Calf Fasciculation, or Benign Fasciculation Syndrome (BFS)

If you don’t read anything else, read this: if you have fasciculations, stop worrying. Anxiety makes it worse. And it’s almost certainly not dangerous or indicative of another issue. Go to the doctor who will confirm that. Now read on.

In January 2014, one evening, I suddenly began having twitches in my calves. Not just little twitches, either. It was the entire muscle – right from my ankle to the base of the back of my knee. In both legs. And it was all of the time, 24 hours a day. I read someone else describe it as like having “insects crawling around under the skin.”

I googled for videos of calf fasciculations but although these do give an idea of what it’s like, the results I found weren’t quite as extreme:

Now, if this has happened to you, there’s good news and not so good news.

Good news:
It’s not going to do you any harm or shorten your lifespan or anything like that.

Bad news:
There’s not much you can do about it.

It wasn’t particularly noticeable during the day, when exercising, but when sitting still it became too annoying. Not painful at all, but uncomfortable. I found there are two ways to reduce the annoying-ness:

  • Have the calf muscle in a stretched position
  • Have the calf muscle pressed against a surface.

Having the muscle stretched meant standing up. When sitting on the sofa, I’d have my legs pressed against the base of the sofa, and then I could sit without it annoying me too much.

The first couple of days were the worst, because I wasn’t used to it. I felt like it was making me feel fatigued, but later realised this was psychosomatic. I desperately ran through the possible causes:

  • Poor quality shoes I had bought a few days prior
  • Exercise (running) on the day it started, immediately following a blood donation session
  • Deficiency in Magnesium, Calcium, or Potassium
  • Deficiency in something else, maybe related to being vegetarian
  • Stress (a common cause)
  • Tiredness
  • Medication side effects (I wasn’t taking any)
  • Alcohol intake (I hadn’t been drinking, and rarely drink much)
  • Infection, eg. Lyme’s disease (I didn’t have anything I knew of!)

Having run through the possible causes, I narrowed it down to having ran back to the office immediately following a blood donation session. You’re really not supposed to do that. I remember my calves having been really sore, and this was understandable since a pint of blood was missing from my body via which to transport oxygen to exercised muscles. I had quickly caused some kind of muscle damage to myself through careless behaviour.

After around 4 days of desperately hoping this stupid twitching would stop (and initially believing it would), I realised I’d need to try and find a solution. The worst part was that I was finding it hard to sleep. The internet wasn’t much help but I compiled a list of potential short-term remedies:

  • Take calcium, magnesium and potassium supplements and get tested for deficiency
  • Lower my stress levels (I thought about it carefully and decided I wasn’t stressed)
  • Get plenty of rest
  • Stretching
  • Wear decent shoes
  • Take Quinine (tonic water). Apparently it’s good for cramps. It tasted awful and didn’t do anything. Apparently quinine tablets would be needed to get a high enough dose to have a chance of doing anything.
  • Reduce caffeine intake. I stopped consuming any caffeine for more than a week. It didn’t work.

None of these did anything. I had no deficiencies (other than in common sense). As time went on I got used to the fasciculations. Sleeping became easy again as I learned to either sleep on my back (calves pressed against the mattress) or on my side (weirdly configured so that one calf was pressed against the other). My initial feelings of fatigue evaporated after just a few days and I started to feel fine and energetic again, having realised that the fatigue was brought on by the mental irritation and depressing google results I was finding.

Note to self – googling a medical issue is a BAD IDEA! Only a doctor can tell you what your ailment is!

I thought carefully about alternative, long-term remedies:

  • Fitness. I resumed running (and quickly injured my foot which has temporarily put a stop to that)
  • Strength training/weight gain. I started Stronglifts 5×5 and the GOMAD diet (google it) and gained 10lbs (mostly of fat, in fairness) in three weeks. I became stronger, including my calves. Which was nice. I’m continuing with the strength training.
  • Copper ointment. Apparently this “complimentary” medicine helps with cramps and damaged muscle. I maintained putting it on my calves for a few days and then lost interest. I don’t think it was going to do anything.
  • Acupuncture – I’ll resort to this if I get desperate and have some cash to throw about.
  • Homeopathy – I’ll need to be very desperate to try this, but who knows. That day may come.

I should mention that I visited the doctor twice. The first time, I was told it was nothing to worry about and to come back in a few weeks if it continued. The second time, I gave a blood sample for calcium, magnesium, and potassium testing – these were negative. I haven’t bothered going back because I know there’s no proven treatment.

How am I doing now? Well, it’s been three months, and the fasciculations are still there. I feel like it’s less intense, though. I can sleep without pressure on my calves – this has only happened in the past two weeks. Sometimes it feels like they’ve stopped, but when I roll up my jeans, they’re still going. Oh well; as long as it feels better, that’s the important thing. My best guess for the cause of the improvement is my weight and strength gains. It may be coincidence, but the calf improvements did seem to begin about a week after I began strength training and weight gain. I’d recommend strength training anyway, since it’s a good health improvement to take on.

Apparently, in a large proportion of cases, this condition subsides within several years – maybe not completely, but often noticeably. The main thing is that it’s not worrying me anymore, and I’m fully confident that it’s going to disappear before the end of the year. In three months it feels noticeably better. After exercise it becomes much more intense, but that’s to be expected and is not a problem.

I have written this post because of the lack of information I found on the internet when trying to self-diagnose. All I found was loads of people deciding that they probably had a disease called ALS. Which they don’t. If recommend you attempt all of the remedies I’ve suggested, starting with the most common ones: stress, over-exercise, alcohol/caffeine consumption, and mineral deficiency.

Leave a comment if you have something similar or know of a potential treatment I haven’t suggested. Good luck!

Futher reading:

Update 31-Oct 2014: It’s been 10 months. It’s as annoying as it was at the beginning. I sleep with pressure on my calves: lying on my side, with one on top of the other, or on my back. Oh well…otherwise healthy :-)

Update 25-Mar-2015: Now 15 months. Nothing new, except it’s totally normal for me now. I don’t run any more because my calves are usually pretty sore afterwords. I walk a lot which I don’t think makes it worse. My son woke me up from a deep sleep one night, and it felt like the fasciculations had gone. I felt my calves and couldn’t feel them moving. I went back to sleep. I don’t know if I was imagining it but that’s the only time it seems like they stopped. I love reading the comments. Makes it all seem normal!

Update 18-Aug-2015: They’ve stopped. Not all at once, but gradually, over the course of the past 6 weeks or so. Actually I think they’re still going but very, very faintly. I don’t think there was anything I have done differently in my life – I have no idea why they stopped. It was about 17 months in total. Weird!! As someone posted in the comments, here is a site with more information, and a discussion forum.