What is Degenerative Disc Disease and What Can You do About it?

What is Degenerative Disc Disease and What Can You do About it?

by | Mar 1, 2022 | Back problems, other

What is Degenerative Disc Disease

What is Degenerative Disc Disease and What Can You do About it?

Back pain is so common it’s almost inevitable. Like sprouting a gray hair, most people deal with at least one episode of low back pain by middle age. A major cause of back pain can be degenerative disc disease. Various factors, including what’s happening both inside and outside your cells, contribute to getting degenerative disc disease. A combination of wear and tear, poor nutrition in the discs, and neural changes over time lead to degenerative disc disease. In this article, we’ll get into what degenerative disc disease is and how you can treat it.

What is Degenerative Disc Disease?

To better understand degenerative disc disease, let’s discuss the umbrella term under which it lies: low back pain. Low back pain is the fifth most common reason people go to the doctor in the United States. Whether people are extremely active or relatively sedentary, healthy or unhealthy, back pain affects most people at some point in their lives. Of the many causes of back pain, degenerative disc disease is the leading cause of lower back pain and disability. One reason may be because our discs start degenerating much earlier than our bones and muscles, which we’ll go into more detail on later. Let’s start by looking at the spine.

Degenerative Disc Disease

A Brief Look at Spine Anatomy

Most people are born with a spine comprised of 33 bones called vertebrae stacked on top of one another like puzzle pieces. By adulthood we typically have 24 vertebrae because the bones at the bottom of the spine fuse together. The vertebrae differ based on their location in the spine and have different functions in the neck (cervical), mid back (thoracic) and low back (lumbar) regions. While degenerative disc disease can occur in any part of the spine, we’ll focus on the most prevalent, the lumbar spine.

Each lumbar vertebra is comprised of a prominent, round body in front, a pointy spinous process in back, a transverse process on either side, the spinal canal, which houses the spinal cord, and facet joints, which articulate with the vertebra above it. When stacked together, they create the spinal column. The spinal column has 4 main functions: to support the weight of the body above the pelvis, to protect the spinal cord, to act as the central axis of the body, and to control posture and movement.

Degenerative Disc Disease

Where do Discs Come into Play?

In between the bodies of the vertebrae lie intervertebral discs, which act like soft pillows and provide flexibility and cushion to the spine. They also allow for the spine’s natural curvature, or lordosis, to absorb shock, provide stability, and carry heavier loads. Each disc is made up of three parts:

  • Nucleus pulposus: The center of the disc containing the “filling”
  • Annulus fibrosus: Inner and outer rings surrounding the nucleus pulposus
  • Terminal endplates: Cartilage and fibrous tissue

How Discs Degenerate

The nucleus pulposus plays the largest role in disc degeneration. A healthy nucleus pulposus is gel-like, well hydrated, and rich in proteins called proteoglycans. It creates pressure in the disc to separate the vertebra, puts tension on the surrounding rings (annulus fibrosus) to hold the disc shape, and helps evenly distribute pressure over the end plates. As we age, the nucleus pulposus loses proteoglycans, which causes the disc to become firmer, dehydrated, and more vulnerable to damage. These changes cause the disc to lose its height and pressure, which sets off a sequence of events that changes the biomechanics of the spine.

Nucleus Pulposus Over Time

 AGE  FILLING CONSISTENCY
 Young  Jelly
 Middle-aged  Toothpaste
 Older  Chalk

 

Disc degeneration over time is inevitable. But many people going through it never even know it’s happening. Discs begin the degeneration process as early as adolescence, with 20% of young people showing mild symptoms. It’s when these changes cause painful and debilitating symptoms that we refer to it as degenerative disc disease, or intervertebral disc disease.

What Causes Degenerative Disc Disease?

Degenerative Disc Disease

Like many other chronic conditions, such as heart disease and diabetes, no one specific event causes degenerative disc disease. Degenerative disc disease results from a complex interaction of genetics, age, structural changes, biochemical changes, environment, trauma, and activity level over time. Three main factors lead to the progression of degenerative disc disease: wear and tear, decreased nutrition in the discs, and neural changes.

