Hispanopedia Wiki
Articulo de referencia

Calambre muscular esquelético

Un calambre es una contracción repentina, involuntaria y dolorosa de uno o más músculos esqueléticos , [ 1 ] [ 2 ] o un acortamiento excesivo de los mismos asociado con activida...

Hispanopedia WikiContenido en espanolLectura gratuita

Un calambre es una contracción repentina, involuntaria y dolorosa de uno o más músculos esqueléticos , [ 1 ] [ 2 ] o un acortamiento excesivo de los mismos asociado con actividad eléctrica. [ 3 ] Si bien generalmente son temporales y no dañinos, pueden causar dolor significativo e inmovilidad similar a la parálisis del músculo afectado. Un calambre generalmente desaparece por sí solo en varios segundos o (a veces) minutos. [ 4 ] Los calambres son comunes y tienden a ocurrir en reposo, generalmente por la noche (calambres nocturnos en las piernas). [ 2 ] [ 5 ] También se asocian frecuentemente con el embarazo , el ejercicio físico o el sobreesfuerzo, y la edad (común en adultos mayores); en tales casos, los calambres se denominan idiopáticos porque no hay patología subyacente. Además de estas afecciones benignas, los calambres también se asocian con muchas afecciones patológicas . [ 2 ] [ 6 ]

La definición de calambre es más estricta que la de espasmo muscular : los espasmos incluyen cualquier contracción muscular anormal involuntaria, mientras que los calambres son sostenidos y dolorosos. [ 1 ] [ 7 ] Los calambres verdaderos se pueden distinguir de otras afecciones similares. Los calambres son diferentes de la contractura muscular , que también es dolorosa e involuntaria, pero que es eléctricamente silenciosa. Las principales características distintivas de los calambres de la distonía son la repentina aparición con inicio agudo del dolor, la afectación de un solo músculo y la resolución espontánea de los calambres o su resolución después de estirar el músculo afectado. [ 2 ] El síndrome de piernas inquietas no se considera lo mismo que los calambres musculares y no debe confundirse con los calambres en reposo. [ 6 ] A los calambres también se les llama a veces " calambre de Charley ", que es un término popular utilizado por la gente en los Estados Unidos.

En circunstancias normales, los músculos esqueléticos pueden controlarse voluntariamente, [ 8 ] y cualquiera de ellos puede verse afectado por calambres. [ 9 ] Los músculos esqueléticos que se ven afectados con mayor frecuencia por los calambres son las pantorrillas , los muslos y los arcos del pie . [ 10 ] [ 9 ]

Gentle stretching and massage, putting some pressure on the affected leg by walking or standing, or taking a warm bath or shower may help to end the cramp.[11] If the cramp is in the calf muscle, dorsiflexing the foot (lifting the toes back toward the shins) will stretch the muscle and provide almost immediate relief. There is limited evidence supporting the use of magnesium, calcium channel blockers, carisoprodol, and vitamin B12.[12]

Causes

Skeletal muscle cramps may be caused by muscle fatigue or a lack of electrolytes such as sodium (a condition called hyponatremia), potassium (called hypokalemia), or magnesium (called hypomagnesemia[13]). Some skeletal muscle cramps do not have a known cause.[6] Motor neuron disorders (e.g., amyotrophic lateral sclerosis), metabolic disorders (e.g., liver failure), some medications (e.g., diuretics and inhaled beta‐agonists), and haemodialysis may also cause muscle cramps.[6]

Causes of cramping include[14]hyperflexion, hypoxia, exposure to large changes in temperature, dehydration, or low blood salt. Muscle cramps can also be a symptom or complication of pregnancy; kidney disease; thyroid disease; hypokalemia, hypomagnesemia, or hypocalcaemia (as conditions); restless legs syndrome; varicose veins;[15] and multiple sclerosis.[16]

As early as 1965, researchers observed that leg cramps and restless legs syndrome can result from excess insulin, sometimes called hyperinsulinemia.[17]

Nocturnal leg cramps

Leg cramps might occur during the night or less commonly while resting. These are involuntary muscle contractions that occur in the calves, soles of the feet, or other muscles in the body. The duration is variable, with cramps lasting anywhere from a few seconds to several minutes. Muscle soreness may remain after the cramp itself ends. These cramps are more common in older people.[18] They happen quite frequently in teenagers and some people while exercising at night. Besides being painful, a nocturnal leg cramp can cause much distress and anxiety.[19] The precise cause of these cramps is unclear. Potential contributing factors include dehydration, low levels of certain minerals (magnesium, potassium, calcium, and sodium, although the evidence has been mixed),[20][21][12] and reduced blood flow through muscles attendant in prolonged sitting or lying down. Nocturnal leg cramps (almost exclusively calf cramps) are considered "normal" during the late stages of pregnancy.[22]

