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EspañolWhat causes leg cramps? Related conditions and treatments
Overview: What do leg cramps feel like?
A leg cramp or “charley horse” occurs when muscles in the leg suddenly, involuntarily, and painfully tighten, often at night or during exercise. The affected muscles can be any muscle in the thighs, legs, or feet, but the calf muscle is the most commonly affected.
When you have a leg cramp, you may feel sudden pain, without warning, in the leg muscles. This is due to an involuntary contracting of the muscle. These cramps can last from several seconds up to ten minutes, with thigh cramps lasting the longest. While the leg is cramping, you will feel pain and tightness in the muscle. Your toes and feet may feel stiff as well. After the cramp passes, you may have some pain and/or tenderness in the legs for a few hours.
Occasional leg cramps—that do not persist—are typically not something to worry about. However, if leg cramps are frequent, unexplainable, or if they interfere with sleep or daily life, see a healthcare professional. The cramps may be a symptom of another disorder.
Key takeaways:
Leg cramps are a common symptom that may be caused by exercise, muscle fatigue, aging, pregnancy, peripheral neuropathy, blood vessel disorders, low potassium, cardiovascular disease, liver cirrhosis, neurological disorders, osteoarthritis, decreased leg vein function, and some medications.
Typically, leg cramps do not require immediate medical attention.
Leg cramps generally do not require treatment, but see a doctor if leg cramps are severe, persistent, or interfering with sleep or daily life. It typically resolves without treatment in a few seconds or minutes but could go on for longer.
Treatment of leg cramps may include stretching, massage, walking, shaking the leg, icing, heat, elevation, over-the-counter pain relievers, treating the underlying condition, or, in rare cases, taking prescription medications such as muscle relaxants or a calcium channel blocker.
Leg cramps can be managed with stretching or other home remedies such as walking or applying heat.
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What causes leg cramps?
The primary causes of leg cramps are:
Exercise or exertion (muscle fatigue)
Aging
Pregnancy
The most common cause of leg cramps is exercise-induced muscle fatigue. Leg muscle fatigue is caused by using the leg muscles, but some health conditions can be contributing causes such as dehydration, electrolyte imbalances, or the use of diuretics (water pills).
Pregnancy and aging don’t actually cause leg cramps. Healthcare professionals believe that nerve damage, a normal part of aging, causes leg cramps in older adults. They also believe that problems with the leg veins cause nighttime leg cramps in pregnant women.
Medical conditions that can cause leg cramps include:
Amyotrophic lateral sclerosis (ALS; also known as Lou Gehrig’s disease)—95% of people with ALS have muscle cramps
Peripheral artery disease—75% of people with peripheral vascular disease report leg cramps
Lumbar spinal stenosis: narrowing of the spinal canal and compression of spinal nerves that travel to the legs (70%)
Low potassium—63% have leg cramps
Coronary artery disease (62%)
Liver cirrhosis (59%)
Parkinson’s disease
Peripheral nerve damage
Dialysis (50%)
Osteoarthritis
Venous insufficiency (leg veins don’t return all the blood back to the heart)
*Sources listed in the resources section at the end of the article
Peripheral nerve damage is a common cause of nighttime leg cramps. Nerve damage doesn’t appear out of nowhere. It has multiple possible causes including aging, diabetes, thyroid disorders, injuries, infections, kidney disease, liver disease, alcoholism, medications, and nutritional deficiencies. None of these problems themselves actually cause leg cramps, but they can lead to peripheral neuropathy.
Medications that can cause leg cramps as a side effect include:
Cancer treatment
Iron supplements or injections
Statins (cholesterol medications)
RELATED: Neuropathy treatments and medications
Should I be worried about leg cramps?
In most cases, occasional leg cramps are not something to worry about, especially if the cause is obvious. Even nighttime leg cramps aren’t a cause for concern for most people. However, if leg cramps or nighttime leg cramps are severe, persistent, or interfere with daily living, then see a doctor or other healthcare professional. If there are other medical conditions such as cardiovascular disease, venous insufficiency, nerve damage, or cancer, inform the treating physician about leg cramps. These cramps won’t worsen underlying medical conditions, but the healthcare professional may be able to alleviate the cramping with medications.
How are leg cramps diagnosed?
Healthcare professionals typically diagnose the cause of leg cramps through a medical history and a physical exam. Tests are rarely needed unless another medical condition is suspected.
