A heads up on leg cramps, blisters & motion sickness

These three health conditions are among the most common ailments that human beings are subjected to. They may be simple yet there is no unanimity when it comes to their treatments. For instance, when you have cramps in your calf muscles, do you point your toes up or down? Does quinine help in controlling cramps? If you have blisters, is it best to puncture it and take the fluid out or just leave it alone? What about motion sickness? Which is the best seat to take when you develop this problem while riding a car or a bus? What about if you are in a boat or ship?

Here’s what you should do if you develop leg cramps, blisters, or motion sickness:

Leg cramps, A knotty problem

Everyone knows what a nocturnal leg cramp is. You wake up from an otherwise restful sleep with a knot of pain in your calf. You try not to wake your bed partner with anguished exclamations or flailing around. If you’ve had one of these cramps before, you probably know what to do. You pull your toes upwards, rub the muscle gently, and if necessary, get up and walk around. Nocturnal cramps can also occur in your feet and thighs.

First off, let’s get some facts straight:

• Claim: There’s usually an identifiable cause of the cramp.

• Fact: Most cramps cannot be traced to anything. Anybody can get them, though older people get them more often.

• Claim: Nocturnal cramps can be alleviated by vitamins and mineral supplements.

• Fact: High-dose dietary supplements won’t prevent or alleviate them, with only a few exceptions. One small study did find that B vitamins may reduce leg cramps in pregnant women, though it was not very convincing. Some researchers are trying to determine if very high doses of vitamin D might help, since D can improve muscle function, especially in the legs of older people. And if you are taking a diuretic for hypertension and begin having leg cramps, your doctor may prescribe potassium.

• Claim: Quinine prevents leg cramps.

• Fact: It may, but this old remedy needs to be retired. Quinine is not a satisfactory treatment because of its dangerous side effects, such as heart arrhythmias and a decrease in blood platelets. You cannot buy quinine over the counter, and the US FDA has cautioned against using prescription quinine for leg cramps.

What to do

There are three things you can do to relieve nocturnal cramps: Massage softly the calf muscles; stretch them by pulling your toes up toward your knee; and walk around. You don’t need to see a doctor for leg cramps, unless they are frequent and/or very painful. Some medications can promote leg cramps  oral contraceptives, some psychiatric drugs, and certain blood pressure medicines, notably diuretics. Your doctor may suggest changing your prescription or lowering your dose. Sometimes, leg cramps go along with such disorders as diabetes or Parkinson’s disease. Treating the underlying condition may help. Pregnancy also increases the risk of leg cramps, as can flat feet and weak leg muscles.

There’s no sure-fire method for preventing leg cramps, but these tips may help:

• Don’t tuck in the sheets and blankets too tightly, since they can press down on your feet if you sleep on your back. That can cause you to point your feet and thus trigger a cramp. Give your feet room. Another way to prevent this is to sleep on your side  or on your stomach with your feet hanging off the end of the mattress.

• Avoid high heels as well as completely flat shoes. Wear comfortable shoes with low heels.

• Massage and stretch your calf muscles, especially before bedtime. One stretch: Stand on a stair with just the front of your feet on it, lower your heels, hold for 10 seconds, then repeat. Or do the classic calf stretch, familiar to runners (see illustration on Page E-1). Calf stretch: Stand two to three feet from a wall with feet perpendicular to the wall, one foot forward. Lean forward, with forearms against the wall, rear knee straight, and rear heel on floor. Hold for 10 to 30 seconds, then switch legs and repeat.

Banishing blisters

Sometimes, the reward of a long run or hike is a big, fat blister. Most are minor, but some can be painful and even infected. Blisters form as a result of friction, when the top layers of the skin separate from the bottom layer and the space fills with fluid. A common cause is ill-fitting shoes; moist and hot skin increases susceptibility.

To stop a blister before it develops, try to prevent rubbing or at least take action as soon as you feel a “hot spot,” as follows:

• Make sure your shoes are not too tight or too loose. When buying hiking shoes or boots, the store may have a sloped surface where you can test the fit. Padded insoles or arch supports may help prevent blisters caused by uneven pressure on your feet.

• Wear socks made from synthetics that wick away sweat  that is, move the moisture away from your skin. They should be seamless and snug enough, so they move with your feet and don’t bunch up. Some wickable socks are promoted as “anti-blister” and may have a double-layer construction. Avoid 100-percent cotton or wool socks, which retain moisture.

• If your feet tend to sweat a lot, try applying an antiperspirant, especially one marketed for excessive seating.

• As a preventive, apply moleskin or athletic tape on blister-prone areas, or at the first sign of a hot spot or blister. There are also many blister-pad products on the market, which typically contain gels that reduce and provide cushioning.

• If you get a blister, leave a small blister alone  just keep the area clean. You can put a donut-shaped pad over the blister (or cut a hole in an adhesive moleskin pad) to relieve pressure. Or try a blister-pad product, designed for both preventing and protecting blisters. Large or painful blisters should be lanced and drained. Wash the area with soap and water; then with a sterile needle (pass it through a flame several times, then let it cool), puncture the blister at its edge. Gently press to release the fluid, then cover with a sterile bandage. Don’t remove the skin or “roof” of the blister  it provides a protective covering. If signs of infection develop, get medical advice. If a blister breaks on its own, simply wash and cover it with a bandage. It should heal quickly.

Motion sickness

Just about anyone can experience motion sickness under severe conditions  a boat rolling over 10-foot waves, say, or a bus ride over twisting mountain roads. But even a simple car ride can cause symptoms in many people, from dizziness and cold sweats, to nausea and vomiting. There may be some genetic factors involved, and women, children, and people who get migraines and vertigo are more susceptible.

Motion sickness occurs when there is a mismatch between what your brain anticipates a movement will feel like and the sensory information it actually receives. Or there can also be a mismatch if your eyes detect motion while your body is still.

S.O.S.

Antihistamines such as dimenhydrinate, meclizine, and cyclizine can help prevent and treat mild cases. They are best taken 30 to 60 minutes before travel. People with lung conditions or glaucoma and men with an enlarged prostate should not take antihistamines. Don’t take them also if you are driving a vehicle. If these don’t work, one option is scopolamine, usually given as a transdermal patch that you place behind your ear six to eight hours before you leave, which allows the medication to be absorbed in small continuous doses.

Most people get used to the motion during a long trip or with repeated exposures. If you still tend to get sick, here are other tips:

• Avoid heavy meals and alcohol before and while traveling (you can eat a light meal beforehand). Try to avoid strong or unpleasant odors, like cigarette smoke and perfume.

• At sea, stay topside and mid-ship; look at the horizon or some other fixed distant point. If below deck, close your eyes.

• Choose a seat in vehicles where you have a clear view of the road ahead. Sitting in the front seat of a car is best.

• Keep your head as still as possible  avoid moving it side to side or tilting it up or down. Refrain from reading, writing, working on a laptop, or doing tasks that require even subtle eye movements.

• Keep windows open for fresh air, if possible. If you have air vents, aim them toward you.

• Try slow, regular breathing. Lying down may also help.