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Question (10/30/2013):

Title: Muscles Have Been Cramping For Years.

My Muscles Have Been Cramping For Years. Random Muscles, Sometimes Severely And At Other Times Just Uncomfortable.

This Happens Everyday!

It's Like Constantly Doing Isometric Exercises.

It Leaves You Worn Out And You Muscles feeling Bruised.

It Interferes With Daily Activities.

My Doctor Does Not Know What Is Causing This And Has Run Several Tests To Eliminate Common Causes.



Dear Gail,

Thank you very much for your question.

Causes of cramping include hyperflexion, hypoxia, exposure to large changes in temperature, dehydration, or low blood salt. Muscle cramps may also be a symptom or complication of pregnancy, kidney disease, thyroid disease, hypokalemia, hypomagnesemia or hypocalcemia (as conditions), restless-leg syndrome, varicose veins, and multiple sclerosis.

Electrolyte disturbance may cause cramping and muscle tetany, particularly hypokalaemia and hypocalcaemia. This disturbance arises as the body loses large amounts of interstitial fluid through sweat. This interstitial fluid comprises mostly water and table salt (sodium chloride). The loss of osmotically active particles outside of muscle cells leads to a disturbance of the osmotic balance and therefore shrinking of muscle cells, as these contain more osmotically active particles. This causes the calcium pump between the muscle lumen and sarcoplasmic reticulum to short circuit; the calcium ions remain bound to the troponin, continuing muscle contraction.

As early as 1965, researchers observed that leg cramps and restless-leg syndrome result from excess insulin, sometimes called hyperinsulinemia. Hypoglycemia and reactive hypoglycemia are associated with excess insulin (or insufficient glucagon), and avoidance of low blood glucose concentration may help to avoid cramps.

About one in every three adults are affected by lower limb muscle cramps. For some people, these cramps reduce quality of life, quality of sleep and participation in activities of daily living. Many interventions are available for lower limb cramps, but some are controversial, no treatment guidelines exist, and often people experience no benefit from the interventions prescribed.

The use of diuretics, statins, and inhaled long-acting ?2-agonists (LABAs) is linked to muscle cramps.

Rest cramps (also known as nocturnal leg cramps) are very common in a geriatric population. Oral magnesium supplements are marketed for prophylaxis of such cramps but clinical trials exploring the efficacy of oral magnesium conflict.

Muscle cramp, twitching and stiffness are common symptoms reported by patients attending neuromuscular clinics. In a proportion of patients, these symptoms may be due to an acquired peripheral nerve hyperexcitabilty syndrome, including benign cramp fasciculation syndrome (BCFS) and disabling neuromyotonia (NMT) or Isaac's syndrome. Antibodies to voltage-gated potassium channels (VGKC) can be detected in approximately 40% of patients with NMT. Recent literature highlights that antibodies which bind to VGKC-associated proteins may also be involved .

Wilson's disease causes a wide variety of signs and symptoms that are often mistaken for other diseases and conditions. Wilson disease (WD) is an autosomal-recessive disorder of hepatic copper metabolism that has tremendous variability in its presentation. Phenotypic diversity of the disease can lead to delayed diagnosis. Spasmodic muscle cramps and weakness are symptoms of Wilson disease.

Polycythemia vera is rarely manifested with symptoms of sensomotor polyneuropathy as the first signs of the disease, and should therefore be recognized by physicians to prevent further axonal damage and major complications of disease by venipuncture or cytostatic therapy.

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