Difference between cramp and spasm?

I had a new experience last night that I definitely would have taken a pass on if I'd been given a chance.

I was just sitting in the recliner watching TV when a felt a deep ache in my armpit and then a  heaviness/numbness along the inner part of my arm.  It was followed immediately by a very painful cramp in my back (I think at or just below the shoulder blade).  I called out to my husband for help.  He could feel the tightness of the muscle but said it felt like it was deep underneath the surface.

There was no position that relieved it.  No pressure or massage he did helped (actually made it worse).  I could barely speak or breathe through it and ended up in a huge sweat.  After about five minutes of this (that seemed to last much longer) I was able to sit back, cradle my arm to my body, and feel it all relax away again.

Additional info:  I'm being treated with calcium for low bone mass and had low vitamin D levels recently.  I had some vision problems (flashing bars and swirls and headless people on TV) just before this event.  I'm dx with MS but never experienced spasms before.  

What do the spasms of MS feel like?  Today my back feels stiff and could go to achy if I'm not careful about position.  I do have a fair amount of stiffness after being still for any amount of time that goes away as soon as I manage to move again.  I always blamed this on arthritis but now that I think about it, it's not so much in the joints as it is in the muscle.  Is this the spasticity of MS?  If so, without it my weak legs might have crashed on me long ago.

I'm looking for opinions about if this is MS related or just a plain old charley horse type cramp.  I hate to give the MS process more power by attributing every daily event to it.  I suspect I'll have to wait and see if this is an isolated occurrence or starts becoming a regular thing to deduce the origin.  Sure hope it doesn't repeat even once.  I truly feel for those of you with spastic symptoms.  Please share what your MS spasms feel like.
  
Mary (who's feeling like receiving a diagnosis has triggered more symptoms)

[twopack]

Guess this slipped by everyone being a weekend.  Still interested in any input.

I did find the excellent Health Page on muscle tone and spasticity.  I remember now looking it over before.  It really caught my attention this time around.  For anyone interested:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Muscle-Tone-And-Spasticity/show/159?cid=36

Mary

[Quixotic1]

Sorry, Mary.  I am both out of it because I feel puny and because I am watching the Olympics.

In reality a spasm feels like a cramp.  In both cases the muscle tightens into a knot.  But, I view the causes as different as described in the Health Page.  That distinction is not universal.  It just gives me a way to look at the problem medically.

Since you have a problem with Ca and Vit D levels, that is a possibility.

Also, something you should probably be taking is Magnesium.  Many people who are low in Calsium are also low in Magnesium.  Most of the supplements out there are magnesium oxide, because it is very cheap.  However, it is not very bioavailable.  I recommend a form of magnesium that is released better to the body for people who are having cramps.

Examples of better Magnesium salts are:

Magnesium orotate
Magnesium arginate
Magnesium taurate
Magnesium sulfate
Magnesium aspartate

You can also get your doctor to run a magnesium level, but a daily supplement won't hurt you.  If you are unsure you can ask your doc.  I, myself, would try a supplement for a few days and see if the cramping/spasming lessened.

The effect of magnesium is to relax muscles.  Any women who have had pre-eclampsia with a pregnancy might remember the injections of Magnesium sulfate to lower the blood pressure (relaxes the muscles in the vessel walls).  Mag sulfate is used to stop premature labor by relaxing the contractions of the uterus.  If you overdose on magnesium (hard to do, but possible) you will be floppy, with super-relaxed muscles that feel weak until the excess magnesium wears off. (a day or two depending on the level.)  Babies that are born to moms given HUGE doses of Mag sulfate will be floopy intially.

I am going to check to see if they have ever looked at magnesium in spasticity.

Quix

[Quixotic1]

I could find no good scientific source stating that Magnesium was beneficial for spasticity.  However, there is testimonial data that it helps some people.  I wasn't strongly convinced, but it is a pretty benign supplement.

I saw a few comments that MS and magnesium deficiency are often associated.  I didn't follow up on that.

Side effects.  Magnesium can cause diarrhea by virtue of relaxing the muscles in the gut.  This is often the reason that some supplements give some people diarrhea.  One of the major "binding chemicals" used to make a supplement take and keep a tablet form is Magnesium stearate.  (Just look at the "inactive" ingredients of a few of your tablet meds)  When magnesium is taken as an antiacid, it can also cause diarrhea.  For us older floks, Milk of Magnesia is taken for constipation and the great, horrific "clean out" for some procedures may include drinking a bottle of the carbonated Mag Citrate.

