Painful cramps

SINGAPORE - Q I am a 45-year-old woman. I have been suffering from leg cramps almost every night.

They start from the toes and spread up to the calf area. The episodes last between fiveminutes and half an hour and are very disruptive to my sleep.

What is the cause of cramps and how can I prevent them?

A In traditional Chinese medicine (TCM), good circulation of adequate blood and qi (energy) is required for good health.

Muscle cramps are typically a sign that there is a blockage of blood and qi flowing to an area of the body.

When this happens, it causes that area to become weak and less able to perform properly, making the area more vulnerable to injury, over-fatigue and pain.

In addition, the liver and gall bladder meridians - channels in the body through which qi travels - are responsible for nourishing the tendons and ligaments of the body.

Tendons are bands of fibrous tissue that connect muscles to bones, while ligaments are bands of fibrous tissue, each connecting a bone to another bone.

If there is an imbalance in the liver and gall bladder or if they are not functioning properly, muscle cramps can be one of the resulting symptoms.

Furthermore, the blood in the body tends to flow back to the liver for storage at night, resulting in less blood flowing to the muscles and tendons.

Hence, leg cramps are more likely to occur during sleep.

Try Massage At Home

TRY MASSAGE AT HOME

TCM treatment for leg cramps aims to reinforce the internal organs, improve the blood and energy circulation and nourish the muscles and tendons of the legs.

For example, white peony root and liquorice root invigorate the liver and spleen and improve blood supply to tendons and muscles.

Numbness of the limbs can be alleviated with angelica root and astragalus root.

Cassia twig and white aconite root promote warmth in the limbs and improve blood circulation.

Acupuncture can play a role in promoting blood circulation, loosening the tendons, relieving cramps and easing pain.

With continued treatment, acupuncture can help to improve the health and functioning of the body, so that it is better able to perform and less prone to muscle cramps.

Tuina, a form of Chinese-style massage, involves applying various manipulations to stimulate the soft tissue, stretch the muscles and mobilise the joints, thus promoting blood circulation and removing stagnant blood.

Massage is an effective home remedy for relieving and preventing leg cramps and can be done as a routine before sleep.

Strengthen Leg Muscles

STRENGTHEN LEG MUSCLES

It is very important to modify some of your lifestyle habits in order to reduce the frequency and severity of leg cramps in future.

Eat a well-balanced diet and avoid frozen and raw food.

Beneficial types of food that can provide warmth and promote blood circulation include mutton, duck, beef, eggs, black fungus, mushrooms, Chinese yam, nuts, sesame, dates, longan pulp and leeks.

Stay hydrated by sipping water regularly throughout the day.

Cut back on drinks that contain alcohol or caffeine.

Avoid the direct air stream of a fan or air-conditioner.

Keep your legs warm.

Stretch your legs regularly, in particular, before going to bed.

Soak both feet in warm water for 10 to 15 minutes every night before sleep.

Avoid overly thick blankets and make sure that you can sleep with your toes pointing upward.

In the day, wear shoes that have proper support.

Do moderate intensity exercises, such as walking or cycling, to strengthen the leg muscles.

Ms Poh Yu Min, traditional Chinese medicine practitioner at Raffles Chinese Medicine at Raffles Hospital.

Condition often gets better without treatment

A Night-time leg cramps are common and are more frequent with increasing age.

In many people, the cramps affect the toes or calves, just like in your case. But the cramps may also affect the thighs. Episodes of cramps are often brief, lasting seconds to minutes, but may last longer.

Sleep disturbance is the main concern for most people, just as it is for you.

In most patients, there is no underlying illness causing the cramps.

But some illnesses are known to be linked to cramps.

They include some neurological diseases - such as Parkinson's disease and nerve problems - diabetes mellitus, hypothyroidism (reduced thyroid function), alcoholism and structural problems such as flat feet.

Other possible factors that may raise the risk of cramps include low calcium levels, excessive sweating, excessive exercise, prolonged sitting and walking on concrete floors.

Some types of medication used for treating asthma and high blood pressure have also been implicated in cramps.

Do consult your family doctor for a thorough physical examination, and a review of your history and any medication that you are taking.

Some tests may be needed thereafter to look for an underlying cause of your cramps.

Cramps often get better without treatment.

There are some things you may be able to do to reduce the frequency and severity of your cramps.

These include stretching of the calf and hamstring muscles before you go to bed.

Riding a stationary bicycle may also help.

Try to untuck the bed cover at the foot of your bed so that your legs can move freely.

Drink enough water and avoid caffeine and alcohol. Taking B vitamins may help.

Your doctor will advise you on what may be suitable for you.

Dr N V Ramani, specialist in neurology and consultant at Raffles Neuroscience Centre at Raffles Hospital.

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