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Muscle Cramping and Dystonia: Self Management Strategies

Written by Dr. Michael Braitsch PT, DPT via May 2024 Newsletter

In our Tribe, we all know that sharing tips and finding ways to help  each other to “self-manage” symptoms that are within each person’s  control is a key to success! A commonly discussed topic in our groups  lately has been “muscle cramping” as it relates to the common PD  symptom of Dystonia. Muscle cramping and dystonia are prevalent  motor symptoms in Parkinson's disease, causing discomfort and  impairing movement. These symptoms can arise due to factors such  as medication fluctuations, fatigue, stress, or prolonged immobility.  Many forms of dystonia may require medical management, botox  injections, or in more severe cases, tendon release procedures;  however, there are commonly accepted self-management strategies  that could be worth researching or exploring prior to changing meds  with your Neurologist or pursuing more intense methods of treatment. 

Stay Active: Regular physical activity remains a cornerstone in managing  muscle cramping and dystonia. Research published in the Journal of  Parkinson's Disease suggests that structured exercise programs, including  aerobic exercise, strength training, and tai chi, can improve muscle control  and coordination, thereby reducing these symptoms. 

Optimize Medication Absorption: Effective management of medications is  crucial in controlling muscle cramping and dystonia. Before you seek to  change the dosage of your medication, ensure that you are getting the  most out of each dose by drinking a FULL GLASS OF WATER with  carbidopa/levodopa, allowing it to travel further into the lower intestines  where it can be absorbed. Also, pay attention to the timing of your meals to  be sure that high-protein meals are not interfering with the absorption of  your meds! 

Incorporate Mind-Body Techniques: Mind-body interventions, such as  yoga, meditation, and deep breathing exercises, can mitigate muscle  cramping and dystonia by reducing stress and promoting relaxation.  Research in the Journal of Neural Transmission suggests that these  techniques modulate neural circuits involved in motor control, leading to  improvements in Parkinson's motor symptoms. 


Allen, N. E., Sherrington, C., & Paul, S. S. (2019). Exercise for preventing and treating falls and mobility problems in Parkinson's disease: A systematic review and  meta-analysis. Journal of Parkinson's Disease, 9(4), 741-759. 

Bhidayasiri, R., Cardoso, F., & Truong, D. D. (2015). Botulinum toxin in blepharospasm and oromandibular dystonia: Comparing different botulinum toxin  preparations. European Journal of Neurology, 22(5), 773-781. 

Pickut, B. A., Van Hecke, W., Kerckhofs, E., & Mariën, P. (2019). Mindfulness based interventions in Parkinson's disease: A systematic review with meta-analysis.  Journal of Neural Transmission, 126(7), 791-802. 

Araújo, T. A., Freire, R. C., Sampaio, T. M., & Araújo, L. S. (2019). Cramp relief with tonic water: Science and clinical myth. Journal of Clinical Neuroscience, 65,  180-183. 

Miller, M., & Stone, N. J. (2010). Association of consumption of tonic water with quinine content and the risk of thrombocytopenia. Archives of Internal  Medicine, 170(10), 851-858. 

Garrison, S. R., Allan, G. M., Sekhon, R. K., & Musini, V. M. (2012). Magnesium for skeletal muscle cramps. Cochrane Database of Systematic Reviews, (9),  CD009402. 

Berger, L. (2007). "Acid–Base Physiology." In M. J. Surfactant Science and Technology, pp. 241-256. CRC Press. 

Garrison, S. R., Allan, G. M., Sekhon, R. K., & Musini, V. M. (2012)

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