed in children when treated with high doses. Experiments (on animals) have shown that overdose increases paradoxical side effects - convulsive syndromes, as well as muscle weakness, respiratory dysfunction up to paralysis.

To eliminate leg cramps that are accompanied by acute pain, the drug Miorix (active ingredient - cyclobenzaprine hydrochloride) can be prescribed. This drug reduces or completely eliminates local hypertonicity of skeletal muscles without having a significant effect on muscle function itself. Studies show that the drug mainly acts at the level of the brainstem, and not the spinal cord, like Baclosan, dampening the excitation of motor peripheral motor neurons (α and γ). It has not proven effective in cramps associated with diseases of the central nervous system. Treatment with Miorix 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. Take once a day at about the same time, you can at night, especially since Miorix provides a sedative effect.

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

Magnesium supplements for leg cramps

One of the most important electrolytes, the deficiency of which causes such a symptom as cramps, is magnesium. It does not allow excess acetylcholine to accumulate in the synapse - it opens the channels of the presynaptic membrane, through which the reverse outflow of acetylcholine not involved in the transmission of an electrical impulse to the myocytes is carried out to the end of the axon. Magnesium deficiency leads to the fact that the channels do not open, and the neurotransmitter accumulates in excess in the synaptic gap. This leads to an increase in the frequency of electrical impulses "ordering" the muscles to contract, that is, to the development of cramps.

There can be many reasons for magnesium deficiency. Alimentary - a limited diet associated with diets, nutritional errors; increased consumption during stress, pregnancy, rapid growth, intense exercise, treatment with diuretics, oral contraceptives, vomiting and diarrhea; impaired absorption - intestinal pathologies, endocrine organs, consumption of incompatible products, etc. Magnesium deficiency has other symptoms, but cramps, initially in the lower extremities, developing with minor loads, are one of the main signs that should be focused on. A biochemical blood test in this case is not a diagnostic marker. Even with a significant deficiency in the blood, the magnesium level will be maintained to the last by removing it from other tissues (muscle, bone).

Magnesium for leg cramps is replenished with the help of vitamin-mineral complex preparations and dietary adjustments. If a deficiency of this vital element for the body is assumed, then it will not be possible to quickly "eat" it.

The most well-known complex preparation for compensating magnesium deficiency is Magne-B6. It is produced by different manufacturers, in different dosages and forms (tablets, drinking ampoules). The combination of magnesium-B6 for leg cramps is very successful. The substances mutually potentiate each other's pharmacological action 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 preparations contain different compounds – 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 one year of age are often prescribed a drinking solution of Magne-B6 in ampoules, which are diluted in 100 ml of water. The solution has a pleasant caramel taste, it contains 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 within two hours after administration.

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

To eliminate magnesium deficiency, patients with vitamin B6 intolerance or its surplus can be prescribed the monodrug Magnerot for leg cramps. The active ingredient is magnesium salt of orotic acid. It is available in tablets containing 0.5 g of magnesium orotate.

Recommendations regarding the choice and regimen of the drug should be given by a doctor depending on the level of the suspected deficiency. If the symptoms of deficiency do not decrease within two to three weeks of starting the drug, the prescribed drug should be reviewed. Side effects are usually limited to skin allergic reactions, and this happens extremely rarely. Even more rarely, digestive disorders may be observed.

There are also contraindications to taking magnesium preparations. These include intolerance to the active and auxiliary components of the drug, magnesium surplus, calcium deficiency, tendency to form phosphate and calcium-magnesium stones in the urinary organs, severe renal dysfunction, atrioventricular block of the I-II degree and chronic pronounced slowing of the pulse.

Taking magnesium preparations may be indicated for pregnant women, but its appropriateness is determined by a doctor. Magnesium penetrates into breast milk, therefore, in case of its pronounced deficiency and the need to take it, the issue of interrupting 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 that requires increased concentration.