Wear and Tear

Natural disc degeneration can start as early as ages 11-16, but most people begin showing symptoms in middle age, after they have put their spines through some wear and tear. Age-related changes cause an imbalance between building tissue (anabolism) and breaking tissue down (catabolism). This changes the composition of the nucleus pulposus, leaving it dehydrated and firmer. As disc height falls, the dynamics of the extracellular matrix (area surrounding disc cells) change, causing the once perfectly functioning spine to use altered movement patterns.

Decreased Nutrition in the Discs

With age, fewer nutrients are supplied to the discs, causing terminal end plates to harden and calcify. Nutrient loss also causes discs to be less capable of load distribution. As one disc degenerates, it causes surrounding segments to work harder to distribute load and maintain postural stability, which accelerates degeneration of the surrounding discs. This in turn affects other structures, such as joints, ligaments and muscle.

Neural Changes

The discs in the spine are aneural (without nerves) and avascular (without blood vessels). So how do they generate so much pain? When the disc degeneration cycle progresses, a series of reactions are stimulated in which cytokines, the immune responses’ signaling cells, are secreted. An inflammatory response follows, which can cause tears in the annulus fibrosis (fissures), push the disc into nerve tissue (bulge), or even cause the nucleus pulposus to rupture and leak out (herniate). Over time, the spinal canal becomes too narrow (spinal stenosis) and compresses nerve tissue (radiculopathy), which causes pain.

Am I at risk?

Degenerative Disc Disease
If you are getting older by the day (hint: we all are!), then you are at risk of disc degeneration. Since discs begin degenerating much earlier than muscles and bones, many people who experience low back pain associated with degenerative disc disease are of working age. This may explain why degenerative disc disease is the leading cause of work-related disability. Some factors may put you at higher risk for developing degenerative disc disease. Here are a few to keep in mind:

  • Age: The older the individual, the higher the risk
  • Genetics: If one or more family members have been affected, you are more likely to be affected
  • Gender: Men are at higher risk
  • Joint laxity: Imbalances in muscle dynamics can create spinal instability
  • Repetitive loading over time: Healthcare workers, foundry and forest workers, production operators, cabinet makers, truck drivers, locksmiths, bricklayers, and workers who lift, rotate, and/or bend are more at risk
  • Environmental factors: Smoking, obesity, and diabetes mellitus increase the risk
  • Psychosocial factors: Low socioeconomic status and depression increase the risk
  • Nutritional deficiency: Poor disc nutrition accelerates degeneration

How do I know if I have Degenerative Disc Disease?

Degenerative disc disease may be present in 90% of people over age 70. So why don’t 90% of people over age 70 have severe low back pain? Many people with degenerative disc disease are asymptomatic and will never need treatment. Others have episodic bouts of pain that are treatable with conservative interventions, which is why your physician usually won’t jump right to ordering an MRI. Chances are, if you have back pain, an MRI will show some degeneration of your discs. But that won’t necessarily change the course of treatment. Managing symptoms is the priority.

Symptoms

Besides the most obvious symptom of low back pain, the next most common symptom is sciatica, or nerve type pain running down the leg. This type of pain is usually sharp and shooting and may feel numb and tingly radiating down the leg and foot. It can be on one or both sides, and can follow what are called dermatomal patterns, or areas of the leg innervated by certain nerves. Specifying the location of your symptoms can help your clinician determine what level of the spine he or she suspects is involved.

Your symptoms may be aggravated with bending, sitting, turning, coughing, sneezing, and occasionally standing. Typically, if sitting aggravates your symptoms, then standing or laying will alleviate them, and vice versa. However, in an acute case of a disc herniation, it may be painful to be in any position.

