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Muscle Cramps

Tips to relieve the pain


Whether they occur while exercising or in the middle of the night, leg cramps are painful. Learn what causes muscle cramps and how to ease the pain.

In the Netherlands a charley horse is called an ijsbeen (ice leg); in France it is a béquille (crutch); in Portugal they call it a paralitica (the paralyzer). And Italians refer to it as a vecchia (old woman). But no matter what it’s called, a muscle cramp is never fun.

Prolonged muscle contraction

Your muscles are the engines that your body uses to propel and move. And just like engines, they turn energy into motion. Muscles work very differently from a gas or electric motor but share one thing in common—they can also seize up. When your car seizes, we call it a stall. When your muscles freeze, it’s a cramp.

When a muscle involuntarily and forcibly contracts and will simply not relax for what seems to be an eternity, it creates an acute debilitating pain that can make you plead for mercy.

Types of muscle

Keep in mind that there are three types of muscles:

  • smooth muscle (found within the walls of organs)
  • cardiac muscle (found in the heart)
  • skeletal muscle (the ones that move you)

What causes a muscle cramp?

The skeletal muscles are the ones that typically cramp. Most sports science literature and research supports the idea that skeletal muscle cramps happen during exercise. If you were to extend your foot with your toe pointed and kept extending it further and further, you could cramp your calf. When muscles are shortened like this, they are also repeatedly stimulated.

Exercise-induced cramps

You may also experience a cramp if you run on your toes or do a lot of toe raises without allowing your calf to return to a flat step or extended position. A cramp may also happen in your “ribs” (it’s really happening in your diaphragm) when you run and don’t breathe rhythmically or deeply enough.

What causes them

In both of these cases the nerves carry signals to the central nervous system from the muscle. The nerves also carry contraction signals from the central nervous system back to your calf or your diaphragm, creating what’s called the reflex arc. This then leads to a sustained contraction in the muscle, which you feel as a cramp.

How to ease a cramp

Almost everybody has experienced a muscle cramp at some time in their life. The bad ones are hard to forget. Most can be stopped if the muscle can be stretched. When it comes to relieving exercise-induced cramps as in the examples above, grab your toe and stretch the calf. Breathing more rhythmically and deeply is another successful way to break the reflex arc signal to stop the cramp.

Nighttime leg cramps

Along with exercise-induced cramping, nighttime (or nocturnal) cramps are very common. These notoriously painful and sudden spasms or tightening of muscles in the calf, thigh, or foot often occur as you fall asleep or wake up. They last seconds and sometimes a dreadful few minutes.

What causes them

Science hasn’t yet figured out exactly what causes this type of cramping. Getting too much exercise or overusing the muscles and standing on hard surfaces for long periods of time can predispose you to them. Sitting for a long time, or putting your legs in awkward positions while you sleep, may also cause cramping.

Mineral deficiencies

Another reason for cramping may be not getting enough potassium, calcium, and magnesium in your diet. Sources of potassium include potatoes, raisins, bananas, spinach, Swiss chard, and coconut water. Magnesium-rich foods include almonds, spinach, Swiss chard, wheat bran and wheat germ, soybeans, and oatmeal.

Supplement with magnesium

It is also relatively safe to supplement with magnesium. Combining both calcium and magnesium together in a 1:1 ratio or, if possible, a supplement of 2 parts magnesium to 1 part calcium can help. If you supplement with too much magnesium it can lead to loose stools or diarrhea. Check with your health care practitioner to determine the correct dosage for you.

Vitamin deficiencies

Although it is not entirely understood why, being vitamin deficient in thiamine (B1), pantothenic acid (vitamin B5), or pyridoxine (vitamin B6) will also cause cramping, particularly during pregnancy.

Stretch to prevent cramps

Ride a bike, or exercise bike, to condition and stretch your muscles. Always stretch your muscles for a few minutes before you go to bed to help prevent the onset of a nighttime cramping episode. But sometimes cramps are just plain unavoidable. And when it’s your child up in the middle of the night whimpering, you can end up feeling helpless.

Other ways to ease cramping

Some say a warm bath helps, others prefer to rub the area with an ice pack. But one of the most effective immediate natural solutions that I recommend in my clinical practice, and have had personal experience with, is what I call “cold water marching.” Combined with castor oil and an Epsom salts wrap, it provides effective relief of cramping (see below).

Most other types of cramps can be prevented by measures such as adequate nutrition and hydration, and attention to good form when exercising. Some cramps are caused by prescription medications (see below).

Whatever the cause, many natural solutions can serve to remedy them. Not all will respond to the same intervention due to the varied types and causes of muscle cramps. 

Drug-induced muscle cramps

It is important to be aware that certain drugs and their side effects are the cause of some muscle cramps. These medications are all known to cause cramps:

  • nifedipine (Procardia) used for angina and high blood pressure
  • furosemide (Lasix), a potent diuretic, may cause the loss of potassium, calcium, and magnesium
  • donepezil (Aricept) used for Alzheimer’s disease
  • neostigmine (Prostigmine) used for myasthenia gravis
  • raloxifene (Evista) used to prevent osteoporosis in postmenopausal women
  • tolcapone (Tasmar) used for Parkinson’s disease
  • lovastatin (Mevacor) and other medicines used to lower cholesterol
  • terbutaline (Brethine) and other drugs used to treat asthma

Seeking help won’t cramp your style!

A registered massage therapist (RMT) can be a great help to someone who experiences cramping. An RMT can help to relax your muscles and promote proper circulation. But if you are experiencing chronic cramping that is very severe, it is necessary to talk with your health care practitioner. These may be symptoms of another problem.

Cold water marching

  • Fill the tub with 3 in (8 cm) of freezing cold water and gently march up and down for one minute.
  • Step out, stretch for one minute, and repeat three times.
  • When complete, apply a rag soaked in 10 parts castor oil to 1 part Epsom salts to affected area; wrap with towel.
  • Go back to bed or lie flat for 20 minutes.


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Matthew Kadey, MSc, RDMatthew Kadey, MSc, RD