When Should I Worry About...

Muscle Cramps: 8 Things That Cause Them & 4 Ways to Stop Them

Feb. 28, 2022 - Katie McCallum

Whether it's a charley horse or a random leg spasm that startles you awake, we've all experienced a muscle cramp before.

They can be incredibly painful, but the good news is that muscle cramps are fleeting. They're also usually nothing to be too concerned about.

"Muscle cramps are a fairly common condition," says Dr. William Ondo, a neurologist at Houston Methodist who specializes in movement disorders. "They can happen in any part of the body, but they're most common in the legs and feet."

Still, they're not always something to just brush off.

For instance, muscle cramps can be particularly problematic if they're waking you up at night. And if accompanied by other symptoms, they can also be a sign of an underlying medical condition.

"While not the most common cause, muscles cramps can even be the result of a neurological issue," warns Dr. Ondo.

Plus, did we mention how painful they can be?

From why they happen to whether pickle juice can really stop them, here's everything you need to know about muscle cramps.

What causes muscle cramps?

You move throughout the day. In doing so, the motor nerves of your peripheral nervous system fire to trigger the muscle contractions necessary for normal muscle movement.

But these motor nerves are incredibly sensitive and, sometimes, they spontaneously misfire — creating muscle contractions that feel anything but normal.

"A muscle cramp is essentially a chaotic, spontaneous muscle contraction," explains Dr. Ondo. "When you do electrical studies of cramps, you see that the motor nerve triggering the affected muscle is firing at an extremely high rate — much higher than when a person consciously moves a muscle on their own."

In many cases, the muscle contracts to such an extreme extent that the whole limb or body physically moves, especially if in larger muscles in the thigh or calf.

"The muscle will eventually fatigue — or you can stretch the muscle to break the contraction — but in the meantime, these extreme contractions can be very painful and problematic," adds Dr. Ondo.

This is different than muscle twitching, a very slight, repetitive contraction of a muscle that may or may not be seen or felt.

As for what exactly causes a nerve to fire at such a rapid rate and cause a cramp, Dr. Ondo says the reason isn't always fully understood.

There are certainly risk factors for developing a muscle cramp, though, including:

  • Initiation of new exercise
  • Dehydration
  • Electrolyte imbalance
  • Aging
  • Inactivity
  • Diabetes
  • Pregnancy
  • Certain medications, most notably diuretics and statins

"There are also some serious underlying nerve issues that can cause muscle cramps, but this is rarer than the benign muscle cramps that otherwise healthy adults are prone to develop," says Dr. Ondo.

Why do we get muscle cramps at night?

Most of the muscle cramps we experience fall into one of either two categories:

  • Cramps that have no clear cause, which tend to occur when the muscle is relaxed (typically at night)
  • Cramps that occur during or after exercise

"Nocturnal cramps, which are muscle cramps at night, seem to become more common with increasing age, but it's still not completely clear why motor nerves might suddenly start firing while your leg is relaxed and you're asleep," says Dr. Ondo. "Then there are the muscle cramps that occur after strenuous activity or even during strenuous activity. When a tight muscle tries to relax, it sometimes begins to contract more than normal instead, causing a cramp."

Exercise-induced cramps may occur either due to an electrolyte imbalance, dehydration or because the muscles are out of shape and are being exercised for the first time in a while.

 

"Although they're classified separately, there's no physiological difference between exercise-induced cramps and nocturnal ones," says Dr. Ondo. "A cramp is a cramp. We just give them different names based on when they occur and what's likely causing them."

How to stop muscle cramps

When a muscle cramp hits, you're likely looking for a way to get rid of the pain fast.

"The main thing you can do to stop a cramp is to stretch the muscle in the opposing direction of the cramp," explains Dr. Ondo. "This can be difficult to do since cramps are very painful, but this works to break the muscle contraction — stopping the cramp. Now, the cramp may still come back a few seconds later, but this is the most effective way to stop a cramp."

As for whether there are foods that help with muscle cramps, the answer is somewhat murky. That's because, overall, muscle cramp treatment isn't very scientific in the first place.

"There are a number of things touted to offer muscle cramp relief, with potassium being the most popular," says Dr. Ondo. "This is why you often hear about pickle juice for cramps, since this juice contains potassium."

Calcium and magnesium supplements are also thought to help with cramps.

"None of these home remedies for muscle cramps, pickle juice included, have undergone rigorous scientific review, though," Dr. Ondo adds. "That being said, there's also no harm in trying them."

According to Dr. Ondo, the best ways to deal with muscle cramps is to prevent them from happening in the first place by:

"Stretching and hydration are really the best ways to prevent the benign muscle cramps that occur at rest or with exercise," adds Dr. Ondo. "And if you're noticing other symptoms accompanying your muscle cramps, that's when it's time to consult a doctor."

When should you see a doctor about muscle cramps?

Most of the time, a muscle cramp occurs by itself (with no other symptoms) and is, fortunately, no big deal — although, admittedly, it can still be very painful in the moment.

But if you're getting muscle cramps frequently, and especially if you have other symptoms of weakness of muscle loss, it's time to consult your doctor.

"There can be metabolic reasons for muscle cramps, such as hormonal disorders that cause electrolyte imbalances," says Dr. Ondo. "A doctor can test for this and treat an imbalance if one is present, which will also likely help reduce the cramps."

And, sometimes, muscle cramps can actually be a sign of something even more worrisome.

"If muscle cramps are accompanied by pain, weakness or reduced muscle size, it's important to consult a neurologist since there are certain neurological disorders that cause cramps," warns Dr. Ondo. "While rare, these are very serious and will need to be ruled out."

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