Muscle Spasm and Cramp

Cramp or muscle spasm is an involuntary, sudden, severe contraction of a muscle and is commonly seen in chiropractic practice. It can happen to any muscle and can last from seconds to several minutes, even days or weeks. It all depends on the cause of the spasm.

If it is triggered by fatigue, dehydration or an electrolyte imbalance, it can usually last from seconds to several minutes. If it is triggered by either a nerve irritation or as a part of a protective mechanism to pain, it can last for days or even weeks depending on how long the trigger stays there.

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. The good news is that most types of cramp and muscle spasm respond very well to chiropractic treatment and advice. There are also other causes of cramp such as side effects from taking medication, or underlying medical problems, which we will cover later under secondary cramp. If the cramp is due to a muscle imbalance the right advice on exercise, and also treatment, is often needed.

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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 to overtime. This is typically due to a combination of fatigue and dehydration.

If it is triggered by a nerve irritation, let’s say from a disc injury, it most frequently causes cramp in the forearm and hand, or calf and foot, if the disc injury is in the neck or lower back respectively. 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’. We have an article where you can read more about facet joint sprain.

Apart from patients having pain-related back spasms, we also see many patients complain of leg cramps when in bed, particular in their calves and feet. Most of the time they occur without any underlying reason, but are more common as you get older. The reason that calf cramp occurs in bed is that when you lie down the foot points down and the calf muscles shorten. A shortened muscle is more likely to go into spasm, especially if it is fatigued from the day’s activities, and if you are dehydrated, which is more common than you might think. The good news is that there is a quick fix for it.

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Get Cramp Due To Lack Of Salt?

Many people think that they get cramps because they haven’t eaten enough salt, but that is extremely unlikely because you lose proportionately far more fluid than salt when you sweat. This is a very well regulated mechanism, unless you have kidney problems.

Don’t make the mistake of taking salt until it has been fully established that you need to.

Do I Get Cramps Due To A Muscle Imbalance?

Another common cause of cramp is muscle imbalance. If the muscle that performs the opposite action, so called antagonist, is weak, the muscle that is stronger tends to go into spasm more easily.

Another example of muscle imbalance is, if two muscles that work together doing the same movement, so called agonists, and the main muscle is weak the secondary muscle has to work harder and will often go into a spasm or cramp as it fatigues. A typical example is if your buttock muscles are weak the hamstrings will eventually go into spasm when it fatigues, for example when you do the bridge exercise (doing hip extensions lying on your back) and get cramp in the back of the thigh.

This is a common cause of hamstring injuries. A muscle imbalance can be corrected with chiropractic treatment and the right advice on exercise.

What is Secondary Cramp?

You can also get cramp due to underlying causes, so called secondary cramp. There is a long 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).

Treating Cramp And Muscle Spasm

Paraspinal Muscle Spasm and Cramp Is best treated by dealing with the underlying cause of the protective spasm, which is most often down to joint pain due to a sprain. Chiropractic treatment is very effective for these types of problems.

You can read more here.

Disc Injuries Causing Spasm and Cramp

A disc injury is a more serious injury, but can still be helped with chiropractic treatment. It is the inflammatory response to the disc injury that causes the symptoms, not the size of the disc herniation or slipped disc.

You can read more about it here.

Cramp Due To A Muscle Imbalance

First you need to identify the cause by taking a history and having a functional examination. Sometimes there is an underlying nerve irritation and interference, inhibiting the muscle, which needs to be dealt with before exercise therapy will be effective.

Calf Cramp

One of the most common types of cramp and spasm we come across apart from back related problems are calf cramp at night.

The quick fix for that is to make sure you stretch before bed and make sure you drink plenty of water during the day. You should drink at least 2 litres of water per day even if you don’t do any manual work.

To stretch your calf muscles either:

Stand with the leg you want to stretch behind you and lean forward against a wall until you feel the stretch, hold for 20-30 seconds and repeat 3 times for each leg.
Alternatively, stand with the front part of your feet on a step, with your heels hanging off the edge. Then slowly lower your heels until you feel the stretch. Hold and repeat as above.

Secondary Cramp

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.

In Summary…

Make sure you drink plenty of water at least 2 litres per day! Coffee and tea do not count, they are diuretics and make you lose water!

Also, make sure you have adequate intake of carbohydrates to maintain the right levels of muscle glycogen, especially if you exercise.

It is important to remember that although most cramp and muscle spasms can be relieved by massage and stretching, it will often only give you temporary relief. 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.

Make sure you stretch your muscles so you maintain your flexibility but don’t stretch your spine! 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.

If you are not sure how to deal with your cramp and muscle spasm, please call or email the Isis Chiropractic Centres. We are happy to help!