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There is no pain quite like a charley horse. These painful muscle cramps can wake you up and literally take your breath away, leaving you writhing and wishing for the discomfort to let up. So how do you stop them in the heat of the moment? And what can you do to prevent them from coming back?
What are muscle spasms?
Muscle spasms and cramps start the same way: one of your muscles contracts on its own. A spasm is a short twitch that lasts for just a few seconds. If the spasm continues and becomes painful, it’s called a cramp. These painful contractions may occur in any part of the body.
What causes muscle spasms?
Sometimes, muscle spasms and cramps happen for no apparent rhyme or reason. These are called idiopathic cramps. Other common causes of muscle spasms include (Bordoni, 2021; Allen, 2012):
- Dehydration: When you don’t get enough water or minerals (electrolytes)––like potassium, magnesium, and glucose (sugar)––you’re more likely to experience muscle spasms.
- Exercise: When you’re exercising, you sweat and lose electrolytes through your skin. Your muscles also get fatigued when you overuse them. Exercising too much, working out without stretching, or not stopping to drink fluids while you exercise puts you at higher risk for cramping.
- Stress: Sometimes, stress can trigger spasms or cramps in muscles.
- Pregnancy: People who are pregnant often get spasms and cramps in their legs or back.
- Medication: Prescription drugs may cause muscle cramps including hormone pills (like birth control pills), medicines for anxiety and depression (like Zoloft or Wellbutrin), blood pressure medication, and drugs used to treat high cholesterol.
- Heart disease: Conditions like clogged arteries (atherosclerosis) may cause leg cramps.
Other health conditions that can trigger muscle cramps include diabetes, fibromyalgia, conditions that affect the brain and spinal cord (nervous system), liver disease, and kidney disease.
Self-care: why taking care of mental health is important for your physical health
Treatment for muscle spasms
When you’re in the throes of a serious muscle cramp, deep breaths and a little bit of time typically help until the muscles relax. While you wait for the cramp to pass, there are things you can try to speed up the process.
- Stretching: Gently stretch the tight muscle, then let it relax. If you have a charley horse, flex your toes up to stretch the calf muscle. Then let your foot slowly relax back down to the floor. If it’s uncomfortable to do on your own, you can have someone else flex your foot for you (Allen, 2012).
- Massage: If you have a sudden cramp in your calf, you may be able to relieve it by gently rubbing or massaging the area. Chronic spasms and cramps may get more relief from deep tissue massage. Deep tissue massage involves applying firm pressure to the painful muscle using deep strokes. This decreases the tension in the affected muscle. A few small studies suggest that deep tissue massage may help manage chronic (and painful) back spasms (Majchrzycki, 2014; Romanowski, 2017).
- Changing position: Standing up with your feet firmly on the floor might relieve a sudden calf muscle spasm.
- Movement: A thigh or calf muscle cramp may feel better after shaking or jiggling your leg. Light exercise like walking around a room, spending a few minutes on a treadmill, or a minute or two on a stationary bike might also relieve the pain (Allen, 2012).
- Heat and cold: Some people find that taking a warm bath or applying a heating pad relieves muscle cramps in the legs, back, neck, and shoulders. Others prefer cold temperatures and utilize ice packs or ice massage.
- Hydrate: Sometimes you get cramps when you exercise and don’t drink enough fluids. You’ll need to rehydrate to replace the fluids and electrolytes your body used up while exercising. Some studies show that keeping well-hydrated while being physically active can help prevent similar cramps in the future (Lau, 2021).
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Medication for muscle spasms
Sometimes that painful spasm or cramp persists even after you’ve stretched, massaged, and rehydrated. If no at-home remedies work, there are a few things you can try (and some things you probably shouldn’t try) to prevent future spasms or treat existing ones:
- Vitamins: Some studies suggest that B complex vitamins (like vitamin B6) help treat muscle cramps and may even help prevent future ones (Katzberg, 2010).
- Anti-inflammatory drugs: While some people take anti-inflammatory drugs (NSAIDs) like ibuprofen to treat muscle spasms and cramps, studies found that they aren’t very helpful in getting rid of muscle spasms (Steen, 2001; Dudley, 1997).
- Muscle relaxants: Some muscle relaxants may relieve the pain of spasms and cramps. Some of the most commonly used include carisoprodol, metaxalone, and cyclobenzaprine (Toth, 2004). These are prescription medications, so if you regularly experience muscle spasms, it may be worthwhile to discuss the issue with a healthcare provider and decide if they may help you. Some studies suggest combining a muscle relaxant and anti-inflammatory medication may be more effective (Pinzon, 2020). Keep in mind that these medications can cause significant side effects so they’re generally intended for short-term use (van Tulder, 2003).
- Other medications: Drugs called calcium channel blockers (diltiazem and verapamil) are sometimes used to treat a painful charley horse. Nerve pain medications (like gabapentin) may be effective for some people (Katzberg, 2010; Voon, 2001; Guay, 2008). Some may recommend medications to prevent frequent, painful spasms. For many years, providers used a drug called quinine for muscle spasms, but since it causes severe side effects it’s not recommended anymore. Other healthcare providers may suggest physical therapy or Botox to treat muscle spasms (Rush, 2015; Ward, 2002).
How can you prevent muscle spasms?
How you prevent uncomfortable cramps depends on the cause. If you frequently cramp up during physical activity, try adding in a warm-up or stretching routine beforehand. Drink plenty of fluids before and during exercise, especially in hot environments where you might sweat more than usual (Bordoni, 2021).
Stretching your calves and hamstrings once a day may help prevent charley horses. Physical activity and routine exercise may also stave off frequent cramps (Hallegraeff, 2012).
How to stop leg cramps
When should I see a doctor?
Muscle cramps are common but unpleasant. You may be able to relieve the pain of a sudden cramp with at-home methods like stretching or massaging the area. If you have frequent cramps or your cramps don’t improve with standard at-home remedies, it’s a good idea to consult a healthcare professional.
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Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.