Other electrolytes and their balance restoration

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

Potassium is in the intracellular space in the form of ions and unstable compounds with phosphorus, proteins and carbohydrates. Normally, there is about 98% of it there, 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 release of ions from the cell occurs when it experiences hypoxia, protein compounds are destroyed, glycogen disintegrates. This occurs both with significant physical exertion and with physical inactivity, pathological metabolism due to diseases, dehydration, and nutritional errors. This leads to an imbalance of potassium ions inside and outside the cell and affects the decrease in resting potential. Myocytes go into an excited state from the slightest impulses, tonic spasms occur.

Potassium preparations can help restore the disturbed balance and stop leg cramps in such cases. Hypokalemia is diagnosed when the potassium content in the blood serum does not reach 3.5 mmol/l. Potassium-Normin tablets can be prescribed to stabilize its level in the body. Potassium losses are possible with vomiting and diarrhea, corticosteroid therapy, and the use of diuretics and laxatives. Deficiency of this chemical element occurs with excessive production of endogenous corticosteroid hormone.

Potassium preparations are contraindicated for sensitized patients, during exacerbation of peptic ulcer, dehydration of the body, extensive traumatic damage to the skin surface, severe symptoms of renal failure - urination disorders, metabolic acidosis. They are not prescribed to patients with congenital muscle weakness.

For the treatment of potassium deficiency, the dose is determined by its degree. One to six tablets per day may be prescribed. Overdose is fraught with hyperkalemia, which manifests itself in muscle weakness and paresis, heart problems, loss of sensitivity, 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 aspartate. Aspartic acid is present in all living organisms in free form and as part of proteins, due to the combination 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. A complete synonym for the drug is Panangin, which can also be recommended to replenish the deficiency of potassium and magnesium in leg cramps. Take one or two tablets three times a day. Caution when prescribing potassium-magnesium therapy should be observed when the patient suffers from dehydration, has impaired renal function or extensive injuries with damage to the integrity of the skin. In this contingent of patients, it is necessary to monitor the content of electrolytes during treatment, since the likelihood of developing hyperkalemia is quite high. In addition to hypersensitivity to medicinal components, contraindications include severe renal failure, hypocorticism, blood pressure below 90 mm Hg and atrioventricular block.

Calcium also plays a major role in leg cramps, with muscle spasms being one of the main symptoms of both calcium deficiency and excess. An imbalance of this substance's cations in the extracellular space and inside the myocyte in any direction leads to its excitation up to the development of tetany. In addition, with calcium deficiency, the sensitivity of sodium channels increases, which additionally leads to an imbalance of this electrolyte. The concentration of ionized calcium tends to change during the day. It reaches its highest values in the extracellular environment at night, approximately at 2-4 o'clock, which leads to an increase in membrane potential and the development of night cramps. This time coincides with a physiological 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 a calcium salt of gluconic acid. Most often used in tablets. It is prescribed as a mineral supplement for calcium deficiency in the body. Calcium gluconate for leg cramps helps to normalize the transmission of nerve impulses, contractile activity of all types of muscles, improve hematopoiesis and blood circulation. It is indicated for deficiency and increased loss of calcium, vitamin D metabolism disorders. This drug can be taken by pregnant women and small children. It penetrates into breast milk, so it is prescribed to nursing mothers according to indications.

However, excess calcium also leads to undesirable effects. Hypercalcemia manifests itself as poor health (weakness, drowsiness), digestive disorders, neurological symptoms (irritability, depressed mood), and heart problems. Calcium salts can be deposited in the body, the blood becomes too thick - blood clots appear. Therefore, calcium preparations are contraindicated for people prone to nephrolithiasis and thrombosis. They are not prescribed to patients with severe heart and kidney damage. They are not combined with quinolone and tetracycline antibiotics, iron preparations, fluorine, and foxglove. Against the background of taking vitamin D, calcium absorption improves, so high doses of both drugs are not prescribed simultaneously without special indications.

When taking calcium, it is worth considering that its absorption is improved by the presence of protein and fats in food. With a magnesium deficiency, the elimination of calcium from the body is accelerated, so the magnesium deficiency must also be compensated.