A lactic acid buildup around muscles can trigger cramps; however, they happen during anaerobic respiration when a person is exercising or engaging in an activity where the heartbeat rises. Medical conditions associated with leg cramps are cardiovascular disease, hemodialysis, cirrhosis, pregnancy, and lumbar canal stenosis. Differential diagnoses include restless legs syndrome, claudication, myositis, and peripheral neuropathy. All of them can be differentiated through careful history and physical examination.[12]

Treatment induced

Various medications may cause nocturnal leg cramps:[12][23]

Statins may sometimes cause myalgia and cramps among other possible side effects. Raloxifene (Evista) is a medication associated with a high incidence of leg cramps. Additional factors, that increase the probability of these side effects, are physical exercise, age, history of cramps, and hypothyroidism. Up to 80% of athletes using statins experience significant adverse muscular effects, including cramps;[24] the rate appears to be approximately 10–25% in a typical statin-using population.[25][26] In some cases, adverse effects disappear after switching to a different statin; however, they should not be ignored if they persist, as they can, in rare cases, develop into more serious problems. Coenzyme Q10 supplementation can help avoid some statin-related adverse effects, but currently, there is not enough evidence to prove its effectiveness in avoiding myopathy or myalgia.[27]

Treatment

Stretching, massage, and drinking plenty of liquids may help treat simple muscle cramps.[28]

Medication

While quinine was a traditional treatment for nocturnal leg cramps, it is no longer recommended due to potential fatal hypersensitivity reactions and thrombocytopenia. Arrhythmias, cinchonism, and hemolytic uremic syndrome can also occur at higher dosages.[12]

Magnesium is commonly used to treat muscle cramps. Moderate-quality evidence indicates that magnesium is not effective for treating or preventing cramps in older adults.[6] It is not known if magnesium helps with cramps due to pregnancy, liver cirrhosis, other medical conditions, or exercise.[6] Oral magnesium treatment does not appear to have significant major side effects, however, it may be associated with diarrhea and nausea in 11–37% of people who use this medicine.[6]

With exertional heat cramps due to electrolyte abnormalities (primarily potassium loss and not calcium, magnesium, and sodium), appropriate fluids and sufficient potassium improve symptoms.[29]Vitamin B complex, naftidrofuryl, lidocaine, and calcium channel blockers may be effective for muscle cramps.[30]

Prevention

Adequate conditioning, stretching, mental preparation, hydration, and electrolyte balance are likely helpful in preventing muscle cramps.[28]