Things to Report Immediately

While degenerative disc disease symptoms may be painful, they aren’t usually dangerous. However, there are a few symptoms that require immediate evaluation by a medical professional. These can lead to rare, but potentially life-threatening complications:

  • Change in bowels or bladder accompanying back pain
  • Saddle anesthesia (loss of sensation in the buttocks, perineum, and inner thighs)
  • Fever
  • Drug abuse
  • Recent trauma (car accident, fall, sports injury, etc.)
  • Unrelenting pain

Diagnosis

Degenerative Disc Disease

When seeking evaluation for degenerative disc disease, you must first choose where to begin for proper medical evaluation. Your primary care physician can diagnose your condition, provide recommendations, and possibly medications to help temporarily, and this physician can provide referrals for therapy, whether this be physical therapy or occupational therapy, depending on your condition. Your primary care physician can also help you to find the most appropriate specialist for your condition — and make this referral for you. This physician may be an orthopedic physician, a physiatrist (PM&R physician), a neurologist, or a neurosurgeon. They all specialize in differing capacities in spinal dysfunction. No matter who you choose, it’s always a good idea to know what to expect.

Your physician will ask a series of questions about your medical history, current symptoms, aggravating factors, and alleviating factors, and any medications you’ve taken for this condition. You will be asked specific questions about your pain, such as location, quality, intensity, and frequency. They may test your strength, flexibility, and range of motion. During this time, it is important to be honest: lay it all out there. Don’t be embarrassed to say you fell off the wagon with your diet, or that you haven’t left your couch since Covid-19 began. It’s important for the physician to know what’s going on in your life so you can be diagnosed accurately.

While an MRI is the main imaging technique for degenerative disc disease, it is just one of many diagnostic tools a clinician may use. Remember that more likely than not, you have disc generation if you have low back pain. Since the results of an MRI often don’t change the treatment plan for the individual, physicians typically only order them if conservative treatment fails.

What to do About it

Treatment typically starts with conservative management, which includes physical therapy, oral medications, injections, and education about understanding pain and coping mechanisms. Statistically, 80% of patients respond to physical therapy within four to six weeks.

For those who still suffer from symptoms after trying conservative care, some promising prospects are less invasive than surgery but still being studied. Restorative therapies include molecular therapy, growth factor therapy, cell therapy and gene therapy. Reconstructive methods include percutaneous IVD techniques, mechanical decompression, and biomaterial injection.

The more invasive treatments and typically last resort for symptom relief are decompression surgery, total disc replacement, and rigid fusion. While fusion protects the integrity of the segment, it may compromise other levels of the spine. It also addresses symptoms, not causes of the condition.

If you want to decrease your risk of getting degenerative disc disease, you can start by exercising. Exercise, especially when done in moderate to high volume, with low repetition and frequency, can decrease your risk of having symptoms. Along with a multitude of other health benefits, exercise will keep your postural muscles strong, spine stable, and cardiovascular system healthy.

What Not to Do

If you suffer from degenerative disc disease, don’t lay around hoping it will go away. Bedrest can make low back pain worse. After 1-2 days of rest per new episode, it is important to move your body. Your clinician will direct you on what kind of activities are safe and effective for your case.

Conclusion

Degenerating discs are about as common as getting wrinkles with age. When they become painful and debilitating, however, we call it degenerative disc disease. It is the result of a complex interplay of actions happening both inside and outside of cells, environmental factors, genes, and change over time. If you have an episode of low back pain, you may have degenerative disc disease, but don’t schedule your surgery just yet. Make an appointment with Dr. Connor to discuss your back issues so you can get back to being you!

The #1 Cause of Belly Fat, Says Science

The #1 Cause of Belly Fat, Says Science

by | Dec 15, 2021 | other, weight loss

The #1 Cause of Belly Fat, Says Science

In an article in Eat This, Not That!, Dr. Connor is quoted saying that when your belly fat is causing health issues, you are at risk. Prevention, or at the very least, early intervention, is key here. Do not wait until your BMI or waist circumference reaches a point to make you wonder if belly fat is the cause; rather, you want to address this earlier in life, and the earlier the better.

Belly Fat
Restless Leg Syndrome: What Is It, What Causes It, and What Can You Do About It?

Restless Leg Syndrome: What Is It, What Causes It, and What Can You Do About It?

by | Nov 29, 2021 | other, sleep

Restless Leg Syndrome 1

Restless Leg Syndrome: What Is It, What Causes It, and What Can You Do About It?

