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I have been suffering from pretty debilitating muscle spasms in my calves for the past month or so, and my right calf, which has been more affected than my left, is now visibly more defined than my left. Is that normal?

is this going on while your serum magnesium is above 0.95 mmol/L and your daily dietary magnesium intake exceeds 400mg, after factoring in any lifestyle-oriented antinutrient considerations such as size/weight, exercise/sweating, emotional stress, toxins, calcium and/or vitamin d3 intake etc?

I am on vitamin supplements because my D was low. The doctor recently diagnosed me with clinically isolated syndrome. I just had an MRI of my thoracic yesterday (found a 9 mm lesion in my brain that is adjacent to the right lateral ventricular atrium). I just wondered if it was normal to have more muscle definition in one limb than another because of spasms.

Try drinking Tonic Water - the Quinine is supposed to help with this issue. My doctor made this recommendation to me a couple of years ago when I had some. I drink Q-Drinks brand Tonic Water which is one of the better brands - many have high fructose corn syrup and other ingredients which you probably want to avoid. Q-Drinkgsis a premium brand (available on Amazon). Their tonic water has real quinine from Peru and is made with organic agave instead of typical sugars.

I guess it is normal to have asymmetric symptoms. My left leg was much worse than right.

An attack messes up everything in body. Your body works in a repair mode and uses lots of minerals/vitamins. I believe time is critical to replace what is missing and D3, B12 intake is critical after an attack. Nothing scientific only my feelings.

just vitamin d3 supplements? anything else in the mix?

I now take a daily multivitamin, monthly B12 shots and a daily B12 supplement, and a daily D3 supplement.

do you exercise/stretch regularly?

how much magnesium and how much calcium in the multi, and how much/what form of d3 per day?

Elliot, I haven't been able to exercise regularly for a couple of months now because it seems to aggravate the pain. Walking can become especially excruciating, especially if I do so most of the day. By the end of the day I'm in a world of hurt.

As for the vitamins, looks like 100 mg calcium but reading this I don't see any magnesium! But the multi has 800 IU and the plain D3 has 2000 IU. Looks like I need to find a different multi though...

ok if you can add a plain magnesium product to the picture, you'd want to take half of your daily magnesium *with* the 2000 IU of d3, and half at another time of day when it won't be monopolized by d3 interactions but can get busy on other things (like keeping muscles nice and relaxed).

my favourite product lately is magnesium glycinate powder capsules. each delivers 180mg elemental magnesium. if you took one of those with the d3, and found a multi containing magnesium to balance out that calcium, you'd probably be in okay shape .

if you're getting sick of pills, 'natural calm' powdered mag citrate is an okay choice. not as readily absorbed into tissue as mag glycinate. but a tasty product. i have only ever gotten plain, and i haven't bothered with it for myself in ages, but i asked in a store some time back and they said the raspberry lemon and the cherry flavours go quickly.

Hi,

In addition to the supplements approach you should look at what your muscles are actually doing. I do like the magnesium idea.

Often the spasm starts a long way from where you feel it. If the spasm is in the calf, try massage on the lateral soleus which is part of muscles that are responsible for what is known as plantarflexion (controlling the angle between the foot and the leg). That muscle is also responsible for pumping blood back to the heart from the extremities of the limb.

If you go to a good masseur and say that is what you want worked they should be able release the tightness in tendons around that muscle by using their fingers. It will hurt a little but it does help. If they can dry needle the tight spots that will really help. If you find the toes cramp, particularly if the three middle ones are pulled down so you put your weight on the tips of them, it will more likely start at the soleus.

It may also be necessary to go further up the leg and check how tight a muscle called the periformis is. This muscle is an external rotater for the hip. Its the muscle that helps you swing your leg over a horse or over a low fence. It also is a muscle the bisects, or alternately can be bisected by, the sciatic nerve. If the muscle is tight then it can crush the nerve and relay pain and spasms down the leg. Often people wake with a cramp in the calf in the middle of the night when they have been lying on a tight periformis which has been crushing the sciatic nerve. Eventually, the leg spasms.

The best way to release the periformis is by a guided cortisone injection into the membrane over it. It is a little odd to be injected lying face down and it is a little painful. Sometimes the local anesthetic can knock out the sciatic nerve so the leg is temporarily very dead.

Other muscles around the hip will be compromised if the perifomis is tight. The glutes will pull at your lower back and change the tilt of your pelvis. That will stress the hip flexors coming from the lower pelvis across the groin. An important muscle, known as the TFL, will try to assume the role of a hip flexor but that will tighten the band down the outside of your thigh and compromise the ability to walk by creating pain in the hips, the knees and down the front of the torso into the top of the leg.

Massage, dry needling and stretching are all needed to overcome this. If the leg has unfatigable clonus then you may need a couple of doses of botox into the hamstrings and calf. They say it's normal after a year but I think it takes longer.

In every case, once you release the muscle you need to exercise it. You don't want to do that by contracting the muscle. It has to be when the muscle is in an elongated and flexible state. This happens in Yoga or Pilates but not by lifting weights. You can accentuate the benefit of exercise if you dry needle to release the fascia (connective tissue) prior to doing it.

The cramps in the hamstrings and the calfs are bad enough but nothing hurts like a cramp down the front of the lower leg through the tibialis anterior. Adressing all of the above helps that sort of cramp a great deal.

Hope that helps.

Regards,

Scott, regarding spasms, YES to the "tibialis anterior" spasms (which I'll admit I had to Google). It feels as if I have MAJOR shin splints when the spasms are bad. I actually didn't know what was going on but from what I've read they're severe spasms that are causing this pain.

I just got the report back from my thoracic MRI... Some bulging discs but no lesions, which is GREAT NEWS! But I'm still trying to figure out why it is that I've got muscles that seem to be constantly spasming. Any ideas? I have an EMG scheduled for July 19.

electrolyte imbalance is certainly one possibility.

low mag can contribute to low vit d3. in a low d3 scenario, adding only d3 without balancing mag could be expected to make any pre-existing low mag situation worse. pretty easy to rule out - add mag for a couple days. that's how long it took my severe symptoms to improve originally. at the time i knew nothing about relative quality of forms - was taking low quality magnesium products and the results were still noticeable. and i could make my problems reoccur, then stop again, by stopping and reintroducing extra mag.

took a long time before i no longer actually felt magnesium kicking in within an hour. i called the phenomenon the 'magnesium knock'. it described the tapping feeling of what i imagined to be broken connections firing again in muscle tissue. then longer before i could skip a day supplementing without immediately feeling the consequences. was a long slow haul to rebuild depleted tissue stores and get into the habit of consuming adequate magnesium in diet, and matching my intake to be consistent with any supplemental d3 intake as well.

Hi,

I don't know what the right dose for magnesium is or how far you can take it but I would take magnesium. I defer to JL on this. I take magnesium and use a very powerful anti spasticity medication called Dantrium. At your stage, Magnesium should be more than enough. I'm not a fan of adding calcium supplements and would prefer that came from your diet.

This is a good description of Periformis syndrome. You will have a devil of a job getting anyone to look for it. You will have to tell them to consider it.

The best exercise would be what is known as leg and footwork on a reformer in a Pilates studio. (Not mat work and you will need a small class). The only action to avoid until the Periformis issue is explored is abduction. That uses the external rotators. You should do internal rotation initially.

If you can, get the membrane above the periformis injected with cortisone but you must exercise by stretching the soleus right down through the plantar. Pilates will do that.

There are other more extreme options such a Botox but I doubt that will solve what you have described.

Regards,