See also

References

  1. 12Minetto, Marco Alessandro; Holobar, Aleš; Botter, Alberto; Farina, Dario (Jan 2013). "Origin and development of muscle cramps". Exercise and Sport Sciences Reviews. 41 (1): 3–10. doi:10.1097/JES.0b013e3182724817. ISSN 1538-3008. PMID 23038243. S2CID 15263712.
  2. 1234Marotta, P. J.; Graziadei, I. W.; Ghent, C. N. (Nov 2000). "Muscle cramps: a 'complication' of cirrhosis". Canadian Journal of Gastroenterology. 14 Suppl D: 21D–25D. doi:10.1155/2000/214916. ISSN 0835-7900. PMID 11110608.
  3. ↑Benzon, Honorio; Raja, Srinivasa N.; Fishman, Scott E.; Liu, Spencer S.; Cohen, Steven P. (2011-06-30). Essentials of Pain Medicine E-book. Elsevier Health Sciences. ISBN 978-1-4377-3593-2.
  4. ↑"Muscle Cramps". medlineplus.gov. Retrieved 2022-09-15.
  5. ↑"Nocturnal leg cramps". UpToDate. Retrieved 2022-09-21.
  6. 1234567Garrison, Scott R.; Korownyk, Christina S.; Kolber, Michael R.; Allan, G. Michael; Musini, Vijaya M.; Sekhon, Ravneet K.; Dugré, Nicolas (September 2020). "Magnesium for skeletal muscle cramps". The Cochrane Database of Systematic Reviews. 2020 (9) CD009402. doi:10.1002/14651858.CD009402.pub3. ISSN 1469-493X. PMC 8094171. PMID 32956536.
  7. ↑"Muscle Cramps (Charley Horse) and Muscle Spasm Remedies". eMedicineHealth. Retrieved 2022-09-25.
  8. ↑"Quick Facts:Muscles". MSD Manual Consumer Version. Retrieved 2025-10-21.
  9. 12Bordoni, Bruno; Goldin, Jennifer; Sugumar, Kavin (2025), "Muscle Cramps", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 29763070, retrieved 2025-10-21
  10. ↑Colberg, Sheri R. (2019-02-08). The Athlete's Guide to Diabetes. Human Kinetics. p. 177. ISBN 978-1-4925-8873-3.
  11. ↑Ray, C. Claiborne (2009-06-09). "Q & A – A Charley Horse in Bed". The New York Times. Archived from the original on 2013-04-07. Retrieved 2009-06-09.
  12. 12345Allen RE, Kirby KA (2012). "Nocturnal Leg Cramps". American Family Physician. 86 (4): 350–355. PMID 22963024. Archived from the original on 2016-03-29.
  13. ↑Gragossian, Alin; Bashir, Khalid; Friede, Rotem (September 6, 2020). "Hypomagnesemia". National Center for Biotechnology Information (NCBI). PMID 29763179. Retrieved October 14, 2020. Hypomagnesemia is an electrolyte disturbance caused when there is a low level of serum magnesium [...] in the blood
  14. ↑Muscle Cramps Symptoms, Causes, Treatment – Do all muscle cramps fit into the above categories on MedicineNetArchived 2008-08-24 at the Wayback Machine. Medicinenet.com. Retrieved on 2011-02-13.
  15. ↑Bergan J. The Vein Book, Hardcover text, Editor Bergan J, 2007. ISBN 9780195399639
  16. ↑"Muscle cramps". www.webmd.com. Archived from the original on October 15, 2007.
  17. ↑Roberts, HJ (1965). "Spontaneous Leg Cramps and "restless Legs" Due to Diabetogenic Hyperinsulinism: Observations on 131 Patients". Journal of the American Geriatrics Society. 13 (7): 602–38. doi:10.1111/j.1532-5415.1965.tb00617.x. PMID 14300967. S2CID 28096190.
  18. ↑"Night leg cramps". Mayo Clinic. Archived from the original on September 23, 2011.
  19. ↑Weiner, Israel H (1980). "Nocturnal Leg Muscle Cramps". JAMA. 244 (20): 2332–3. doi:10.1001/jama.1980.03310200066033. PMID 7431559. Archived from the original on 28 December 2010. Retrieved 26 October 2011.
  20. ↑Schwellnus MP, Nicol J, Laubscher R, Noakes TD (2004). "Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping (EAMC) in distance runners". Br J Sports Med. 38 (4): 488–492. doi:10.1136/bjsm.2003.007021. PMC 1724901. PMID 15273192.
  21. ↑Sulzer NU, Schwellnus MP, Noakes TD (July 2005). "Serum electrolytes in Ironman triathletes with exercise-associated muscle cramping". Med Sci Sports Exerc. 37 (7): 1081–5. doi:10.1249/01.mss.0000169723.79558.cf. PMID 16015122. S2CID 12582883.
  22. ↑Wick M. "What causes leg cramps during pregnancy, and can they be prevented?". Mayo Clinic. Retrieved 2018-04-03.
  23. ↑Garrison SR, Dormuth CR, Morrow RL, Carney GA, Khan KM (January 2012). "Nocturnal leg cramps and prescription use that precedes them: a sequence symmetry analysis". Arch. Intern. Med. 172 (2): 120–6. doi:10.1001/archinternmed.2011.1029. PMID 22157068.
  24. ↑Sinzinger H, O'Grady J (2004). "Professional athletes suffering from familial hypercholesterolaemia rarely tolerate statin treatment because of muscular problems". Br J Clin Pharmacol. 57 (4): 525–8. doi:10.1111/j.1365-2125.2003.02044.x. PMC 1884475. PMID 15025753.
  25. ↑Bruckert E, Hayem G, Dejager S, Yau C, Bégaud B (2005). "Mild to moderate muscular symptoms with high-dosage statin therapy in hyperlipidemic patients—the PRIMO study". Cardiovasc Drugs Ther. 19 (6): 403–14. doi:10.1007/s10557-005-5686-z. PMID 16453090. S2CID 24525127.
  26. ↑Dirks, A. J.; Jones, KM (2006). "Statin-induced apoptosis and skeletal myopathy". Am. J. Physiol., Cell Physiol. 291 (6): C1208–12. doi:10.1152/ajpcell.00226.2006. PMID 16885396. S2CID 13313618.
  27. ↑Lamperti C, Naini AB, Lucchini V, et al. (2005). "Muscle coenzyme Q10 level in statin-related myopathy". Arch. Neurol. 62 (11): 1709–12. doi:10.1001/archneur.62.11.1709. PMID 16286544.
  28. 12Bentley S (June 1996). "Exercise-induced muscle cramp. Proposed mechanisms and management". Sports Med. 21 (6): 409–20. doi:10.2165/00007256-199621060-00003. PMID 8784961. S2CID 24366112.
  29. ↑Bergeron MF (March 2003). "Heat cramps: fluid and electrolyte challenges during tennis in the heat". J Sci Med Sport. 6 (1): 19–27. doi:10.1016/S1440-2440(03)80005-1. PMID 12801207.
  30. ↑Katzberg HD, Khan AH, So YT (2010). "Assessment: Symptomatic treatment for muscle cramps (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology". Neurology. 74 (8): 691–6. doi:10.1212/WNL.0b013e3181d0ccca. PMID 20177124.
  • Muscle Cramps (of Skeletal Muscles)