"Descrizione" by Al222 (19763 pt) | 2024-Jan-01 11:04 |
Several components are used to aid in the prevention of muscle cramps. These include:
Components that may contribute to or exacerbate muscle cramps.
Studies
Miller TM, Layzer RB. Muscle cramps. Muscle Nerve. 2005 Oct;32(4):431-42. doi: 10.1002/mus.20341. PMID: 15902691.
Abstract. Muscle cramps are a common problem characterized by a sudden, painful, involuntary contraction of muscle. These true cramps, which originate from peripheral nerves, may be distinguished from other muscle pain or spasm. Medical history, physical examination, and a limited laboratory screen help to determine the various causes of muscle cramps. Despite the "benign" nature of cramps, many patients find the symptom very uncomfortable. Treatment options are guided both by experience and by a limited number of therapeutic trials. Quinine sulfate is an effective medication, but the side-effect profile is worrisome, and other membrane-stabilizing drugs are probably just as effective. Patients will benefit from further studies to better define the pathophysiology of muscle cramps and to find more effective medications with fewer side-effects.
Katzberg HD. Neurogenic muscle cramps. J Neurol. 2015 Aug;262(8):1814-21. doi: 10.1007/s00415-015-7659-x.
Abstract. Muscle cramps are sustained, painful contractions of muscle and are prevalent in patients with and without medical conditions. The objective of this review is to present updates on the mechanism, investigation and treatment of neurogenic muscle cramps. PubMed and Embase databases were queried between January 1980 and July 2014 for English-language human studies. The American Academy of Neurology classification of studies (classes I-IV) was used to assess levels of evidence. Mechanical disruption, ephaptic transmission, disruption of sensory afferents and persistent inward currents have been implicated in the pathogenesis of neurogenic cramps. Investigations are directed toward identifying physiological triggers or medical conditions predisposing to cramps. Although cramps can be self-limiting, disabling or sustained muscle cramps should prompt investigation for underlying medical conditions. Lifestyle modifications, treatment of underlying conditions, stretching, B-complex vitamins, diltiezam, mexiletine, carbamazepine, tetrahydrocannabinoid, leveteracitam and quinine sulfate have shown evidence for treatment.
Maughan RJ, Shirreffs SM. Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Med. 2019 Dec;49(Suppl 2):115-124. doi: 10.1007/s40279-019-01162-1.
Abstract. Muscle cramp is a temporary but intense and painful involuntary contraction of skeletal muscle that can occur in many different situations. The causes of, and cures for, the cramps that occur during or soon after exercise remain uncertain, although there is evidence that some cases may be associated with disturbances of water and salt balance, while others appear to involve sustained abnormal spinal reflex activity secondary to fatigue of the affected muscles. Evidence in favour of a role for dyshydration comes largely from medical records obtained in large industrial settings, although it is supported by one large-scale intervention trial and by field trials involving small numbers of athletes. Cramp is notoriously unpredictable, making laboratory studies difficult, but experimental models involving electrical stimulation or intense voluntary contractions of small muscles held in a shortened position can induce cramp in many, although not all, individuals. These studies show that dehydration has no effect on the stimulation frequency required to initiate cramping and confirm a role for spinal pathways, but their relevance to the spontaneous cramps that occur during exercise is questionable. There is a long history of folk remedies for treatment or prevention of cramps; some may reduce the likelihood of some forms of cramping and reduce its intensity and duration, but none are consistently effective. It seems likely that there are different types of cramp that are initiated by different mechanisms; if this is the case, the search for a single strategy for prevention or treatment is unlikely to succeed.
Stephens HE, Joyce NC, Oskarsson B. National Study of Muscle Cramps in ALS in the USA. Amyotroph Lateral Scler Frontotemporal Degener. 2017 Feb;18(1-2):32-36. doi: 10.1080/21678421.2016.1245755. Epub 2016 Dec 15. Erratum in: Amyotroph Lateral Scler Frontotemporal Degener. 2017 Aug;18(5-6):470.
