Cramp
| Classification according to ICD-10 | |
|---|---|
| R56.8 | Other and unspecified cramps |
| ICD-10 online (WHO version 2019) | |
A cramp ( Middle High German krampf , Old High German chrampho ), Latinized Krampus or Crampus (plural Crampi ), also called muscle cramp or spasm , is an unwanted and often painful muscle tension. The causes of muscle spasms are very different, with repeated spasms it is often nerve or muscle diseases. The seizure and febrile seizure are to be distinguished from the convulsions described here .
causes
Cramps have various causes such as mineral deficiency ( electrolyte disorder , e.g. magnesium deficiency or hypocalcemia ), for example as a result of excessive alcohol consumption, metabolic disorders (e.g. diabetes mellitus ), poor blood circulation, drug side effects, hypothyroidism , nerve damage , overuse of the muscles or orthopedic Causes (e.g. foot misalignment). The susceptibility to muscle cramps is also increased during pregnancy. Often a muscle spasm occurs for no apparent cause. A common cause of muscle cramps typical of sports is a magnesium deficiency . The cause of muscle spasms at rest can be a lack of calcium in the blood .
A physiologically normal magnesium concentration in the body favors the return of potassium into the cell, which is important for the termination of the action potential and the termination of the influx of calcium ions from the sarcoplasmic reticulum ( sER ). Magnesium is a physiological calcium channel blocker that reduces the release of calcium inside the muscle cell. A lack of magnesium can consequently lead to persistent, painful muscle contraction . Overall, magnesium has an inhibitory effect on the neuromuscular system. It reduces the electrical excitability of the neuron and decreases the nerve conduction speed . Correspondingly, a low magnesium concentration lowers the threshold of nerve excitation and increases the nerve conduction speed.
As a mostly benign phenomenon known to many people, muscle cramps can occur after overexertion of individual muscle groups and electrolyte disorders. Often there are nocturnal calf cramps, also known as crampus syndrome (out of date), or so-called writing cramps of the hand muscles. They can often be alleviated by relaxation exercises or prevented by adding magnesium . Magnesium can be better absorbed by the body in a citrate compound.
Sometimes a lack of sodium chloride (table salt) is the cause of cramps. Sodium chloride is increasingly secreted through sweat during exercise. Compensation is absolutely necessary because an electrolyte deficiency in relation to the extracellular space can seriously impair the function of the nerve cells.
Likewise, a lack of potassium (for example through excessive exudation) can contribute to the development of cramps. As an important electrolyte , it is important for controlling muscle activity (potassium deficiency, see hypokalaemia ).
Alternatively, the hypothesis of a neuromuscular origin for the development of muscle spasms is represented by numerous medical professionals. For example, sporadic nocturnal muscle spasms appear to be triggered by motor neurons. In certain cases, the aspect of fatigue (local or central) could also play a crucial role. Both the exact causes of the muscle spasm and the pain it causes have not been fully researched.
According to a study from 2004, the cause of muscle spasms in athletes could not be a lack of electrolytes, as suggested in the literature, but rather arise from a neuronal dysfunction in the target muscle spindles and the Golgi tendon organs .
treatment
The recommended for muscle and joint injuries PITCH control ( P housing, E is, C ompression, H ochlagern) is not suitable for muscle spasms. In particular, cooling is not recommended for treating muscle spasms. P housing and H on the other hand ochlegen can contribute to pain relief and regeneration.
To treat the spasm, the range of motion of the joint should be exhausted so that the muscle can shorten in order to prevent the tendon reflex from being triggered again . Then tense the antagonist , as this inhibits the spasmodic muscle via a recurrent neuron in the spinal cord. A gentle relaxing massage or a heat treatment can also help against acute muscle pain.
A spasm can often be ended by stretching the affected muscle. In the case of a calf cramp, this can be done, for example, by positioning the forefoot of the affected leg on an elevation or by stretching the leg backwards and putting weight on it.
