Have you ever experienced a “charley horse”? If yes, you probably still remember the sudden, tight and intense pain caused by a muscle locked in spasm.

A cramp is an involuntary and forcibly contracted muscle that does not relax. Cramps can affect any muscle under your voluntary control (skeletal muscle). Muscles that span two joints are most prone to cramping. Cramps can involve part or all of a muscle, or several muscles in a group.

The most commonly affected muscle groups are:

• Back of lower leg/calf (gastrocnemius)
• Back of thigh (hamstrings)
• Front of thigh (quadriceps)

Cramps in the feet, hands, arms, abdomen, and along the rib cage are also very common.

Although the exact cause of muscle cramps is unknown (idiopathic), some researchers believe inadequate stretching and muscle fatigue leads to abnormalities in mechanisms that control muscle contraction. Other factors may also be involved, including poor conditioning, exercising or working in intense heat, dehydration and depletion of salt and minerals (electrolytes).

Stretching and Muscle Fatigue

Muscles are bundles of fibers that contract and expand to produce movement. A regular program of stretching lengthens muscle fibers so they can contract and tighten more vigorously when you exercise. When your body is poorly conditioned, you are more likely to experience muscle fatigue, which can alter spinal neural reflex activity. Overexertion depletes a muscle’s oxygen supply, leading to build up of waste product and spasm. When a cramp begins, the spinal cord stimulates the muscle to keep contracting.

Heat, Dehydration, and Electrolyte Depletion

Muscle cramps are more likely when you exercise in hot weather because sweat drains your body’s fluids, salt and minerals (i.e., potassium, magnesium and calcium). Loss of these nutrients may also cause a muscle to spasm.

Although most muscle cramps are benign, sometimes they can indicate a serious medical condition.

See your orthopedic physician if cramps are severe, happen frequently, respond poorly to simple treatments, or are not related to obvious causes like strenuous exercise. You could have problems with circulation, nerves, metabolism, hormones, medications, or nutrition.

Muscle cramps may be a part of many conditions that range from minor to severe, such as Lou Gehrig’s disease (amyotrophic lateral sclerosis), spinal nerve irritation or compression (radiculopathy), hardening of the arteries, narrowing of the spinal canal (stenosis), thyroid disease, chronic infections, and cirrhosis of the liver.

Muscle cramps range in intensity from a slight tic to agonizing pain. A cramping muscle may feel hard to the touch and/or appear visibly distorted or twitch beneath the skin. A cramp can last a few seconds to 15 minutes or longer. It might recur multiple times before it goes away.

Diagnosis

During your appointment, discuss with your orthopaedic doctor your medical history, including details about allergies, illnesses, injuries, surgeries, and medications.

Your physician may ask you several questions:

• How long have you experienced cramps?
• Is there a family history of the problem?
• Do your cramps occur only after exercise, or do they happen while at rest? Does stretching relieve the cramps?
• Do you have muscle weakness or other symptoms?

As a precaution, your doctor may want to take a routine blood test to rule out diseases.

Cramps usually go away on their own without seeing a doctor.

• Stop doing whatever activity triggered the cramp.
• Gently stretch and massage the cramping muscle, holding it in stretched position until the cramp stops.
• Apply heat to tense/tight muscles, or cold to sore/tender muscles.