II. Epidemiology

  1. Acclimatized athletes and laborers at end of work

III. Pathophysiology

  1. Hyponatremia and volume depletion from profuse sweating
  2. Provoked by muscle overload or Fatigue, dehydration or electrolyte disturbance

IV. Symptoms

  1. Symptom onset during or after exertion
  2. Painful muscle contractions or cramps (esp. larger muscle groups)
    1. Abdominal Muscles
    2. Gastrocnemius (Calves)
    3. Quadriceps
    4. Hamstrings
  3. Associated symptoms
    1. Increased thirst
    2. Excessive sweating
    3. Sinus Tachycardia

V. Signs

  1. Distinguish from Heat Exhaustion
  2. Findings of Heat Stroke are absent
    1. Normal mentation and
    2. Core Temperature <104 F

VI. Labs

  1. Labs are not indicated in most cases of isolated Heat Cramps
    1. Consider lab testing if systemic symptoms suggest associated Heat Exhaustion
  2. Basic chemistry panel (chem8)
  3. Creatinine phosphokinase (CPK)

VII. Management

  1. Rest
  2. Oral hydration with electrolyte replacement (salt containing solution)
  3. Stretching and massage of cramping muscles

VIII. Prevention

  1. See Heat Illness Prevention
  2. Prior to work or Exercise:
    1. Adequate Stretching
    2. Adequate water intake
  3. With Exercise (especially longer than 1 hour)
    1. Ingest a drink containing Glucose and Sodium

IX. References

  1. Czerkawski (1996) Your Patient Fitness 10(4): 13-20
  2. Salinas and Ruttan (2017) Crit Dec Emerg Med 31(9): 3-10
  3. Sandor (1997) Physician SportsMed, 25(6):35-40
  4. Barrow (1998) Am Fam Physician 58(3):749-56 [PubMed]
  5. Gauer (2019) Am Fam Physician 99(8):482-9 [PubMed]
  6. Hett (1998) Postgrad Med 103(6):107-20 [PubMed]
  7. Wexler (2002) Am Fam Physician 65(11):2307-20 [PubMed]

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Ontology: Heat Cramps (C0085592)

Concepts Injury or Poisoning (T037)
MSH D018882
ICD9 992.2
ICD10 T67.2
SnomedCT 87108006, 157725005
English Cramp, Heat, Cramps, Heat, Heat Cramp, Effects of heat cramp, heat cramps, heat cramps (diagnosis), Heat cramp, Heat cramps, Heat cramps (disorder), Heat cramp (finding), heat cramp, Heat cramp (disorder), Stokers' cramp, cramp(s); heat, cramp(s); stoker's, heat; cramp(s), stoker's; cramp(s), Heat Cramps
Japanese 熱痙攣, ネツケイレン
Czech křeče z horka, Křeče z horka
French Crampes de chaleur, Crampes dues à la chaleur
German Hitzekrämpfe, Hitzekrampf, Hitzekraempfe
Spanish calambres por calor (trastorno), calambre por calor (hallazgo), calambre por calor, calambre de los fogoneros, Calambres por Calor, calambres por calor, Calambres por calor
Korean 열경련
Portuguese Cãibras devidas ao Calor, Cãibras pelo calor
Hungarian Hőgörcs
Italian Crampi da calore
Norwegian Hetekramper
Dutch hitte; kramp, kramp; hitte, kramp; stoker, stoker; kramp, Hittekramp, hittekrampen, Kramp ten gevolge van oververhitting