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On cramp, sensation and pain

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hard to find a non-athletic-looking image of leg cramp

In recent times I’ve been suffering from cramp, usually in bed in the early mornings, almost always in the calf but sometimes in the foot, around the toes but sometimes at the back of the foot, and invariably on the left leg. So all of this leads to a great variety of thoughts and anxieties. What is cramp? What causes it? Can it be cured or prevented? Why only on the left side? Why now and not in the past? Will it keep getting worse? How to describe the sensation? What’s the difference between a description of a sensation and the sensation itself?  Can pain be measured? Can it be distinguished from pain response?

The cramps I suffer from are clearly not the same thing as those experienced by footballers near the end of a go-for-broke cup final, when they crumple in a heap of agony and have to be massaged back to life by a team-mate, an exercise which also seems to involve a stretching of the afflicted muscle. I’ve heard this has to do with a lack of oxygen getting to the muscle when it’s being strenuously exercised. I don’t know if I’ve ever experienced that kind of cramp (does it feel different?) but I do recall getting a sharp pain in the abdominal region, referred to by others as ‘the stitch’, when, either during a football game or a school run, I exercised myself beyond my level of fitness – which was very easily done. That pain, however, was qualitatively different from the cramps of today. It didn’t feel muscular.

 So now to what the pundits say. First, on ‘stitch’, this BBC health and fitness website has it that ‘most scientists believe the pain is caused by a reduction of blood supply to the diaphragm, causing it to cramp’. It’s certainly common in long-distance runners, but as I recall – and it’s been a long time since I’ve been silly enough to bring on that particular pain – it felt very different from the leg cramps, more like an organ pain, of the stomach perhaps, or the duodenum (I’ve no idea). If it is a muscular cramp, it’s an indication that these cramps can feel very different from each other.

It hasn’t taken me long to realise that the science of cramps isn’t particularly well-developed. Though perhaps that’s a bit unfair – better to say that it’s not settled, due largely to its complexity. Some cramps, though surely not mine, are caused by muscle fatigue, while others are caused by a lack of electrolytes, or it could be a combo.

So what are these electrolytes? Salts, acids and bases mostly, which become ionised in solution when an electric current passes through it. The major electrolytes in our body are calcium, sodium, magnesium, potassium, phosphate and chloride.

Okay, I’ve got it slightly wrong. These electrolytes, or ‘lytes’ as the pundits call them, dissolve in any ‘polar solvent’, such as water, and separate into cations and anions. I learned a bit about this at school but I’ve forgotten. Basically the dissolved lytes become ionised, I don’t know why, becoming either positively charged (having fewer electrons than protons, making them cations), or negatively charged anions (with more electrons than protons). These anions and cations disperse more or less uniformly through the fluid, making it electrically neutral. But when an electric potential (something very complicated, but I think it basically means an electric charge) is applied to the fluid, the cations gravitate (surely the wrong word!) to the electron-rich electrode, the anions to the … other one.

What does this mean for cramp sufferers? Fuck knows, but I think it means that if you don’t have enough of these lytes, for whatever reason, you don’t get this ionisation happening and that’s bad for your body. Anyway, we’ve all presumably heard of these probably bogus electrolyte-bearing drinks that are advertised as a salvation for athletes, of which I’m very obviously not one, but it does seem possible that I’m a bit light on my lytes. What I’m doing here is engaging in a bit of deductive reasoning a la Sherlock Holmes. If you eliminate all the impossibles, whatever’s left, however improbable, is probably true, or something like that.

So… my cramps are definitely not caused by hyperflexion (flexing of a muscle beyond normal limits), or by hypoxia (deprivation of oxygen at the tissue level). Nor is it likely to be a complication of pregnancy (I wish). I don’t want to think about it being symptomatic of kidney or thyroid disease (I feel otherwise healthy), but they’re extreme improbabilities that might need to be looked at later. Three other conditions are highlighted on the fabulous Wikipedia: hypokalemia, hypomagnesemia and hypocalcaemia. Careful inspection from the astute reader should render these terms intelligible. They refer, bien entendu, to a, presumably chronic, lack of potassium, magnesium and calcium, respectively (the aforementioned lytes). A quick glance at the symptoms of these three conditions suggests to me that they can be relegated to the bottom section of the list of probable causes. Often they result from the use or overuse of prescription medication. I don’t take any.

Now I’m starting to run out of possible causes, and I don’t want to complicate the problem too much. Actually the best advice I’ve read so far on the Wikipedia website is this: Stretching, massage and drinking plenty of fluid, such as water, may be helpful in treating simple muscle cramps. Obviously they don’t include wine as a useful fluid in these circs. That may be my downfall – alcohol tends to dehydrate, which is negative in itself but also seems implicated in cramping. It narrows the blood vessels (hypoxia enfin? the blood vessels oxygenate the muscles don’t they?), which is probably what gives that headachey hungover feeling I sometimes have in the morning. It also causes a build-up of lactic acid, another probable cause of cramping. I’m beginning to feel that a few small adjustments, such as drinking some water before bed-time, avoiding excessive alcohol intake, and keeping the muscles of the lower leg warm (cramping always seems more excruciating in winter) might be enough to solve my problems, which are only minor after all.

So that’ll do me, all that philosophical stuff about the nature of pain will have to wait for another day. I need to hydrate and keep warm, firstly, and I’ll see how that helps as winter is coming.


Written by stewart henderson

April 29, 2017 at 5:53 pm

Posted in fitness, health, pain

Tagged with , ,

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