This topic came to me during our Heart Pharmacist weekly telephone meeting. One of our patients was experiencing leg pain and fatigue that occurred during the day, but worsened at night. Leg cramps is not an uncommon issue with patients, but this one had an uncommon solution.
Leg cramps, especially at night, can be excruciatingly painful. Usually after a few minutes with gentle stretching and massaging the muscle cramp will subside. Sometimes, this is not always be the case and leg pain can continue into the next day. Generally this is something that can be treated by your local Heart Pharmacist. A Physician visit is rarely required, unless the pain persists or seems to be point sensitive.
A Pharmacist bag of tricks for leg cramps are simple and is usually effective. The first solution is to increase your intake of calcium. I generally recommend chewing a TUMS calcium antacid tablet before bed. Calcium can be quite helpful for reducing leg cramps at night. If you want to go one step further, have a small glass of tonic water before bed. The small amount of quinine in tonic water can also help with leg cramps.
If this doesn’t work I recommend taking a magnesium supplement at bedtime. Often calcium and magnesium can be found in a combined tablet. Magnesium is also a good muscle relaxing supplement. Some patients also mention that it can sometimes help them fall asleep. Check with your Heart Pharmacist to see if calcium and magnesium are right for you. Especially if you are taking antibiotics or medications for osteoporosis.
Potassium is also helpful for muscle cramping. This is usually more of a solution for high intensity athletes exercising under warm weather conditions. A common home remedy is to have a banana before bed to help with leg cramps. Increasing your fruit intake for any reason is a good idea. However your body is generally good at ensuring it has enough potassium to fulfill its needs. If your leg cramps rapidly goes away after increasing your intake of bananas, you might want to bring this to the attention of your Physician.
Another helpful tip requires a bit of training. It is common in the night to stretch your legs when you shift around. A natural tendency is to stretch by pointing the toes. Pointing the toes can lead to muscle cramping. If you do stretch your legs stretch by pushing your heels down and pulling your toes closer to your shins. The opposite of pointing your toes. Sometimes a warm bath before bed can also relax stiff muscles. Add a bit of Epsom salts (magnesium) to your bath water.
In this case, our patients leg cramps were caused by a medication. Medications called ‘statins’ are commonly prescribed to help lower cholesterol. Elevated cholesterol is a modifiable risk factor for heart disease. However a common side effect with statins, along with stomach upset, is muscle pain. In this person’s case, stopping or switching their statin was not a preferable option. Another oddball side effect of statins is to reduce the amount of a substance called Co Enzyme Q10 (CoQ10) in the body. CoQ10 is used for energy production is muscle cells, and a deficiency can manifest itself as muscle fatigue or aching. We recommended taking CoQ10 100mg daily. The leg cramps improved and decreased in frequency to make our patient happy. Ask your Doctor or Heart Pharmacist if CoQ10 would be right for you and your medications.
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