If you've ever had a cramp in your leg or foot, you know the pain is excruciating, almost like your muscle is on fire. What makes it worse is that most of us aren't exactly sure what to do to stop the pain. We spoke to Crystal Holmes, D.P.M., a member of the American Podiatric Medical Association, and assistant professor of podiatric medicine at the University of Michigan School of Medicine, about why leg cramps happen and how to get rid of them when they do.
"Most leg cramps are in the calf muscle, and foot cramps happen in the arch of the foot or at the base of the toes," says Dr. Holmes. "They can last anywhere from several seconds, to 15 minutes. If the cramp is so bad that you can't walk for longer than that, it is not normal and you should call your doctor immediately," she says.
There are many reasons cramps occur and most are benign, but there are reasons that can be very serious. But first, find out what you can do to get immediate relief.
If your foot or leg is cramping up, Dr. Holmes suggests doing the following:
First, get to a place where you won't fall and hurt yourself. "People commonly fall," says Dr. Holmes. Sit down or lie down and try to identify where the cramp really is. Is it in the calf? The arch of the foot or base of toes? "Later, you may need to come back and tell your doctor," she says. Once you identify where the cramp is, you can try any of these methods:
• Stretch your foot outward, like a ballerina, then flex the foot back towards you. "Flex it toward the wall then back towards your nose," she says. This should stretch the muscles and loosen the cramp.
• Massage the area. Use your hands to gently massage the cramp, or you can try taking a water bottle and rolling it up and down over the muscle, says Dr. Holmes. For a cramp in the foot or toes, try massaging the arch and the base of the toes on the underside of the foot. If that doesn't work, try massaging the side of the foot or the top.
• Try to move it. "Movement will typically help," she says. Carefully try to take a step or put pressure on the foot.
• Take an over-the-counter pain reliever. "If it's safe for you to take a pain reliever, you can take it, but that's really for the first time you have a cramp," says Dr. Holmes. "If the cramp doesn't get better when you take the pain reliever, or the cramps are persistent, it merits and evaluation by your doctor."
This, says Dr. Holmes, is the most common reason cramps occur. "Cramps usually come from muscle-related soreness from overuse," she says. "Perhaps you were walking all day, or not wearing supportive shoes, or you did more than usual. When that happens tendons and ligaments are firing a little more." This kind of cramping feels more like a dull ache than an acute cramp, and generally goes away in a day or two. If you have persistent pain in your achilles tendon at the back of the ankle or in your shins, you may have tendonitis and should see your doctor, says Dr. Holmes.
Treatment: Check your shoes and see if the soles or insides are worn out. You may need new ones, or perhaps you need shoes that offer more support. You may also want to talk to your podiatrist about orthotics, a custom inset created for your foot which gives support and cushioning. Dr. Holmes also recommends doing stretches before you exercise. To learn great stretches for people over 50, click here.
"Often when you are low in calcium, potassium or magnesium, cramping can occur," says Dr. Holmes. "Low vitamin D or B can also result in some cramping." Dehydration—not drinking enough water during the day—also falls into this category. "When electrolytes are imbalanced, it can cause issues or problems, and even muscle weakness if really progresses," Dr. Holmes says.
Treatment: "Lots of people just start eating a lot of bananas when they get cramping," she says. "They're high in potassium, but the problem is, you don't know if you are deficient in potassium and if you are, you don't know how much you need." Before you start taking any supplements or change your eating habits, talk to your doctor and ask her to check your vitamin and mineral levels so you have a definitive answer. As for dehydration, perhaps you exercised and didn't drink enough, which is common, but if you're dehydrated often or have severe dehydration, you and your doctor need to really figure out the cause, Dr. Holmes says.
"Vascular disease is quite serious, and is a supply and demand issue," says Dr. Holmes. "With vascular disease, there is not adequate blood flow and your muscles are screaming out for more." You might have cramping when you put your feet up and rest. "Essentially, gravity works in your favor when you're walking to pull blood down," she says. "But when you're lying down, blood doesn't get pulled down." Some people with vascular disease have trouble getting up, or walking at all. "This kind of cramping is persistent, which makes it problematic," says Dr. Holmes. She also points out that while everyone will see some decrease in blood circulation as we age, vascular disease is often related to a sedentary lifestyle, where people don't move around as much, and smoking, which constricts blood vessels.
Treatment: If cramping is persistent, talk to your doctor immediately about a work up by a vascular specialist, who may recommend lifestyle changes as well as medication to increase blood circulation.
Nerve damage or neuropathy can be caused by a variety of illnesses like diabetes, and certain medications like anti-viral medications or chemotherapy. When nerve damage or neuropathy happens, cramping can occur as a side effect. "People can also feel numbness in their limbs or temperature disturbance where they feel hot when it's cold, and cold when it's hot," says Dr. Holmes.
Treatment: Talk to your doctor to figure out if one of the medications you're taking is the cause.
"Sometimes cramping can be from things you can't correlate," says Dr. Holmes. For example, she tucks her feet underneath her when she's sitting and working, which can lead her to feel numbness in her legs and cramping. "People may not realize they're sitting in an unusual position, or maybe they are resting their feet in a certain way when they drive a lot." In terms of foot and toe cramps, she also says age is a contributing factor. "As we get older, 50 and above, we're more likely to have hammer-toe deformities, so shoe wear can aggravate your feet and cause cramps."
Treatment: Try stretching, massage, and taking an over-the-counter pain reliever if it's safe for you.
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