Skip to main content
SpringerLink
Log in

Muscle cramp: Main theories as to aetiology

  • Published:
European archives of psychiatry and neurological sciences Aims and scope Submit manuscript

Summary

Historically relevant hypotheses on the pathophysiology of muscle cramp are reviewed. Psychosomatic, static, vascular, myogenic and neural theories are highlighted from a clinician's point of view. Modern neurophysiological research leaves little doubt that true muscle cramp is caused by explosive hyperactivity of motor nerves. Several mechanisms may be involved including spinal disinhibition, abnormal excitability of motor nerve terminals and spreading of muscle contraction by ephaptic transmission or axon reflexes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Acchiardo SR, Skoutakis VA, Hatch FH (1975) Management of muscle cramps in hemodialysis patients: controlled prospective study. Proc Dial Transplant Forum 5:6–8

    Google Scholar 

  2. Berrios GE (1984) Epilepsy and insanity during the early 19th century. Arch Neurol 41:978–981

    Google Scholar 

  3. Bittorf A (1910) Zur Kenntnis der Muskelkrämpfe peripheren Ursprungs und verwandter Erscheinungen. Dtsch Z Nervenheilkd 39:208–227

    Google Scholar 

  4. Chillar RK, Desforges JF (1972) Muscular cramps during maintenance haemodialysis. Lancet II:285

    Google Scholar 

  5. Danieli HW (1979) Simple cure for nocturnal leg cramps. N Engl J Med 301:216

    Google Scholar 

  6. Dennig H (1926) Ueber den Muskelcrampus. Dtsch Z Nervenheilkd 93:96–104

    Google Scholar 

  7. Denny-Brown D, Foley JM (1985) Myokymia and the benign fasciculation of muscle cramps. Trans Assoc Am Physicians 61:88–96

    Google Scholar 

  8. Elmqvist D (1970) Perifert utlösta muskelkramper. Nord Med 83:95

    Google Scholar 

  9. Erben S (1928) Ueber den Crampus und sein Bekämpfung. Wien Klin Wochenschr 43:1499–1501

    Google Scholar 

  10. Féré C (1900) Les crampes et les paralysies nocturnes. Médécine moderne. Cited in: Näcke P (1901) Zur Pathogenese und Klinik der Wadenkrämpfe. Neurol Zentralbl 20:290–296

    Google Scholar 

  11. Fowler AW (1973) Relief of cramp. Lancet I:99

    Google Scholar 

  12. Gilchrist JM (1988) The axon reflex as ephaptic transmission: an hypothesis. Electromyogr Clin Neurophysiol 28:209–211

    Google Scholar 

  13. Gonce M, Delwaide PJ (1982) Les crampes musculaires. Rev Med Liège 37:274–279

    Google Scholar 

  14. Gootnick A (1943) Night cramps and quinine. Arch Intern Med 71:555–562

    Google Scholar 

  15. Grund G (1927) Der lokale Muskelcrampus als Tonusphänomen. Dtsch Z Nervenheilkd 97:1–9

    Google Scholar 

  16. Hall AJ (1947) Cramp and salt balance in ordinary life. Lancet II:231–233

    Google Scholar 

  17. Holmes TH (1951) Muscle spasms, professional cramp and backache. In: Cecil RL, Loeb RF (eds) A textbook of medicine, 8th edn. Saunders, Philadelphia, pp 1443–1447

    Google Scholar 

  18. Jenkins PG, Dreher WH (1975) Dialysis-induced muscle cramps: treatment with hypertonic saline and theory as to etiology. Trans Am Soc Artif Intern Organs 21:479–482

    Google Scholar 

  19. Joekes AM (1982) Cramp: a review. J Royal Soc Med 75:546–549

    Google Scholar 

  20. Kehrer F (1923) Crampes. In: Levandowski M (ed) Handbuch der Neurologie, Bd 1. Springer, Berlin, pp 148–152

    Google Scholar 

  21. Klimke W (1936) Ueber lokalisierte Muskelkrampf-Zustände und ihre Entstehung. Zeit Gesamte Neurol Psychiatr 155:592–607

    Google Scholar 

  22. Kugelberg E (1946) Neurologic mechanism for certain phenomena in tetany. Arch Neurol Psychiatry 56:507–521

    Google Scholar 

  23. Ladell WSS (1949) Heat cramps. Lancet II:836–839

    Google Scholar 

  24. Lambert EH (1969) Electromyography in amyotrophic lateral sclerosis. In: Norris FN Jr, Kurland LT (eds) Motor neuron diseases: research on amyotrophic lateral sclerosis and related disorders. Grune & Stratton, New York, pp 135–153

    Google Scholar 

  25. Lanari A, Muchnik S, Rey N, Semeniuk G (1973) Muscular cramp mechanism. Medicina (Buenos Aires) 33:235–240

    Google Scholar 

  26. Layzer RB (1980) Motor unit hyperactivity states. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 41. North Holland, Amsterdam, pp 295–316