For some people, laying down to sleep comes with uncomfortable sensations that make them feel like they have to move their legs. This experience, called restless leg syndrome (RLS) or Willis-Ekbom Disease, can keep a person awake at night, often tossing and turning as they cannot get comfortable. Don’t confuse RLS with leg cramps — these are two different conditions. Leg cramps are sharp pains that develop when muscles in the legs suddenly contract. Leg cramps may last a few seconds to a few minutes. On the other hand, RLS leads to ongoing feelings of discomfort. About five to 10 percent of adults in the U.S. have restless leg syndrome. The condition also affects two to four percent of children. Women develop this condition more often than men. Additionally, older adults are more likely to develop RLS and to have worse symptoms. More than four out of five people with RLS also develop another sleep disorder called periodic limb movement of sleep (PLMS). PLMS causes the legs or arms to regularly move and jerk while a person is sleeping.

Symptoms of Restless Leg Syndrome

RLS causes uncomfortable feelings in the lower limbs. People with RLS feel like they can’t control the urge to move their legs. Often, moving around makes the discomfort disappear, but the feelings usually return once movement stops. People with RLS may also describe feelings of pulling, twitching, crawling, throbbing, burning, or itching. Occasionally, RLS may also affect muscles in the arms or other parts of the body. RLS symptoms often appear later in the day, in the evening or at night. A person may notice restless legs when they are sitting or lying down. Some people may wake up in the middle of the night with twitchy legs and have a hard time falling back asleep. RLS symptoms may also pop up during the day when a person has been sitting for a long time, such as on an airplane flight. Restless leg syndrome may also lead to additional problems during the day. RLS often prevents a person from getting a good night’s sleep, which can lead to memory loss, difficulty focusing, and mood changes. Additionally, when RLS goes untreated, it impacts productivity at work.

Long-Term Effects of RLS

When people don’t get enough sleep, they are also at risk for physical and mental health problems, including diabetes and depression. One study found that people with restless leg syndrome were four times more likely to develop heart disease or experience a stroke. This group was also at risk for developing kidney disease.

Restless Leg Syndrome Causes

Pills
​ Normally, the brain “talks to” the muscles in the legs using nerves. Experts believe that RLS develops when the nerves in the leg muscles can’t communicate with the brain as well as they should. Doctors don’t know why most cases of RLS occur. However, in some cases RLS is linked to genetics, an underlying health condition, or a particular medication.

Genes and Restless Leg Syndrome

Researchers have identified certain gene changes that increase a person’s risk of developing RLS. It’s not yet clear how these gene changes lead to RLS, but they may affect the way nerves develop before a person is born. There also may be other genetic factors that scientists have not yet discovered. This means that RLS can be passed down from parents to children. Most people diagnosed with the condition have a family member who also has RLS.

Health Conditions Leading to RLS

RLS is often linked to low levels of iron. The brain uses this mineral to make a dopamine, a brain chemical, often called a neurotransmitter. Dopamine is needed in order for the brain to control muscle movement. When a person doesn’t have enough iron in the brain, this process may be disrupted. Other vitamin and mineral deficiencies have also been linked to RLS. For example, people with low levels of magnesium or folate, a B vitamin, may also experience RLS symptoms. Other disorders may also lead to restless leg syndrome. These include:

  • Diabetes
  • Multiple sclerosis
  • Rheumatoid arthritis
  • End-stage renal disease (loss of kidney function)
  • Parkinson’s disease
  • Peripheral neuropathy (nerve damage)

Another RLS cause is pregnancy. In this case, the symptoms usually disappear a couple of weeks after giving birth. Some experts think that RLS happens during pregnancy as a result of low iron and folate levels, since pregnancy requires higher levels of these nutrients.

Medications That Cause RLS

Restless legs may be a side effect of certain medications. These can include:

  • Antidepressants
  • Antipsychotics
  • Anti-nausea drugs
  • Cold medications
  • Allergy medications
  • Drugs used to treat hypertension (high blood pressure)

If you notice RLS symptoms after trying a new medication, talk to your health care team. Your doctor may be able to prescribe you an alternate medication that doesn’t lead to restless feet and legs.

How Is RLS Diagnosed?

What causes leg cramps and what to do about them
Doctors may perform a physical or neurological exam if they suspect that a person has RLS. During this time, the doctor will usually ask about what symptoms a person is experiencing, how often the symptoms occur, what medications a person is using, and the person’s personal and family health history.

