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Leg cramps - unknown cause - Management
Additional information
- Other conditions that may mimic leg cramps [Miller and Layzer, 2005]:
- Focal muscle pain:
- With swelling — trauma, ruptured tendon, Baker's cyst, deep vein thrombosis, thrombophlebitis, infection, inflammation (myositis).
- Without swelling — exertional myalgia, peripheral arterial disease, restless legs syndrome.
- Generalized muscle pain:
- With muscle weakness — inflammation (polymyositis), infection (toxoplasmosis), metabolic (alcohol, statins), Guillain–Barré syndrome.
- Without muscle weakness — polymyalgia rheumatica, collagen-vascular disease, Parkinsonism, fibromyalgia.
- Dystonia — involuntary muscle contractions that lead to abnormal movements. Can be generalized or focal (e.g. writer's, pianist's, or typist's cramp).
- Myoclonus — sudden, involuntary jerking of a muscle or group of muscles without pain. For example, while drifting off to sleep.
- Secondary causes of leg cramps are shown in Table 1.
Table 1. Secondary causes of leg cramps.
Cause | Conditions | Symptoms and signs |
|---|
Exercise | — | Cramp often occurs during rest after exercise. |
Lower motor neurone problems | Motor neurone disease Radiculopathy (e.g. peripheral nerve injury) Neuropathy (e.g. peripheral neuropathy) | Wasting muscles, power loss, and absent reflexes. |
Metabolic problems | Renal disease (50% of people with uraemia complain of leg cramps) Liver disease Hyperthyroidism Hypothyroidism (20–50% of people) | Hyperthyroidism may lead to myopathy and associated leg cramps. Hypothyroidism is associated with weakness, enlarged muscles, and painful muscle spasms. |
Acute volume depletion (possible low sodium levels) | Heat cramps (miners, firemen, athletes) Diarrhoea, vomiting Diuretics | — |
Medication | Diuretics, salbutamol, raloxifene, nifedipine, phenothiazines, penicillamine, nicotinic acid, statins | — |
Pregnancy | — | 30% in the third trimester. Cramps stop after delivery. |
|
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