Abstract. The objective of this study was to describe muscle cramps in an US sample of amyotrophic lateral sclerosis (ALS) patients. Utilizing an anonymous web based questionnaire we queried ALS patients regarding the severity, frequency, time-course, treatment of muscle cramps and their relationship to pain. The survey had 282 respondents with 92% reporting that they had cramps. For 20% of the sample, cramps were stated to be the presenting ALS symptom. Cramp severity was rated at a mean of 5.2/10 and the mean cramp frequency was 5.3 cramps per day. Cramp intensity and frequency did not correlate with duration or severity of ALS. Pain as measured with the Patient Reported Outcome Measurement Information System (PROMIS) pain scales was not statistically different from the US general population. Cramp severity and frequency significantly and positively correlated with the PROMIS pain scales. Patients with more severe cramps were more likely to use prescription medications for their cramps compared to patients with milder symptoms. Treatments directed at cramps were tried by 57%. In conclusion, cramps are a common symptom in ALS and it does not correlate with disease duration or severity. The severity of cramps is on average moderate and many patients try treatments.
Maquirriain J, Merello M. The athlete with muscular cramps: clinical approach. J Am Acad Orthop Surg. 2007 Jul;15(7):425-31. doi: 10.5435/00124635-200707000-00007.
Abstract. Muscle cramps are involuntary, painful, spasmodic contractions of the skeletal muscle. Although cramps are a common clinical complaint, their etiology and management have not been well established. Exercise-associated muscle cramps occur during or immediately following exercise, and they are associated with muscular fatigue and shortened muscle contraction. The main challenges for treating physicians are to identify whether the complaint represents a true muscle cramp as well as to rule out the presence of an underlying serious clinical condition. Muscle cramps may be a symptom of any of several conditions, including radiculopathies, Parkinson's disease, hypothyroidism, diabetes mellitus, vascular problems, electrolyte disorders, and metabolic myopathies. Cramps also may occur as a side effect of certain drugs (eg, lipid-lowering agents, antihypertensives, beta-agonists, insulin, oral contraceptives, alcohol). Most athletes who experience exercise-associated muscle cramps are healthy individuals without systemic illness. Therapy should focus on preventing premature fatigue by means of appropriate nutrition and adequate training.
Schwellnus MP. Muscle cramping in the marathon : aetiology and risk factors. Sports Med. 2007;37(4-5):364-7. doi: 10.2165/00007256-200737040-00023.
Abstract. Skeletal muscle cramps are commonly encountered in marathon runners by medical staff. However, the aetiology, and therefore management, of this condition is not well understood. Exercise-associated muscle cramping (EAMC) is defined as an involuntary, painful contraction of skeletal muscle during or immediately after exercise. In early anecdotal reports, cramps were associated with profuse sweating, together with changes in serum electrolyte concentrations. No mechanism explains how such imbalances in serum electrolytes result in localised muscle cramping. The 'muscle fatigue' hypothesis suggests that EAMC is the result of an abnormality of neuromuscular control at the spinal level in response to fatiguing exercise and is based on evidence from epidemiological studies, animal experimental data on spinal reflex activity during fatigue and electromyogram data recorded during bouts of acute cramping after fatiguing exercise. The development of premature muscle fatigue appears to explain the onset of EAMC.
Hensley JG. Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health. 2009 May-Jun;54(3):211-8. doi: 10.1016/j.jmwh.2009.01.003.
Abstract. Sleep disturbance during pregnancy can result in excessive daytime sleepiness, diminished daytime performance, inability to concentrate, irritability, and the potential for an increased length of labor and increased risk of operative birth. Sleep disturbance may be the result of a sleep disorder, such as leg cramps, a common yet benign disorder, or restless legs syndrome, a sensorimotor disorder. Both disrupt sleep, are distressing to the pregnant woman, and mimic one another and other serious disorders. During pregnancy, up to 30% of women can be affected by leg cramps, and up to 26% can be affected by restless legs syndrome.
Evaluate |