May 04, 2017

Got a Charley Horse?

Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.

Have you ever had a charley horse? You know the muscle cramp in your calf that makes you jump straight out of bed. Why do they occur? Is it a deficiency in magnesium, calcium or potassium? Could it be your medications or a sign of a deeper problem?

According to recent research, about 1 in every 3 adults is affected by muscle cramps of the lower limbs. In most cases the pain is temporary and goes away on its own. Some people have severe regular cramping that interferes with sleep, daily activities and quality of life.

In a study of 500 people over 60 years old, 31 percent reported being woken up by muscle cramps and 15 percent had cramps more than 3 times each month.

The most common situation for cramps to occur are during exercise, at night time (especially in the elderly), during pregnancy, in those with neurological diseases and during kidney dialysis.

We really have no exact trigger to point to as the root event, but it has been shown the muscle contracts due to rapid nerve firing up to 150 times per second. So the problem is not the muscle, but the nerve firing that muscle. And why is it usually the calf muscle? I can’t find an answer to that question at all.

If you have regular cramps like these, look to any medications you may be taking first of all. Statins are a common offender, as are ACE inhibitors (blood pressure pills), some asthma drugs, and diuretics are among the many that can cause cramps.

Other factors that can cause cramps are poor blood circulation in the legs, muscle fatigue, dehydration and mineral deficiencies.

Magnesium deficiency is common in Americans, with estimates showing 80 percent are not getting enough. A key sign of low magnesium is regular cramps in the legs. Low magnesium in the presence of high calcium levels is a problem that is common in Americans. Most American diets average 3.5 to 1 in calcium to magnesium ratio; it should be closer to 1 to 1.  This scenario can cause any muscle to go into spasm randomly. This is why I rarely recommend anyone take more calcium supplements. We get enough in our diet.

Low potassium can also trigger cramps. Only 2 percent of adults get the RDA of 4,700mg of potassium each day. It is found in fruits, vegetables, dairy, salmon and nuts. Low potassium is common and exacerbated in people with malabsorption syndromes like Cohn’s or those taking heart medications.

Too little calcium is also a cause of cramps. Low calcium increases the excitability of nerve endings and then the muscles they stimulate. Those at risk of low calcium are pregnant women and the elderly.

Getting rid of a charley horse is no exact science, but stretching the toes upward is the most commonly used tactic to ease the pain after it starts. Soaking in Epsom salts has been shown to have some preventive and relief effects. Massaging the area with heat will increase blood flow and soothe the pain.

As you can see, it’s hard to tell where your cramps are originating, so you need to assess those areas one by one. Eat a balanced diet, stay hydrated …and don’t get old or pregnant.