Muscle twitching and cramping can be an annoying and painful condition, for which there can be several causes.
Muscle cramps can be classified into three main categories: congenital abnormalities, acquired medical diseases, and specific acquired skeletal muscle cramp syndromes. The most common, are the acquired skeletal muscle cramp syndromes. These are: (1) exercise associated muscle cramps (EAMC), which are the most common among athletes; (2) occupational cramps, such as writer’s cramp; (3) nocturnal calf muscle cramps – cramps that occur at night, mostly in the elderly and (4) pregnancy associated cramps. Although it’s important to keep all four types in mind when dealing with cramping, EAMC, are the most commonly experienced by athletes.
Pickle juice has been used to prevent and treat muscle cramps for decades, if not longer. Like most folk remedies, it’s unclear how or when it was started, or by whom. Other health care professionals also treat muscle cramps with mustard. Exactly how it works remains a mystery. But the key ingredient seems to be vinegar, because vinegar alone and mustard have yielded results similar to pickle juice. Two ounces of pickle juice also seems to be effective in treating acute cramps that occur during competition or practice. Generally, the cramps will subside within 30 seconds.
Doctors may feel they have to resort to drugs like Sinequin (Doxepin) or Klonopin (Klonazepam). Sinequin is a tricyclic anti-depressant and anti-histamine that can produce marked sedation. This medication may enhance the effect of Klonopin, but it can reduce muscle twitching all by itself. Klonopin is an anti-anxiety medication and anti-convulsive/anti-spasmodic. It is useful in dealing with muscle twitching, restless leg syndrome, and night-time grinding of the teeth (bruxism).
Risk factors for Muscle Cramps / Twitching
Dehydration
Excess sweating or dehydration can deplete minerals in the body – minerals that are important for good muscle function, such as sodium, potassium, calcium, magnesium and phosphorus.
Mercury Toxicity / Amalgam Illness
Unusual tics or twitching of facial muscles have been associated with mercury toxicity, as well as with muscle cramps in cases of high occupational exposure to mercury.
Hypoglycemia
As hypoglycemia progresses a variety of symptoms can occur including muscle twitching. Amongst 300 patients in one study (185 female, 115 male) found to have relative hypoglycemia (a drop of 20% or more below the fasting blood sugar level during a 6-hour glucose tolerance test), 23% had muscular twitching or cramps.
Tourette's Syndrome
The “tics” commonly seen in TS may include uncontrollable blinking, facial grimaces, head jerking, muscle twitches, as well as involuntary vocalizations.
Vitamin D Requirement
Vitamin D is necessary for absorption of calcium. A vitamin D deficiency can result in muscle cramping. Even one dose has helped in some cases of chronic muscle cramping.
Magnesium Requirement
Early symptoms of magnesium deficiency can include fatigue, anorexia, irritability, insomnia, and muscle tremors or twitching. Many cases of muscle cramps are caused by low concentrations of magnesium. [Muscle cramps and magnesium deficiency: case reports. Canadian Family Physician. July 1996: 42; pp.1348-1351]
Hypokalemia / Potassium Need
Severe hypokalemia may produce muscular malfunction, but is rarely seen in a normal outpatient population. Replacement of potassium and sodium can help to prevent muscle cramps. Potassium levels can be maintained by eating bananas and oranges or drinking orange juice.
History of leg/foot cramps
Muscle Cramps / Twitching suggests the following may be present
Tourette's Syndrome
The “tics” commonly seen in TS may include uncontrollable blinking, facial grimaces, head jerking, muscle twitches, as well as involuntary vocalizations.
Recommendations for Muscle Cramps / Twitching
Marijuana
Some people claim that cannabis is effective for relieving muscle spasms in general, not just those that result from multiple sclerosis or paralysis. A book is available on the Internet about this subject called Muscle Spasm, Pain & Marijuana Therapy: Testimony from Federal and State Court Proceedings on Marijuana’s Medical Use edited by R.C. Randall.
Tod Mikuriya, M.D. describes his clinical experiences with different kinds of spasms in Marijuana Medical Handbook. Overall, his report is favorable with regard to the benefits seen when treating muscle spasms.
Conventional Drugs / Information
Medications such as diuretics or water pills can lead to cramping due to loss of sodium and potassium.
Homeopathic Remedies / Vaccines
There is a homeopathic preparation called “Calcium Absorption”. It is distributed by Bioforce and Bioforce USA. It may help in reducing muscle twitching and cramping.
