Muscle cramps can range from being a slight ache to a piercing pain, and the cause of the discomfort can vary. While it’s possible that muscle cramps can be a symptom of something more serious, for most people, they’re an occasional irritation that can be avoided by following a few simple steps. 

“A cramp is an involuntary forcible contraction of a muscle that does not relax,” says Kathryn Reilly, a sports medicine specialist physician with OU Physicians Family Medicine in Oklahoma City. “Cramps can affect any skeletal muscle, but are most common in the legs and feet. Nocturnal or rest cramps occur at night and can affect sleep.”

She says rest cramps aren’t well understood but can happen when a person makes a movement, such as pointing the toe away from the head with the leg stretched out, thus shortening the calf muscle. 

Common causes for muscle cramps include vigorous activity and muscle fatigue from exercise; muscle fatigue from repetitive use or from lying in any awkward position for a long time; and dehydration – whether from environmental conditions, inadequate water intake or certain medications.  Low levels of calcium, magnesium and/or potassium in the blood can also be a culprit, caused by diuretics, vomiting, poor diet, hyperventilation or certain medical conditions involving calcium absorption. Medications used to treat high cholesterol, high blood pressure and angina, asthma, and certain prescriptions for Alzheimer’s can also increase the risk for muscle cramps. 

“There are also medical conditions that cause pain that feels like a cramp, but is a symptom of a more serious problem,” says Reilly. “Poor circulation to the legs can cause a cramping pain that goes away with rest, called claudication. Pressure on a nerve in the lower back can also cause a cramping pain in the leg – usually just one – that is made better by bending over slightly, like when pushing a shopping cart. These can be very serious problems and should be evaluated by a doctor.” 

To help prevent common muscle cramps, Reilly offers the following recommendations:

• Stretch before and after exercise;

• For activities lasting more than an hour, plan ahead and drink one to two cups of water per hour for a few hours beforehand and eat a few small, salty snacks;

• During exercise, drink small amounts of fluid every 20 minutes;

• For night cramps, stretch before going to bed. Stretch the calf muscle by standing two to three feet away from a wall and leaning toward the wall, keeping the leg straight and the heel on the ground. The stretch should be held for 30 seconds and repeated three times.

“A cramp can often be broken by forcing the muscle to stretch in the direction opposite to the cramp,” says Reilly, adding that a gentle massage of the muscle or use of a hot pack can provide relief.

To help a ‘Charley horse,’ a cramp in the calf muscle, she suggests standing on the leg for a short time. 

 “Those with frequent rest cramps can consider taking a supplement with calcium and magnesium, as well as a 2,000 IU of vitamin D, as long as they do not have kidney disease,” says Reilly.