Extreme muscle cramps: what to know and do

A cramp may follow strenuous activity, heat, sweating, prolonged sitting, or an awkward position. It can affect the calf, foot, thigh, or another muscle and may leave soreness after the spasm stops. Repeated or widespread cramps can occur with dehydration, thyroid problems, kidney disease, low vitamin D, reduced muscle bulk, circulation problems, or a muscle strain. The cramp alone does not identify its cause.

Stop the activity and slowly stretch the affected muscle. For a calf cramp, straighten the leg and draw the toes towards you; gentle walking or massage may help once the muscle begins to release. Sip fluids, especially after sweating, and avoid forceful stretching or sudden exercise. Arrange a clinical review if cramps keep returning, disturb sleep, involve several areas, or began after a new medicine.

Seek urgent help for a cramp with fainting, confusion, severe weakness, chest pain, trouble breathing, a cold or unusually pale limb, or inability to move the area. Prompt assessment is also sensible when swelling, redness, fever, dark urine, or persistent severe pain accompanies the spasm. A clinician may examine circulation, nerves, muscles, medicines, and hydration.

Ask whether your pattern suggests dehydration, muscle strain, thyroid disease, kidney disease, circulation trouble, or vitamin D deficiency. Bring a list of medicines and supplements, note where cramps occur, what you were doing, how long they last, and whether weakness or numbness follows.