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Dr Uzair
Dr Uzair, Doctor
Category: Medical
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Experience:  MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
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Iam male 71 yrs old and suffer from severe cramp in my right

Resolved Question:

Iam male 71 yrs old and suffer from severe cramp in my right leg namely my hamstring and can happen at any time day or night usually when leg is relaxed. It can happen when i kneel down and i have to straighten my leg quickly to prevent seizure. I also get cramp in my calf muscles but not as often as my hamstring which is always tight, my right knee feels permanently tight as in a vice. I work full time and spend majority of my day standing. I cannot find anyone who can find the cause of this painful and annoying problem. Richard XXXXXX

Submitted: 1 year ago.
Category: Medical
Expert:  Dr Uzair replied 1 year ago.
Hi. Welcome to JustAnswer. I shall try my best to assist you while you are corresponding with me.
This seems like a neuropathy, an impinged nerve in the lumbosacral plexus which can cause cramping of the muscles that it supplies due to being irritated and inflamed and firing impulses every now and then. The most common cause is an impingement of the sciatic nerve where it exits the spinal foramina in the L4 to S3. Since, the sciatic nerve supplies both the hamstrings group as well as the muscles of the calf through its tibial nerve component this signifies that it is being compressed some where along its course before it exits the main trunk. If this were a systemic or generalized condition then other muscle groups would also have been affected from time to time, since the problem seems to be localized to the back of the thigh and the calf, this is not a generalized disorder like electrolyte imbalance, dehydration etc.
I would suggest that you see your PCP and ask to be referred to a Neurologist, an evaluation is warranted here which will include a physical examination, an MRI of the lumbosacral area (Myelogram), electrodiagnostic studies (nerve conduction study and electroencephalogram), electrolyte panel (to rule out any electrolyte abnormalities).
The treatment is mostly aimed at eradication of the mechanical compression over the nerve, this can be done by minimally invasive procedures as well as open surgical techniques. In mild to moderate cases, conservative therapy including anti inflammatory medication (intra lesional and/or oral) and
phyiotherapy is also effective.
Hope this helps.
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Let me know if there are any more queries regarding this.
Best wishes.
Dr Uzair, Doctor
Category: Medical
Satisfied Customers: 6412
Experience: MBBS, FCPS (R) General Surgery. Years of experience in Emergency Medicine.
Dr Uzair and 2 other Medical Specialists are ready to help you
Expert:  DrRussMD replied 1 year ago.

Hello

I would not suggest a neurologist.

I would suggest an orthopedist, a non invasive one, as the initial treatment is physical therapy, and if too far advanced, orthopedic surgery.

In addition, circulation problems need to be excluded in this lack. It does not act like this, but lower extremity dopplers should still be done.

This distribution is not specifically the sciatic nerve, although close, and if spinal disease, involved more than the sciatic nerve.

The initial treatment is not neurological treatment, but rather physical therapy However, there is enough about this that it might not be a compressed nerve problems.

Tendonitis, with arthritis in the knee needs to be ruled out as well.

X ray and MRI might be the initial tests, not EMG.

I am a double board certified doctor.

I will give you accurate and full answers.

Let me know if you have more questions.

Please click a positive.

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