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muscle cramp

Etiology: 1) electrolyte imbalances a) diuretics b) corticosteroids c) emesis d) diarrhea e) poor diet 2) anti-hyperlipidemic agents -> HMG CoA reductase inhibitor (statin) 3) interferon alpha 4) alcohol 5) nocturnal leg cramps 6) post-exertional 7) hypothyroidism 8) liver disease 9) renal disease 10) malignancy 11) myasthenia gravis Pathology: - painful, spasmodic muscular contraction, especially a tonic spasm Laboratory: 1) electrolytes 2) liver function tests 3) renal function tests 4) thyroid function tests 5) serum creatine kinase 6) erythrocyte sedimentation rate 7) serum C-reactive protein Management: 1) general measures a) treatment 1] stretching - pull up on toes to stretch gastrocnemius (leg cramp) 2] gentle heat 3] massage 4] ice b) prevention 1] adequate hydration 2] diet: water, K+, Ca+2, B vitamins 3] stretching 2) specific measures for specific etiologies 3) pharmaceutical agents a) quinine 200-500 mg/day 1] significantly reduces cramp frequency, intensity [5] 2] benefit modest 3] avoid routine use due to potential adverse effects [4] 4] for use up to 60 days, risk of serious adverse effects similar to placebo [5] b) possibly effective 1] vitamin B complex 2] calcium channel blockers such as diltiazem [4]

Related

abdominal cramping

Specific

leg muscle cramp

General

myalgia (muscle pain) cramp

References

  1. Dorland's Medical Dictionary, 23rd ed., WB Saunders, Philadelphia, 1990
  2. Weiner SR. In: Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  3. Sohrabvand F et al, Vitamin B supplementation for leg cramps during pregnancy. Int J Gynaecol Obstet 2006, 95:48 PMID: 16919630
  4. Katzberg HD et al Assessment: symptomatic treatment for muscle cramps (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2010 Feb 23;74(8):691-6. PMID: 20177124
  5. El-Tawil S, Al Musa T, Valli H, Lunn MP, El-Tawil T, Weber M. Quinine for muscle cramps. Cochrane Database Syst Rev. 2010 Dec 8;(12):CD005044 PMID: 21154358