Feb 20, 2007 By Martha A. Simpson, D.O. Professor Of Family Medicine 4 min read

Question: What causes really bad leg cramps? I am in my mid-thirties and in good health. I am not overweight and I exercise. I thought only old people got these. Should I worry? Should I be taking medications for this? They happen a couple of times a week. My mother says “Charlie-horses” are normal. Answer: A muscle cramp is an involuntary contraction of a single muscle or a group of muscles. They are more common as you get older, but can occur at any age. Almost everyone experiences muscle cramps at some time in their life. The leg is a frequent location, but they can occur in any muscle.

After you’ve had a cramp, the affected muscle is usually tender. Many people feel that calf muscle cramps are “normal” since they happen so often. Frequently, there is no obvious cause for a calf muscle cramp.

Usually, muscle cramps last only a few seconds. Sometimes, though, they can continue for more than 15 minutes. Once you have an episode, it’s common to experience recurrences. Cramps can follow an injury to a muscle group, or they may occur during an activity without any apparent injury.

Overusing a muscle group leads to muscle fatigue, which can cause cramps. You often see this during an athletic event when a player falls down for no apparent reason and comes back into the game a few minutes later after the cramp as been attended to by the training staff.

Many people have leg cramps at night. This is common in older adults and can disrupt sleep. The exact cause is not known.

If you get dehydrated due exposure to extreme temperature or vigorous exercise, you might get muscle cramps. In these cases, the cramp can be the result of the loss of sodium or the loss of fluid. Patients undergoing kidney dialysis are prone to muscle cramps if their potassium gets low, and pregnant women get leg cramps from low calcium or magnesium.

Bad circulation in the legs does not generally cause cramps in the legs, but instead produces pain in the legs with activity. This type of muscle pain, however, can be difficult to distinguish from muscle cramps.

The treatment for leg cramps is to treat the underlying cause if it can be found. Fluid replacement, electrolyte replacement, and decrease in certain activities can eliminate cramps. At the time of the cramp, stretching and gently massaging the muscle may help to relieve the spasm.

For most common muscle cramps, prevention is the best treatment. Depending on the cause of your cramps, there are several steps you can take that might help prevent or lessen future episodes. Be sure to get adequate amounts of appropriate fluids – plain old water is usually best. Also, make sure you are getting enough calcium and magnesium. If you’re having nighttime cramps, try doing a stretching exercise before you go to bed. If your cramps are activity related, a pre-workout stretch and a cool-down period before you head to shower can be beneficial. Some people say vitamin E is helpful.

The good news is that common muscle cramps are not usually the first symptom of a serious medical problem. They are just annoying. Of course, if you are concerned, or have a chronic medical condition, you should discuss your cramps with your family physician.

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Family Medicine(r) is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to begin readerquestions@familymedicinenews.org readerquestions@familymedicinenews.org end

. Medical information in this column is provided as an educational service only.

It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions.

Past columns are available online at www.familymedicinenews.org.