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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34998
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I had to get up 30 minutes ago (maybe 3rd time in 9 months)

Resolved Question:

I had to get up 30 minutes ago (maybe 3rd time in 9 months) when I pointed my foot downward as I was half-asleep. I had immediate, severe, pain in my peroneus longus (or perhaps extensor digitorum longus, I'm looking at a diagram) which was hard as a rock. You could see that it was hard. The pain ran up the muscle from the outside of my ankle, it ran out 1/2 inch on either side from the big bone that sticks out from outside of the ankle. There was no swelling or redness, just a rock hard muscle and excruciating pain. I tried to get out of bed, when I put my toes down and touched the floor the pain was even worse. I laid on my side with my legs pulled up half-way and tried to massage the muscle which didn't seem to make much difference. (And not really massage, the muscle was rock hard). After about 10 minutes it went away. This has happened before, exactly the same way, perhaps September and May of 2011. And a couple of times when my toes were pointed down and it started to happen, but I pulled them up. Happens only at night. Thanks. Tim Harlan
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.
Hello Tim Harlan,

Do you think that it is a pain due to cramp in the muscles?

Dr. Arun
Customer: replied 5 years ago.
The pain is directly related to the rock hard muscle, I've never had a muscle as hard as this. I should mentioned that there is some suspicion that I have neuropathy in both feet from insulin resistance (glucose tolerance test), EMG/NCS showing neuropathy and numbness, right foot worse than left from spondylolesthesis (from age 13) and chronic herniated disc at L5-S1(age 25), I'm 62 now. Some concern about circulation in the legs due to the back issue, have not gotten results of new MRI of low back. This has only happened 3 times this year, but maybe once a year in the last 3-4, I've never mentioned to a physician.
Expert:  Dr. Arun Phophalia replied 5 years ago.
Hello Tim,

In the night time when one moves muscles or stretch them; there is an excessive contraction of the muscles (thus the rock hard feeling) and pain. An excessive and persistent contraction of muscles fibers and delayed relaxation of the muscles is called cramp. Neuropathy and circulation issues can be responsible for it. Take Calcium and vitamin D with a supplement of magnesium and zinc a day, for the prevention of recurrence. Gatorade, can help as it contain electrolytes. Do follow up with your doctor for a blood test to check the electrolytes.

Do the following measures so it is arrested immediately, if this recurs;

1) Straighten the leg, flex the foot upward toward the knee, or grab the toes and pull them toward the knee.

2) Walking or shaking the affected leg, then elevating it, may also help.

The exact cause of cramps is not well understood, but there are some risk factors that are thought to contribute to this condition:

1) Muscle fatigue,

2) Heavy exercising,

3) Dehydration,

4) Over weight

5) Electrolyte imbalances,

6) Vitamin deficiency,

7) Age above 60.

The medical causes related to the disease process are;

1) Calcium and phosphorus imbalances can cause cramping.

2) Low potassium or sodium (salt) levels.

3) Deficiencies of a nutrient called hesperidin, an antioxidant flavonoid found in oranges and other citrus fruits, have also been linked to nocturnal leg cramps.

4) Overexertion, standing on concrete for long periods, or prolonged sitting (especially with the legs contorted) may contribute to nighttime cramps.

5) Having structural disorders in the legs or feet (such as flat feet) may increase the risk for cramps.

6) Among the many medical causes of muscle cramping include hypothyroidism, Addison's disease, uremia, hypoglycemia, anemia, and certain medications.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Dr. Arun
Dr. Arun Phophalia and 3 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Thanks, ***** ***** very helpful.
Expert:  Dr. Arun Phophalia replied 5 years ago.
You are very welcome.

Good luck.

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