Doctors can test iron levels with a simple blood test. These tests may show that low iron stores have caused red blood cell levels to drop, in a condition known as iron-deficiency anemia. Blood tests can also be used to look at other aspects of health, including kidney function.

Doctors often recommend a sleep study in order to diagnose sleeping problems. During this test, a person will stay overnight in a clinic or hospital. Also, home sleep studies can be conducted in one’s own bed. Electrodes can help measure body functions like heart rate and brain waves. A video camera may also be used to capture movements while a person sleeps. This test may indicate that a person has RLS or another sleep condition such as sleep apnea or narcolepsy.

Restless Leg Syndrome Treatments

Stretching legs
RLS usually can’t be cured. However, it may be possible to rectify the underlying root cause of the problem. Symptoms may briefly disappear, but they frequently return later. However, remedies are available to help relieve symptoms and improve sleep. Some people with mild symptoms may not need any treatments.

Immediate Treatments

Moving around usually leads to instant relief for restless legs. If you are having a hard time falling asleep because of RLS symptoms, try getting up and walking around for a little bit. Massaging or stretching the leg muscles may also calm the uncomfortable sensations.

Some people also feel better after taking a hot bath. Using a hot water bottle or ice pack may calm restless legs.

Lifestyle Changes

RLS may be partly caused by environmental or lifestyle factors. Some substances, including alcohol, caffeine, and tobacco, may cause RLS or worsen symptoms. Drinking less alcohol and coffee and quitting smoking may help symptoms appear less often. Additionally, getting more physical activity throughout the day can relieve symptoms.

Practicing good sleep hygiene may also make it easier to fall asleep. Try to follow a regular sleep schedule, laying down to bed at the same time each night and setting an alarm for the same time each morning. Additionally, try to keep your sleeping area cool, dark, and quiet.

Diagnosing Other Health Conditions

When RLS is caused by another health condition, diagnosing and treating that condition often provides relief. A good first step when looking for RLS treatments is visiting your doctor and making sure you are in good health.

Iron Supplements

When RLS is caused by low iron levels, taking iron supplements can help. These supplements can be purchased over-the-counter. For those with very low levels of iron, intravenous (IV) iron treatments can also help boost iron levels.

Even when blood tests show that a person has normal iron levels, doctors may still recommend iron supplements. Studies have shown that iron treatments can help everyone, regardless of iron test results. Researchers think that some people may have normal levels of iron in the blood, but low levels of this mineral in the brain. For this reason, iron supplements are often the first treatment a doctor will suggest.

Other Vitamin or Mineral Supplements

Researchers have found that taking folate supplements may also improve RLS symptoms. This treatment has been effective both in people with genetic cases of RLS that run in families, as well as RLS that develops due to underlying health conditions. Folate deficiencies may also be responsible for RLS symptoms during pregnancy. One study found that pregnant women who took folate supplements were much less likely to experience RLS symptoms.

It’s possible that magnesium levels may also be linked to RLS. However, studies have reported conflicting results — some have found that magnesium supplements help people with RLS get a better night’s sleep, while others have not found magnesium to be effective. However, these supplements may be worth a try for some people. Make sure to take the recommended dose of any vitamin or supplement, as high doses can make you sick.

Medications for Restless Leg Syndrome

There are several different drug options that may change the levels of certain brain chemicals in order to help with restless leg syndrome. Doctors may prescribe:

  • Anti-seizure medications such as Horizant (gabapentin enacarbil), Neurontin (gabapentin), and Lyrica (pregabalin)
  • Medications that affect levels of dopamine, including Requip (ropinirole), Mirapex (pramipexole), and Neupro (rotigotine)
  • Antidepressant or anti-anxiety medications
  • Pain medications, including low doses of opioid drugs

These medications often work in different ways. They may affect different brain chemicals or change the way different sensations feel. Additionally, each of these drugs can lead to varying side effects. People with RLS may need to try more than one option before they find something that works well for them.

