EFFECTIVENESS OF MAGNESIUM CITRATE ADJUNCTIVE THERAPY ON CRAMPING PAIN INTENSITY IN NOCTURNAL LEG CRAMPS PATIENTS AT BETHESDA HOSPITAL YOGYAKARTA
DOI:
https://doi.org/10.31603/pharmacy.v10i1.9534Keywords:
Nocturnal leg cramps, NLC, Magnesium, Cramping pain, Pain intensityAbstract
Nocturnal Leg Cramps (NLC) are involuntary lower limb contractions that are painful and occur during long rest periods. Magnesium is thought to have potential in the treatment of NLC as one of the precipitating factors of NLC is low levels of certain minerals, such as magnesium deficiency. This study aimed to assess the effectiveness of magnesium adjunctive therapy in reducing cramping pain intensity in patients with NLC. This study was a randomized clinical trial, open-label, controlled group that was followed up for 2 weeks. 30 subjects who have been diagnosed with the NLC short-form adaptation of ICSD 2005 were divided into 2 groups; (1) the intervention group who was given standard NLC therapy (calcium and gabapentin) with additional therapy of magnesium citrate 100 mg (Hi-Mg100) one tablet a day, (2) the control group who was only given standard NLC therapy. NLC cramping pain was measured using the Numeric Rating Scale (NRS) before the administration of therapy (baseline) and at week 2 after therapy. The results obtained were the addition of magnesium to standard therapy provided a significant reduction in cramping pain intensity between before and after treatment based on the Wilcoxon signed rank test (p=0.000). However, there was no statistically significant difference effect between the two therapy groups based on the Mann-Whitney test (p=0.073). In conclusion, magnesium adjunctive therapy was not significantly more effective in reducing cramping pain than standard drug therapy in patients with NLC.
References
Abate, M., Vanni, D., Pantalone, A., & Salini, V. (2013). Cigarette smoking and musculoskeletal disorders. Muscles, Ligaments and Tendons Journal, 3(2), 63–69. https://doi.org/10.11138/mltj/2013.3.2.063
Allen, R. E., & Kirby, K. A. (2012). Nocturnal Leg Cramps. American Family Physician, 86(4), 350–355. https://www.aafp.org/afp/2012/0815/p350.html
Ayuningtyas, D., Tuinman, M., Prabandari, Y. S., & Hagedoorn, M. (2021). Smoking-Related Social Control in Indonesian Single-Smoker Couples. International Journal of Behavioral Medicine, 28(4), 455–465. https://doi.org/10.1007/s12529-020-09935-z
Bahk, J. W., Kim, H., Jung-Choi, K., Jung, M. C., & Lee, I. (2012). Relationship between prolonged standing and symptoms of varicose veins and nocturnal leg cramps among women and men. Ergonomics, 55(2), 133–139. https://doi.org/10.1080/00140139.2011.582957
Barna, O., Lohoida, P., Holovchenko, Y., Bazylevych, A., Velychko, V., Hovbakh, I., Bula, L., & Shechter, M. (2021). A randomized, double-blind, placebo-controlled, multicenter study assessing the efficacy of magnesium oxide monohydrate in the treatment of nocturnal leg cramps. Nutrition Journal, 20(1), 1–12. https://doi.org/10.1186/s12937-021-00747-9
Bordoni, B., Varacallo, M., & Sugumar, K. (2022). Muscle Cramps. StatPearls, 461–464. https://doi.org/10.1002/9781444317008.ch121
Breda, A. P., Pereira De Albuquerque, A. L., Jardim, C., Morinaga, L. K., Suesada, M. M., Fernandes, C. J. C., Dias, B., Lourenҫo, R. B., Salge, J. M., & Souza, R. (2014). Skeletal muscle abnormalities in pulmonary arterial hypertension. PLoS ONE, 9(12), 1–13. https://doi.org/10.1371/journal.pone.0114101
Brown, T. M. (2015). Sleep-Related Leg Cramps: A Review and Suggestions for Future Research. Sleep Medicine Clinics, 10(3), 385–392. https://doi.org/10.1016/j.jsmc.2015.05.002
Bufford W., T. (2016). Hypertension and Aging. HHS Author Manuscript, Ageing Res Rev, 96–111. https://doi.org/10.1016/j.arr.2016.01.007.Hypertension
Buttaravoli, P. M. (2022). Muscle Cramps: (Charley Horse). In Minor Emergencies (4th ed., pp. 515–517). https://www.clinicalkey.com/#!/content/book/3-s2.0-B9780323662031001199?scrollTo=%23top#refInSitufur1
Castro, M. (2007). Placebo versus best-available-therapy control group in clinical trials for pharmacologic therapies: Which is better? Proceedings of the American Thoracic Society, 4(7), 570–573. https://doi.org/10.1513/pats.200706-073JK
Food and Drug Administration. (2016). Food Labeling: Revision of the Nutrition and Supplement Facts Labels. 81(103), 240–402.
Fritschi, C., Collins, E. G., O’Connell, S., McBurney, C., Butler, J., & Edwards, L. (2013). The Effects of Smoking Status on Walking Ability and Health_related Quality-of-Life in Patients with Peripheral Arterial Disease. J Cardiovasc Nurs, 28(4), 380–386. https://doi.org/doi:10.1097/JCN.0b013e31824af587.
