Leg Cramps

What are leg cramps?

Leg cramps are sudden, involuntary, intense muscle spasms, usually in your calf, foot or thigh. You might also know them as “charley horses.” Sometimes, the cramp may cause your leg muscles to contract — to tighten uncontrollably. Although painful to live with, cramps in your legs are generally harmless.

How long do leg cramps last?

Muscle cramps in your legs can last from several seconds to several minutes.

Who gets leg cramps?

The older you are, the more likely you are to have leg cramps. This is because your tendons (the tissues that connect your muscles to your bones) naturally shorten as you age. Women are also more likely to get them. Up to 60% of adults get leg cramps at night, as do up to 40% of children and teenagers.

What are nighttime leg cramps?

Nighttime leg cramps happen when you’re not very active or when you’re asleep. They may wake you up, make it harder for you to fall back asleep and leave you feeling sore all night. Yearly, monthly, weekly, nightly — the frequency of leg cramps depends on the person.

Night leg cramps (nocturnal leg cramps) can happen to anyone at any age, but they happen most often to older adults. Of people over age 60, 33% will have a leg cramp at night at least once every two months. Nearly every adult aged 50 and older will have them at least one time. Approximately 40% of people experience leg cramps during pregnancy. Healthcare providers believe that’s because the extra weight of pregnancy strains your muscles.

About 3 out of 4 reported cases of leg cramps happen at night.

What are the warning signs that leg cramps are coming?

Unfortunately, leg cramps happen very suddenly. There aren’t any warning signs. But there are risk factors, like pregnancy and the use of medications that have leg cramps as a side effect. If you know you have certain risk factors, you can be on the alert for leg cramps, so you won’t be as startled when they happen.

What does a leg cramp feel like?

A leg cramp feels like a clenched, contracted muscle tightened into a knot. It can be severely uncomfortable, painful or even unbearable. Your muscles in the area might hurt for hours after the cramp goes away.

What causes leg cramps?

Some leg cramps happen for no known reason. These are called “idiopathic” cramps. Possible causes of these leg cramps include:

• Involuntary nerve discharges.
• Part of your leg muscle isn’t getting enough blood.
• Stress.
• Too much high-intensity exercise.

What causes leg cramps at night?

Possible causes for leg cramps at night (nocturnal leg cramps) include:

• Sitting for long periods of time (like at a desk job).
• Overusing your muscles.
• Standing or working on concrete floors.
• Having poor posture during the day.
• Kidney failure, diabetic nerve damage, mineral deficits and issues with blood flow.

What medications may cause leg cramps?

Medications have side effects. A prescription you’re taking could be causing your leg cramps. In that case, work closely with your healthcare provider to determine the pros and cons of the medication vs. its side effects. Your provider may be able to put you on a different medication that doesn’t have leg cramps as a side effect.

Medicines that have leg cramps as a side effect include:

• Albuterol/Ipratropium (Combivent®).
• Conjugated estrogens.
• Clonazepam (Klonopin®).
• Diuretics.
• Gabapentin (Neurontin®).
• Naproxen (Naprosyn®).
• Pregabalin (Lyrica®)
• Statins.
• Zolpidem (Ambien®).
• Sertraline (Zoloft®).
• Fluoxetine (Prozac®).
• Celecoxib (Celebrex®).

Cancer treatments like chemotherapy can cause nerve damage, which may also cause leg cramps.

When to worry about leg cramps

Sometimes, leg cramps happen for no reason, but other times, they could be a sign or symptom of a health condition. “Secondary” leg cramps are a symptom or complication of a more serious health condition. If you have any of the following conditions, your leg cramps may be a result of that condition.

Also, keep in mind that if you don’t already know you have any of these conditions, your leg cramps may be a sign that you do. Always consult a healthcare provider if you think your leg cramps are a symptom of something serious.

Leg cramps can be a sign of serious conditions, including:

• ALS (amyotrophic lateral sclerosis/Lou Gehrig’s disease): Progressive neuromuscular disease.
• Congestive heart failure: When your heart can’t pump blood well enough to give your body a normal supply.
• Cirrhosis of the liver: Scarring of your liver.
• Diabetes: A disease that prevents your body from properly using the energy from the food you eat.
• Flat feet: The absence of a supportive arch in your foot.
• Hypokalemia: Low potassium levels in your blood.
• Kidney failure: A condition in which one or both of your kidneys no longer work correctly.
• Osteoarthritis: The corrosion of the cartilage that protects your bones.
• Parkinson’s disease: A neurological movement disorder.
• Peripheral artery disease: Narrowing of the arteries in your legs or arms.
• Peripheral neuropathy: A group of nerve diseases that can cause a range of symptoms, including cramps and pain.

How are leg cramps diagnosed?

Your healthcare provider will need to know your medical history, medications and a description of what you’re experiencing. Be specific. Report your symptoms to your healthcare provider and include the following information:

• When the leg cramps started happening.
• What your pain feels like.
• When the cramps happen (at night, for example, or after vigorous exercise).
• How long the cramps last.
• Any other symptoms you’re experiencing.

Do I need to have any testing done to diagnose my leg cramps?

There’s no specific test to diagnose leg cramps. But your provider will likely check your vital signs and do routine tests (like getting samples of your blood and urine). These can show if you have a medical condition you didn’t know about.

How do I stop leg cramps immediately?

