About six months ago, one of my best friends completed his last round of chemo. He has since gone on to defeat cancer. Unfortunately, chemotherapy and the barrage of prescription meds are the gifts that keep on giving well beyond the scope of the treatment. He is cancer-free, but his body took an unimaginable beating. Not to go into too many details, but one of the things he has to deal with is rampant muscle cramping. He deals with it every day to varying degrees and often finds himself awakened at night by a pain excruciating enough to make him literally yell out. His wife and he asked me if I could offer them any advice. While I could only offer advice in the most generic sense (especially since I have no oncology background), I did find myself inspired to blog about muscle cramps.
First of all, what is a muscle cramp? Basically, for the scope of this blog article, it’s the involuntary, forcible, sustained, seemingly-spontaneous, and frequently painful contraction of muscle. A momentary involuntary muscle contraction is a spasm. An involuntary muscle lockdown is a cramp. Normally, they can last anywhere from a few seconds to several minutes. Any voluntary muscle can cramp, and many involuntary muscles of the organs can also experience this. They can involve a segment of a muscle or an entire muscle group. They can occur as a result of injury, and they can occur when at rest.
What causes them? Generally speaking, cramps are caused by hyperexcitability of the nerves stimulating the muscles. Drilling down deeper, there are several potential underlying factors that contribute to cramping. Dehydration, electrolyte depletion, low blood calcium, low blood magnesium, vitamin D deficiency, low potassium, trauma, muscle fatigue, and “altered neuromuscular control” are all listed as possible causes. Few of these causes are universally accepted as definitive. Beyond these causes, diseases and afflictions, such as multiple sclerosis and stroke, can also involve cramping.
The common, everyday causes seem fairly straight forward, but it’s the complexities of our bodies and our lives that complicate things. It should be easy to stay hydrated, and it should be easy to maintain vitamin and mineral thresholds with supplements (or diet… crazy suggestion, I know). Dehydration and deficiencies occur, though. If you exercise and wait for thirst as your sign to hydrate, then you could be in trouble because thirst lags behind the demand being put on your body. Are you an avid coffee drinker? Do you drink coffee all day long or out of balance with water consumption? If you do, just know that you might be inhibiting calcium, B vitamin, and magnesium absorption. How much candy or refined sugar do you consume? Every bit of that tasty sweetness leaches the body of vitamins and minerals through the corresponding digestion, detoxification, and elimination required. How much time do you actually spend outside in the sun? If you aren’t getting direct sunlight for 10-15 minutes three times per week, then you could be D deficient. When you work out, do you warm up beforehand AND stretch afterwards? If you don’t do both, then you could be increasing your cramp susceptibility. Are you trying something new with your workouts? Well, as good of shape as you might find yourself, new, unfamiliar things increase the chances of cramping. Are you working out in a fatigued state? Attempting to push through excessive physical fatigue is inviting a cramp… or worse.
What is the treatment? It’s widely accepted that if you can stretch the muscle, then you stop the cramp. Massaging the affected area is another common method for relaxing a contracted muscle. If the cramp is relating to fluid or electrolyte loss, then replacement is essential. In more extreme cases, such as dystonic muscle disorders, Botox injections have been used to treat the cramping occurring in a limited group of muscles.
What is the prevention? There is no guaranteed, fool-proof way to avoid cramps in every situation. The best things to do, though, are: stretching regularly, adequate fluid (non-soda) intake, exercising regularly, and proper vitamin and mineral supplementation. Consult a physician when you consider supplements and dosages.
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