Leg Cramp

Finding Relief From Painful Muscle Spasm

leg cramp
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A leg cramp is a sudden, uncontrolled contraction of a muscle. This type of pain is most commonly experienced in the lower extremity, and therefore often called a leg cramp or a "charley horse." Leg cramps occur when the muscle suddenly and forcefully contracts. The most common muscles to contract in this manner are muscles that cross two joints. These muscles include the calf (crossing the ankle and knee), the hamstring (crossing the knee and hip), and the quadriceps (also crossing the knee and hip). Typical symptoms of a leg cramp include:

  • Sudden, sharp pain, most often in the back of the leg
  • Contraction of the muscle
  • A "quivering" sensation of the muscle
  • Ongoing aching and fatigue following muscle relaxation

Leg cramps usually last less than one minute but may last several minutes before the contraction subsides. In some patients, the spasms occur primarily at night and can awaken the patient from sleep. More severe leg cramps can cause pain that lasts several days after the cramp occurs.

Causes of Leg Cramps

The exact cause of a leg cramp is not well understood, but there are some risk factors that are thought to contribute to this condition:

  • Muscle fatigue
  • Heavy exercising
  • Dehydration
  • High weight (not necessarily obesity)
  • Electrolyte imbalances
  • Medications (statins, prednisone, others...)

The most common cause that is typically seen in patients who develop leg cramps is exercising in an unusual way, meaning either more activity or a different exercise. Leg cramps are more common in young (adolescent age) and older (over 65) patients. Patients who weigh more are more prone to developing leg cramps. Also, some medications can cause side effects of muscle spasms. There are some rare genetic conditions that can make muscle cramping more likely and more severe, although these are quite uncommon. The vast majority of people who sustain a leg cramp from athletic participation require no specific tests or studies to be performed.

Preventing Muscle Spasms

  • Stay Hydrated
    • It is not well known exactly how dehydration and muscle cramping are related, but it is known that dehydration can predispose to leg cramps. Drink at least three full glasses of water each day, including one before bedtime. Also drink plenty of fluid before, during, and after exercise.
  • Stretch Regularly
    • Stretching can relax muscle fibers. When working out, a good post-workout stretching routine can help relax muscles and prevent cramps. Make sure you cool down after exercising and do not exercise vigorously just prior to sleep.
  • Train Gradually
    • Gradually build up an exercise program, and try to avoid sudden increases in activity. The "10% Rule" is a good rule of thumb: never increase your exercise over one week by more than 10% compared to the week before. Sudden changes in activities can cause leg cramps. Most athletes that have leg cramps, such as long-distance runners, have increased their level of intensity or duration of activity too quickly.

Treatment of Leg Cramps

Usually, instinct takes over when a leg cramp strikes, and you massage and stretch the sore muscle. This is a perfect instinct and often solves the acute problem. The best steps are:

  • Massage the cramped muscle
  • Stretch the muscle (gently!)
  • Cooling the skin can help, particularly in high temperatures
  • Drink more fluids

If leg cramps become a persistent and recurring problem, you should be evaluated by your doctor. Because electrolyte imbalances can cause cramping, some blood may be analyzed to ensure the levels of potassium and other electrolytes are normal. There are also muscle relaxing medications that can be prescribed if the muscle cramping is a recurrent problem, particularly at night. However, for the vast majority of athletes, medications should not be used as a treatment of isolated episodes of muscle cramps. Finally, your medications and medical history should be reviewed to investigate possible factors contributing to your leg cramps.

While many people use medications such as quinine or magnesium to treat muscle cramping, there is little evidence to support the use of these drugs, especially in athletes. Interestingly, there is a well-known placebo effect of using drugs to treat muscle cramps. Studies have repeatedly shown effects of up to 50% improvement in symptoms when a placebo drug is used to treat muscle cramping.

One warning sign of muscle damage is dark urine, particularly in the hours that follow an episode of severe cramping or muscle injury. If an athlete has an episode of severe muscle cramping, followed by darkening of the urine, they should immediately seek medical evaluation. Further testing can be performed to evaluate for muscle injury.

A Word From Verywell

Most leg cramps are spontaneous, painful events that will quickly resolve. In some unusual circumstances, they can occur as part of a syndrome or as a more severe problem. If your symptoms of leg cramps seem more frequent or more severe than is typical, you should discuss these with your doctor. There are some strategies to improve hydration and nutrition, and there are even medications that can help control symptoms of more severe leg cramps.

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