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

Calcium chloride has not lost its relevance for leg cramps. It is available in a solution for oral administration, and many believe that calcium is better absorbed in liquid form. 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 a tablespoon of the solution twice or three times a day, children - one or two teaspoons.

There are currently many other calcium preparations, the manufacturers of which position them as more revolutionary in terms of absorption. For example, it is known that calcium is very well absorbed when it enters the body in the form of citrate, that is, calcium salt of citric or ascorbic acid, which promotes excellent dissolution and absorption in the intestine. It cannot be said that this is not so, however, such chemical forms are important for people with low acidity (hypoacid, atrophic gastritis). They have a chance that the tablet will enter the intestine unchanged. In this case, the formula of the compound matters.

For all other patients, this does not play a significant role. After all, before getting into the intestine, the tablet first gets into the stomach. In a person with normal or increased acidity, any calcium compound, reacting with hydrochloric acid, immediately turns into calcium chloride, which instantly disintegrates into ions. In the main environment of the intestine, calcium ions react with fatty acids from the food eaten, again forming poorly soluble compounds.

More modern calcium preparations: balanced complexes with vitamin D3 (Calcium D3 Nycomed, Calcemin in various forms, Calcium D3 citrate), Calcium-osteovit - contains two forms of calcium (citrate and hydrophosphate) and, in addition to vitamin D3, ascorbic acid, retinol, pyridoxine. Solgar complex - a food supplement in the form of syrup or tablets - can also be prescribed. Contains calcium, magnesium in the form of citrates and vitamin D3.

Sodium cations in the extracellular environment must also have a certain concentration. As soon as it becomes lower than the intracellular one, water begins to penetrate into the cells, dilutes the potassium concentration, and this leads to a decrease in the cellular resting potential and convulsions. Most often, this occurs with a deficiency of adenosine triphosphate (ATP), the main chemical energy transporter. This substance is synthesized by cellular mitochondria and maintains its viability. In this case, sodium adenosine triphosphate injections can be prescribed. They are administered intramuscularly on an outpatient basis at 1 ml once a day for the first two to three days of treatment, then the dose is increased to 2 ml and administered once or twice a day for another two weeks. Intravenous injections of ATP are made only in a hospital.

No-shpa for leg cramps

The popular antispasmodic Drotaverine or No-shpa can have a certain positive effect on leg cramps, however, it cannot be called the drug of choice. The drug effectively relieves spasms of smooth muscles, that is, those that line the internal organs and blood vessels. Striated muscles are located on the bones of the skeleton. And if smooth muscles contract and relax spontaneously, without external impulses, then skeletal muscles - only by signals coming from the central nervous system, that is, it is necessary to act directly on the brain or spinal cord. No-shpa does not have a direct effect on striated muscles, but it is able to dilate blood vessels and improve blood flow to various tissues. Therefore, in case of cramps in the lower extremities caused by insufficient peripheral circulation due to vascular constriction, for example, after hypothermia, No-Spa can dilate these vessels and, by 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, by blocking the activity of this enzyme, can have an indirect anticonvulsant effect.

The drug does not eliminate the cause of cramps, but can be used as a means of emergency aid simultaneously with physical impact on the stiff muscle - rubbing, warm compress. People with hypotension, heart disease and kidney disease should be careful with No-shpa.

Wobenzym

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

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

The complex enzymatic preparation Wobenzym, as its manufacturers claim, has the ability to strengthen the immune system, reduce swelling and pain, and not only thin the blood, but also break down existing blood clots. Various enzymes included in Wobenzym freely penetrate the circulatory system and are carried with the blood flow to almost all tissues and organs, due to which it affects all biochemical processes occurring 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 preparation contains pancreatin (a mixture of pancreatic enzymes of animal origin). These are proteases that break down protein molecules, starch molecules – amylases that promote the absorption of fats, converting them into fatty acids and triglycerides, 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 reliably studied.

The plant glycoside rutin (rutoside) strengthens the walls of blood vessels, has a pronounced anti-inflammatory and anti-edematous effect, prevents the adhesion of red blood cells and increases their elasticity. The angioprotector reduces congestion in the veins and promotes lymph drainage, thereby soothing pain and itching, and eliminating 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.