Drugs that alter dopamine levels often work well short-term but may increase symptoms in the long run. People who use these drugs regularly may need to take increasingly higher doses in order to feel an effect. If this side effect develops, a person may need to stop taking the medication and switch to a different one. Anti-seizure medications don’t have this effect and seem to work better over time to keep restless legs under control.

Medical Devices

Researchers have developed a couple of devices for RLS treatment. Some have even been approved by the U.S. Food and Drug Administration (FDA). You need a prescription from your doctor in order to get these devices.

One device, the Relaxis pad, is a pillow-sized pad that is placed under the legs. The device vibrates as you fall asleep. Some researchers think that the vibrations cause the leg muscles to send certain signals back to the brain. These signals may override the other signals caused by RLS that lead to discomfort. One study found that the Relaxis pad worked as well as RLS drugs, and came with fewer side effects.

The Restiffic foot wrap is another device designed to treat RLS. The wrap puts pressure on muscles in the bottom of the foot. Scientists believe that this feeling of pressure sends signals to the brain, which then tells the leg muscles to relax. In one small clinical trial, the device improved RLS symptoms to a greater degree than medication.

Conclusion

If you are plagued by restless legs at night, it may help to talk to your health care team. Your doctor can recommend or prescribe various treatments and check to make sure RLS isn’t caused by another health problem.

For many people, restless leg syndrome can be treated with simple at-home solutions, including taking iron supplements, getting more exercise, and avoiding alcohol, caffeine, and tobacco. When these strategies don’t work well enough to manage RLS, medications or devices may be effective.

If you would like to discuss RLS, please make an appointment.

Leg Cramps: What Causes Them and What to Do About Them

Leg Cramps: What Causes Them and What to Do About Them

by | Nov 10, 2021 | other

Young woman holding apple

What Is a Leg Cramp?

A leg cramp, also called a charley horse, is a sudden pain in a leg muscle. Leg cramps often develop when a muscle becomes strained during activity or when a person is dehydrated. Less common causes include injury or an underlying condition. Fortunately, there are many things that you can do at home to help treat and prevent most cases of muscle cramps.

Leg cramps develop when there is a problem with one or more muscles in your leg. Muscles that are most often affected include the hamstrings (back of the upper leg), quadriceps or quads (front of the upper leg), or calf (back of the lower leg).

Muscles are made up of many small fibers. Nerves control groups of fibers, connecting muscles to the brain. When you “tell” a muscle to move, the muscle fibers contract — they become tighter, leading to movement.

Leg cramps occur when one of the muscles in the legs contracts suddenly, without you controlling it. Usually, you are able to relax a muscle after moving it, but during a cramp, the muscle stays tightened, and you can’t tell it to relax. Muscle cramps usually lead to pain. A cramp may go away after a couple of seconds, or it may linger for several minutes. In addition to your legs, muscle cramps also commonly appear in the arms, hands, feet, side of your chest, or abdomen.

What Causes Leg Cramps?

Many things can lead to cramping muscles. They may develop as a result of exercise or hydration habits, appear as a symptom of an underlying injury or condition, or occur as side effects of certain treatments.

Physical Activity and Leg Cramps

Leg Cramp

Most often, your leg is cramping because you overused a muscle. You may have strained or pulled one of your leg muscles while exercising or performing physical activity.

Cramping may be a sign that your body can’t keep up with the amount of physical activity you are trying to do. You may need to start using a less intense exercise routine, or taking more frequent breaks during bouts of physical activity.

How Water Affects Muscle Cramping

Dehydration is a very common cause of leg cramps. Dehydration develops when a person doesn’t drink enough water to replace all of the fluids that they lose.

Illness that leads to diarrhea or vomiting can lead to dehydration. The same is true for diseases that cause people to sweat or urinate too much, including kidney disease and diabetes. Both young children and older adults also have a higher risk of dehydration.

Getting a lot of physical activity or spending time in hot temperatures can easily lead to dehydration if a person isn’t drinking enough water. When people sweat a lot, and don’t replace the fluid they lose, they may end up with heat cramps.

Leg Cramps and Electrolyte Imbalances

Even if you’re drinking a lot of water, you may still experience cramping if you don’t get enough electrolytes. Electrolytes are minerals such as sodium, calcium, potassium, and magnesium. Electrolytes are found throughout your body, including in your muscles. They help control how much water enters and leaves different tissues. Electrolytes also help cells absorb nutrients and get rid of waste.

