The Best Ways to Handle Muscle Cramps


Muscle cramps. Charley horses. Muscle spasms. No matter what you call them, those twitches are downright annoying — not to mention painful — especially when they hit during your workout or when you’re sleeping.

Here’s what you need to know about cramps and how to deal with them when they strike.


A muscle cramp is an involuntary and forceful contraction of a muscle. These can last as little as a few seconds or as long as 15 minutes — and they commonly strike in the thighs, calves, foot arches, arms, hands, abdomen and along the rib cage, according to the Cleveland Clinic.

Despite their name, muscle cramps are not a muscle problem, they’re a nerve problem, says Dr. Scott Garrison, an associate professor of family medicine at the University of Alberta who’s conducted research on nocturnal leg cramps.

Your muscles only contract when your nervous system tells them to, and it sends this message to the target muscle (or muscles) via nerve cells called motor neurons. When your nervous system fires these motor neurons faster than usual, you wind up with muscle cramps.

“We can’t tell you exactly why the nerves do that, but it’s the nerve that’s at fault, not the muscle,” Garrison says.

There are two common types of muscle cramps: nocturnal and exercise-associated.

Though nocturnal and exercise-associated muscle cramps look and feel similarly, their triggers differ.

As the name suggests, nocturnal cramps happen during the night (usually when you’ve been asleep for a period of time) and typically hit the calves. “The trigger appears to be the longer that you are immobile, the more likely you are to cramp,” Garrison says.

Meanwhile, exercise-associated cramps have exactly the opposite trigger; they hit when you overexert yourself or when you exercise in hot weather.


Nocturnal cramps can strike anyone (one study reports up to 60% of adults have experienced nocturnal leg cramps), but some people are more prone to them than others, Garrison says. Namely, pregnant women, children, people with nerve disorders and people over 50 years of age (up to 33% of the over-50 crowd is affected by nocturnal leg cramps, according to research published in BMC Family Medicine).

Interestingly, research also shows nocturnal leg cramps may be seasonal: Cramp symptoms in the peak of summer are roughly double what they are mid-winter. Though researchers don’t yet know why, Garrison — who was the study’s principal investigator — speculates it may be that nerves are trying to regrow to make up for lost neurons. “It’s conceivable that human physiology has some seasonality to it, and maybe we do more growth and repair in the summer when resources are generally more plentiful,” he says.

Though you can’t do much about your age or many other factors that make you prone to cramping, there are steps you can take to minimize their occurrence.

For example, certain medications can boost your odds of experiencing nocturnal cramps. “The most useful thing for trying to stop cramps is looking to see what medications you’re on,” Garrison says.

The two biggest culprits are beta agonists (commonly used to treat asthma and chronic obstructive pulmonary disease) and a blood pressure medication known as potassium-sparing diuretics. If you’re bothered by nocturnal cramps and you currently take either type of medication, Garrison recommends talking to your doctor to see if you can switch to something else.

Other medications that have strong ties to leg cramps include naproxen (e.g., Aleve), intravenous iron sucrose (used to treat iron deficiency anemia in patients with chronic kidney disease), conjugated estrogens (a prescription used to treat symptoms of menopause), raloxifene (used to treat and prevent osteoporosis and decrease risk of developing invasive breast cancer in postmenopausal women) and teriparatide (another osteoporosis medication), according to a 2012 study in American Family Physician.

In general, stretching before bed is unlikely to help, Garrison says. That said, one study in the Journal of Physiotherapy found stretching before bed reduced the frequency and severity of nocturnal leg cramps in adults over the age of 55. However, anecdotal evidence suggests a few minutes of easy exercise (i.e., a quick session on a stationary bike or treadmill) may relieve nocturnal leg cramps.

Quinine, an effective treatment for malaria, may also reduce cramps, but due to potential health risks, the FDA has advised U.S. physicians against prescribing it for muscle cramps.

If you don’t find relief from nocturnal leg cramps, see your doctor who may be able to offer alternative suggestions or identify an underlying issue that’s causing or contributing to your nocturnal leg cramps.


Stretching before exercise probably won’t prevent cramps from hitting mid-workout, Garrison says. “Having said that, stretching while you are cramping is highly likely to stop the cramp.”

So if a cramp strikes during your workout, your best bet to get rid of it is to stretch the muscle, “which, unfortunately, is the exact opposite thing that you want to do, because it hurts to do that,” Garrison says.

There are also a couple of things you can do to try to prevent muscle cramps from happening at all. First, as exercise-associated muscle cramps often occur as a result of overexertion, watch your workout intensity — especially if you’re prone to cramping.

Dehydration may also make you more prone to mid-workout muscle cramps, especially if you’re exercising in the heat. Be sure to drink plenty of fluids throughout the day and even more while you’re exercising.


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