Wobenzym is recommended to be included in the complex treatment of many diseases of almost all organs, however, the effect of the drug has not been studied enough, so not all experts believe in its effectiveness. It is known how each component of the drug acts on its own, but their combined effects are practically not established, there are no authoritative studies of the drug's effect. At least, you need to take tablets for a long time to get a noticeable result - three times a day from three to ten tablets. First, take a therapeutic dose for two to three weeks, then another two to three months half as much, a maintenance dose. Swallow the tablets whole before meals, washing down with a sufficient amount of water, then eat after half an hour.

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

No clinically significant negative interactions with other drugs have been identified. It can neutralize the side effects of antibiotics (dysbacteriosis) and enhance their effect. It also makes treatment with glucocorticosteroids and cytostatics easier to tolerate.

Injections for leg cramps

In severe cases, with severe pain during or after cramps, when oral forms are ineffective, they resort to injection forms of drugs - painkillers, anti-inflammatory drugs, vitamins. 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 applies to intravenous injections. In this case, the drug enters the blood directly and its effect occurs instantly. But intravenous injections are usually prescribed to patients in a hospital setting, 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 taking the drug delivered by the last two methods occurs almost simultaneously (if the instructions for taking are followed), and side effects usually develop to the same extent. Moreover, it is currently recommended to give preference to oral dosage forms.

However, there are cases when it is necessary to resort to injections. For leg cramps, painkiller injections may be prescribed. Usually, NSAIDs are used, for example, ketorolac (ketanov). An 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 case of diseases and injuries of the musculoskeletal system, Mydocalm can be prescribed in injections. In addition to analgesic, this drug also has a central muscle relaxant effect. The analgesic effect of tolperisone is supplemented by lidocaine, which is the second component of the injection solution. It is a good conductor of the main active component, potentiates the analgesic effect and makes the injection itself less painful. Mydocalm injections can be done both intramuscularly and intravenously.

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

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

Magnesium for leg cramps, administered intravenously, provides an almost immediate anticonvulsant, as well as a calming and vasodilatory 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 the listed actions, magnesium has a laxative, 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 there are 500 mg of magnesium per kilogram of the patient's weight. The injections are painful, but this method is considered optimal.

Intravenous administration is practiced only in cases of urgent need, drip or very slowly jet. Almost always, magnesium sulfate is diluted with glucose or sodium chloride solutions. Injecting the drug directly into the blood gives an immediate effect, but side effects are also not long in coming. And they are manifested by suppression of the heart and central nervous system up to the development of a coma and death.

The Milgamma vitamin complex is considered by modern medicine not so much as a compensatory remedy for vitamin deficiency conditions, but as a drug that relieves pain and night cramps in the legs in various types of chronic neuropathies and manifestations of degenerative changes in the spinal column, as well as in acute conditions (trauma, postoperative conditions, stress). Its action has not yet been fully explained, however, the effects are undeniable and, perhaps, it is the saturation of the body with vitamins B1, B6 and B12 that helps stop cramps. An ampoule of injection solution contains 100 mg of the first two vitamins and 1 mg of vitamin B12. The compatibility of these components is ensured by potassium hexacyanoferrate. In liquid form, this component dissociates 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 injection solution also contains lidocaine hydrochloride (20 mg), which provides pain relief at the time of injection and faster delivery of the active substance into the systemic bloodstream (conduction effect). In acute conditions, daily intramuscular injections of one ampoule are usually prescribed. The course is usually ten days. In cases of chronic convulsions, such as diabetic polyneuropathy or spinal prolapse, treatment courses are periodically repeated.

Injections of antispasmodics may be prescribed, for example, No-shpa or ATP, the decrease in the concentration of which can also cause convulsions. The advisability 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. Firstly, when the patient rubs the preparations into the skin of the legs, he does it with massage movements. Secondly, external agents have a temperature effect, warming or cooling.