When the body’s fluid balance is thrown off, the levels of electrolytes can become abnormal as well. Dehydration can lead to low electrolyte levels in the muscles, which then make the muscles begin to hurt.

Leg Cramps as a Symptom of Other Conditions

What causes leg cramps and what to do about them

Menstruation sometimes causes leg cramps. During a menstrual period, the muscles of the uterus contract in order to get rid of the uterine lining. This often leads to pain in the abdomen during a period. In some cases, pain can be felt in other parts of the body, such as the back or the legs. Pain during periods is normal for some people, but can also be a sign of a health condition. About half of women with endometriosis experience leg pain during periods.

Muscle cramps can also be a pregnancy symptom. Many pregnant women report cramps in their legs or feet, especially towards the end of the pregnancy. Leg cramps most often appear at night.

Sometimes, leg cramps may actually be a sign of injury in your back or neck. If you have a problem with your neck or spine, such as an injury or pinched nerve, the nerves that connect the brain to the legs may be affected. As a result, the nerve may make the muscle contract when it shouldn’t.

Several other disorders can cause muscle cramping. These include:

  • Thyroid problems: The thyroid gland helps control many different processes within the body. About four out of five people with an underactive thyroid (hypothyroidism) have pain or weakness in the muscles.
  • Nerve disorders: When there are problems with the nerves that control the muscles, a person may experience muscle cramps, pain, or twitching.
  • Kidney disorders: More than one out of three people with kidney disease have ongoing muscle pain.
  • Alcoholism: The more a person drinks alcohol, the more likely they are to have leg cramps, especially at night. Additionally, people with liver damage often have leg cramps.
  • Diabetes: This disorder occurs when the body can’t properly regulate blood sugar levels. This can cause nerve damage, which may lead to leg cramps.
  • Fibromyalgia: People with this disorder often experience muscle pain and stiffness in addition to tiredness, mood changes, memory problems, and insomnia.

Muscle cramps that happen often, don’t go away, or don’t have a clear cause may be a sign of these or other disorders. If your legs cramp frequently or happen along with other health changes, talk to your doctor.

Leg Cramps as a Treatment Side Effect

Certain drugs can cause leg cramps. These include certain diuretics (water pills), asthma medications, cholesterol medications, the high blood pressure medication nifedipine, and others. If you have recently changed which medications you take, or changed a medication dose, ask your doctor whether leg cramps are a possible side effect.

People with kidney failure often need to undergo dialysis treatments. During dialysis, waste and extra fluid is filtered out of the blood. Between 25 and 50% of people receiving dialysis have leg cramps.

Treating Leg Cramps

The most common causes of leg cramps can be treated at home. They usually don’t signal any major problem. However, in some cases, you may need medical care. Talk to your doctor if these strategies are ineffective at preventing or relieving your leg cramps.

Basic Home Care for Muscle Cramps

How to treat leg cramps

Cramping develops when a muscle contracts but doesn’t relax. One of the first things to try when you notice a leg cramp is to stretch the muscle. This may help loosen it. Don’t try to stretch too far or too fast, or you may risk injuring the muscle. Stretching before physical activity may also help prevent a leg cramp from forming. Additionally, some people tend to get leg cramps at night. If this is the case for you, stretch before going to bed. Massaging the muscle during or after stretching may also help.

To stretch your legs, try the following after consulting your physician to ensure they are appropriate for you. Hold each stretch for about 15 seconds:

  • Hamstring stretch: Stand with your feet shoulder-width apart. Bend forward and try to touch your toes, although it’s okay if you can’t reach them. Don’t lock your knees — bend them slightly. You should feel a light pulling in the backs of your thighs.
  • Quadriceps or thigh stretch: Hold on to a wall, chair, or other sturdy object for balance. Stand on your left leg, bending your right knee. Reach down with your right hand to grab your right foot. Pull gently, stretching your foot straight up towards your back. You should feel this stretch in the front part of your thigh. Make sure to stretch both legs.
  • Inner thigh stretch: Stand with your legs a couple of feet apart. Bend your left knee and shift your hips to the left. You should feel a slight pulling in your right inner thigh. Next, stretch the left side by bending your right knee and moving your hips to the right.
  • Calf stretch: Stand a couple of feet from a wall, and place both hands on the wall. Bend your left knee, placing your left foot on the ground near the wall. Move your body forward, towards the wall, while keeping your right knee straight and your right toes and heel planted on the ground. You should feel the stretch in the back of your right leg, below the knee. Repeat on the other side.

