A lifetime of muscle cramps.
Recently I had the pleasure of treating a lovely 86-year-old post-polio survivor. For as long as she could remember she had been experiencing debilitating muscle cramps all over, which have become progressively worse as she has gotten older. The cramps had become so bad she was afraid to leave the house. The cramps would happen at any time, becoming more severe at night. They would often wake her with their intensity and pain.
By the time she came to see me she was quite distraught, and rightly so. She explained that her doctor took little interest in her condition, I offered that muscle cramps are still a mystery in the medical world with little understanding of what causes them or how to stop them.
After discussing the investigations she had already undertaken, including blood tests, and ruling out anything more serious, we embarked on a plan that completely eradicated the cramps for her. I am going to share our management plan with you in the hope it may help others that are suffering from debilitating cramps.
1. Exercise - (gently)
When we get older our muscle mass reduces causing our muscle strength to decline. This leads to the muscles fatiguing quicker, increasing the likelihood of cramps occurring. My patient explained that she had become so afraid to move in case the cramps started. This was in fact the worst thing she could do, but I sympathised, it was a viscous cycle for her and one she had no idea how to stop. The reduced movement also leads to poor circulation. I encouraged her to incorporate some of the strength exercises she was doing in her once weekly group exercise class at home, as well as doing some walks around the house before she went to bed to get some blood flow to the muscles. I suggested she ask her daughter (who was a keen yogi), to give her some gentle stretches she could do. She now has a 10min yoga routine she does daily. We discussed using the heat pack when needed and especially before going to bed.
2. Keep hydrated
The other main area we managed was hydration. She came to me during a week that had been incredibly hot, we discussed making sure she was hydrated. I suggested she visit the chemist and purchase some hydralyte. I would not normally recommend this, water would normally suffice, but with the cramps being so intense I thought it was worth trying. She took the hydralyte for a week and also made sure to take it with her to her exercise class.
3. Education
Most importantly, we discussed the plan together. She had been so afraid of the cramps but now she had an understanding of what was going on she did not feel as anxious. She also had some ‘tools’ to prevent them, and in the case of a cramp occurring we spoke about how to deal with them.
On her third appointment she entered my rooms looking strong and confident, a stark difference to the first appointment. Her cramps had all but disappeared. She told me she had got her life back and was enjoying catching up with friends for lunch and going to the theatre again.
The above is not a magical cure, all the steps we took are quite typical for someone experiencing muscle cramps. This story is significant because in all the years she has been experiencing such painful and disruptive cramps, no one has tried these steps with her? Such simple adjustments have made such a significant impact on one person’s life. Hopefully, they will also help others.