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Leg cramps - unknown cause - Management
How should I assess someone with leg cramps to identify a cause?
- Idiopathic leg cramps are indicated by a history of sudden calf, thigh, or foot pain; most often in an elderly person, and at night (or when resting). The pain usually lasts for several minutes and there are no abnormal findings on physical examination.
- The following points in a history and examination may help exclude secondary causes (see Table 1) or other conditions which mimic leg cramps:
- Symptoms of calf pain with exercise, an urge to move the legs, or leg numbness or weakness.
- Signs of muscle wasting and fasciculations, skin pallor, calf swelling, or varicose veins. Abnormal leg pulses, capillary refill, loss of sensation or power, or altered reflexes.
- History (or symptoms) of an underlying condition (e.g. thyroid disease).
- Medication (e.g. diuretics, salbutamol, nifedipine).
- Investigations are usually not needed, unless an underlying cause is suspected (e.g. blood tests for electrolytes, calcium, thyroid function tests, fasting glucose, liver function tests, magnesium, and creatinine kinase).
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