    Google Scholar 

  27. Layzer RB (1982) Diagnostic implications of clinical fasciculations and cramps. In: Rowland LP (ed) Human motor neuron diseases. Raven Press, New York, pp 23–27

    Google Scholar 

  28. Layzer RB (1985) Renal disorders. In: Layzer RB (ed) Neuromuscular manifestations of systemic disease. Davis, Philadelphia, pp 293–294

    Google Scholar 

  29. Layzer RB (1985) Diagnosis of neuromuscular disorders. In: Layzer RB (ed) Neuromuscular manifestations of systemic disease. Davis, Philadelphia, pp 19–22

    Google Scholar 

  30. Layzer RB (1986) Muscle pain, cramps and fatigue. In: Engel AG, Banker BQ (eds) Myology. McGraw-Hill, New York, pp 1907–1922

    Google Scholar 

  31. Layzer RB, Rowland LP, Ranney HM (1967) Muscle phosphofructokinase deficiency. Arch Neurol 17:512–523

    Google Scholar 

  32. Layzer RB, Rowland LP, Cramps (1971) N Engl J Med 285:31–40

    Google Scholar 

  33. McArdle B (1951) Myopathy due to a defect in muscle glycogen breakdown. Clin Sci 10:13–33

    Google Scholar 

  34. Milutinovich J, Graefe U, Follette WC, Scribner BH (1979) Effect of hypertonic glucose on the muscular cramps of hemodialysis. Ann Intern Med 90:926–928

    Google Scholar 

  35. Moss HK, Herrmann LG (1947) Night cramps in human extremities. Am Heart J 35:403–408

    Google Scholar 

  36. Näcke P (1901) Zur Pathogenese und Klinik der Wadenkrämpfe. Neurol Zentralbl 20:290–296

    Google Scholar 

  37. Neal CR, Resnikoff E, Unger AM (1981) Treatment of dialysisrelated muscle cramps with hypertonic dextrose. Arch Intern Med 141:171–173

    Google Scholar 

  38. Nicholson JH, Falk A (1945) Night cramps in young men. N Engl J Med 233:556–559

    Google Scholar 

  39. Noebbels JL, Prince DA (1977) Presynaptic origin of penicillin afterdischarges at mammalian nerve terminals. Brain Res 138:59–74

    Google Scholar 

  40. Norris FH, Gasteiger EL, Chatfield EO (1957) An electromyographic study of induced and spontaneous muscle cramps. Electroencephalogr Clin Neurophysiol 9:139–147

    Google Scholar 

  41. Perchuk E (1964) The diagnosis and treatment of nocturnal leg cramps. Clin Med 71:1167–1174

    Google Scholar 

  42. Rish BL (1985) Nerve root compression and night cramps. JAMA 254:361

    Google Scholar 

  43. Rivlin S (1973) Nocturnal calf cramp. Lancet I:203

    Google Scholar 

  44. Rowland LP (1985) Cramps, spasms and muscle stiffness. Rev Neurol (Paris) 141:261–273

    Google Scholar 

  45. Shuman CR (1953) Nocturnal cramps in diabetes mellitus: clinical and physiological correlations. Am J Med Sci 225:54–60

    Google Scholar 

  46. Stålberg E, Trontelj JV (1970) Demonstration of axon reflexes in human motor nerve fibres. J Neurol Neurosurg Psychiatry 33:571–579

    Google Scholar 

  47. Stewart WK, Fleming LW, Manuel MA (1972) Muscle cramps during maintenance haemodialysis. Lancet I:1049–1051

    Google Scholar 

  48. Strümpell A von (1921) Dtsch Z Nervenheilk 72:118

    Google Scholar 

  49. Vold E (1900) Ueber ‚Hallucinationen‘, vorzüglich ‚Gesichtshallucinationen‘ usw. Allg Z Psychiatr 17:654

    Google Scholar 

  50. Wernicke C (1904) Ein Fall von Crampus-Neurose. Berl Klin Wochenschr 43:1121–1124

    Google Scholar 

  51. Wilder J (1940) Crampus disease and localized muscular cramps. Med Rec 152:442–446

    Google Scholar 

  52. Wolman L (1949) Cramp in cases of prolapsed intervertebral disc. J Neurol Neurosurg Psychiatry 12:251–257

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute of Neurology, St. Radboud Hospital, Catholic University of Nijmegen, P.O. Box 9101, NL-6500 HB, Nijmegen, The Netherlands

    P. H. P. Jansen, E. M. G. Joosten & H. M. Vingerhoets

Authors
  1. P. H. P. Jansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. M. G. Joosten
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. M. Vingerhoets
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jansen, P.H.P., Joosten, E.M.G. & Vingerhoets, H.M. Muscle cramp: Main theories as to aetiology. Eur Arch Psychiatr Neurol Sci 239, 337–342 (1990). https://doi.org/10.1007/BF01735062

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01735062

Key words

Search

Navigation