Leg cramps- Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Introduction

Leg cramps, or Charley horses, are a common and usually harmless condition where the muscles in your leg suddenly become tight and painful. It is a common problem that affects the feet, calves, and thigh muscles. They involve sudden, painful, and involuntary contractions of a leg muscle.

They often occur while a person is sleeping or resting. They can be gone in a few seconds, but the average duration is 9-10minutes and the pain is excruciating. In most cases, there is no identifiable reason why they happen, and they are harmless. Sometimes, however, they can indicate an underlying disorder, such as diabetes or peripheral artery disease. It usually occurs in the calf muscles, although it can affect any part of your leg, including your feet and thighs. After the cramping has passed, you may have pain and tenderness in your leg for several hours.

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Signs & symptoms

Episode of sudden pain in the muscles of the leg that lasts from a few seconds up to 10 minutes.

An involuntary contraction (shortening) of the leg muscle.

Leg cramps without any reason or idiopathic are primary leg cramps.

Leg cramps developing as a symptom or complication of a health condition, are known as secondary leg cramps.

Causes

  • Exercise 
  • Medicines such as statins, Iron sucrose (Venofer), Conjugated estrogens, Raloxifene (Evista), Naproxen (Aleve), Teriparatide (Forteo)
  • Liver diseases like cirrhosis
  • Dehydration and electrolyte imbalances.
  • Alcohol abuse
  • Chronic kidney failure
  • Cancer treatment
  • Parkinson’s disease
  • Peripheral artery disease
  • Pregnancy, especially in the later stages
  • Motor neuron disease
  • Lou Gehrig’s disease (
  • Spinal nerve compression
  • Thyroid diseases
  • Spinal stenosis
  • Chronic obstructive pulmonary disease
  • Chronic kidney diseases
  • Diabetes, especially type 2 diabetes
  • Fibromyalgia

Sleeping with the foot stretched out and the calf muscles shortened may trigger night cramps.

Pathophysiology

The precise mechanism of leg cramps is unknown, but several myopathic, neurologic, and metabolic causes have been suggested. Most cases of leg cramps are idiopathic. There are many theories explaining the mechanism of leg cramps.

Electromyographic studies suggest that leg cramps originate in the lower motor neurons with hyperactive, high-frequency, involuntary nerve discharge. Some scientists hypothesize that our “civilized” lifestyle no longer requires repetitive squatting that stretches the leg tendons and muscles. Others have suggested that in the nocturnal recumbent position, the foot is passively in plantar flexion and the calf muscle fibres are already maximally shortened, so uninhibited nerve stimulation leads to cramping. Some researchers suggest that muscle fatigue is a primary cause of leg cramps. Studies of endurance athletes show that a higher-than-normal intensity of exercise is associated with leg cramps. The mechanism of this association remains unclear. Nerve dysfunction or damage has been suggested as a cause of leg cramps because of the high prevalence in patients with neurologic conditions such as parkinsonism. Metabolic causes are suggested by the high prevalence in patients undergoing haemodialysis that is associated with hyperphosphatemia, but not with hyper- or hypocalcaemia. Patients with low parathyroid hormone levels who are undergoing haemodialysis have a lower-than-expected incidence of leg cramps.

Diagnosis

A history and physical examination are usually sufficient to differentiate nocturnal leg cramps from other conditions, such as restless legs syndrome, claudication, myositis, and peripheral neuropathy.

Treatments

No medication is likely to prevent leg cramps.

Painkillers

Stretching exercises like, Hamstring muscle stretch

Prognosis

Leg cramps are mostly short-term and self-limiting. But recurrence will be there if underlying cause is not addressed.

Complications

Leg cramps are not usually a cause for concern, but sometimes they can indicate an underlying problem. If cramps are severe or happen frequently, it is important to rule out any underlying condition.

Disease & Ayurveda

Mamsamedogatavaata

Nidana

Dhaatukshaya(degeneration)

Aavarana(obstruction to channels in the body)

Purvaaroopa

Not mentioned

Samprapti

Due to the causative factors Vaata gets vitiated and gets lodged in the muscles and adipose tissue causing the signs & symptoms.

Lakshana

Thodaadhyaan karkasaan granthi  – Rough painful lumps

Bhrama          – Vertigo

Guru angam  – Heaviness

Mushtidandahatopama        – Feels pain like beaten with fist/stick

Atiruk            – Unbearable pain

Stabham         – Stiffness (not able to move)

Divisions

Not mentioned

Prognosis

Saadhya when the disease is new

Krichrasadhya when the disease is chronic   

Chikithsa

Samana

Lepana with soolaharadravyas

Parisheka with warm soolaha-sothahara dravyas

Upanaha with Vaataharadravyas

Sodhana

Sneha (Anhyanga)

Sweda (Potalisweda)

Vasti

Virechana

Raktamokshana

Daahakarma

Commonly used medicines

        Maharasnadi kashayam

Sahacharadi kashayam

Rasnerandadi kashayam

Kaisoraguggulu

Guggulutiktakaghrutam

Brands available

AVS Kottakal

AVP Coimbatore

SNA Oushadhasala

Vaidyaratnam oushadhasala

Home remedies

Medical professionals suggest the following to ease cramping:

  • Stop the activity that caused the cramp.
  • Stretch and massage the muscle.
  • Hold the leg in the stretched position until the cramp stops.
  • Apply heat to muscles that are tight or tense.
  • Use cold packs on tender muscles.

Diet

  • To be avoided

Drink enough liquids. Ensure enough hydration.

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)

Milk and milk products – increase kapha and cause obstruction in channels

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Green gram, soups, sesame oil.

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Behaviour:

Protect yourself from very hot & cold climates.

Better to avoid exposure to excessive sunlight wind rain or dust.

Avoid lifting heavy weights and other vigorous physical activities.

Maintain a regular food and sleep schedule.

Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.

Avoid climbing of stairs.

Yoga

Vigorous exercises are not allowed in painful conditions.

Only stretching, moderate walking, and mild cardio exercises are advised. Also, specific yogacharya including bhujangaasana, salabhasana, vajrasana is recommended. Caution must be there to consider the range of movement and flexibility. 

Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.

Yoga can maintain harmony within the body and with the surrounding system.

Salabhasana

vajrasana

Bhujangasana

exercises for leg pain

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330021/

https://pubmed.ncbi.nlm.nih.gov/19202219/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460850/

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