8 The posterior calf muscles (gastrocnemius and soleus) are usually involved, but cramps of the foot and thigh also are common. 1 With regard to idiopathic leg cramps, about 80% of episodes involve the gastrocnemius muscle in the calf, with a mean duration per episode of 8 to 9 minutes in adults. 10 While the exact mechanism is unknown, the probable cause is thought to be muscle fatigue and nerve dysfunction rather than electrolyte or other abnormalities. 1,8 After the cramping has passed, patients may experience residual pain and tenderness in the affected leg for several hours. 8,9Ī muscle cramp is a sudden, involuntary, muscle contraction or spasm leg cramps are painful and incapacitating, lasting an average of 9 minutes per episode. Although mostly benign and self-limited, muscle cramps may also be indicative of a wide variety of potentially serious systemic disorders (e.g., endocrinologic, neurologic, and vascular disorders), treatment with certain drugs (TABLE 1), and occupational factors a significant portion of cases are idiopathic. Nocturnal leg cramps are common occurrences among older, generally healthy adults (TABLE 1). The pharmacist can also guide prescribers and patients to avoid 1) the addition of unnecessary medications 2) the use of medication without supportive evidence in the treatment of nocturnal leg cramps and 3) the risk of polypharmacy-associated adverse events, which are particularly troublesome in older adults. Pharmacists can provide guidance and recommendations as to how to proceed to find comfort, mitigation, and further evaluation, if appropriate, based on a patient’s medical history, medication therapy, and lifestyle issues. 9 The focus of this column is benign idiopathic leg cramps, although they can be associated with other underlying conditions. 8 Idiopathic leg cramps are common, short-lived, and usually involve the calf muscle and/or the foot and thigh. Exercise-associated leg cramps during or immediately after exercise 7Ĭommon risk factors for muscle spasms specific to older adults include strenuous exercise (idiopathic), hemodialysis, and cirrhosis.Benign idiopathic leg cramps in the absence of a causative disorder, typically at night, and.5,6 The most common types of leg cramps, however, are: 2-4Ĭertain medications (e.g., diuretics, angiotensin II receptor blockers, stimulants, cisplatin TABLE 1) have been reported to cause leg cramps in some individuals, and muscle cramps are reported in as many as 35% to 86% of patients receiving hemodialysis. 1 Approximately 20% of patients who experience leg cramps have symptoms on a daily basis, to the extent that it prompts them to seek medical attention. 1 Nocturnal leg cramps, slightly more common in women, are reported by 50% to 60% of adults prevalence increases with age. The recurrent painful muscle tightening usually occurs in the calf muscles and not only can disturb sleep but can cause secondary insomnia. It may also be particularly troublesome when there is no awareness as to how to effectively intervene to mitigate this lower-limb muscle spasm and prevent it from reoccurring. Waking up abruptly from sleep due to an acutely painful leg cramp can be a jolting experience.
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