What Is a Charley Horse?

What is a charley horse?

A charley horse is a term used when referring to a muscle cramp or spasm. Although muscle cramps can occur in any muscle in the body, they are commonly experienced in the leg. In a muscle spasm, the muscle uncontrollably contracts and does not relax. 

When the contracting muscles do not relax for several seconds, severe pain can be experienced. Having severe muscle spasms can result in muscle soreness, which can last up to a day. As long as the pain is not recurring or prolonged, these muscle spasms are normal.

Infrequent charley horses are often treated and managed at home. However, when muscle spasms are frequently experienced, medical intervention may be required to determine if an underlying medical condition causes them.

Consulting your doctor can help determine the cause of your muscle spasms along with knowing some preventive measures and treatments to help relieve the pain.  

Causes

Even though the exact cause of charley horses is idiopathic or unknown, researchers believe that muscle fatigue or overuse of muscles and inadequate stretching can lead to certain abnormal mechanisms that regulate the contraction of muscles. Other factors that might bring on muscle spasms include:

• Dehydration
• Nerve compression due to a spinal cord injury or a herniated disk (slipped disk)
• Low levels of electrolytes, such as calcium, magnesium, or potassium
• Sitting down for too long
• Standing too long on hard surfaces
• Pregnancy
• Poor blood circulation
• Certain medications, such as high blood pressure medicine, statins, and drugs for chronic obstructive pulmonary disease (COPD)
• Dialysis

Having the following conditions also increases your risk of having charley horses:

• Alcoholism
• Diabetes
• Hypoglycemia (low blood sugar)
• Hypothyroidism and other types of hormonal imbalances
• Parkinson’s disease
• Flat feet

Charley horses and upper leg spasms also often occur while kicking during swimming, running, or jumping. They can also happen when you go to bed at night. According to experts, it may be that your nerves send wrong signals to your muscles and mistakenly tell your calf muscles to move and incorrectly contract while you’re sleeping. Stress can also cause spasms in the neck. 

Who gets charley horses?

Anyone can get muscle spasms. However, they are more commonly experienced by:

• Athletes
• Older adults
• Pregnant women
• People who smoke
• People who are overweight or obese
• People who are diagnosed with nerve problems and thyroid disorders
• People who take certain medications, such as statins, diuretics, or Evista (raloxifene hydrochloride)

People who are obese are more prone to getting charley horses due to poor blood circulation. Athletes, on the other hand, are more likely to get muscle spasms because of muscle overuse or fatigue. 

Diagnosis

A medical diagnosis isn’t usually required in people who get occasional charley horses. However, for those who get recurrent or frequent muscle spasms without a clear cause must consult a doctor for further investigation.

Your healthcare provider’s diagnosis is usually based on the results of your physical examination and medical history.

An MRI scan may be ordered by your doctor to help determine if the cause of your frequent charley horses is nerve compression. Aside from this imaging scan, blood tests may also be performed to check your electrolyte levels and rule out low levels of calcium, magnesium, or potassium.

If nerve damage and other complex causes are suspected, your healthcare provider may refer you to other specialists or a physical therapist. 

Treatment

The treatment for muscle spasms usually depends on their underlying cause. If the spasms are due to exercise, massages and simple stretches can help relax the muscle and stop it from further contracting.

The relaxation process can also be accelerated by the use of heating pads. Applying an ice pack to the affected area can also help numb the pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may also be recommended by your doctor to help relieve the pain. If ibuprofen isn’t effective enough to relieve your pain, your healthcare provider may prescribe other types of pain medications.

People with severe charley horses may be prescribed with an antispasmodic drug. Additionally, physical therapy can help people cope with charley horses and prevent further complications.  

If these treatments fail, surgery may be recommended by your doctor. Surgery is performed to enlarge the area around a nerve and relieve pressure. This procedure may help, especially if the cause of your muscle spasm is nerve compression. 

Certain stretches and massages can also provide immediate pain relief when you get charley horses. During a muscle spasm, apply pressure to the affected site using your hands to help relieve the pain. You can also use both of your thumbs to gradually apply pressure to the cramp until you are relieved from pain.

The following stretches can also help relieve the pain if the muscle spasm is in your leg:

• Straightening the back of the leg that is having the cramp and lunging forward
• Stepping the leg that isn’t having the cramp forward into a lunge
• Standing on tip toe for a few seconds to help stretch the muscles on your calf
• Standing up

Prevention

Occasional charley horses can be easily prevented once you identify what causes them. The following tips can help prevent future charley horses:

• Avoid exercising in severe weather.
• Make sure to drink water throughout the day.
• Consume beverages that contain electrolytes (e.g., Gatorade).
• Consume foods that are rich in potassium, such as bananas.  
• Take multivitamins that contain zinc and magnesium. 
• Make sure to stretch before and after exercising.
• Do not train the same group of muscles on consecutive days.
• Stretch before going to sleep. 

When to See a Doctor

Consult your doctor if your muscle cramps are:

• Frequent
• Severe
• Prolonged
• Not relieved by drinking enough fluids and stretching
• Accompanied by muscle weakness
• Accompanied by redness, swelling, and warmth

Outlook

The outlook is often excellent for most people who get charley horses. Muscle spasms are often treatable, but also tend to get better with time and rest. Regularly occurring muscle spasms can be prevented by consuming enough fluids and proper exercise. 

However, medical intervention is often needed if your muscle spasms are caused by an irritated nerve. In such cases, you can discuss treatment options with your doctor. 

References

Muscle Cramps. (June 2017) https://orthoinfo.aaos.org/en/diseases--conditions/muscle-cramps

Charley Horse. (May 2017) https://medlineplus.gov/ency/article/002066.htm

Muscle Cramps. (November 2016) https://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/symptoms-of-brain,-spinal-cord,-and-nerve-disorders/muscle-cramps

Nocturnal Leg Cramps. (October 2018). https://www.uptodate.com/contents/nocturnal-leg-cramps?search=leg%20cramps&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1