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Muscle cramps are defined as involuntary, painful contractions of particular muscles. A wider term which includes any painful or painless involuntary muscle contraction is muscle spasm. Fasciculations are contractions of particular motor units within some muscle. Cramps can affect every muscle in the body. They are very common among healthy persons, but they can also be a sign of some medical conditions.

In healthy people, there are several muscles that are commonly affected by cramps due to their localization and exposure to stretching. For example, inner thigh, calves, feet, and lower back contain big muscles that are very susceptible to stretches, even during everyday activities.

Physiology

Skeletal muscles are supposed to contract voluntarily. This process requires strict coordination between several components, including motor neurons, calcium, and energy sources such as ATP (Adenosine triphosphate and glycogen). Irritability of motor neurons, disturbed calcium levels, or lack of energy sources can cause muscle cramps. There are many possible causes that can disturb the balance between these components.

Causes

Ordinary muscle cramps are very common in older persons, but also appear in healthy young people. They usually occur in the calves, inner thighs, and feet. The cause of this phenomenon is still unknown, but it is suggested that stretching and an electrolyte imbalance can be provocative factors. Ordinary muscle cramps usually last for several minutes and can be terminated by stretching the contracted muscles. Muscle soreness due to these cramps can last for 1-2 days. Further diagnostics and treatment are unnecessary if the cramps occur only occasionally.

Atherosclerosis is a degenerative process occurring in the walls of blood vessels which leads to their narrowing and consequent lowering in blood supply to the certain areas of the body. Muscle tissue is relatively resistant to poor blood supply comparing to other tissues (for example brain tissue), but it can show some functional disorders due to hypoxia. Namely, energy is necessary for relaxation of muscle fibers, and if energy sources are empty due to poor blood supply, the muscles stay contracted longer than usual which is manifested by painful cramps or spasms called intermittent claudications. The symptoms are strongest while walking or running and they decrease during the rest. These atherosclerotic blood vessels can be treated with medications such as vasodilators and surgery (bypass graft implant, sent insertion, etc.).

Spinal nerves are responsible for the innervation of skeletal muscles. If there is a nerve compression or nerve damage, the nerve cells can be irritated, producing muscle cramps. The symptoms are usually worse while walking than during rest. X-ray, CT, and MRI imaging of spinal structures can reveal this condition.

Electrolyte imbalance is often present in patients taking diuretics. Hypokalemia (low blood potassium), hypocalcemia (low blood calcium), and hypomagnesemia (low blood magnesium) can cause muscle cramps. If you are taking diuretics or you are on some kind of diet, talk to your doctor to check your electrolyte levels.

Proper nutrition and hydration, along with vitamins and minerals is necessary to keep optimal energy levels and electrolyte balance. Try changing your lifestyle first and then contact your doctor if your symptoms still persist.

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