How to ease and prevent sudden and painful muscle cramps

If you find yourself gripping your foot in agony during your morning swim, or wake up from a jolt of pain in your calves at night, you are not alone. Muscle cramps are extremely common, with most people having experienced one at least once in their lives.

“Almost everyone would have experienced some form of muscle cramp. They are sudden, involuntary and painful contractions of one or more muscles,” said Dr Poh Seng Yew, Senior Consultant, Department of Orthopaedic Surgery, Singapore General Hospital (SGH).

“Most cramps last for a few seconds. However, some may last for 10 to 15 minutes, and can be so painful that the patient is literally gripping his limb.”

Common areas for a cramp to occur include the calves, thighs, foot arches, arms, hands, chest and abdominal wall. Though the cause is not always clear, factors such as dehydration and muscle overuse may contribute towards it.

“When you are dehydrated, the fluid and salt balance around the muscle is affected. This results in abnormal muscle activity in the form of cramps,” Dr Poh said.

“Intense exercise that causes muscle overuse or direct trauma to the muscle may also result in cramps. This may happen when an athlete engages in an activity he is not usually accustomed to. In such cases, he should rest, regulate his activity, or train so that the muscle is more accustomed to this kind of activity,” he added.

While anyone can suffer from cramps, some individuals tend to be more prone to it. Studies suggest that the elderly, especially those over the age of 65, tend to suffer from it more frequently.

“With age, there is loss of muscle mass, and the remaining muscles get fatigued more easily, resulting in cramps. Some other  hypotheses include muscle and nerve degeneration, and the prevalence of medical conditions such as circulatory disorders, which come with age,” he said.

Pregnant women are another group that is more prone to cramps, particularly in the calf. As the foetus grows within the uterus, it presses on the nerves and blood vessels that pass through the abdomen and into the legs, causing a circulatory disturbance to the lower limbs.

Venous blood that is low in nutrients and oxygen, and high in waste, pools in the legs and causes abnormal muscle activities, which manifest as cramps. Hormonal changes during pregnancy also affect circulation in the limbs.

The good news is most cramps are manageable and go away on their own. Dr Poh recommends rest and simple stretching exercises.

“Stretch the affected muscle for about 15 to 30 seconds to lengthen it, and repeat the stretch as necessary until the muscle relaxes. You can also apply a warm towel or hot pack over the area, or give yourself a warm massage. Avoid vigorous exercise for at least an hour following a cramp to allow the muscles and nerves to recover,” he advised.

Although usually innocuous, cramps may sometimes be a sign of more serious underlying conditions such as nerve compression, poor blood circulation, and electrolyte imbalance because of diet or medication. Cramps may also be a sign of diseases like diabetes, thyroid, liver, kidney or heart condition, he said. Red flags include redness, leg swelling, skin changes, numbness or muscle weakness.

When cramps become more frequent and painful, and affect quality of life or sleep, seek medical advice. In such cases, doctors may prescribe muscle relaxants to ease the discomfort while they evaluate the underlying cause.

Keeping cramps at bay

Hydrate, hydrate, hydrate
Drink plenty of water before intense physical activity.

Warm up, cool down
Stretch major muscle groups for 5 to 10 minutes before and after exercising.

Stretch calf muscles
If prone to night cramps, do calf stretches or light exercise such as riding a stationary bicycle before bed. Keep the toes propped up towards the body, with a pillow placed at the end of the bed to keep the calves in a stretched position.

Wear compression stockings
If the cause of the cramp is venous insufficiency, wear compression stockings to reduce the pooling of venous blood in the legs. 

Cramps usually go away on their own, says Dr Poh Seng Yew.