According to statistics, about 30% of elderly people over 60 years old and 50% of patients over 80 suffer from this disease. Moreover, 4 out of 10 patients experience paroxysms more than three times a week. Often convulsions are observed in both lower and upper extremities.
By the nature of muscle contractions convulsions are divided into:
- clonic – alternate short-term reduction of various muscle groups;
- tonic – a long spasm of several muscle groups at the same time (the patient stiffens, unable to move);
- mixed – tonic-clonic (predominance of tonic) or clonic-tonic (prevalent clonic) spasms.
According to the mechanism of development there are:
- Epileptic – convulsions in the legs occur as part of epileptic seizures. In addition to the lower limbs, convulsions are observed in other parts of the body.
- Non-epileptic seizures occur when the dysfunction of the sleep regulation center and other pathologies of non-epileptic genesis occur.
By origin paroxysms are:
- Idiopathic – independent occurrence, often at night.
- Secondary – against the background of other diseases.
Idiopathic ones can be triggered by increased vascular tone at night, excessive exercise, or age-related shortening of the tendons in the legs.
Causes of secondary paroxysms of the lower extremities
Secondary paroxysms can be caused by:
- Pathology of the nervous system – damage to the nerve endings that innervate the muscles.
- Violation of blood circulation in the lower extremities – varicose veins, atherosclerosis, thrombosis.
- Slowing down the metabolism leading to a lack of vitamins (D, group B) and trace elements. As a result of deficiency of calcium, magnesium, potassium, the nerve conduction of muscle tissue is disturbed. Reduced iron content leads to hypoxia, oxygen starvation of myofibrils.
- Endocrine diseases – an imbalance of hormones leads to involuntary paroxysms.
- Degenerative dystrophic changes in articular cartilage – the transmission of nerve impulses through the muscle tissue is disturbed.
- Chronic diseases of the liver and kidneys – the detoxification function of these organs is disturbed, toxins accumulate in the blood.
- Traumatic and inflammatory processes.
- Stress, leading to an overstressing of muscles and nerve endings.
- Infections and intoxication with heavy metals – as a result, the content of harmful substances in the blood rises, convulsions occur.
- The retention of body fluids, leading to a deficiency of electrolytes, which causes paroxysms.
- abuse of alcohol, coffee, black tea, smoking;
- intramuscular injection;
- sudden, sharp sound or smell;
- poor nutrition;
- sleep in an uncomfortable position;
- too high or low temperature in the room.
Secondary paroxysms in the elderly can be caused by certain groups of drugs that provoke muscle spasms. It:
- diuretics – diuretics, used for edema, high blood pressure, renal and heart failure;
- statins – reduce cholesterol in the blood;
- Nifedipine – treatment of angina;
- Raloxifene – prevention of bone destruction during menopause.
At first, involuntary contraction can occur only because of provoking factors – a sharp sound, a shot, an excess of alcohol, staying in cold water, a long walk. It is manifested by a spasm of tonic nature, lasting about a minute, causing unbearable pain, inability to move.
Secondary seizures occur constantly, characterized by:
- bouts of pain;
- compaction, stress, affected muscle or muscle groups;
- swelling and redness of the limb;
- characteristic tingling, twitching, numbness.
In the case of epileptic seizure paroxysms, an aura state precedes the attack – a sensation of certain smells, weakness, headache, panic, dyspepsia – nausea, vomiting, diarrhea. The seizure itself is accompanied by darkening of the eyes, loss of consciousness, subsequent amnesia, involuntary urination and salivation. Tonic convulsions are replaced by clonic ones in the classical variant of an epileptic seizure, or one thing prevails.
Clinic of non-epileptic variants depends on the root cause, localization of paroxysms, associated symptoms.
Types of paroxysms in the elderly
Spasm of the gastrocnemius muscle – the most common type of leg cramps. It is marked by sudden stiffness, tension, hardening of the muscle. When you try to straighten your leg or move, there is a sharp pain. An elderly person feels tingling, twitching in the area of the muscle.
If the attack does not stop within 1–2 minutes, is accompanied by dizziness, severe headache, fainting, involuntary urination, you should immediately call an ambulance.
Cramps in the toes – observed with excessive physical exertion on the foot (with exhausting exercises, long walks – an elderly person does not count his strength).
In older people, in addition to leg cramps, often there are spasms of the fingers. They are caused by the same reasons as paroxysms in the legs, an additional factor may be a long work at the computer.
During paroxysms it is necessary:
- Calm down, try to relax your foot as much as possible. It is desirable that with a man of old age were near relatives or a nurse.
- To do kneading, starting from the foot, gradually climbing up the shin. Alternate with strokes.
- Prick the place of numbness with something sharp (hairpin, pin). With frequent attacks, you need to pin a pin to your pajamas so that you are always at hand.
- Walk barefoot on the cold floor (if a person can move).
- Pull the big toe, which will cause muscle stretching and removal of spasm.
- Pinch a sore muscle (if possible). Often in older people, it is completely “stone”, in which case it is recommended to warm up part of the face above the upper lip (this zone is reflexively “responsible” for the reduction of leg muscles).
