Spasms are contractions of the hands, thumbs, feet, or toes that are sometimes seen with muscle cramps, twitching, and convulsions (tetany). Spasms are usually brief, but they can be severe and painful.

Spasms of the hands or feet may be an important early sign of tetany, a potentially life-threatening condition. Tetany is due to a problem with the body's calcium levels, which can be linked to the following:

• Alkalosis in the body
• Ingestion of alkaline salts
• Lack of vitamin D
• Reduced function of the parathyroid glands (hypoparathyroidism)

The spasms are usually accompanied by the following symptoms:

• Cramping
• Fatigue
• Muscle weakness
• Numbness, tingling, or a "pins-and-needles" feeling
• Twitching
• Uncontrolled, purposeless, rapid motions

• Muscle cramps, usually caused by sports or occupational muscle injury
• Parkinson's disease
• Hypocalcemia (low calcium levels in the blood)
• Hypomagnesemia (low magnesium levels in the blood)
• Thyroid disorders
• Dystonia
• Huntington's disease
• Hyperventilation -- calcium becomes temporarily less available to the body during hyperventilation
• Damage to a single nerve or nerve group (mononeuropathy) or multiple nerves (polyneuropathy) that are connected to muscles
• Multiple sclerosis
• Use of certain medications

If vitamin D deficiency is the cause, supplemental vitamin D should be taken under the doctor's direction. Calcium supplements may also help.

If you notice recurrent spasms of your hands or feet, call your health care provider.

Your provider will obtain your medical history and will perform a physical examination. Laboratory testing of blood and urine may also be done.

Medical history questions documenting hand or foot spasms in detail may include the following:

• Do the spasms appear to be involuntary or purposeless?
• Are they prolonged?
• At what age did the spasms first appear?
• Does the presence of spasms seem variable over weeks to months?
• Do spasms occur repeatedly (recurrent)?
• Do several spasms occur in a row (repetitive)?
• Are the spasms slow or rapid?
• Can the spasms be voluntarily suppressed?
• How long have you had spasms?
• Is it worse when you exercise?
• How much calcium-containing food do you eat (such as milk products)?
• What have you done to try to treat the spasms? How effective was it?
• What other symptoms do you have?
  • Do you have numbness or a "pins-and-needles" feeling?
  • Do you have muscle weakness?
  • Do you have fatigue?
  • Do you have muscle cramps elsewhere?
  • Do you have seizures?

Tests may include the following:

• Blood tests to measure magnesium and calcium levels
• Hormone levels
• Kidney function tests
• Vitamin D levels (25-OH vitamin D)

Griggs RC, J??zefowicz RF, Aminoff MJ. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 418.