For leg cramps, various ointments and gels are used. For example, Troxevasin gel. It is prescribed for cramping contractions of the calf muscles of unknown origin, as well as for patients with venous insufficiency, different stages of varicose veins and thrombophlebitis, and injuries. The drug improves microvascular perfusion, activates blood circulation, and 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 to damaged skin surfaces.

Apply a thin layer of the gel in the morning and before bedtime to the areas where cramps occur and rub in until completely absorbed.

Phleboton, Troxegel, Troxerutin have a similar effect.

In addition, you can use warming ointments and creams for leg cramps:

• Apizartron: the main component of the ointment is bee venom obtained from live insects, which is well absorbed through the skin surface and has a multifaceted effect (warms, reduces inflammation, improves blood circulation and detoxification, eliminates hypoxia), the effects are enhanced by other components - NSAIDs methyl salicylate and allyl isothiocyanate;
• Comfrey cream: contains comfrey extract in combination with various components - bee venom, chondroitin, bear bile, bischofite, etc.;
• Shark fat cream for leg cramps - it can be with different additives, you need to choose the one that corresponds to the underlying pathology (Shark fat and ginger or with leeches - directly for cramps associated with muscle strain, with acacia - for varicose veins and venous insufficiency, with glucosamine and chondroitin - for arthrosis, and so on);
• Kapsikam ointment with turpentine oil and many others.

There are many reviews that regular pharmacy glycerin helps well with leg cramps. They simply rub it on the places that are cramping and they say they go away. Official medicine does not really explain this method of treatment. Perhaps, it is simply the effect of massaging the legs with glycerin that works. Perhaps, this method is more from the category of folk recipes using ready-made products that can be bought at any pharmacy.

These include a patch for leg cramps. For example, you can stick a pepper or mustard patch on the cramped leg surface. In addition, some people use a regular mustard plaster to eliminate discomfort.

Vitamins for leg cramps

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

B vitamins, along with vitamins A, D and E, magnesium, potassium, calcium and other useful substances contain various vitamin and mineral complexes, some of which were mentioned above. For leg cramps, the doctor will help you choose the right one based on the examination results.

Vitamin B3 or nicotinic acid can also be prescribed for leg cramps, since its deficiency often leads to their occurrence. Deficiency of this vitamin affects the condition of the skin, nervous system and gastrointestinal tract. Significant deficiency manifests itself as the "disease of three Ds" (dermatitis, diarrhea, dementia) - pellagra. Dermatitis is provoked by sunlight. In addition, the patient usually sleeps poorly, gets tired quickly, has a worsening appetite and constantly loose stools, and also becomes irritable, aggressive and very forgetful. In addition to high doses of nicotinic acid, other B vitamins are prescribed - B1, B6, B9, B12. This disease most often affects chronic alcoholics, people with diseases of the digestive tract or undergoing long-term therapy with drugs that prevent the absorption of these vitamins, those who work hard physically and eat poorly. Contraindications to the use of nicotinic acid include its intolerance, decompensated hypertension, and 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, which contains rutin and vitamin C, helps to get rid of numbness and cramps at night during the development of chronic venous insufficiency and in the initial stages of superficial thrombophlebitis. Ascorutin helps to get rid of leg cramps caused by wearing uncomfortable shoes, in particular, high heels. In addition to cramps, it is possible to get rid of swelling, heaviness and pain in the legs. The vitamin preparation is not recommended for increased blood clotting, reduced potassium content, increased calcium, the formation of oxalate stones, gout. Long-term treatment and high doses of the drug can only be taken as prescribed by a doctor.

Physiotherapy treatment

Physiological effects on the body can be a valuable addition to drug therapy, optimized nutrition and hydration. Depending on the patient's health, a very wide range of physiological procedures can be offered using direct and alternating electric current, electromagnetic oscillations, thermal procedures, laser equipment.

Massage for leg cramps helps to get rid of the cramps themselves and prevent their occurrence in the future. 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 lymph drainage and eliminate edema, develop supporting muscles and the articular-ligamentous apparatus and improve their mobility. With the help of massage, you can correct the consequences of injuries, flat feet, improve well-being with arthritis, arthrosis, venous insufficiency.

