Dear Dr Nina: Can I stop leg cramps from waking me?
Ask the Doctor...
Q I'm in my late forties and quite fit and healthy but I keep walking up at night with cramps and spasms in my calves and it can be quite painful. I drink plenty of water during the day and, as far as know, I have enough salt in my diet. Any ideas what it could be? Or what I can do to stop it happening?
Dr Nina replies: Nocturnal leg cramps are very common, especially in those over the age of 50. The exact cause is not actually known and there are lots of theories as to why these occur.
Risks include jobs that involve sitting for long periods of time or sitting improperly. Overexerting muscles and standing or working on concrete floors also seems to increase the risk.
Certain medical conditions such as pregnancy, Parkinson's disease, conditions that affect blood vessels, nerves and muscles, and diabetes are associated with an increased risk.
Medication such as diuretics (water tablets), cholesterol-lowering medication and asthma meds may also be associated with cramps.
In the majority of cases, there is a simple underlying cause, but a doctor review will help rule out anything more serious.
Peripheral vascular disease (PVD) causes narrowing of the arteries outside the heart. It is estimated to affect at least one in 20 people over the age of 55. Only 20pc of those affected are undergoing treatment despite the fact that the risk of having a heart attack or stroke is increased four to five times.
A family history of PVD increases your chance of developing the condition. Other factors that increase the risk include smoking, obesity, high cholesterol, high blood pressure and diabetes.
In those who smoke, the risk of PVD is increased fourfold. PVD is extremely common in diabetics, occurring in up to one third of those with the condition. The more risk factors you have, the higher your chance of developing the disease
In PVD, arteries around the body become progressively narrowed by the build-up of plaques, called atheroma. It becomes more difficult for blood to flow and provide oxygen and nutrients to the tissues.
As the plaques enlarge, the blood supply to the limbs may be reduced in times of higher demand, such as walking or exercising. This may cause pain in the legs on walking that is eased by rest. Cramp-like pain may also occur at night in bed when the legs are elevated. This is often relieved by standing or dangling the legs. If you are diagnosed with PVD, it is especially important to lead a healthy lifestyle. Diabetics need to take special care of their limbs and feet as they are particularly at risk of amputations.
If you aren't getting pain walking and you don't have any risks for vascular disease, make sure you stay well-hydrated, drinking at least 1.5 to two litres daily. Some find that ensuring adequate calcium and magnesium in their diet or taking supplements helps.
Stretching the feet and calves before bed has been shown to reduce the frequency of cramps. An older remedy is quinine. This may help but it should be used with caution as it can irritate the heart, increasing the chance of an abnormal rhythm. Don't ignore your leg cramps. Your GP may be able help.
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