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June Russell's Health Facts

Leg and Foot Cramps, Restless Legs

[Overview]   [Restless Leg Syndrome (RLS)]   [RLS and Iron]  

Overview

Many individuals have had the experience of having a peaceful night of sleep interrupted suddenly and without warning by a ‘charley horse’ cramp in some part of their leg or foot, and to make matters worse there is often residual pain even after the cramping has disappeared. Although these cramps happen to people of all ages, two-thirds of those over age 65 have them at one time or another.

Possible reasons for leg/foot cramps may be: poor circulation, lack of enough salt, dehydration, abnormal mineral or hormone levels, pinched nerves, alcohol or tobacco use, partially-obstructed flow of blood to the legs, nutritional deficiency, environmental toxicity or chemical sensitivity.

As people age, leg cramps become fairly common and related to reduced activity, or muscle fatigue when the muscles don't get enough blood supply. Getting moderate regular activity during the day, or stretching the muscles before bedtime, generally reduces the likelihood of cramps during the night, as well as wall pushups which stretch the calf muscles of the leg.

Certain medicines have been reported to increase chance of cramping, as well as alcohol, sugar and caffeine. Once the muscle is cramped, the only thing to do is to stretch it out - the sooner the better. It is most helpful if the person who has the cramp can relax the leg entirely, and have someone else put the stretch on the affected muscle. One way to treat one’s own calf/foot cramp is to sit with the leg outstretched, relax the leg and use the towel as a sling to pull the toes of the foot toward oneself, or lean forward to put a stretch on the calf muscle. For continuing pain, an ice pack may help, along with massaging the affected muscle.

If you have this problem, try increasing the consumption of calcium, using 600 mg calcium (carbonate or other) up to as much as 1500 mg, at night before retiring. Magnesium citrate (400 mg up to 750 mg) can be used with the calcium, or add later after trying just the calcium. Since the magnesium may produce loose bowels, you may want to start with 100 mg and then increase to the suggested levels - or to bowel tolerance. Foods rich in magnesium are nuts, apricots, whole grains and soybeans.

In addition to the calcium/magnesium, there are other recommendations that may lessen the severity of leg/foot cramps, in getting them less often or shortening the duration. Some of these can improve or alleviate the problem of cramps: vitamin E (300 IU's/day); taking B-complex daily (including B-12); Vitamin A (10,000 units/day); potassium (100 mg/day), but this is best replaced by potassium chloride salt used liberally on foods (available in supermarket) or eating foods rich in potassium (bananas, orange juice, potatoes, etc.); folic acid (800 mcg/day), L-tryptophan (by prescription only), homeopathic remedies, or herbs especially for leg/foot cramps can be obtained at health food stores; magnets; tonic water (which contains a very small amount of quinine which can be helpful for cramping, but can be dangerous if receiving anticoagulant medication).

Additional suggestions: Sleep with legs bent, avoid high heels, eliminate sugar and caffeine (caffeine interferes with your body’s absorption of magnesium, and can make you feel jittery), soak feet/legs in warm/hot water or use heating pad for ten minutes before bedtime, place a pillow at the end of the bed to prop up your feet. For dehydration, drink more water, not alcohol or caffeine, because they will dehydrate the body even more. If a disorder of the circulation is responsible, then try wearing graded tension elastic support hose in bed.

Ann Landers suggests this “cure”: put an unwrapped bar of soap under the sheets so that the cramped leg rests upon it (the soap can be kept in place by putting rubber bands around it and pinning the rubber bands to the sheet). Although there is no apparent explanation for this ‘cure-all,’ her readers swear that it really works.