Vitamin D Testing
The best way to check if your muscle aches are due to vitamin D deficiency is to get tested with a 25 (OH) Vitamin D level. If it is less than 30mg/dl then you should take a vitamin D supplement. Food sources only provide upwards of 100 IU/day.
Magnesium
See the link between Muscle Cramps and Magnesium Requirement.
Oxygen
Yoga deep breathing techniques may help reduce the tendency for muscles to cramp.
One man, George Spence, reported that:
“A year ago I noticed that the cramps seemed to happen at times when I was at rest and breathing shallowly. I decided to try some deep breaths to see if getting more oxygen to the muscles would ease the pain and contraction. At the very first twitch of a cramp I take 2-3 or more very deep breaths. To my amazement, it not only relieved the cramps, but it stopped them completely within seconds, and they do not recur in the immediate future. This has worked for me 100% of the time. I can honestly say that it saved me hours of pain and that I have been completely in control of the cramps for a year. The cramps still try to start, but none has gotten beyond a few seconds. The speed of the relief in my case has been remarkable.
I told a friend about this treatment. The friend also suffered from cramps. After a month he reported that it had worked for him as well.”
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
Glossary
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Bruxism
Prolonged, unintentional grinding and clenching of the teeth, usually occurring during sleep. 'Bruxers' are often unaware that they have developed this habit. Symptoms include abraded/chipped teeth (in extreme cases, waking up with tooth chips in the mouth); facial pain; oversensitive teeth; tense facial and jaw muscles; headaches; dislocation of the jaw; damage to the tooth enamel, exposing the inside of the tooth; a popping or clicking in the temporomandibular joint (TMJ); tongue indentations; damage to the inside of the cheek.
Mineral
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Sodium
An essential mineral that our bodies regulate and conserve. Excess sodium retention increases the fluid volume (edema) and low sodium leads to less fluid and relative dehydration. The adult body averages a total content of over 100 grams of sodium, of which a surprising one-third is in bone. A small amount of sodium does get into cell interiors, but this represents only about ten percent of the body content. The remaining 57 percent or so of the body sodium content is in the fluid immediately surrounding the cells, where it is the major cation (positive ion). The role of sodium in the extracellular fluid is maintaining osmotic equilibrium (the proper difference in ions dissolved in the fluids inside and outside the cell) and extracellular fluid volume. Sodium is also involved in nerve impulse transmission, muscle tone and nutrient transport. All of these functions are interrelated with potassium.
Potassium
A mineral that serves as an electrolyte and is involved in the balance of fluid within the body. Our bodies contain more than twice as much potassium as sodium (typically 9oz versus 4oz). About 98% of total body potassium is inside our cells. Potassium is the principal cation (positive ion) of the fluid within cells and is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. Potassium regulates the water balance and acid-base balance in the blood and tissues. Evidence is showing that potassium is also involved in bone calcification. Potassium is a cofactor in many reactions, especially those involving energy production and muscle building.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Magnesium
An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.
Phosphorus
The second most abundant mineral in the body found in every living cell. It is involved in the proper functioning of both muscles and nerves. It is needed for metabolic processes of all cells, to activate many other nutrients, and to form energy-storage and energy-releasing compounds. The phosphorus content of the body is approximately one percent of total body weight. Phosphorus combines with fats to form phospholipids.
Anxiety
Apprehension of danger, or dread, accompanied by nervous restlessness, tension, increased heart rate, and shortness of breath unrelated to a clearly identifiable stimulus.
Hypoglycemia
A condition characterized by an abnormally low blood glucose level. Severe hypoglycemia is rare and dangerous. It can be caused by medications such as insulin (diabetics are prone to hypoglycemia), severe physical exhaustion, and some illnesses.
Fasting Blood Sugar
(FBS): Blood is drawn before breakfast (i.e., after fasting), then the glucose (sugar) in the blood is measured.
Glucose
A sugar that is the simplest form of carbohydrate. It is commonly referred to as blood sugar. The body breaks down carbohydrates in foods into glucose, which serves as the primary fuel for the muscles and the brain.
Vitamin D
A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Anorexia Nervosa
An eating disorder characterized by excess control - a morbid fear of obesity leads the sufferer to try and limit or reduce their weight by excessive dieting, exercising, vomiting, purging and use of diuretics. Sufferers are typically more than 15% below the average weight for their height/sex/age and typically have amenorrhea (if female) or low libido (if male). 1-2% of female teenagers are anorexic.
Hypokalemia
Abnormally low blood potassium.