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Leg Cramp

Finding Relief From Painful Muscle Spasm

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Updated April 04, 2014

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).

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.

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-work out 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 athltes 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!)
  • Take a hot shower or bath to warm and relax the muscle

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 problem, particularly at night. Finally, your medications and medical history should be reviewed to investigate for possible factors contributing to your leg cramps.

Sources:

Maquirriain J and Merello M. "The Athlete With Muscular Cramps: Clinical Approach" J Am Acad Orthop Surg July 2007 ; 15:425-431.

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