The healthcare professional will primarily try to distinguish whether you’re experiencing an actual muscle cramp or something else. The “cramping” may be muscle pain, nerve pain, muscle jerking (myoclonus), involuntary movements of the leg, or restless legs syndrome (RLS). All of these are symptoms or conditions that people often refer to as “leg cramps.” Some are signs of a potentially serious problem.
If the leg cramps are genuine cramps, then the healthcare provider will try to determine a cause. Be prepared to answer questions like:
Does the muscle get tight?
What activities are associated with the cramps?
When do cramps happen?
How often?
How long do they last?
What medical conditions are you diagnosed with?
What prescription and over-the-counter medications are taken?
What other symptoms do you have?
In a physical examination, the healthcare provider can’t really examine the actual leg cramps. They’re involuntary, so they can’t occur on command. Instead, the healthcare provider will examine the leg and the feet. Various pulse points will be touched, and blood pressure will be taken. Reflexes in the leg will be tested. The healthcare provider may touch or poke parts of the skin to test sensitivity. The healthcare provider may also look for signs of neurological problems.
RELATED: Restless legs syndrome treatments and medications
How long do leg cramps last?
Leg cramps are typically temporary and last for a few seconds or minutes, but can go on longer. However, even after the muscle relaxes, there may be some residual pain or soreness.
How to stop leg cramps
There is no medication that will immediately stop leg cramps. A few things might help when a leg cramp strikes:
Massage the muscle
Stretch the muscle gently
Shake or jiggle the leg
Walk around
Apply heat, such as a heating pad, or take a warm shower, to increase blood flow to the muscle
Apply ice to help relieve pain
Elevate the leg
If the cramping doesn’t go away, consider taking an over-the-counter pain reliever for the pain
Medications are rarely used as routine leg cramp treatments. None have been proven to work, but some doctors may prescribe a muscle relaxant, calcium channel blocker, or vitamin B12. Pregnant women with nighttime leg cramps may also be prescribed multivitamins or magnesium. Pain relievers may help relieve some of the pain during a long bout with a leg cramp, but they do not prevent or stop leg cramps.
RELATED: Which magnesium supplement is best for me?
Living with leg cramps
If leg cramps are a recurrent problem, a few strategies may help reduce the incidence:
Warm up and stretch before exercising
Stretch the legs after exercising
Maintain proper hydration to prevent muscle fatigue
Regularly stretch the leg muscles throughout the day, particularly calf-stretching and foot-stretching
If sedentary, do mild exercises with the legs during the day and particularly before bedtime
Keep covers loose when sleeping
Try to keep the feet pointed upright when sleeping on your back (prop the feet up with a pillow)
Try to hang the feet over the edge of the bed when sleeping on your stomach
Most importantly, know when to consult your healthcare provider
Leg cramps are very common. They are often temporary and can be caused by problems that aren’t serious. In some cases, recurrent, unexplainable leg cramps can be caused by serious conditions such as nerve damage, venous insufficiency, peripheral vascular disease, and cardiovascular disease.
If the pain is severe, interfering with sleep or daily life, or there are other symptoms, then it’s time to get medical advice from a healthcare professional.
FAQs about the causes of leg cramps
What causes leg cramps at night?
Nocturnal leg cramps are most commonly experienced by older adults and pregnant women. Neither aging nor pregnancy causes leg cramps. They are more like risk factors because they can cause other problems that may be responsible for the leg cramps.
What causes leg cramps during pregnancy?
About 50% of pregnant women will experience leg cramps at some point during the pregnancy. Healthcare professionals don’t know why. One theory is that pregnant women start having problems with the leg veins. They become less able to return blood to the heart, so the blood supply starts pooling in the legs.
What causes leg cramps in diabetics?
Diabetes doesn’t directly cause leg cramps. However, diabetes frequently causes nerve damage in the hands, feet, and legs. It is this nerve damage that is responsible for unwanted leg cramps.
What’s next? Additional resources for people with leg cramps
Test and diagnostics
Muscle cramps, Clinical Methods: The History, Physical, and Laboratory Examinations, 3rd edition
Nocturnal leg cramps, American Family Physician
Treatments
Leg cramps, Cleveland Clinic
Leg cramps, NHS
Muscle cramps, StatPearls
Nocturnal leg cramps, American Family Physician
Scientific studies and clinical trials
Leg symptoms in outpatient veterans, Western Journal of Medicine
Nocturnal leg cramps: a common complaint in patients with lumbar spinal canal stenosis, Spine
The role of serum zinc and other factors on the prevalence of muscle cramps in non-alcoholic cirrhotic patients, Journal of Clinical Gastroenterology