You want to get rid of a leg cramp the moment it strikes. You might be finishing up an exercise routine, or a cramp might wake you up in the middle of the night. In moments like that, unfortunately, there aren’t any magical injections that can instantly relieve your pain. However, there are eight steps to take to possibly get rid of a leg cramp:

1. Stretch: Straighten your leg and then flex it, pulling your toes toward your shin to stretch the muscles. Stretch the cramped muscle and gently rub. For a thigh cramp, try pulling the foot on that leg up toward your buttock. Hold on to a chair to steady yourself.
2. Massage: Use your hands or a roller to massage the muscles.
3. Stand: Get up. Press your feet against the floor.
4. Walk: Wiggle your leg while you walk around.
5. Apply heat: Use a heating pad or take a warm bath.
6. Apply cold: Wrap a bag of ice in a towel and apply it to the area.
7. Take pain medications: Take ibuprofen or acetaminophen to help with the pain.
8. Elevate: Prop up your leg after the cramp starts to feel better.

What kinds of stretches help get rid of leg cramps?

Try this if your cramp is in your calf muscle: While standing (or sitting), straighten your leg and lift your foot until your toes are pointing at your shin. Pull on your toes if you’re able to reach them. You can also try walking around on your heels.

What medicines may help with leg cramps?

There aren’t any recommended medications that can prevent leg cramps 100% of the time. However, some prescription medications show a little evidence of preventing leg cramps. Under the direction of your healthcare provider, you might want to try the following:

• Carisoprodol (Soma®): A muscle relaxant.
• Diltiazem (Cartia XT®): A calcium-channel blocker.
• Orphenadrine (Norflex®): Treats muscle spasms and relieves pain and stiffness in muscles.
• Verapamil: A calcium-channel blocker.
• Magnesium.
• Gabapentin (neurontin): An anticonvulsant and nerve pain medication.
• Vitamin B complex.

What vitamins may help with leg cramps?

No vitamin is likely to help with a leg cramp 100% of the time. But some experts do recommend that you take a vitamin B complex or magnesium for leg cramps.

Can leg cramps be cured?

Leg cramps don’t have a cure at this time. Fortunately, there are steps you can take to prevent and manage your leg cramps.

Can leg cramps get worse?

It depends on the person. Some people see improvement with prevention and treatment plans, while others struggle. Your cramps may feel worse and happen more often as you age.

How can I prevent leg cramps?

Ideas for prevention include several activities you may want to do every day:

• Exercise: Do leg exercises during the day, and mild, brief walking or biking right before bed.
• Hydration: Drink eight glasses of water each day and avoid alcohol and caffeinated beverages.
• Medications and vitamins: Take all vitamins and medications (including muscle relaxants) exactly how your healthcare provider prescribes them.
• Prepare your bed space: Keep a heating pad and massage roller next to your bed.
• Shoes: Purchase supportive shoes.
• Sleeping position: Experiment with different positions to see if one works better than another. Keep your toes up if you’re on your back and hang your feet over the end of the bed if you lie on your front.
• Stretch: Stretch your legs before and after exercising, and right before you go to sleep.

What kinds of stretches help prevent leg cramps?

Try the following to prevent leg cramps in your calves:

1. Stand about 3 feet (1 meter) away from a wall.
2. Lean forward. Touch the wall with your arms outstretched while keeping your feet flat.
3. Count to five before you stop and do it over and over again for at least five minutes.
4. Repeat three times per day.

How do I take care of myself?

Planning is key. Work with your healthcare provider to develop:

• A prevention plan that gives you lifestyle tips to keep a cramp from happening.
• An in-the-moment treatment plan that tells you what to do when a cramp strikes.

When should I see my healthcare provider?

See a healthcare provider if your leg cramps are unbearably painful, happen frequently or last for a long time. Also, talk to your provider right away if you have any of the following symptoms in addition to leg cramps:

• Muscle cramps in other parts of your body.
• Significant pain.
• Swelling or numbness in your leg.
• Changes in the skin of your leg.
• Waking up over and over again with leg cramps.
• Your leg cramps are stopping you from getting enough sleep.
• You have fluid abnormalities or electrolyte imbalances.

See a healthcare provider immediately if you’re concerned that your leg cramps are a symptom of an underlying serious medical condition.

When should I go to the ER?

Go to the emergency room if a leg cramp lasts longer than 10 minutes or becomes unbearably painful. Also, go if a leg cramp happens after you touch a substance that could be poisonous or infectious. For example, if you have a cut on your skin that touches dirt, you could get a bacterial infection like tetanus. Exposure to mercury, lead or other toxic substances should also be a reason to go to the emergency department.

What questions should I ask my healthcare provider?

Questions you may want to ask your provider include:

• Do you think my leg cramps are a symptom of an underlying condition?
• Can you show me the best exercises I can do to stretch my muscles?
• Can you show me the best massage techniques I can use to help with my leg cramps?
• Is it safe for me to take medication for my leg cramps? Which medications should I take?
• Do you recommend that I see a physical therapist, sleep specialist, massage therapist or other specialist?
• How can I help my child when they have a leg cramp?
• Should I keep an eye out for symptoms other than leg cramps that might indicate a more serious condition?
• How often should I come back to visit you about my leg cramps?

What’s the difference between leg cramps and restless legs syndrome (RLS)?

Although both nocturnal leg cramps (leg cramps at night) and restless legs syndrome tend to happen to you at night or when you’re at rest, restless legs syndrome doesn’t cause severe pain. Restless legs syndrome is uncomfortable, but not agonizing. It’s a crawling sensation that makes you want to move your legs. When you do move, the restlessness stops, but there’s still discomfort.