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Leg Cramps and Nerve Root Pressure

Q: I spend my days chasing after two toddlers, so occasional muscle pain is just par for the course. But about a month ago I began experiencing frequent and painful cramping in the backs of my legs, especially when I'm sitting. It's getting so bad that I can't even sit down to enjoy dinner with my family! What could this be, and what can I do about it?

Dr. Donnica:
It's unclear exactly what is causing your symptoms, but it is clear what you need to do about it. You need to consult a physician for a complete physical exam. You've described a syndrome called nerve root pressure, which probably has its origins in some sort of back strain, especially if the pain extends below the knee. (It could be "sciatica" if the sciatic nerves are affected, but there are many other nerve root possibilities.) With nerve root pressure, the pain is generally worsened by sitting, prolonged standing, forward bending, coughing, sneezing, lifting or straining (as in a bowel movement). The pain may be temporarily relieved by walking, lying down, and extending (straightening) the spine. If you have numbness, tingling or weakness in one or both legs or any loss of bladder or bowel control, you should seek immediate medical attention.

There are many other factors that may contribute to leg cramping, although the exact causes are generally unknown. Conditions your doctor will want to rule out include spondylolisthesis (a bulging of the disc between the spinal vertebrae) and spinal stenosis. Inadequate stretching and muscle fatigue (common for moms!), deconditioning, dehydration, and depletion of electrolytes (e.g. potassium, magnesium, and calcium) may also be factors. Self-care tips include stopping the activity that seemed to trigger the cramp; gently stretching and massaging the affected muscles; and holding the affected muscles in a stretched position until the cramp stops. Keep well hydrated and be sure to get an adequate amount of calcium and magnesium in your diet or with supplements. Most importantly, however, is for you to get a medical evaluation.

Created: 11/7/2004  -  Donnica Moore, M.D.

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