The sudden pain and stiffness in the calf muscles that make us unable to move our legs for a while…. We all might have had this worse experience multiple times in our life.

A muscle cramp is a sudden strong, painful contraction of a muscle that lasts from a few seconds to several minutes. It usually occurs in the legs. Though it lasts only for seconds to minutes, there are multiple complex mechanisms underlying the cramps.

What causes muscle cramps?

• Dehydration
• Decreased levels of calcium, magnesium, potassium, sodium
• Excessive physical exercise
• Exposure to cold
• Tight wears or shoes
• Constant position for a longtime
• Pregnancy
• Other medical conditions like blood flow obstructions, kidney diseases, thyroid disorders etc.
• Medications like diuretics, steroids, birth control pills etc.

Ayurvedic understanding

Ayurvedic classics have many references of muscle cramps where it is explained as a single disease or a symptom. All the references explain the involvement of “vata dosha” in the development of muscle cramps. “Pindikodveshtana” or catching or tightening pain in the muscles is one among the 80 types of diseases caused by vata according to Caraka Samhita. Pindika denotes muscle and udveshtana is tightness. It is also explained as a symptom in holding the urge to defecate (purisha vega dharana), anaemia (pandu roga) and as an effect of excessive walking (atichankramana). 

Involvement of all the three bio-energies

Tridoshas viz. vata, pitta and kapha are the basic factors (bio-energies) that maintain the normalcy of the body and vitiation of the same causes diseases. In a muscle cramp, derangement of all the three doshas are observed. 

Clinical features

Sudden onset of severe localized pain in the muscle is the classical feature of cramps. The pain may be of wide range (ruk/toda/shoola/dandamushti hata iva vedana). Sometimes the pain may be associated with;

• Inability to move the limb (gurvanga)
• Inability to perform muscle functions 
• Fatigue (shrama)
• Small lump in the muscle (shwayathu/granthi)
• Abnormal sensations (pipeelikabhisarana)

General management

Most of the muscle cramps resolve on their own within minutes.

• Stretching: 

Stretch the affected muscle and extend gently

Put the body weight on the affected side bending the knee slightly

Stand on toes for a few seconds

• Massage:

Gently rub over the muscle 

Gently massage downwards

• Cold or Hot packs:

Can be applied for 15-20 minutes multiple times a day

Cold packs for cramps associated with inflammation

Hot packs for simple cramps with pain

• Drink adequate quantity of water

Ayurvedic management

Vata reducing management is mainly advised. As kapha is in a depleated state, hydrating and nourishing line of management is also adopted. 

• Oleation (snehana) : localized massage (sthanika abhyanga) with vata reducing oils
• Fomentation (svedana) : local steam application (naadee sveda) or leaf poultice (patra pinda sweda)
• Medicated enema (vasti) : Fat-based enema (anuvasana basti) / milk-based enema (ksheera basti) / Decoction enema with nervine tonic decoctions (niruha basti)

Oral medications

Shankha bhasmam, Pravala pishti, Parpati kalpana

Chitrakadi vati, Lavana  bhaskara churnam

Guduchyadi, Manjishtadi, Prasarinyadi kashayam

As these procedures and medications are strong and are customized based on the individual conditions, it should only be administered under professional Ayurveda supervision.

Prevention

• Drink adequate water
• Regular stretching exercises
• Nutritional diet including fruits and vegetables
• Regular body massage 
• Avoid tight dress and high heels