Charley Horse: Everything You Need to Know
Medically reviewed by Theresa Marko, PT, DPT, MS
"Charley horse" is another name for a muscle spasm. You can get a charley horse in just about any muscle, but they most commonly affect leg muscles. This spasm comes on suddenly and seemingly without reason. Though it doesn't last long, it can be quite painful.
This article explores the causes, remedies, and prevention of a charley horse, as well as the signs that you should see a healthcare provider.
andreswd / Getty Images
Charley Horse vs. Cramps: What's the Difference?
Charley horses, muscle spasms, and muscle cramps are all the same thing. They're a sudden, involuntary contraction of a muscle, which doesn't relax right away. It feels like a tight, painful knot. Sometimes, the muscle spasm forces you into an unusual position. For example, your foot or toes may curl.
A charley horse can last anywhere from a few seconds to several minutes. After severe cramping, your muscles might continue to ache for hours or even several days.
They commonly occur in the muscles of the calf (gastrocnemius), back of the thigh (hamstring), or front of the thigh (quadriceps). But they can occur in any muscle, including the feet and toes, arms and hands, abdomen, and along the rib cage.
A charley horse can even happen when you're sound asleep. Nocturnal leg cramps are common. Frequent nocturnal cramping can make it very difficult to get a good night's sleep, which can lead to other health concerns. About 40% of people who have nocturnal leg cramps have them at least three times a week.
What Causes Charley Horses?
The cause isn't always obvious. But getting a charley horse during or just after physical activity is fairly common. This is especially true when you exercise in the heat or for a long time. An exercise-induced charley horse can happen early on or after you've been exercising a while.
Other reasons you might get a charley horse include:
Muscle fatigue due to overuse, injury, or age
Imbalance of electrolytes (charged minerals in the blood, such as magnesium, potassium, or calcium)
Changes in circulation and stress on muscles during pregnancy
Sitting in awkward positions
Side effects of medicines such as statins (used to lower cholesterol)
Compression or irritation of the nerve that connects to a muscle
Not enough blood getting to your muscles
Getting dialysis, a treatment for kidney failure
Who's at Risk for Charley Horses?
Just about all adults have had a charley horse at some point. They are more likely to occur in athletes, infants, young children, and adults over age 65. Other factors that may increase risk are:
Strenuous activity
Not stretching and warming up before exercising
Pregnancy
Taking certain medications, such as statins or diuretics (water pills)
Having certain medical conditions, such as thyroid, nerve, and blood disorders
Sedentary lifestyle
Family history of leg cramps
Diagnosing the Cause of Frequent Charley Horses
Though painful and disruptive, a charley horse is usually not a cause for concern and doesn't require a medical diagnosis. However, you should see a healthcare provider if muscle cramps are frequent, severe, or last a long time, or if you have symptoms such as:
Numbness
Muscle weakness
Swelling, redness, or your muscle feels warm to the touch
Getting no relief after drinking fluids and stretching
In rare cases, muscle cramps could indicate a problem with the spine, liver, or blood vessels.
Usually, a healthcare provider will take a complete health history to include all symptoms and any medications you take. The provider will also make a diagnosis based on results from the following interventions, as needed:
Physical examination: To assess tight, hard, or tender muscles, muscle weakness, swelling, or redness
Blood tests: To check blood glucose, blood counts, kidney function, thyroid function
Imaging tests: Such as magnetic resonance imaging (MRI) to look for compressed nerves and other nerve problems
Depending on the results, your healthcare provider may refer you to a specialist such as the following:
Physical therapist: To help heal injuries, manage pain, improve function, learn proper exercise and stretching techniques, teach joint mobility techniques, manual trigger point release, and ergonomics with activity modification to help avoid tightness from prolonged inactivity
Neurologist: To evaluate nerve and muscle function
Vascular specialist: To evaluate blood flow
What You Can Do at Home for a Charley Horse
In many cases, what you can do may depend on the cause and the setting. Most cramps go away within a few minutes. In the meantime, here are some things you can try:
Stop whatever activity you're doing.
Massage the area.
Place a warm compress or heating pad on the muscle.
Take a warm shower.
Once the muscle relaxes, you can try a cold compress for pain relief. If the pain persists, you can also take an over-the-counter pain reliever.
For exercise-induced muscle cramps, you may need to rest and drink fluids. Signs of dehydration include:
Thirst, dry mouth
Light-headedness, dizziness
Fatigue, confusion
Increased heart rate and breathing
Stretches for Instant Relief
When a charley horse hits, stretching can provide quick relief. Try these stretches:
Calf: Keep your knee straight and point your foot toward the knee. Or try putting some weight on your leg by standing. If it happens during the night, sit up, wrap a blanket around your foot, and pull your toes toward you, keeping your knees straight.
Front lower leg: Stand, put your weight on your toes, and lift your heels.
Hamstring (back of thigh): Sit on the floor with legs extended. Slide your hands down your legs until you feel a burning sensation in the cramped muscle. Hold for 30 seconds and slowly return to a sitting position.
Quadriceps (front of thigh): Steady yourself with a chair and pull your foot toward your buttock.
Toes: If your toes are curled, use your hand to bend them in the opposite direction.
Medical Treatment for a Charley Horse
Muscle cramps don't usually require medical treatment. For many years, healthcare providers prescribed the malaria drug quinine off-label to treat nighttime muscle cramps. "Off-label" means prescribing a drug for a purpose or at doses other than what it was approved for by the Food and Drug Administration (FDA).
In the case of quinine, the FDA warns that the drug can cause serious side effects and is not approved to treat muscle cramps.
In severe cases, your healthcare provider may consider stronger pain relievers or muscle relaxants.
If you have a medical problem that causes cramps, treating that problem may help. For example, if you don't get enough essential nutrients in your diet, your healthcare provider may prescribe specific dietary supplements.
If your cramps are a side effect of a medication you already take, your provider may be able to prescribe an alternative.
How to Prevent a Charley Horse
You may not be able to prevent charley horses completely, but there are a few things you can do to make them less likely:
Stay well hydrated, especially before and during physical activity.
Perform daily stretches to improve flexibility.
Stretch and warm up before exercising.
Stretch your calves before going to bed.
Try to get at least 30 minutes a day of moderate-intensity exercise.
Maintain a healthy diet and take supplements if recommended by your healthcare provider.
Use mobility tools to help muscle elasticity, such as a stick roller, foam roller, knob tool, and massage gun.
Summary
Most people have a charley horse from time to time. They're often due to muscle fatigue, dehydration, or insufficient warm-up time from exercising. The risk of more frequent charley horses increases with age and certain medical conditions.
The occasional charley horse usually is harmless and is not a cause for concern. But if you have frequent, painful muscle cramps or other symptoms, it's best to see a healthcare provider to check for underlying conditions that should be treated.
Read the original article on Verywell Health.
