Celine Dion is paralyzed due to muscle cramps: What are Muscle Cramps?

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Everyone must have had cramps, that is, muscle cramps. This condition will appear without any warning, and then cause muscle stiffness in the legs, arms, toes or hands, which may take a few minutes. Can alleviate. 

Why do cramps occur? How to recognize cramps? And more importantly, how to quickly recover from cramps and prevent cramps from recurring?

Pietro Bassi, a neurologist at the Muscle Spasm Diagnosis and Treatment Center of the Palazzo Della Salute-Wellness Health Clinic under the GSD Group to provide us with relevant answers.

In Palazzo Della Salute-Wellness, patients can be diagnosed and treated by a multidisciplinary team of experts to find out the cause of muscle spasms, and tailor the treatment according to the different conditions of the patient.

What is muscle cramps?

Muscle cramps (cramps) are sudden, short-lived, involuntary, painful contractions of muscles or muscle groups. This is a very common disease that can occur in any healthy age group. 

But 40% of cases occur in people over 50 years of age.

Night leg cramps

The most common form of cramps in the lower extremities is benign idiopathic cramps in the legs, which usually occur at night. 

In Italy, 73% of the population have encountered this condition, and may be accompanied by the following symptoms:

• Calf twitches
• Curved soles or toes

Muscle cramps caused by exercise

Some muscle cramps are related to physical exercise and will appear during or after the exercise. 

Usually this symptom is harmless, and people will not consult a doctor for it. 

However, this condition can cause severe pain and cause the muscle tissue to not function properly.

The condition may last from a few seconds to a few minutes.

Causes of muscle cramps

There are many risk factors that can increase the risk of cramps or worsen the severity of cramps, such as:

• Tightness of the calf muscles due to lack of stretch or exercise, and chronic edema in the lower leg
• Dehydration
• The content of potassium or magnesium is too low, the electrolyte status changes
• Musculoskeletal abnormalities, such as calf muscle contraction caused by prolonged sitting, flat feet or structural diseases such as knee hyperextension
• Nervous system disease (peripheral neuropathy, plexus disease, radiculopathy, motor neuron disease, myopathy) or metabolic disease (alcoholism, hypothyroidism)
• Taking certain drugs or substances

1. Angiotensin II receptor inhibitors, cisplatin, clofibrate, diuretics, donepezil
2. Drugs with β-adrenergic agonist effects, including bronchodilators and certain β-blockers
3. Lovastatin, oral contraceptives, pyrazinamide, raloxifene
4. Stimulants such as amphetamine, caffeine, cocaine, ephedrine, nicotine, pseudoephedrine, teriparatide, tolcapone, vincristine

• After stopping certain drugs or substances: alcohol, barbiturates, benzodiazepines, sedatives, hypnotics or certain toxins
• pregnant

A disease that may be mistaken for cramps

The clinical evaluation of muscle spasms aims to find out how to treat the disease. 

Usually the patient already knows the cause of the cramps, and the symptoms are already serious. 

Through clinical evaluation, the following other diseases that may be mistaken for spasms can also be ruled out:

• Intermittent claudication, the patient will have intermittent menstrual pain when walking, causing the patient to be unable to walk continuously
• Dystonia is an involuntary muscle twitching and spasm, resulting in abnormal body posture or abnormal movement
• Restless legs syndrome, patients will feel an urgent need to move their legs at any time

How to diagnose cramps

In order to understand the cause of the disease more clearly, patients need to pay attention to and record all relevant information when cramps occur:

• Duration of cramps
• Frequency of occurrence
• The place or situation where it happened
• The area where the pain occurs and any related symptoms

In particular, you need to pay attention to all possible causes of cramps, such as:

• Muscle stiffness, weakness, pain, loss of consciousness, these may be related to nervous system or muscle diseases
• Vomiting, diarrhea, excessive exercise and excessive sweating, recent dialysis, dehydration, electrolyte or fluid imbalance due to diuretics
• Leg cramps caused by pregnancy or irregular menstruation
• Unable to tolerate cold, and it is accompanied by weight gain and skin changes, which may be caused by hypothyroidism
• Weakness caused by neurological diseases
• Pain or loss of sensation may be caused by peripheral neuropathy or radiculopathy

At the same time, clinical evaluation also needs to consider the patient’s drug use history, including whether there is excessive drinking. 

After collecting and observing all symptoms, the patient needs to undergo related examinations, including:

• Skin examination to check for alcoholism, edema, eyebrow loss (related to hypothyroidism), changes in skin water retention and filling degree, etc.
• Nervous system examination to assess the condition of tendon reflexes
• Blood pressure measurement of the whole body limbs, weak pulse or low ankle-brachial blood pressure index, there may be limb ischemia problems
• If the inspection finds any abnormal situation, the expert will decide whether to conduct further evaluation and testing

What to do if cramps occur

If cramps occur, stretching the muscles will help the muscles return to their normal state. 

For example, if you want to solve the spasm of the calf, pulling up the feet and toes with your hands can relieve it to a certain extent. 

Once stretching cannot solve the problem, or the problem continues to occur, you need to consult an expert immediately to find the most suitable solution.

Nutrition that can be added to prevent muscle cramps:

• Calcium, magnesium and potassium
• B complex or vitamin E

For some serious patients, experts will consider the pros and cons and prescribe some drugs (antihistamines, calcium antagonists, gabapentin, benzodiazepines, quinine) to the patients based on the cause of cramps.

Different mechanisms of action can be targeted to treat spasticity caused by different reasons.

How to prevent cramps

Experts concluded that there are some measures that can help prevent muscle cramps, such as:

• Avoid exercising immediately after eating
• Perform soothing muscle stretching exercises before exercising or going to bed

Stretching before running is very useful. Before running, you can bend the knee of one foot forward, while the knee of the other leg is extended to the back, and the body is in a lunge position. 

Place your hands near your hips, and the heels of both feet must be in contact with the ground. 

The leg with the bent knee slowly leans forward until the muscles stretch on the back of the leg. 

The greater the distance between the two feet, the better the stretching effect. Repeat five times each time, hold for 30 seconds, and then you can change sides to stretch.

• Need to replenish a lot of water after exercise, especially potassium-containing liquids
• Control the intake of irritating substances, such as caffeine, nicotine, ephedrine and pseudoephedrine
• No smoking
• Eat foods rich in magnesium, potassium and calcium (bananas, green leafy vegetables such as broccoli, arugula, spinach and cabbage, eggs, yogurt, beans and wheat germ)