Muscle Cramps: Causes and Treatment Options

A muscle cramp can bring a jogan athlete with leg cramp

er to his knees or elicit the fear of drowning in a swimmer; however, athletes are not the only individuals to experience a muscle cramp or spasm. According to one estimate, approximately 95 percent of people will at some time in life experience the sudden, sharp pain associated with a muscle cramp.

The good news is that most types of cramp and muscle spasm respond very well to chiropractic treatment and advice.

A muscle spasm, commonly seen in a chiropractic practice, is an involuntary sudden, severe contraction of a muscle, part of a muscle, or several muscles that usually act together. If the spasm is forceful and sustained, it becomes a cramp that can last from seconds to several minutes, days or even weeks. It all depends on the cause of the spasm. If you feel the need to stretch or massage muscles regularly due to cramp, there is usually an underlying cause that should be dealt with.

Most people describe a muscle cramp as a feeling of tightness in the muscle; it’s not unusual to feel a lump of hard muscle tissue underneath the skin in the vicinity of the cramp. During a spasm or cramp, it may be painful, or even difficult to use the affected muscle or muscle group.
Cramps and spasms can affect any muscle, even those affiliated with the body’s various organs; however, they are most common in the calves, hamstrings, and quadriceps. Cramps in the feet, hands, arms, and lower back occur frequently, as well.

One of the most common types of cramp and spasm we come across in chiropractic clinical practice which can often be easily remedied, apart from back related problems, are a calf cramp at night (nocturnal cramp) and restless leg syndrome (RLS). Click here for further information on these 2 conditions. But let us first look at the causes of cramp.

Many Possible Causes:
Common as they are and painful as they can be, a shroud of mystery surrounds the cause of muscle spasms and cramps. Some researchers believe that inadequate stretching and muscle fatigue lead to cramps. According to the University of Michigan, other possible factors include a low level of fitness, overexertion (especially in intense heat), stress, and depletion of electrolytes through excess sweating or dehydration. Certain side effects from taking medication such as diuretic drugs, or underlying medical problems, can also cause cramping of muscles. If the cramp is due to a muscle imbalance, the right advice on exercise and also treatment is often needed.

The Muscles Involved Gives A Clue To The Cause Of Cramp:
The muscles involved usually give a good clue to the mechanism and cause of the cramp.

If the cramp is triggered by fatigue (drop in muscle glycogen), dehydration or an electrolyte imbalance, it happens most frequently to the calf muscles, feet or back of the thigh (hamstring muscles). You may have seen footballers lying down on their backs asking a teammate to stretch their calves, especially if the match has gone it to overtime. This is typically due to a combination of fatigue and dehydration and can usually last from seconds to several minutes.

If it is triggered by a nerve irritation or part of a protective mechanism to pain, let's say from a disc injury, it most frequently causes cramp in the forearm and hand or in the calf and foot, if the disc injury is in the neck or lower back respectively. It can last for days or even weeks depending on how long the trigger stays there.

If there is a joint sprain in the neck, mid back or lower back, you will normally get the cramp or muscle spasm in the muscles locally where the injury is, and also the muscles of the shoulder girdle and hip girdle (buttock muscles). The muscles affected are the paraspinal muscles, close to the spine. This is a very common condition, often misdiagnosed as ‘just a muscle spasm’.

What Is Secondary Cramp?

You can also get cramp due to underlying causes, so called secondary cramp. There are along list of causes. Here are some examples:

  • Neurological conditions: for example, Multiple Sclerosis, motor neurone disease and peripheral neuropathy
  • Liver disease such as cirrhosis: toxins can build up, which can cause muscles spasm
  • Bacterial Infection such as tetanus, which is a bacterial infection
  • Toxins: poisonous substances, such as lead or mercury
  • Dehydration and a lack of electrolytes e.g., low sodium, low potassium, or low magnesium can trigger muscle cramps Pregnancy: usually during the last trimester of pregnancy,  the extra weight can place strain on the leg muscles, making them more vulnerable to cramping
  • Medication: Certain medications have shown to cause leg cramp. These include: Diuretics (used to treat conditions such as high blood pressure); Statins and Nicotinic Acid (used to treat people with high cholesterol levels in their blood); Raloxifene or Evista  (used to prevent osteoporosis); and, Nifedipine (used to treat angina and Raynaud’s phenomenon).

