Via practica 6/2010

Muscle cramps in general practice

Muscle cramp is a sudden involuntary and painful shortening of muscle. Primary (or idiopathic) muscle cramps, without known cause, occur normally in healthy persons. They are very frequent especially in elderly and pregnant women, presenting usually at night as nocturnal leg cramps. Secondary muscle cramps are not so frequent. They are caused by multiple divers causes: 1. Systemic disorders – diabetes, hypothyroidism, cirrhosis, electrolyte disturbances, uremia, etc. 2. Neurogenic disorders – radiculopathies, polyneuropathies, motor neuron disease, spinal amyotrophies. 3. Muscle disorders – dystrophinopathies, metabolic myopathies, neuromyotonia, etc. 4. Drug and toxin induced cramps – statins, fibrates, diuretics, ethanol, etc. The first diagnostic step in a patient with muscle cramp is to find out if the cramps are of primary or secondary origin. Treatment of primary muscle cramps is empiric (antiepileptics, magnesium, stretching exercises). In patients with secondary muscle cramps the pathogenic therapy of underlying disease is of crucial importance. This paper covers the clinical presentation, pathogenesis, diagnosis and treatment of muscle cramps.

Keywords: muscle, primary cramps, secondary cramps, pathogenesis, diagnosis, treatment