Living Well with Parkinsons Disease

Dancing in the Rain: Lessons Learned on my Personal Journey with PD (more at www.PDPlan4Life.com) Copyright 2013-20 Sheryl Jedlinski

Nocturnal leg cramps take their toll

By Sheryl Jedlinski

Most nights I awake about 2 a.m. … writhing in pain, drenched in sweat, and yelling for help. One of my legs is spasming out of control and the muscles feel hard to the touch. I try to move my leg, to forcefully extend it outside of the curled up ball that is now me, but it is too rigid to change position.

“Tony, I can’t move,” I call to my husband, trying to tone down the panic I’m feeling. “I’m paralyzed.”

“No, you’re not,” he responds as he sits down beside me on our bed, massages my limbs, and calmly reassures me that my cramping will relax in 10 minutes and we will go to the kitchen to have a snack, just like we always do. Thankfully, he is right.

The first I heard of nocturnal leg cramps was about two years ago when I started experiencing them myself. Gaining in frequency and intensity over time, the cramping has risen to the number 1 spot on my personal list of “favorite” PD symptoms, dropping incontinence to number 2. Imagine how painful leg cramps are that they beat out incontinence and the inconvenience and embarrassment that accompanies it.

Unlike typical muscle cramps, nocturnal leg cramps are often caused by a neuro-muscular imbalance and nutrient deficiencies. One-third of adults aged 60+ years and nearly one-half of those aged 80+ report experiencing regular incapacitating episodes of involuntary leg muscle contractions followed by hours of recurrent episodes and residual pain. These uncontrolled spasms can occur due to inactivity during the day, tired muscles, or certain underlying  medical conditions such as:

  • Narrowing of the arteries that deliver blood to the legs.
  • Compression of the nerves in your spine.
  • Too little potassium, calcium, and magnesium.

Muscle cramps and dystonia occur when muscles tighten or shorten involuntarily. Parkinson’s muscle cramps are generally caused by muscular rigidity and reduced movement (bradykinesia) rather than by muscles contracting.

Most often related to muscle fatigue and nerve problems, nocturnal leg cramps are also linked to certain behaviors, types of medications (diuretics) and serious underlying medical conditions from diabetes to Parkinson’s to liver and thyroid problems. Avoid confusion with Restless Leg Syndrome (RLS) which presents with a crawling sensation that makes you feel the need to move your legs. As you move the restlessness is relieved, but discomfort returns when movement stops. With nocturnal leg cramps, the tightened muscle needs to be actively stretched out for relief.

With the majority of leg cramps considered harmless, most people do not consult with their doctor unless the cramps are:

  • Severe and frequent.
  • Associated with leg swelling, muscle weakness\atrophy, redness or skin changes.
  • Unrelated to an obvious cause (e.g. strenuous exercise).
  • Negatively impacting quality of life by leading to poorer quality sleep and more daytime sleepiness.

To help prevent or relieve the discomfort caused by involuntary nocturnal leg cramps try:

  • Drinking enough water and limiting alcohol consumption to avoid dehydration.
  • Muscle relaxants.
  • Sitting properly (without legs crossed) so as not to impair circulation.
  • Stretching leg muscles/riding a stationary bicycle before bed.
  • Massaging cramped muscles.
  • Taking a hot shower/bath or applying hot/cold compresses.
  • Sleeping with your feet and toes extending away from your body.
  • Untucking the bed covers at the foot of your bed.
  • Wearing shoes that fit your feet properly and using shoe inserts for extra arch support.
  • Walking and then elevating your legs.

Experiencing occasional nocturnal leg cramps is normal, and usually not a cause for undue concern. Simple home remedies such as flexing the foot, stretching the legs, or massaging the tense muscle may do the job. Anyone experiencing regular nocturnal leg cramps for prolonged periods should see a doctor for a full diagnosis. I guess it is way past due for me to follow my own advice in this area, but I am I an even stronger believer in “better late than never.”

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This entry was posted on June 7, 2020 by in Coping Strategies, Exercise, Neuropathy, Parkinson's symptoms, Sleep.

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