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

Acupressure can also help with leg cramps. It can also help get rid of the underlying disease. There are many receptors on the surface of the feet, which, when acted upon, cause reflex reactions in all organs. By stimulating certain points, a good reflexology specialist can achieve a real improvement in the patient's health and relieve him of leg cramps. Acupressure normalizes hormonal status, improves the functioning of the immune system and internal organs.

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

Gymnastics for leg cramps is one of the main areas of their prevention. Together with a good diet and drinking the required amount of fluid, it can relieve the patient of discomfort without the use of drugs, if its occurrence is not associated with a serious systemic disease. True, in this case, you will have to make some effort. And drug treatment alone without physical impact on the body's muscles will not allow you to get rid of the problem for a long time.

Folk remedies

Cramps that do not arise due to illness can be completely eliminated with the help of centuries of ancestral experience. Folk recipes for leg cramps are often very simple. Sometimes it is not entirely clear how a 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 most skeptical recipe concerns the use of a fragrant piece of toilet soap. It is recommended to put it under the blanket at night in the area of the lower extremities. And that's it! Experts in this method claim that you will forget about discomfort. Only the soap must be fragrant. What kind of smell it should emit is not specified. Apparently, it doesn't matter. Experts believe that soap for leg cramps acts as a placebo. The patient is worried, expecting a cramp, but puts a piece of soap, calms down, believes and falls asleep peacefully.

Moreover, a piece of soap in bed (sometimes in socks) helps with other pains – bursitis, arthritis, arthrosis, restless leg syndrome. It’s hard to believe, but it’s easy to try.

If a cramp seizes your leg during the day, you can apply a piece of soap to the sore spot. They say it will go away. Another folk method of first aid is to squeeze a metal object in the corresponding hand.

A copper wire bracelet can be worn on a leg that is prone to muscle spasms on a regular basis.

Other recipes for leg cramps are more complicated. At the very least, you need to get the ingredients, since you can always find soap in the household.

For example, collect onion peels and brew tea from them every morning. Onion peels help with leg cramps not immediately, but approximately two months after the start of therapy (stable effect). People who tried this method of treatment managed to normalize blood pressure and stabilize vision. Within a year of such therapy, the vascular network on the calves disappears. Many note a strengthening of the immune system - they began to get sick less often, chronic cough passed, the work of the heart and digestion stabilized.

Lemon also helps with leg cramps. It is used as an external remedy. The recipes are slightly different. The simplest one is to thoroughly lubricate both heels from the bottom and side to the bone with a piece of lemon every day for ten days before going to bed. Let the juice applied the first time dry, then repeat the procedure and leave it until the morning. Some sources recommend lubricating the place of the cramp - calves, thighs, feet.

You can also use warm liquid honey (wrap your feet after application), mustard oil, 6% apple cider vinegar.

Apple cider vinegar for leg cramps is also taken internally. It helps eliminate potassium deficiency and prevents dehydration. The drink is easy to prepare: dilute a tablespoon of natural apple cider vinegar in a glass of warm boiled water. Drink this drink every night before bed. Another drink option: dilute one teaspoon of apple cider vinegar and honey in a glass of warm water with the addition of a tablespoon of calcium lactate (food additive E327).

B vitamins are fully represented in brewer's yeast. They can be "obtained" in liquid natural form at breweries and private breweries; brewer's yeast is sold in capsules at the pharmacy without additives and with additives, in particular, with minerals and vitamins. In some cases, a course of brewer's yeast helps with leg cramps.

Any folk medicine does not ignore herbal treatment. Phytotherapy uses sedative herbs and infusions to combat convulsions if it is assumed that they arose against the background of stress. These are lemon balm, mint, thyme, peony, motherwort, valerian root.

For venous insufficiency, use a tincture of horse chestnut fruits. It is made with vodka or apple cider vinegar and used externally, for rubbing into the places of spasms before bed. Rub without fanaticism, from the bottom up. Preparation of the tincture: split ripe chestnut fruits, crush them into several pieces and pour up to half of a three-liter jar. Pour either of the two liquids to the edges of the jar and insist in a dark place at room temperature for two weeks.

