THE CLINIC: Mysterious Muscle Cramps

Fri, 5 Oct. 2012 - 1:50 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:

I am 55 years old, male, averaging 27 miles per week over the last 10 years. Over the last four years, I have experienced muscle cramping in various muscles from my pelvis to my ankles. They occur mysteriously, and sometimes last weeks or even months, preventing me from running until they subside. I stretch before and especially after running, but I have noticed that my calf muscles tighten up while sitting. I have seen physical therapists and physicians over the last four years, but the cause of this cramping remains unknown. My blood work is normal, including blood count, metabolic profile, and thyroid testing. Should I take potassium supplements or quinine?

 

Frank Gebraigh
Pittsburgh, PA

 

ANSWER:

If your potassium is not low or at the very least on the low end of the normal range, it is probably not advisable to just begin taking it supplementally. A tendency toward cramping can have many causes. Sodium loss through sweating tends to be the more common source of cramping in many athletes. If you are on a low sodium diet and/or your sodium was low or at the low end of normal, you may need to increase your intake. If dehydration is playing a role, you may need to increase your fluid intake. Drinking a sports drink (which contains electrolytes) can help you achieve both. If you’re taking a diuretic medication (e.g., one that treats hypertension), this may be an additional factor contributing to the cramping.

 

I assume your blood and thyroid tests have revealed no kidney or liver disease. Likewise, cramping associated with a low calcium level is not likely the case if your calcium was in the normal range. Other causes to consider include disorders involving muscle tissue and/or the central and peripheral nervous system, and poor blood circulation to your legs (very unusual in a runner). A physical exam will help you determine whether you should consult a neurologist or a vascular specialist.

 

While determining the cause of your cramps is advisable, in the short term quinine may provide some degree of relief. Quinine sulfate is now only available by prescription. It ceased to be made available over the counter in 1995 when the potential for (very rare) adverse effects were reported. Quinine in the form of tonic water may be worth a try. Supplemental vitamin E has also been suggested as a treatment, but its effectiveness is controversial; a daily dose of 400IU should probably not be exceeded. Some epilepsy medications can be prescribed to treat cramps, but these tend to have significant potential for side effects.

 

Brian L. Bowyer, MD
Columbus, OH

 



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The American Running Association (ARA) and its Clinic Advisory Board disclaims responsibility and shall have no liability for any consequences suffered as a result of your reliance on the information contained in this site. ARA does not endorse specifically any test, treatment, or procedure mentioned on this site.


(RUNNING & FITNEWS® November/December/January  2006-2007 • Volume 25, Number 1)



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