You can also use temperature to your advantage to help relieve a leg cramp. Putting a heating pad or hot water bottle on the affected area can help loosen a muscle. Once the muscle is relaxed, try numbing pain with an ice pack.

Hydrate Yourself

Sliced orange

The amount of water needed each day varies a lot from person to person, depending on things like age, sex, activity levels, climate, and health conditions. However, leg cramps may be a sign you’re not drinking enough. Try carrying around a water bottle with you during the day, or switching out other beverages for water during mealtimes. Children, older adults, and lower-income people are less likely to get enough water.

If you develop leg cramps after working outside or undergoing a lot of physical activity, you may be experiencing heat cramps or heat exhaustion. Start rehydrating yourself and eat a snack. Your cramps should start getting better within an hour. If they don’t, seek medical care. Additionally, get medical treatment if you have signs of heat exhaustion such as heavy sweating, cool skin, dizziness, a fast heartbeat, or confusion.

Get More Electrolytes

If you currently have cramps, it may be better to hydrate with a beverage that contains electrolytes. One study found that drinking water after an intense workout actually increased the chances that a person developed cramps. However, when dehydrated people drank electrolytes after finishing a workout, muscle cramps became less likely.

To prevent future leg cramps due to dehydration, make sure to properly fuel your body and drink enough fluids before being active or spending time in hot temperatures. Sports drinks that contain both carbohydrates and electrolytes can help. In one small study, people who had a sports drink before and during physical activity were able to exercise for more than twice as long before developing leg cramps.

In addition to using sports drinks when you are physically active, you can also try getting more electrolytes through your diet. Try eating more foods that contain these important minerals:

  • Potassium: leafy greens like spinach or Swiss chard, sweet potatoes, clams, yogurt, bananas, orange juice, and coconut water
  • Calcium: dairy foods such as milk, yogurt, and cheese, as well as leafy green vegetables, tofu, sardines, and salmon
  • Magnesium: nuts, seeds, beans, leafy green vegetables, and whole grains

Medication for Leg Cramps

Pain from basic leg cramps can often be relieved with over-the-counter medications. A good option to try is non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or high-dose aspirin. In more severe cases cases, doctors may be able to prescribe medication such as muscle relaxers to help with cramped muscles.

NSAIDs may also help when leg cramps are caused by a menstrual period. Additionally, taking an oral contraceptive (birth control pill) can reduce menstruation symptoms including pain.

Other Treatments for Leg Cramps

If leg cramps are caused by an underlying health condition, treating that condition may help this symptom improve. Additionally, if cramping is caused by a medication, you may be able to talk to your doctor about switching to a new treatment plan.

In some cases, leg cramps occur because a health condition or treatment prevents enough blood from getting to the leg muscles. Massage can help stimulate blood flow, causing people to have fewer leg cramps.

When To Get Medical Help

Talk to your doctor if your legs cramp frequently and don’t go away after trying home remedies. You should also talk to a doctor if your cramps lead to severe pain or don’t disappear after a few minutes. Additionally, if leg cramps appear along with other symptoms like weakness, redness, swelling, or warmth, they may be a sign of something more serious.

Conclusion

Leg cramps can have many causes. However, most often cramping is simply a sign that you need to take it easier or drink more water. Stretching out the cramped muscle, grabbing a sports drink, and taking an NSAID are strategies that can help in the moment while the muscle is cramping.

If these simple treatments don’t work, leg cramps may be a sign that something else is going on. It may be time for a conversation with your doctor. Most causes of leg cramps can be managed with proper treatment, once you have a better understanding of the cause.

If you are concerned about muscle cramps and would like to discuss with Dr. Connor, please make an appointment.

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