Dr. Roach: Nocturnal leg cramps a common problem

Keith Roach
To Your Health
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Dear Dr. Roach: My 76-year-old husband has severe muscle cramps. Originally it occurred in his legs, but now it also affects his hands and feet. He screams in pain. Recently he had an attack and asked me to get him some bananas. I did, and the cramping stopped minutes after eating one. A friend of ours used to bring us bananas, and I believe my husband was better when he was eating them regularly.

He is under care for thyroid problems, lung congestion and irregular heartbeat, but no one seems to know what to do about the cramping. He hasn’t had any cramping since he started eating bananas regularly. Do you have any evidence of bananas minimizing cramping?

K.H.

Dear K.H.: Nocturnal leg cramps are extremely common. As many as 60% of Americans report having nocturnal leg cramps. Usually no cause is identified, but electrolyte abnormalities — usually too-low blood levels of sodium, potassium, magnesium or phosphate — can predispose a person to developing cramps.

Dr. Keith Roach

Effective treatments to stop a cramp when it is happening is a forceful stretching of the affected muscle. If the cramp is in the calf muscle, this means straightening the knee and pointing the foot toward the shin as hard as it will go. Another approach is to put the foot on the floor and lean forward, pressing the foot hard into the floor.

Bananas have a lot of sugar, magnesium and potassium. If your husband has had low levels of these, a banana a day or more might possibly help correct the abnormality. Some medicines for lung congestion due to heart failure (such as many diuretics) can deplete potassium and magnesium. There is no way that eating a banana can stop an attack within minutes based on its electrolyte or other nutritional content.

Pickle juice has been used by athletes to stop muscle cramps, and a study showed that not only is it rapidly effective, but that the mechanism is through the brain and nerve cells, essentially “telling” the muscle to stop cramping, not through electrolytes going to muscles. I suspect that a similar mechanism is helping your husband.

Regular moderate exercise, stretching, proper footwear and loose bedding all can help prevent leg cramps.

Dear Dr. Roach: I am a 68-year-old male on blood pressure medication. During a recent doctor’s appointment, I shared my blood pressure readings for the previous two months. I mentioned to him my concern about the fluctuations I was seeing in my diastolic (lower) blood pressure readings. I was not getting consistent readings, high or low. I was always told the lower number was the important one. To my surprise, he said that was no longer the case. The higher number (systolic) was the value they focus on now, although both values are important. Have you heard anything about this?

M.L.

Dear M.L: Elevation of both the systolic and diastolic numbers confers risk for developing heart disease, but the systolic number is generally the more important. However, people with normal systolic and high diastolic are at risk as well. Fluctuations in blood pressure readings are common and expected, although extreme swings (greater than 20 points in a short time) do raise suspicion for rare underlying medical conditions, such as tumors of the kidney or adrenal glands, or blockages in the arteries to the kidneys. For most people, we look at the average of many readings to base treatment on.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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