Charley Horse: Symptoms, causes and treatment

Leg cramps can cause discomfort during the day as well as night. But if you are mostly experiencing leg cramps at night, it may be due to charley horse.

Leg cramps at night can be so painful that they can cause sleep disruptions. The sharp pain, which last for just a few minutes, can be mostly felt in the calves and feet. Charley horses are the involuntary contractions of leg muscles, especially during nighttime. These occur without any warning. People who are over 60, athletes who overuse their muscles, or exercise without adequate warm-up, tend to have these cramps more. Read on to know the symptoms and causes of charley horse, and what you can do to get relief from pain.

What is charley horse?

Charley horse is the uncomfortable involuntary leg cramps or spasms or muscle twitching that some people experience, especially at night, says orthopaedic surgeon Dr Simon Thomas. There is no definite reason why they occur mainly at night. It may be due to sudden signals from the brain and a mismatch between the signal and muscle activity. You may experience pain in your calf, thigh or foot muscles. The cramps generally go away on their own in 10 minutes or less, according to a research published in the Cochrane Database of Systematic Reviews in 2021.

Woman with leg pain
Charley horses mostly strike at night. Image courtesy: Freepik

What are the symptoms of charley horse?

The muscle spasms occur without any warning and frequency can be few days, week, months or years. Here are some symptoms –

  • People with charley horse typically have severely painful spasms in the legs more so at night. It usually wakes them up from sleep and is a very uncomfortable feeling to have.
  • You may observe gentle twitching beneath the skin of calves. It may affect one side, but more commonly, both sides are involved. The twitches usually subside spontaneously, but sometimes they are sustained and continue for long, affecting sleep.
  • The affected muscle (for example calf muscle) feels squeezed and contracted like a tight knot.

What are the causes of charley horse?

Most of these cramps are idiopathic, which means the cause is unknown, explains knee and hip surgeon Dr Jay Shah. But some of the causes are –

  • Dehydration
  • Lack of vitamins or minerals
  • Stress
  • Poor posture
  • Cholesterol lowering drugs
  • Overuse of muscles while playing a sport or workout

Such muscle cramps are more common in people with diabetes, liver disease and thyroid problems. Heat stroke or prolonged sun exposure may also cause severe muscle twitching.

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Elderly people are generally at greater risk because the tendons are short, says Dr Shah. Pregnant women are also commonly affected perhaps due to the increased inflammation and weight during pregnancy. People with low water intake also tend to be affected more often.

Woman massaging her legs
Elderly people have higher chances of experiencing charley horses. Image courtesy: Freepik

How to treat charley horses?

Applying heat to the affected area can help with charley horses. Here are some more ways to do away with the pain even if lasts for a brief period of time.

1. Stretching

Immediate relief occurs spontaneously or by gentle stretching. To do stretching, start by pulling your toes and ankle towards your body. Hold this position for 10 seconds and then relax. Do it 10 to 15 times at a time.

2. Pain killers

Sometimes, pain killers and muscle relaxants are required for more severe pain for three to four days. They reduce inflammation, and provide rest to the calf muscle, relieving the spasm, says Dr Thomas.

3. Vitamin E

Long-term relief can be provided by Vitamin E and Levocarnitine preparations if the condition is chronic and recurrent. These may be taken twice a day for approximately two months or as prescribed by your doctor.

You may need to consult your doctor if it does not resolve even after trying these tips.