Garrison, S. R., Birmingham, C. L., Koehler, B. E., McCollom, R. A., & Khan, K. M. (2011). The effect of magnesium infusion on rest cramps: Randomized controlled trial. Journals of Gerontology - Series A Biological Sciences and Medical Sciences, 66 A(6), 661–666. https://doi.org/10.1093/gerona/glq232
González-Roldán, A. M., Terrasa, J. L., Sitges, C., van der Meulen, M., Anton, F., & Montoya, P. (2020). Age-Related Changes in Pain Perception Are Associated With Altered Functional Connectivity During Resting State. Frontiers in Aging Neuroscience, 12(May), 1–10. https://doi.org/10.3389/fnagi.2020.00116
Hallegraeff, J., de Greef, M., Krijnen, W., & van der Schans, C. (2017). Criteria in diagnosing nocturnal leg cramps: a systematic review. BMC Family Practice, 18(1), 29. https://doi.org/10.1186/s12875-017-0600-x
Harmsen, J. F., Sistig, A., Fasse, A., Hackl, M., Wegmann, K., & Behringer, M. (2021). Neuromuscular Electrical Stimulation Reduces Leg Cramps in Patients With Lumbar Degenerative Disorders: A Randomized Placebo-Controlled Trial. Neuromodulation, 24(8), 1483–1492. https://doi.org/10.1111/ner.13315
Herzberg, J., Medical, K., City, K., Stevermer, K. J., & Healthcare, M. (2017). FPIN ’ s Help Desk Answers Treatments for Nocturnal Leg Cramps. 96(7).
Khan, S., Sohail, S., Farheen, H., Ramzan, T., Imtiaz, I., & Mehmood, Z. (2022). Frequency of Nocturnal Leg Cramp Symptoms and Gender Comparison of Stress, Physical Activity and Sleep Disturbances in Middle Aged Adults with Nocturnal Leg Cramps. Journal of Turkish Sleep Medicine, 9(3), 199–203. https://doi.org/10.4274/jtsm.galenos.2022.59454
Krishnan, K. C., Mehrabian, M., & Lusis, A. J. (2018). Sex differences in metabolism and cardiometabolic disorders. Current Opinion in Lipidology, 29(5), 404–410. https://doi.org/10.1097/MOL.0000000000000536
Laursen, D. R. T., Hansen, C., Paludan-Müller, A. S., & Hróbjartsson, A. (2020). Active placebo versus standard placebo control interventions in pharmacological randomised trials. Cochrane Database of Systematic Reviews, 2020(7). https://doi.org/10.1002/14651858.MR000055
Liu, J., Song, G., Zhao, G., & Meng, T. (2021). Effect of oral magnesium supplementation for relieving leg cramps during pregnancy: A meta-analysis of randomized controlled trials. Taiwanese Journal of Obstetrics and Gynecology, 60(4), 609–614. https://doi.org/10.1016/j.tjog.2021.05.006
Madla, C. M., Gavins, F. K. H., Merchant, H. A., Orlu, M., Murdan, S., & Basit, A. W. (2021). Let’s talk about sex: Differences in drug therapy in males and females. Advanced Drug Delivery Reviews, 175. https://doi.org/10.1016/j.addr.2021.05.014
Maor, N. R., Alperin, M., Shturman, E., Khairaldeen, H., Friedman, M., Karkabi, K., & Milman, U. (2017). Effect of magnesium oxide supplementation on nocturnal leg cramps: A randomized clinical trial. JAMA Internal Medicine, 177(5), 617–623. https://doi.org/10.1001/jamainternmed.2016.9261
Rabbitt, L., Mulkerrin, E. C., & O’Keeffe, S. T. (2016). A review of nocturnal leg cramps in older people. Age and Ageing, 45(6), 776–782. https://doi.org/10.1093/ageing/afw139
Schwalfenberg, G. K., & Genuis, S. J. (2017). The Importance of Magnesium in Clinical Healthcare. Scientifica, 2017. https://doi.org/10.1155/2017/4179326
Sebo, P., Cerutti, B., & Haller, D. M. (2014). Effect of magnesium therapy on nocturnal leg cramps: A systematic review of randomized controlled trials with meta-analysis using simulations. Family Practice, 31(1), 7–19. https://doi.org/10.1093/fampra/cmt065
Seifollah, S., Mousavi, B., Zeraati, A., Moradi, S., & Mousavi, M. B. (2015). The Effect of Gabapentin on Muscle Cramps During Hemodialysis A Double-Blind Clinical Trial. Saudi Journal of Kidney Diseases and Transplantation, 26(6), 1142–1148.
Supakatisant, C., & Phupong, V. (2015). Oral magnesium for relief in pregnancy-induced leg cramps: A randomised controlled trial. Maternal and Child Nutrition, 11(2), 139–145. https://doi.org/10.1111/j.1740-8709.2012.00440.x
Templeton, K. J. (2020). Sex and Gender Issues in Pain Management. The Journal of Bone and Joint Surgery. American Volume, 102, 32–35. https://doi.org/10.2106/JBJS.20.00237
Yezierski, R. P. (2012). The Effects of Age on Pain Sensitivity: Preclinical Studies. Pain Medicine, 13(SUPPL. 2), 1–15. https://doi.org/10.1111/j.1526-4637.2011.01311.x
