Nocturnal (occurring at night) leg cramps are characterized by sudden tightness in the muscles of the thigh, calf, or feet. These leg cramps often occur while a person is in bed, awake or asleep. A cramp can cause pain and make you unable to move your leg. Duration may just be a few seconds or can last for several minutes. Leg cramps are common both in children and in adults but tend to occur as one gets old, occurring in 50 percent of people older than 50 years old. There is no gender difference. Pain and sleep disturbance can lead to insomnia or lack of sleep.
Causes of leg cramps
In most cases, the cause of leg cramps is unknown (idiopathic). In other persons, causes include flat-footedness or other inborn deviations from normal, sitting in an awkward position or sitting too long in one position, standing or walking a lot on concrete floors, taking medications that alter body fluid balance like diuretics, undergoing dialysis treatments (for kidney failure) during which excess water is removed from the body, or performing activities that entail too much sweating without proper and adequate salt replacement. It has been shown that patients with the most common form of leg cramps do not have water or electrolyte imbalance.
Other causes include excessive exercising, hypothyroidism, low blood sugar levels (hypoglycemia), Parkinson’s disease, and diabetes mellitus. Exercise-associated muscle cramping or EAMC is thought to be associated with muscle fatigue. Leg cramps may also be due to peripheral vascular disease, venous insufficiency, anemia, opioid withdrawal, and nonalcoholic cirrhosis (nonalcoholic liver disease) and bariatric surgery which includes stomach bypass and other weight-loss surgeries done to manage extreme obesity.
Some of the medications associated with the occurrence of leg cramps are beta agonists (especially inhaled long-acting beta agonists), some diuretics, angiotensin 2 receptor blockers, benzodiazepines, teriparatide, pyrazinamide, raloxifene, donepezil, neostigmine, clofibrate, oral contraceptives, and statins. Among pregnant women, pregnancy-related leg cramps are in part attributed to low blood levels of the mineral magnesium.
When you have a leg cramp, slowly stretch the affected leg or foot. Measures that may prevent more cramps are: lying down with the legs and feet up, a hot shower with focused water spraying on the affected leg for about five minutes, a warm bath, and walking around or jiggling the affected leg or foot. In some cases, rubbing the leg or foot with ice wrapped in a towel can help prevent another cramp.
What long-term activities can help prevent cramps?
Among persons who lack exercise, riding a stationary bike for a few minutes before going to sleep may help; stretching exercises; wearing shoes with firm support; keeping bed covers loose at the foot area; drinking plenty of water if there are no medical contraindications like heart failure or severe kidney disease; limiting caffeine intake; not exercising in very hot weather or in a hot room; and staying cool during exercise.
Seek medical help if the cramps are frequent, very painful, or affect other parts of the body like the upper back or the belly. Underlying medical conditions have to be ruled out and treated by a doctor. The ailment should also be differentiated from restless leg syndrome, periodic limb movement disorder, and other medical conditions.
Even vaccinated and booster-vaccinated persons can still catch any variant of the Covid-19 virus. The Omicron variant is highly transmissible compared to the Delta variant. As of this writing, it appears that the Omicron variant causes only mild disease compared to the Delta variant, and that it may not cause severe disease.
Some sources state that hospitalization and death rates are not high among Omicron-infected patients. It is however still too early to make conclusions and it is not yet safe to be complacent. We need to continue basic measures of social distancing and to sanitize. Disruptions in services that impact on our lives can still occur when several people in frontline services, hospitals, groceries, and other basic services will test positive for the virus, whether the disease is mild or severe. Quarantine law shall apply, shortened or not. Tests for the virus will be done, repeatedly as required, straining finances and resources. The safest option is still to be prudent and to follow the guidelines issued by the World Health Organization, our government and local government units, the Department of Health, and other agencies in charge.
A study in Denmark (results released ahead of peer review) has shown that overall, when booster-vaccinated persons were the ones who brought home the Covid-19 virus, they were less likely than unvaccinated and vaccinated but not boosted persons to pass the virus to other persons.
There is new coronavirus variant – B.1.640.2 and nicknamed “IHU” detected in southeastern France in October 2021. It is being monitored by the WHO which says that for now, IHU is not a variant of concern. It did not appear to have spread widely over the past two months compared to the Omicron variant which spread very rapidly.