What Causes Muscle Cramps…….and What to Do When They Strike

By John Voelz

Doctor of Physical Therapy


Night leg cramps are painful, involuntary spasms and contractions of certain muscles in your legs. Often nocturnal leg cramps, also known as “Charlie Horses,” come on suddenly at night while in bed. Mostly found in the calf muscles and the hamstrings, cramps can be a reoccurring event that becomes very disruptive. More than 50% of older adults experience muscle cramps, and in many cases they happen at least three times per week.



Dr. Amsler, Dr. Boode, and I are often questioned about how leg cramps occur, how to get rid of one, and more importantly, how to prevent them from happening in the first place. 


What Causes Muscle Cramps??

The short answer is that nobody is completely sure what causes them. Muscle tissue does not often act independently. The nerves that attach to muscle cells are usually to blame for what goes on with the muscle. Nerves are the power lines that run from your spinal cord ultimately to each individual muscle fiber. An “electro-chemical” impulse that travels the length of the nerve eventually causes each muscle fiber to shorten, resulting in a complete muscle contraction. The electro-chemical signal traveling the nerve path is a flow of “electrolytes.” In the case of nerve signals, these are mainly sodium and potassium. If there is an imbalance or disruption in the electrolyte action, nerve signals are affected, and the muscle tissue may cease to function, or it might function erratically.



Medical science is trying to learn more about what specifically causes random muscle cramps, especially the kind that come on while you’re lying in bed (there is a different type of muscle cramping that is due to poor blood circulation, but we’re not talking about that kind).


Most of the research and anecdotal reports points to a combination of factors that can lead to muscle cramps. These include dehydration, electrolyte imbalances, vitamin and mineral depletion, and muscle fatigue. There are probably other factors that have not been identified, but these conditions alone or combined may be capable of disrupting the nerve signal enough to “agitate” the muscle and cause it to spasm forcefully and painfully.


Certain common medications can also cause cramps. The diuretic furosemide (Lasix) is one example. Other medications include Aricept, Evista, nifedipine, albuterol, and lovastatin. Medical conditions that result in nerve compression, such as stenosis can produce cramping pain in your legs. Diabetic neuropathies can sometimes cause muscle cramps as well.


Treating an Acute Muscle Spasm

Let’s start this section by reviewing exactly what NOT TO DO when you feel a knotting muscle cramp. Further shortening of the muscle will only make things worse. For example, if you feel knotting in your calf muscle, do not point your foot down — this will shorten the calf muscle further and compound the spasm. The best thing to do is to reach down, grab your toes/foot and pull back, stretching the calf. The stretch should release the spasm. Maybe you’ll have to use a towel or have someone help. Firmly massaging the spasm will also help to relax the muscle.



Preventing Muscle Cramps

The exact cause of muscle cramps is vague, and so are the means of preventing muscle cramps. Some research has uncovered success with medications such as quinine, and also the blood pressure medication diltiazem. Non-prescription supplements have been shown effective in preventing muscle cramps. These include the following (and always remember to check with your doctor before taking supplements):


-Vitamin B Complex



-Vitamin E



So in reality, a good multi-vitamin may be an effective and safe alternative. Other ways to possibly prevent muscle cramps is to maintain good hydration and electrolyte balance. Drinking Gatorade/G2 regularly might, in this respect, be a good idea. Finally, regular stretching exercises for the involved muscles could be useful. Finding what works for you may, in the end, be the best strategy. Asking your doctor might give some direction as well.


Click on the picture below to check out a video with more information on muscle cramps
















John VoelzWhat Causes Muscle Cramps…….and What to Do When They Strike

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