Are Charley Horses Keeping You Awake at Night? Here, Experts Explain Why

Are Charley Horses Keeping You Awake at Night? Here, Experts Explain Why

Being jolted awake by an unexplained, unrelenting leg cramp is its own special type of nightmare. Then there’s the annoyance of one popping up mid-workout—even after you stretched! These cramps, also known as charley horses, seem to happen at random, so what gives? Experts say there are a few known causes of charley horses, but their prevalence and severity vary from person to person. Keep reading to learn more about why they happen and how to prevent the inconvenient, stubborn pain from sneaking up.

What is a charley horse?

A charley horse is simply another name for a muscle cramp or spasm, says Dmitriy Dvoskin, M.D., a doctor dual board-certified in pain management and physical medicine and rehabilitation who practices at Pain Management New York City. He adds that the cramp is “a temporary, yet intense spasm felt when the muscle involuntarily contracts.” It most often happens in the legs, but can happen anywhere in the body, adds Melissa Prestipino, D.P.T., a physical therapist and certified personal trainer practicing in Sparta, NJ.

Why is the sensation so painful and swift? You can thank your brain for sending improper signals. “Normally, when we contract our muscles, a signal from the motor cortex in our brain is sent to the muscle that instructs that muscle how to contract,” explains Karen Litzy, P.T., D.P.T., a physical therapist in New York City. During a charley horse, an involuntary signal is sent to the muscle without the “proper instructions,” she says, and as a result, the muscle fibers shorten and contract too hard. “A danger signal is then sent to the brain from the muscle area and the brain may perceive it as dangerous enough to cause pain,” she adds.

Depending on the cramp’s intensity, Dr. Dvoskin says it’s normal to feel a knot in the affected area after the pain self-relieves.

What causes a charley horse?

Although some charley horses happen without a known cause, says Dr. Dvoskin, some common contributing factors are medication (particularly cholesterol-lowering statins and blood pressure-reducing diuretics), dehydration, low electrolytes, malnutrition or deficiency in certain vitamins and minerals like calcium or potassium, and muscle overuse. People who are pregnant, have experienced a stroke, have hypothyroidism or neuropathy, or are overweight are also more prone to charley horses. Prestipino adds that those who smoke and have poor blood circulation are more likely to cramp easily.

Charley horse treatments and prevention

According to Dr. Dvoskin, Prestipino, and Litzy, there are a few measures you can take to prevent cramping:

  • Stretch before bed

  • Make sure your bedsheets aren’t tightly tucked towards the bottom of the bed, so you can freely move and flex your feet

  • Stay hydrated

  • Talk to your doctor about magnesium supplements (which have been found to help pregnancy-related cramping)

If you find yourself stuck in a cramp that won’t self-relieve, Litzy recommends applying pressure to the area and walking around if it’s in the leg. “You can also gently stretch the affected muscle while slowly breathing in and out,” she adds.

When to see a doctor about charley horses

Dr. Dvoskin advises seeing a doctor if you experience charley horses while taking a statin or diuretic medication, or if you’re having frequent or severe cramps. “If you notice that the charley horses are associated with decreased sensation in the lower extremities and/or increased back pain, it can be a sign of nerve damage and should be evaluated by a physician,” he adds.

If your cramps don’t improve with exercise, hydration, or massaging the muscles, Prestipino says you should seek medical care, adding: “If the charley horse is accompanied by fever, leg swelling, trouble breathing, nausea or vomiting, or change in the temperature or color of skin, you should see a doctor.”

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