One of the most common complaints I hear from my patients involves painful muscle cramps and what to do about them. Likely, you've gotten your share of them too, especially if you're active and exercise regularly. Sometimes they're just a vague, achy "charley horse" or tightness and other times muscle cramps can be a deep, intense, zapping pain that jolts you awake in the middle of the night. If you've been bothered by muscle cramps, let me share with you what I tell my patients about getting rid of and preventing them.
What Causes Muscle Cramps?
Muscle Drink
Muscle cramps can be brought on by inadequate stretching prior to exercise, but are most often brought on from overall dehydration. If you're sweating a lot, from exercise or outside work, and not drinking enough fluids to re-hydrate yourself, you can lose a lot of electrolytes, namely the minerals sodium, potassium, magnesium, calcium, and chloride. Certain drugs, like diuretics, can also cause you to lose a lot of fluid through excessive urination.
If you do not replace these lost electrolytes well enough through food or electrolyte drinks, the deficiency can lead to bad muscle cramps usually in your legs, but sometimes also in your stomach and even your heart! Potassium, calcium and magnesium are responsible for making muscles "fire" when you move and relax when you're inactive. Insufficiencies of these minerals can keep muscles from working properly and they begin to cramp.
How To Stop Muscle Cramps
As I tell my patients, the best way to stop muscle cramps is to prevent them from occurring in the first place. However, if you've ever experienced a bad cramp in the middle of the night, all you can think of is how fast you can stop it! Here are several fairly quick emergency remedies that should get rid of a bad muscle cramp when it occurs:
Get Up and Move Around: When you get a really bad muscle cramp, your body almost propels you to get up and move, and that's exactly what you should do. Making the muscle move increases blood circulation to it and helps "iron out" the painful kink in it. Pulling your toes back towards your knees often helps as well. Then, move quickly to the refrigerator where you can grab some potassium, calcium, and magnesium to help further iron out that cramp.
Replace Potassium: Muscle cramps usually respond fairly quickly to the intake of potassium. You must replace it daily especially if you are sweating a lot and/or live in a hot, humid or very cold and dry climate, to keep muscles (including your heart!) working correctly. Other signs of low potassium are heart palpitations and undo fatigue. Some good food sources are:
• Vegetable juice: Contains 650 mg of potassium.
• Orange juice: Contains 250 mg of potassium.
• Milk: Contains about 600 mg of potassium and about 350 mg of calcium. Cramp fix: Blend 8 oz milk with 8 oz orange juice and a banana. High in potassium and calcium, it can relieve a dehydration cramp within a few minutes and tastes great.
• Pickle juice: Some of my patients swear by this natural remedy to stop a muscle cramp. The juice has potassium and sodium in it.
• Almond milk: 8 oz contains 230 mg of potassium and about 30% calcium.
• Banana: Contains 495 mg of potassium.
Replace Calcium and Magnesium: Calcium and magnesium deficiencies also contribute to cramps too. A large glass of milk, a cup of hot cocoa will help as they contain both calcium and magnesium. So will taking a supplement of calcium, magnesium and zinc, about 1,200 mg. Like potassium, they must be replaced daily by your food and/or supplements.
Non-Emergent Prevention for Muscle Cramps
Here are some other things you can do on your own to relax and unwind your muscles after exercise or working outside in hot or very cold weather.
Hydrate, hydrate: We can become dehydrated quickly especially in very cold dry weather or very hot humid weather or from exercise/sweating. The Institute of Medicine recommends that men consume 13 cups (8 oz) of water/fluid a day and women 9 cups. If you drink caffeinated beverages, replace 1 extra cup of water for every cup of caffeinated drink. Drinks like Gatorade and other commercial electrolyte drinks help replace lost minerals as well.
Epsom salts bath: This old standby really works. Epsom salts contain magnesium which helps relax tense muscles and keep them from spasming and cramping. Fill a warm bath with about 1 cup of Epsom salts (bought at your grocery or pharmacy) and soak for at least 30 minutes after strenuous exercise.
Watch Your Food Intake: 4,000 mg of potassium a day is optimal, but minimum 2,500; at least 1,200 to 1,500 mg of calcium and 600 mg of magnesium a day to prevent deficiencies.
• Potassium: Artichokes, potatoes, raisins, pinto beans, beet greens, white beans.
• Calcium: Dairy, fish, green leafy vegetables.
• Magnesium: Cocoa, spinach, legumes, halibut, almonds, soybeans, cashews.
As I counsel my patients, with a little more careful attention to your potassium, calcium and magnesium and fluids intake, you should be able to prevent sleep robbing, painful muscle cramps from occurring. However, for muscle pain/cramps that are not relieved by some of the above suggestions, please contact your doctor, or go to your nearest emergency room or urgent care as your pain may be symptoms of claudication, blood clot, muscle, ligament or tendon tear.
Mark Bromson, M.D.
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