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Muscle Cramps/Night (Nocturnal) Cramps
Published in Charles Theisler, Adjuvant Medical Care, 2023
Up to 60% of adults report that they have had nocturnal leg cramps.1 Most of the time, it is not possible to identify an apparent cause for night-time leg cramps or charley horses. Most often, muscle cramps involve a calf, foot, or thigh. Nocturnal leg cramps are quite painful and can leave the muscle tender for up to a day or so. Cramps can be caused by low blood mineral levels of calcium, potassium, or magnesium.2,3 Deficiencies of certain vitamins, including thiamine (B1), pantothenic acid (B5), and pyridoxine (B6), can also cause muscle cramps.3 Medications strongly associated with causing leg cramps include intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide.1 No prescription medication is recommended for muscle cramps.4
Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Myopathy refers to disorders with muscle weakness due to dysfunction of muscle fiber. Muscle cramps, stiffness, and muscle spasms can also occur. Pain is not a typical symptom of myopathy. Upon thermal imaging, flaccid myopathies with weakness and muscle disuse appear cool over the involved muscles, while muscular cramps or “tight” myopathies will appear warm due to the heat produced by prolonged, intense muscular contraction. This heat is conducted to overlying skin where it can be viewed thermographically (Figure 11.14). White blood cells and macrophages are generally absent in non-inflammatory myopathy, thus production of NO is not a major feature. The muscular dystrophies, mitochondrial myopathies, and glycogen storage diseases are non-inflammatory myopathies.64
Answers
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
McArdle’s syndrome is another glycogen storage disease, resulting in inefficient use of energy substrate in muscle due to muscle phosphorylase deficiency. Exercise results in cramp that tends to settle with a period of rest. Creatine kinase levels may be elevated. It is generally a benign disorder and may not even be picked up until later in adult life when the individual takes up strenuous exercise. No specific treatment exists but the patient should be advised to stop exercise on the onset of muscle cramps. Failure to do so may result in rhabdomyolysis, myoglobinuria and subsequent renal failure.
Statin associated muscle symptoms (SAMS): strategies for prevention, assessment and management
Published in Expert Review of Cardiovascular Therapy, 2023
Iulia Iatan, G. B. John Mancini, Eunice Yeoh, Robert A. Hegele
Although statins are generally well-tolerated and among the most commonly prescribed drugs, adverse effects remain the main cause of non-adherence of therapy [12,13]. Statin intolerance refers to a clinical ‘’umbrella term’’ of various signs and symptoms experienced by patients, manifesting on a continuum and pertaining to multiple organ systems [14,15]. Statin-associated muscle symptoms (SAMS) are the most common form of statin intolerance, also cited as the most frequent reason for medication modification and discontinuation [16–18], in turn resulting in increased risk of adverse cardiovascular outcomes. Although, the term SAMS is used to describe muscle symptoms that occur in the presence of statin use, it does not necessarily imply causation by the statin. Symptoms are typically bilateral, symmetrical, and confined to skeletal muscle [12], usually without creatine kinase (CK) elevation and without objective neuromuscular findings. Some of the frequently reported symptoms are muscle aches or soreness, cramps, weakness and/or fatigue. Very rarely, myopathy or rhabdomyolysis, accompanied by objective signs of weakness and/or CK elevation may occur at a rate of 1 in 10,000 patients per year [17,19,20], simvastatin being the most commonly implicated.
The effect of abdominal massage and stretching exercise on pain and dysmenorrhea symptoms in female university students: A single-blind randomized-controlled clinical trial
Published in Health Care for Women International, 2023
Nazan Ozturk, Emine Gerçek Öter, Meryem Kürek Eken
Stretching exercises are one of the non-pharmacological methods in the treatment of primary dysmenorrhea. It is stated that exercises help to alleviate cramps by increasing blood circulation, and stimulates the production of endorphins, which act as the body’s natural pain killers (Blakey et al., 2010). Chantler et al. (2009) showed that exercise can reduce the severity and duration of dysmenorrhea because it reduces stress by providing relaxation and increases endorphin release and blood flow (Chantler et al., 2009). Although there are studies in the literature showing the positive effects of exercise on primary dysmenorrhea, there are also studies reporting that it has no effect (Abbaspour et al., 2006; Blakey et al., 2010; Chantler et al., 2009; Nasri et al., 2017). Massage reduces stress as it improves blood and lymph flow. Rubbing the abdomen with soft, rhythmic, and circular movements can be effective in reducing pain (Blakey et al., 2010). The extracts of the various oils used in massage therapy are absorbed through the skin or the olfactory system, providing relief. There are studies showing that abdominal massage reduces pain (Beiranvand et al., 2015; Shahr et al., 2015; Sut & Kahyaoglu-Sut, 2017; Vagedes et al., 2019).
Developments in the assessment of non-motor disease progression in amyotrophic lateral sclerosis
Published in Expert Review of Neurotherapeutics, 2021
Adriano Chiò, Antonio Canosa, Andrea Calvo, Cristina Moglia, Alessandro Cicolin, Gabriele Mora
The pathophysiology of pain in ALS is multifactorial [116,119]. Much of the chronic pain in ALS seems to result as a secondary effect of the motor impairment of ALS (i.e. nociceptive pain). Nociceptive causes of ALS pain develop as disease progresses, due to degenerative changes in connective tissue, bones and joints leading to musculoskeletal pain related to muscle atrophy and weakness and prolonged immobility. Joint contractures are common, as shoulder pain [120]. Spasticity and cramps are also common primary causes of pain in ALS. In a study, about one third of ALS patients had prominent spasticity, and 42.5% of them reported pain, evaluated with a numeric rating scale [121]. In about 25% of patients cramps are the major cause of pain, in particular in those with spinal phenotype [122]. Decubitus ulcers are caused by skin pressure, even if they are rather uncommon despite patients reduced mobility. In the more advenced phases of the disease patients may complain diffuse and unexplained pain.