Dear Dr. DonohueI have leg cramps at night quite often. They wake me up, and I have to straighten my leg slowly. I do 15 bends, squats, modified push-ups and sit-ups every night. What causes these cramps? What can I do to stop them? I am physically fit and healthy at age 80. R.C.

AnswerNighttime leg cramps are the bane of a significant number of older people. What causes them is a question to which no one has come up with an answer. That hasn't stopped people from suggesting a number of possible causes: low magnesium, low potassium, too little calcium. None of these has been proved.

Some medicines have been implicated as possible causes. Water pills (diuretics) have been cited, as have long-acting beta-2 agonists used for asthma control.

Peripheral artery disease, a common malady of the elderly, is said to be common among people who suffer from nighttime cramps. That's the circulatory problem where there's obstruction to blood flow to the legs because of clogged arteries. The various kinds of arthritis also are said to contribute to nighttime cramping.

Ways to end cramps include doing exercises before going to bed. Leg exercise is particularly important. If you have a stationary bike, it might be one way to conquer cramps. Stretching exercises for the leg muscles also are important. If the calves are cramping, then stand on a stair with your heels projecting off the stair. Lower your heels, and hold that position for 10 seconds. Repeat 10 times at bedtime, and do this exercise three times during the day.

Medicines sometimes can be helpful if nothing else is working. Examples are gabapentin (Neurontin), diltiazem (Cardizem) and a multivitamin containing a mix of B vitamins. Tonic water, because of its quinine content, often is offered as a preventive step.

The booklet on restless leg syndrome and nighttime cramps offers more tips. Readers can obtain a copy by writing: Dr. Donohue No. 306, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient's printed name and address. Please allow four weeks for delivery.

Dear Dr. DonohueMy husband was diagnosed with ataxia. What is it? R.A.

AnswerAtaxia is uncoordinated muscle movement. For most ataxia patients, it indicates a stumbling walk.

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