Leg cramps.

Foot and leg cramps are among the most frequent complaints presented by patients of both sexes, especially older persons. Similar cramping may occur in the thighs or in other skeletal muscles of the extremities and trunk. Foot and leg cramps usually occur after unusual exertion or during sleep. "Nocturnal leg cramps" may be of sufficient intensity to prevent sleep. "Pregnancy cramps" are particularly distressing. Effective treatment of foot and leg cramps requires an understanding of the etiology, pathophysiology and diagnostic techniques. Weight reduction and improved diet are essential. Among the useful supplementary medications are calcium lactate or gluconate, vitamin-mineral supplements, sympathetic blocking agents, vasodilators, ataraxics, muscle relaxants, quinine, hydrochloride, antihistamines, and nonmercurial diuretics. Improved foot care and correction of foot imbalance is usually required. Edema and venous insufficiency are improved by elastic support, by repeated foot elevation for massages, by manipulations and exercises and by the use of diuretics. There may be need for operations on the veins and for sclerotherapy. Patients with arterial insufficiency are often benefited by lumbar sympathetic blocks with long-acting anesthetics and intra-arterial injections with relaxants, vasodilators, thrombolytic enzymes and anticoagulants. Sympathectomy, angiography and reconstructive arterial operations are indicated in only a small proportion of patients with foot and leg cramps.