- Warm up the place of numbness – put the foot in warm water, smear with warming ointment or rub it with an alcohol solution.
- If the heat does not help, cover the foot with ice or wrap in a wet towel.
- After the cessation of the spasm, it is necessary to raise both legs, lie down for 10-15 minutes, which helps to restore blood circulation and prevents another attack.
The tactics of treatment depends on the etiology, age of paroxysms, the duration and severity of the attack, the age and general condition of the patient.
Treatment is complex. Includes pathogenetic (elimination of the cause), symptomatic (relief of the attack) therapy, physiotherapy, a special diet, the use of traditional medicine.
Pathogenetic therapy is aimed at eliminating the underlying disease:
- normalization of blood circulation in the legs, elimination of atherosclerosis, thrombosis – angioprotectors, anti-atherosclerotic drugs, antiplatelet agents;
- restoration of the balance of vitamins and trace elements – preparations of iron, calcium, magnesium, potassium, vitamins of groups B, D;
- endocrine hormone therapy;
- restoration of the cartilage tissue of the joints – chondroprotectors, immunomodulators;
- timely treatment of chronic diseases of the liver, kidneys;
- fight against infections and intoxications – detoxification therapy, antibiotics, anti-inflammatory drugs;
- elimination of stress – tranquilizers, sedatives, antidepressants.
- liquid retention liquid – diuretics.
It should be remembered that the majority of diuretics bring along with the liquid some trace elements, especially potassium, which again can provoke convulsions. Therefore, along with diuretics that are not potassium-sparing, it is necessary to prescribe potassium preparations.
Symptomatic therapy includes drugs that directly relieve muscle spasm, eliminate pain. It:
- muscle relaxants – reduce muscle tone, reduce the risk of involuntary contraction;
- anticonvulsants – a special group of drugs that prevent the occurrence of paroxysms;
- magnesium preparations – prevent the absorption of calcium by muscle tissue, which leads to muscle relaxation;
- analgesics, nonsteroidal anti-inflammatory drugs – eliminate pain.
Great assistance in the treatment of leg cramps in the elderly has a special exercise. Therapeutic gymnastics can improve blood flow in the legs, normalizes the conduction of nerve impulses in the muscle tissue. Recommended set of exercises:
- To stretch the legs, trying to strain the muscles as much as possible. Pull socks on yourself.
- Stand on the outer parts of the feet, slowly count to 10, then return to the starting position.
- Stand on your toes, raise your arms up, stretch. Slump down on your heels.
- Walk barefoot first on the outside, then on the inside of the feet for 2-3 minutes.
- Slowly lean forward from a sitting position, trying to reach alternately to the toes of each leg.
The whole set of exercises should not exceed 15 minutes, so that an elderly person does not overwork. If you experience pain, discomfort, you should immediately stop training. It should be borne in mind that in case of venous stagnation, only a doctor performs the selection of exercises!
Older people need to reconsider their diet. Exclude fatty, spicy, salty. Do not eat pastries, black tea, coffee in large quantities, canned food. Enrich the menu with products containing potassium, magnesium, calcium, vitamins D and B:
- peas, beans;
- oatmeal and buckwheat groats, bran;
- raisins, dried apricots, prunes;
- dairy products;
- different types of cabbage;
- bananas, blueberries, figs;
- low-fat varieties of poultry and fish;
- green salad, dill, parsley.
Herbal remedies used in the treatment of leg cramps in the elderly – this is tinctures, decoctions, compresses, ointments, baths with herbs.
Here are some recommendations:
- Lubricate the foot with lemon juice.
- Rub muscle with mustard, chamomile oil, ointment on the basis of celandine.
- Drink decoctions of honey, poppy, wormwood, thyme, linden, birch buds, adonis.
- There is butter made from crushed garlic mixed with honey.
- To make trays with chamomile, essential oils, mint, valerian, horsetail.
Treatment of folk remedies should be carried out in parallel with the medication strictly under the supervision of a doctor!
In order to prevent older people, it is recommended:
- Timely treat chronic somatic, infectious, endocrine diseases.
- Quit bad habits – to eliminate the use of alcohol, do not smoke.
- Observe the mode of the day, do not overwork – go to bed and get up at the same time, get enough sleep, if possible, sleep 1 hour during the afternoon, after lunch, properly distribute physical activity.
- Efficient and balanced diet. Do not overeat. Drink at least 2 liters of fluid per day to prevent dehydration.
- Daily exercise feasible, walking.
- It is enough to be in the fresh air, before going to bed it is necessary to take a walk.
- Learn to cope with stress, not to succumb to their impact.
- Daily massage the legs with a special massager.
- Wear comfortable shoes.
Paroxysmal phenomena in the legs of elderly people are completely treatable if you follow all the doctor’s instructions and implement preventive measures. At all stages, the elderly person needs support and warmth of loved ones, understanding, and willingness to help. It is important not to leave the elderly people alone with their problems, to be near, to fight together with the disease.