An ointment is made from celandine juice and Vaseline in a 1:2 ratio. It is rubbed into areas prone to cramps before bedtime. The course of treatment is two weeks.

To relieve leg cramps, drink linden tea with honey, infusion of birch buds, chamomile, and thistle.

Homeopathy

Since convulsions are caused by various reasons, almost the entire arsenal of homeopathic remedies is used to eliminate them, and the treatment is aimed at eliminating the underlying pathology. Although sometimes symptomatic assistance is provided in acute cases.

For night cramps use Agaricus (Red fly agaric), Calcarea carbonica (Carbonate of lime), Hyoscyamus (Black henbane), Nux vomica (Nut emetic), Sulphur (Sulphur), if the feet, toes and soles are cramped; Ambra (Contents of the intestines of a sperm whale), Arsenicum album (White arsenic), Kali carbonicum (Potassium carbonate), Sepia (Contents of the bursa of a black cuttlefish) - thigh muscles; Lycopodium (White club moss), Pulsatilla (Pulse grass), Strontiana carbonica (Carbonate of strontium) - gastrocnemius.

When prescribing treatment, not only the localization of the cramps is of great importance, but also the time of their onset, the severity of the pain, other symptoms and characteristics of the patient. With the correct prescription of the drug, it is usually possible to get rid of not only the painful symptom, but also to normalize the functioning of the entire body.

Surgical treatment

Surgeries are resorted to only in extreme cases, if the cramps are very painful, do not respond to conservative treatment and cannot be stopped. They do not operate on the muscles that are cramped directly, but surgically eliminate the cause of this condition - a neoplasm, a spinal hernia, or replace a damaged joint that cannot be restored.

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

Diet for Leg Cramps

Correcting the daily menu to increase the amount of foods rich in magnesium, potassium, calcium, vitamins B and D can help eliminate the deficiency of essential electrolytes caused by alimentary reasons. It is also recommended to optimize the diet for cramps caused by chronic pathologies. It is best to consume vitamins and microelements from food. You will not get hypervitaminosis this way, the body will simply remove the excess.

You need to 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 the absorption of magnesium. Most of them contain a lot of iron, folic acid, vitamin C. Leg cramps do not threaten lovers of green salads dressed with vegetable oil (vitamin E). All types of cabbage, spinach, lettuce, green onions, parsley, dill are not rare and scarce for our zone. Salads go well with a piece of meat, liver, sea fish, which also contain many anticonvulsant components.

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

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

Vitamin D, which helps absorb calcium, is found in egg yolks, cod liver, and butter. The endogenous vitamin is produced in the body under the influence of sunlight, and you don’t need to be in the sun for long to get it. 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 tolerance - allergic reactions to food products occur, some products are prohibited for certain diseases. Nevertheless, it is possible in any case to choose a suitable diet. Professional nutritionists can help with this.

At the same time, it is necessary to avoid dehydration, that is, to drink a sufficient amount of clean, non-carbonated water. On hot days and during physical exertion, the amount of water drunk should increase. For each organism, this indicator is also individual, you need to listen to your desires and satisfy them.

Drinking coffee, drinking alcohol, taking diuretics and laxatives increases the consumption of electrolytes; this should be taken into account when planning your daily menu.

Prevention

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

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

Maintain a normal body weight, exercise, but without fanaticism, and give your body feasible loads.

Wear comfortable shoes every day, but if you had to wear narrow shoes or high heels during the day, you need to take care of your tired feet in the evening - do a light massage, a bath with herbal infusion, simple gymnastics. 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 experience any symptoms of illness.

Forecast

Cramps are unpleasant, but do not pose a mortal danger in most cases. Getting rid of them is also generally easy with the help of massage and relaxing gymnastics. Regular cramps can be a symptom of pathological changes in the body, but with timely treatment by a doctor, most of the causes of such a symptom are completely eliminated or controlled.