Patient: Over the past 5 or so years I’ve experienced involuntary muscle contractions in my calves. Wasn’t particularly bothersome at first but over the years, mainly these past few months the symptoms are getting more frequent. This concerns me. It only happens when I’m laying down for a period of time. At first if I were sitting down watching TV for a period of time. Then it moved onto when I was trying to go to sleep. It did not have a preference to what time of day, but mostly when my legs were inactive for any period of time. There is no pain involved. The calf muscle (mostly my right, but may be the left occasionaly) will contract causing my foot and toes to point straight up. My leg will usually elevate itself slightly during this. It will last approx. 3 seconds, but will be repetitive usually every 20 seconds or so. Out of frustration one time, I’ve punched my calf, which did seem to break the cycle. Walking, of course, stops the spasm completely. I have no other symptoms, but this. There is no tingling, no creepy crawling feeling, nothing that I can directly connect to possible RLS. My calf muscles are slightly tired afterwards to their workout. I would like to mention previous medical history to assist in your opinion. I am 37 and female. I suffer from OAB (over active bladder)which I take 8 mg toviaz for this. I suffer from headaches frequently, almost daily, without any specific diagnosis except for “tension headaches” for roughly the past 16 years. My feet for about the same amount of time have always had a burning, itching and tingling feeling to them, particularly at night. Cold lotion helps from keeping me awake with it at night. For the past 5 years or so I’ve dismissed a slight twitch in my neck. Lastly, but not least, usually around 2-3 times a year, I experience a severe pain in my belly button area. Lasts usually for a few days then will clear up. It is extremely painful to touch and movement. I don’t know if any of these are related, but it couldn’t hurt to disclose them. I’m unsure of what kind of doctor I should see about the leg spasms. I do not want to pay my primary dr. just to be referred to a specialist if I can skip that step. Any advice is welcome.
Doctor: Muscle cramps are extremely common, and nearly everyone experiences a cramp at some time in their life. Cramps are comm mon in adults and become increasingly frequent with aging. However, children also experience cramps. Any of the muscles that are under our voluntary control (skeletal muscles) can cramp. Cramps of the extremities, especially the legs and feet, and most particularly the calf (the classic “charley horse”), are very common. Muscle cramps are felt to be caused by excessively excited nerves that stimulate the muscles. This can occur particularly after injury to nerve and/or muscle; dehydration with low blood levels of calcium, magnesium, or potassium; from certain medications; and even at rest. The pain that is associated with muscle cramps that are caused by poor circulation to the legs that worsens with walking is referred to as claudication. Deficiencies of certain vitamins or minerals, including iron deficiency, thiamine (B1), pantothenic acid (B5), and pyridoxine(B6), can also cause muscle cramps.Muscle cramps usually cause a temporary nuisance and typically resolve on their own without treatment. When muscle cramps continually recur, it is time to seek an evaluation by a physician. The primary treatment of muscle cramps involves methods to relax the affected muscle. This typically involves stretching, massage, and heat application. Other treatments are directed toward the underlying cause of the muscle cramps and can include rehydration, electrolyte repletion, hormone treatment, calcium supplementation. Most cramps can be stopped if the involved muscle can be stretched. For many cramps of the feet and legs, this stretching can often be accomplished by standing up and walking around. For a calf muscle cramp, the person can stand about 2-2½ feet from a wall (possibly farther for a tall person) and lean into the wall to place the forearms against the wall with the knees and back straight and the heels in contact with the floor. Another technique involves flexing the ankle by pulling the toes up toward the head while still lying in bed with the leg as straight as possible. For writer’s cramp (contractures in the hand), pressing the hand on a wall with the fingers facing down will stretch the cramping finger flexor muscles. Gently massaging the muscle will often help it to relax, as will applying warmth from a heating pad or hot soak. If the cramp is associated with fluid loss, as is often the case with vigorous physical activity, fluid and electrolyte (especially sodium and potassium) replacement is essential. Medicines are not generally needed to treat an ordinary cramp that is active since most cramps subside spontaneously before enough medicine would be absorbed to even have an effect.