Heat Cramps: Dehydration, Electrolyte Imbalance, and Prevention

Individuals that engage in heavy exercise can develop heat cramps from overexertion. Can knowing the causes and symptoms help prevent future episodes from happening?

Heat Cramps

Heat cramps can develop during exercise from overexertion or prolonged exposure to high temperatures. The muscle cramps, spasms, and pain can range from mild to severe.

Muscle Cramps and Dehydration

Heat cramps often develop because of dehydration and electrolyte loss. (Robert Gauer, Bryce K. Meyers 2019) Symptoms include:

• Cramping
• Spasms
• Pain in the abdomen, arms, or legs. (Centers for Disease Control and Prevention. 2022)

Electrolytes like sodium, calcium, and magnesium are important for properly functioning muscles, including the heart. The primary role of sweating is to regulate the body’s temperature. (MedlinePlus. 2015) Sweat is mostly water, electrolytes, and sodium. Excessive sweating from physical activity and exertion or a hot environment can cause electrolyte imbalances that lead to cramps, spasms, and other symptoms.

Causes and Activities

Heat cramps most commonly affect individuals who sweat excessively during strenuous activity or are exposed to hot temperatures for prolonged periods. The body and organs need to cool down, which causes sweat production. However, too much sweating can lead to dehydration and electrolyte depletion. (Centers for Disease Control and Prevention. 2022)

Risk Factors

Factors that can increase the risk of developing heat cramps include: (Robert Gauer, Bryce K. Meyers 2019)

• Age – Children and adults 65 years and older have the highest risk.
• Excessive sweating.
• Low sodium diet.
• Preexisting Medical Conditions – heart disease, diabetes mellitus, and obesity are conditions that can increase the risk of muscle cramping.
• Medications – blood pressure, diuretics, and antidepressants can affect electrolyte balance and hydration.
• Alcohol consumption.

Self-Care

If heat cramps begin, immediately stop the activity and look for a cool environment. Rehydrate the body to replenish the fluid loss. Staying hydrated and drinking fluids regularly during intense activity or in a hot environment can help prevent the body from cramping. examples of beverages that increase electrolytes include:

• Gatorade
• Pedialyte
• Coconut water (FoodData Central. 2019)
• Milk (FoodData Central. 2019)

Gently applying pressure and massaging affected muscles can help reduce pain and spasms. As symptoms resolve, it is recommended to not return to strenuous activity too soon because additional exertion can progressively lead to heatstroke or heat exhaustion. (Centers for Disease Control and Prevention. 2021) Heatstroke and heat exhaustion are two heat-related illnesses. (Centers for Disease Control and Prevention. 2022)

• Heatstroke is when the body loses the ability to regulate temperature and can cause dangerously high temperatures.
• Heat exhaustion is the body’s response to excessive fluid and electrolyte loss.

Symptom Timing

The timing and length of heat cramps can determine whether medical attention is necessary. (Centers for Disease Control and Prevention. 2022)

During or After Activities

• The majority of heat cramps develop during activities because of the exertion and sweating, causing more electrolytes to be lost and the body to become more dehydrated.
• Symptoms can also develop minutes to hours after activity has ceased.

Duration

• Most heat-related muscle cramps will resolve with rest and hydration within 30–60 minutes.
• If muscle cramping or spasms do not subside within one hour, seek professional medical attention.
• For individuals with heart conditions or on a low-sodium diet who develop heat cramps, regardless of duration, medical help is necessary to ensure there are no complications.

Prevention

Tips for preventing heat cramps include: (Centers for Disease Control and Prevention. 2022)

• Drink plenty of fluids before and during physical activities.
• Avoid alcohol and caffeinated beverages.
• Avoid exercising or exposure to extreme heat during peak sunlight hours.
• Avoid tight and dark-colored clothing.

Assessing Patients In A Chiropractic Setting

References

Gauer, R., & Meyers, B. K. (2019). Heat-Related Illnesses. American family physician, 99(8), 482–489.

Centers for Disease Control and Prevention. (2022). Heat stress — heat related illness. The National Institute for Occupational Safety and Health (NIOSH) Retrieved from www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#cramps

MedlinePlus. (2015). Sweat. Retrieved from medlineplus.gov/sweat.html#cat_47

FoodData Central. (2019). Nuts, coconut water (liquid from coconuts). Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/170174/nutrients

FoodData Central. (2019). Milk, nonfat, fluid, with added vitamin A and vitamin D (fat free or skim). Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/746776/nutrients

Centers for Disease Control and Prevention. (2012). Frequently asked questions (FAQ) about extreme heat. Retrieved from www.cdc.gov/disasters/extremeheat/faq.html