Dear Dr. Roach: I’ve had muscle spasms and cramping in my lower legs and feet for quite some time. It almost always happens when I’m laying in bed and in the early morning hours. If I stand up and walk around, it stops, but if I lay back down, it usually starts up again.
I am 65 and exercise daily, usually 40-50 minutes on an arc trainer and another 20 minutes on the treadmill. I’m 5 feet, 6 inches tall and weigh 145 pounds. The cramps usually happen on Saturday and Sunday mornings, never during the week. Exercise during the week usually starts around 5 p.m. On the weekends, it varies depending on the day’s plan.
Anon.
Nocturnal leg cramps are extremely common. It’s estimated that nearly half of people over 50 have them. My first-line treatment is stretching, specifically the back of the upper leg (hamstring) and lower leg (calf) muscles at least four times daily. I also advise some light exercise before bed. Many of my patients and readers have noted that keeping the bedsheets and covers tightly tucked in is a big trigger for cramps.
In your case, because they are happening only on the weekend, there’s something different about your routine on the weekend compared to the rest of the week. It could be the timing of your exercise as your letter seems to suggest, but I also wonder about some other potential causes.
One important one is alcohol. If it’s your habit to have even a glass or two on Friday and Saturday nights, this is one likely reason why you might have muscle cramps just on Saturday and Sunday.
If stretching doesn’t work, and you can’t figure out the cause, then a visit to your doctor is in order. There are some medical conditions that occasionally cause leg cramps (especially sleep disorders like restless leg syndrome). Although many of my patients try supplements, I haven’t seen a lot of benefit. However, a trial of a B complex vitamin wouldn’t hurt.
Dear Dr. Roach: I am a 79-year-old woman. I came down with COVID about a year ago, and it lasted for about a week and a half. I have been in pretty good health since then, except for a mucus/phlegm buildup in my throat. Every morning, there is a lot of coughing when trying to get rid of it. It is clear and has no color to it.
I asked my doctor about it, and his response was, “That’s a tough one. Try Ricola cough drops!” They don’t help. Any suggestions?
M.M.
Persistent mucus in the back of the throat either comes from the nasopharynx (if it’s post-nasal drip) or the lungs. For my patients with this concern, I make a diagnosis with a careful exam. (There are often findings on the physical exam that can point one way or the other.)
If I think the problem is post-nasal drip, I’ll try a mediation to reduce it, such as a nasal steroid. Sometimes this solves the problem entirely, but there are alternatives if this doesn’t work. A salt water gargle may help the mucus come out more easily.
If the mucus in the back of the throat seems to be coming from the lungs, I suspect asthma, which produces abnormal mucus. A cough is common after COVID, but it usually doesn’t last a year. Again, a trial of an asthma medicine is one approach, while other physicians might recommend pulmonary function testing to look at your lung function.
Personally, I recommend a more thorough evaluation with at least a chest X-ray.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