But unless you are very sensitive, a typical supplement of Magnesium will not do this.  Or, if you are like me and always monumentally constipated the added action is beneficial.  :))

Quix

[twopack]

Thanks for your very helpful information Quix.  No need for an apology.  The Olympics come around far less frequently than I do and are one of the more worthwhile things to watch on TV.  I wasn't thinking that there was all day coverage on weekends.  

It was a very quiet w/e around here but I found helpful stuff in the health pages.  It doesn't hurt at all to force me into hunt mode every once in a while.  But the additional info you gave me was great.  I had wondered about magnesium.  It just seems I keep adding individual supplements to my pill organizer.  I'm going to run out of room soon.  

I've been thinking that I may need to reevaluate my supplements.  I have added many over the years to self treat symptoms.  It's entirely possible that what was needed in the past is needed less (or not at all) now.  I fear that I may have pushed myself into a new imbalance.

Your comments reminded me that I needed a dose of IV magnesium after my knee replacement surgery (so there's history).  Also, I have taken low dose HTCZ for years and my K+ often hovers at the lowest side of normal limits.  I may need a little boost of both elements.  BTW - a little extra magnesium would be a gift to my GI tract too ;-)

I see my PCP this week.  I'm sure she planned on checking at least the vitamin D level.  I'll make sure the order includes electrolytes and Mg too.  I haven't had any more cramps/spasms but I have had increased weakness lately and some fleeting feelings of fullness in the chest with fluctuating BP and heart rate.

Mary

[twopack]

I saw Dr. Jill today.  She ordered a CMP, Mg and vitamin D level.  I'm not sure she thinks the lytes are off.  We'll know in the morning.  She did ask me if I'm familiar with the MS hug.

My last statement above ("have had increased weakness lately and some fleeting feelings of fullness in the chest with fluctuating BP and heart rate") earned me a ticket to the stress test lab for Thursday.  I've had two before but didn't do well because I couldn't go long enough on the treadmill.  This one will be chemical.  Now is when I'm certainly looking for a NORMAL report.

As an aside, she wasn't real impressed with the big MS specialist's written report.  She gave me a copy and said she wanted my input.  Basically he was more waffley in print than in person (imagine that!).  

Several times he made note of something being consistent with MS.  No less than four times he said he couldn't rule out MS.  His biggest stumbling point appears to be lesions that are in nonspecific locations and not grossly changed over time.

He recommends treatment with Copaxone "if she is going to take a medication for MS".  He states he offered to send me "anywhere in the country" for a second opinion.  (My insurance wouldn't even pay for this THIRD opinion outside our area.)  He failed to mention that he actually advised AGAINST another opinion as he felt it was too risky since there was clearly something wrong and someone else might just dismiss it all.  The best he can bring himself to in conclusion is that "if this represents MS, it appears to be a very stable disease."  He will see me back in six months.

Then Dr. Jill tells me they have yet to firmly diagnose anyone she has referred.  She doesn't know where to send patients who need a good neuro eval.  She had hoped that a place holding themselves up as THE premiere MS facility would be more willing to take on the difficult cases.  WTF!!  Do I even want to go back there?  What are my choices?  Curses upon curses upon curses.........

Mary

[twopack]

K+ and Mg are OK at 3.7 and 95.  Vitamin D level is still low so she'll call in another script for that.

The quest for an answer continues.  I've got to go get ready for that stress test now.

Mary

[twopack]

The trouble never seems to end.  I had a chemical stress test since my legs just can't do that treadmill long enough.  They injected the medicine and immediately reproduced the symptoms I've had off and on for the last few weeks.  Then they had a hard time getting it stopped.

Seems I have some heart block going on.  I'm hooked up to a monitor for the next two days and then see a cardiologist on Monday.  Just what I needed - another ologist!  So I STILL don't know where that big cramp fits into the picture.

I'm going to have to check my birth certificate.  I must be way older than anyone ever told me.

correction on the labs - magnesium was 2.5

Mary

[DawnYM]

Hi Mary, I have the same problem with my legs for the past maybe 6 years!!! No fun, so I'll be watching to see what happens with you!!!

[twopack]

Thanks Dawn.  The legs aren't likely to get better.  It's the MS.  I'd be happy to keep them from getting worse.  

This heart stuff adds a whole new dimension to being wiped out though.  As soon as I try to do anything all my strength leaks right out of my feet and I'm so weak it brings tears to my eyes.

It just doesn't seem fair for something else to pop up right now.

OH I FORGOT.  Life isn't fair.
Mary (apologizing for the pitiful party)