If you have secondary leg cramps, treating the underlying cause may help relieve your symptoms. Leg cramps that occur during pregnancy should pass after the baby is born.Treating cramps that occur as a result of serious liver disease can be more difficult. Your treatment plan may include using medications such as muscle relaxants.We would recommend that you contact your GP if you think your medication may be causing your cramps. You should never stop taking a prescribed medication unless your GP or Consultant advises you to do so.

Treatment of Muscle Spasms and Cramps:
Typically, muscle cramps require no treatment other than patience and stretching; medicines are not generally needed to treat an ordinary muscle cramp. Gentle and gradual stretching, along with massage, may ease the pain and hasten recovery.

When a muscle spasm or cramp is the result of an injury, applying ice packs for the first two to three days may help alleviate the pain. Spasms that last a long time may be treated with moist heat for 20 minutes several times a day.

If you tend to get muscle cramps during exercise, make sure you drink enough fluids, and, after your workout, consider a warm Epsom salt bath followed by stretching of the affected muscles. Generally speaking, water is sufficient for rehydration; however, some may find a sports drink or juice beneficial as a means to restore their body’s electrolyte balance.

If your muscle cramps are associated with a specific medical condition, keep in mind that you need to address the underlying health problem for the cramps to subside with your health care provider such as your chiropractor or medical physician.

Tips for Prevention:
As with any health condition, it is always best to prevent muscle cramps or spasms—especially if you tend to develop them. Consider altering your diet and lifestyle by incorporating the following suggestions:

  • Make sure you stretch your muscles so you maintain your flexibility, but don’t stretch your spine!
  • Incorporate strengthening exercises into your fitness routine.
  • An important thing to remember is that although most cramp and muscle spasm can be relieved by massage and stretching, it will often only give you temporary relief. Call us for an assessment for chiropractic treatment advice.
  • If your problem keeps returning and you regularly feel the need to use a foam roller to massage the muscles due to tightness, you are likely to have an underlying problem that chiropractic is likely to help.
  • Back problems cannot be resolved just by stretching. If you stretch the spine by twisting or bending you will only move the most flexible part the most and not the stiff part. If you continue to do that you will create an instability, which is likely to make you more vulnerable to injury and subsequent muscle spasm.
  • Take steps to improve your diet. Eliminate sugar and caffeine from the diet, and increase consumption of fiber and protein. In addition, remember to eat plenty of calcium and magnesium rich foods, such as green leafy vegetables, yogurt, legumes, whole grains, tofu, and Brazil nuts. High-potassium foods, including bananas, avocados, lima beans, and fish, may also be helpful.
  • Make sure you have adequate intake of carbohydrates to maintain the right levels of muscle glycogen, especially if you exercise.
  • Before and after you exercise, stretch muscle groups that tend to cramp.
  • Avoid dehydration. To prevent dehydration, consume plenty of fluids (1-2 litres per day) and foods high in water such as fruits and vegetables.
  • Avoid excess sodium and soda (high in phosphoric acid), as they can leach calcium.
  • Avoid chocolate, caffeine, and alcohol, which can interfere with magnesium absorption.
  • Improve your posture. For example, you may have mid-back spasms after sitting at a computer desk for too long in an awkward position.

Vitamin E has been said to help minimize cramp occurrence. Although scientific studies documenting this effect are lacking, anecdotal reports are common and fairly enthusiastic. Since vitamin E is thought to have other beneficial health effects and is not toxic in usual doses, taking 400 units of vitamin E daily could be considered.

Discuss with your doctor of chiropractic if your cramps are severe, happen frequently, respond poorly to simple treatments, or are not related to obvious causes like strenuous exercise. These could indicate a possible problem with circulation, nerves, metabolism, hormones, medications, and/or nutrition.

Click here to contact Dr. Pisarek at Advanced Healthcare for further information as to how he can help your muscle cramps.


  4. The American Chiropractic Association
  9. American Academy of Orthopaedic Surgeons. Muscle Cramp. Accessed 11/5/2014.
  10. Vinetz JM, Clain J, Bounkeua V, Eastman RT, Fidock D. Chapter 49. Chemotherapy of Malaria. In: Brunton LL, Chabner BA, Knollmann BC, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw-Hill; 2011.
  11. American Academy of Family Physicians. Nocturnal Leg Cramps. Accessed 11/5/2014.

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