To avoid cramps during or after physical activity, it is often recommended to take sufficient fluids before, during and after exercise. Drinking water containing calcium contains sufficient calcium, but cannot supply the body with all the salts and minerals excreted in sweat. This is usually done through a healthy and balanced diet. Fruit juices and mineral waters can provide a quick balance if they contain enough sodium (chloride), potassium and magnesium. Pay attention to the content of these substances in so-called isotonic beverages as well. Sports drinks often only achieve a short-term improvement through the sugar they contain. The consumption of isolated sugars, however, often causes a fluctuation in the blood sugar level, which can also be counterproductive (see: Electrolyte #Physiology ).
Since the causal relationships between cramps as a result of physical activity have not yet been clarified, cramps during exercise can only be ruled out for the time being by avoiding unusual stress. This means that the load (even in competitions) must not be different or significantly more intense than during regular training.
It is occasionally reported that taking magnesium helps with cramps (or other muscle problems) in the short term, but has not been scientifically proven. By drinking diluted vinegar or "cucumber water" (the vinegar-containing liquid in which cucumbers are pickled), however, according to a US study, the duration of cramps can be reduced by almost half to an average of 85 seconds.
The effectiveness of quinine has been scientifically proven, but because of possible side effects, it should only be used under strict medical supervision. The daily dose for treating convulsions should not exceed 200–400 mg. Older people often experience nocturnal leg cramps. Adequate hydration , a balanced diet rich in magnesium, light and regular exercise and stretching have a preventive effect .
Drugs with diuretic effects , such as B. many antihypertensive agents contribute to the loss of salts from the body and can thus promote cramps.
Types of convulsions
Other types of convulsions are cerebral seizures . Rapidly successive convulsions, such as a seizure, are also called convulsions . They are typical of epilepsy .
Tonic seizures (long-lasting) be at tetanus , when tonic Fazialiskrampf , when torticollis and occasionally in the hysteria observed.
Mostly painful spasms of the smooth muscles in hollow organs (e.g. gall bladder , intestine , urinary bladder ) are called colic . In connection with blood vessels, bronchi and the larynx , one speaks of spasms, such as vasospasm , bronchospasm or laryngospasm .
See also
Web links
Individual evidence
- ↑ Alphabetical index for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 474
- ↑ SPASM, m.. In: Jacob Grimm , Wilhelm Grimm (Hrsg.): German dictionary . tape 11 : K - (V). S. Hirzel, Leipzig 1873 ( woerterbuchnetz.de ).
- ^ HC Diener, K. Westphal: Differential diagnosis and treatment of cramps. In: MMW Fortschr Med. 155 Suppl 3, Oct. 10, 2013, pp. 83-86.
- ↑ Jennifer G. Hensley: Leg Cramps and Restless Legs Syndrome During Pregnancy. In: Journal of Midwifery & Women's Health. 54, 2009, p. 211, doi: 10.1016 / j.jmwh.2009.01.003 .
- ↑ a b Crampi / muscle cramps. AWMF guideline, 2008, p. 654 ff.
- ↑ H. Mörl In: H. Mörl (Ed.): Muscle cramps. Springer-Verlag, 1987, pp. 59-66.
- ↑ Klaus Golenhofen: physiology today. Textbook, compendium, questions and answers. 1st edition. Urban & Fischer, Munich 1997, ISBN 3-437-42480-7 , pp. 60-61.
- ^ Rainer Klinke, Stefan Silbernagl (ed.): Textbook of Physiology. 4th edition. Thieme, Stuttgart 2003, p. 94.
- ↑ MP Schwellnus u. a .: Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners . In: Br. J. Sports. Med. 38, 2004, pp. 488-492.
- ↑ a b Stretching the calf muscle , illustration on the Mayo Clinic website.
- ↑ a b Description of the causes of cramps on the Mayo Clinic website.
- ↑ see also the individual references in the article on muscle cramps during sport in the English Wikipedia.
- ↑ Magnesium during sport - do you feel the cramps? Consumer advice center, as of January 11, 2017
- ↑ KC Miller, GW Mack, KL Knight, JT Hopkins, DO Draper, PJ Fields, I. Hunter: Reflex inhibition of electrically induced muscle cramps in hypohydrated humans. In: Medicine and science in sports and exercise. Volume 42, Number 5, May 2010, pp. 953-961, doi: 10.1249 / MSS.0b013e3181c0647e , PMID 19997012 .
- ↑ Side effects of quinine . drug telegram
