Concluded Case

Cramp on calf muscle

56 years old male patient with complain of cramp in bilateral calf muscle during sleep for 30 years. Cramp is relieved on stretching. No pain during walking. On examination no redness, no swelling, no tenderness. What is the differential diagnosis and treatment?Dr. Shivraj Agarwal Dr. Parveen Yograj

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Concluded answer

Cramps for 30 years- calf muscles in a 56 years old male . D/D -, 1.Chronic venous insufficiency. 2.Restless leg syndrome. 3..Vitamin- D deficiency 4.Buergers disease 5.Fibromyalgia 6.Hypochondriasis . Get baseline investigation 1.A colour doppler study of lower limb vessels to look for chronic venous insufficiency, Buergers disease, varicose veins and peripheral vascular disease 2.Serum vitamin D levels 3.Blood for CBC, KFT s.uric acid and LFT . Treatment- 1.If chronic venous insufficiency is present leg elevation at night, elastic compression stockings , tab cilostazol 50 mg B.D 2.Tab L- carnitine , CoQ , and magnesium containing supplements are very effective in such cases Cap Nurofill - C and tab Go - Cram O.D for 3 months will do wonders 3.Vitamin D- supplements as per the report 4.If there is psychological component, tab opipramol bed time will prevent nocturnal cramps, 5.Physiotherapy Thanks

All Answers

Cramps for 30 years- calf muscles in a 56 years old male . D/D -, 1.Chronic venous insufficiency. 2.Restless leg syndrome. 3..Vitamin- D deficiency 4.Buergers disease 5.Fibromyalgia 6.Hypochondriasis . Get baseline investigation 1.A colour doppler study of lower limb vessels to look for chronic venous insufficiency, Buergers disease, varicose veins and peripheral vascular disease 2.Serum vitamin D levels 3.Blood for CBC, KFT s.uric acid and LFT . Treatment- 1.If chronic venous insufficiency is present leg elevation at night, elastic compression stockings , tab cilostazol 50 mg B.D 2.Tab L- carnitine , CoQ , and magnesium containing supplements are very effective in such cases Cap Nurofill - C and tab Go - Cram O.D for 3 months will do wonders 3.Vitamin D- supplements as per the report 4.If there is psychological component, tab opipramol bed time will prevent nocturnal cramps, 5.Physiotherapy Thanks

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This patient is having muscle cramps sitting sleep for 30 yrs Now 30 yrs is a lot of period, three decades!! Now some thing that is present for 30 yrs and has not progressed it means that it is not some thing dangerous Now which are the disease which remain constant for 30 years and do not progress?? Leg cramps occurring at night (nocturnal leg cramps) are a common symptom of venous disease. In fact, in the San Diego Population Study, leg cramps were the second most common symptom in people with venous disease with a prevalence of 14.3%. So we must consider venous insufficiency as cause of the cramps, because venous insufficiency is known to be present for years together without causing much damage. Please do venous Doppler If venous insufficiency is found, is treatment may bring about relief Limb elevation and below knee Grade I stockinette may help

Valuable opinion
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Cramp during sleeping time D/D Restless leg syndrome Peripheral neuropathy Overuse of muscle during day time Inadequate water intake causing dehydration

Agree@Nihar Ranjan Mohanty

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Ask him to do regular Calf Muscles stretching. It will improve the Flexibility and avoid the Frequency of Cramps . It's advisable not to try Stretching during cramps. Hold Relax Technique will help. https://youtu.be/2FJqZcmz4V4 calf muscles Stretching Technique

Restless leg syndrome.

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