Sources:
----- {"Taking Charge of Leg Cramps," John Hopkins Medical Letter, Jan. 1997}

----- {Emo Daniel, M.D., "Leg Cramps Respond to Home Remedies," Medical Foundation Clinic, Mar. 2001}

----- {HealthCentral.com - Thriveonline.com - Mar. 2001}

----- {JAMA - March 2001}

----- {"Night-time Leg Cramps," Dr. Gabe Mirkin on Fitness, Mar. 2001}

----- {"More on Restless Legs," Richard Huemer, M.D., past president of the Orthomolecular Society, Let’s Live magazine, Oct. 1997}

----- {"Restless Legs," Andrew Weil, M.D., Self Healing newsletter, Jan. 1997}

----- {"Restless Leg Syndrome (RLS)," Postgraduate Medicine, 1999, in Health Gazette, newsletter, Aug. 1999}

----- {"Ask the Experts," ‘Restless legs, Sleepless nights,’ Dr. Joseph Pizzorno, Natural Health magazine, March/April 1998}

----- {CBS.com, “Medical Minute,” Dr. Murray Feingold, March 2001}

----- {Ann Landers column, The Daily Progress, March 15, 2001}

Restless Leg Syndrome (RLS)

Restless Leg Syndrome can be caused by lack of iron, vitamin B-12 or folic acid, diabetes, Parkinson's disease, low thyroid function, several drugs including lithium, beta blockers, antidepressants, antihistamines, caffeine, alcohol, and smoking. Sometimes this problem can be painful and leave you exhausted in the morning.
{"Restless Legs Syndrome Is Very Common," Dr. Gabe Mirkin on Fitness, 1996. One of several references was Archives of Internal Medicine, 1996}

Restless leg syndrome (RLS) affects 25% of people over age 65. Because you are exhausted all the time, restless legs syndrome can cause depression. It is also seen in kidney failure and in any disease that damages nerves. Drugs used to treat Parkinson’s disease can help RLS sufferers. A report from Spain shows that the anticonvulsant gabapentin (Neurontin) also helps control RLS (Neurology, 2002).
{Dr. Mirkin’s E-Zine, April 2003}

Leg cramps that disrupt sleep are not usually caused by exercise. “If you are taking medication for edema or high blood pressure, have your sodium potassium levels evaluated,” advises Daniel Wagner, MD, medical director of the Sleep-Wake Disorders Center at the New York Weill Cornell Medical Center. B vitamins may bring relief. A 1998 study in The Journal of Pharmacology reported that taking B complex for three months could reduce nocturnal cramps. Stretching exercises for calf muscles are also helpful. Restless legs syndrome (RLS) is a creepy crawly sensation in your legs, or your legs seem jumpy, and although it is more common with age, it is beginning to be recognized in younger and younger groups. Symptoms occur most often in the legs, sometimes in the arms. According to Dr. Wagner, RLS can be caused in some people by an iron deficiency.
{“Outwitting the Sleep Stealers,” When there are leg cramps, Food and Fitness Advisor newsletter, June 2003}

Restless legs tend to occur when people are awake and relaxed, and they notice as they are starting to lie down, they get this sensation under their skin — and the only thing that makes the sensation go away is to get up and walk around or move their feet. It is a very uncomfortable condition that occurs more in the elderly. Tonic water tends to work more for leg cramps. Some of the narcotic agents will decrease this, and other drugs like Sinemet or L-dopa can have a dramatic effect on this.
{Dr. Marty Sharp, psychopharmacologist, sleep researcher and Director of the Tri-state Sleep Disorder Center in Cincinnati, Ohio - on People’s Pharmacy, PBS radio health program, March 29, 2003, Show #447}

Restless Leg Syndrome (RLS) and Iron

A small study from the Mayo Clinic tells us that Restless Leg Syndrome (RLS) is sometimes associated with anemia; so donating blood could result in iron deficiency anemia shortly thereafter.
{The Johns Hopkins Medical letter, Health After 50, June 2003}

A specific receptor for iron transport is lacking in patients with RLS (Restless Leg Syndrome), according to the first-ever autopsy analysis of the brain of people with RLS, done by the Dept. of Neuroscience and Anatomy, Penn State College of Medicine. This study was presented at the Association of Professional Sleep Societies meeting in Chicago on June 5, 2003.
{Possible physical cause for RLS established,” arthritis.about.com - June 2003}

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