Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 10, 2015

That tight, painful feeling has returned. The one that all athlete's fear and all women hate universally: the general cramp.


Definition & Facts

A muscle cramp, or a cramp in general, is a painful and involuntary muscle contraction. Often, the contraction will not relax by itself. During an average lifetime, at least one muscle will cramp up. Some experience many cramps in their life time - whether by exercising and overworking the muscle or from pregnancy and menstruation.

Often, the muscle can be seen contracting or it can be felt hardening in a forceful, sustained contraction that then turns into the cramp. It may recur many times before the cramp goes away completely. Common cramps are the "Charley horse" in the calf, and cramps in the feet.


There are many causes of cramps. The most common cause of any muscle cramp is overexertion during exercise, also known as a true cramp. These may appear many hours after the exercise is over, or may occur during the exercise. Another common cause is sitting or lying down in an awkward position for a long period of time.

Repetitive use of a specific muscle can also cause a cramp. An injury to a specific muscle may also result in a spasm or cramp. Doing activities that are unfamiliar to the muscles (a new work out routine, a new sport, etc.) can also cause a cramp. Dehydration - whether from increased salt intake or from excessive loss of fluids from sweating - can increase the risk of a cramp happening.

Sodium loss could also help exacerbate a cramp. If on a medication that increases the volume of urine produced and the liquids are not replenished fast enough, cramps can happen. Other causes can include:

When to see a doctor

Many cramps can be fixed at home. However, there are certain conditions that require a visit to the doctor. For a leg cramp, for example, these include a cramp that appears when walking or using the legs, but goes away after rest.

This could be a sign of a condition called claudication: the narrowing of blood vessels in an area of the body. This could be a life threatening condition as it could mean that claudication is also happening to the vessels that supply the brain, the heart, or both. For women, menstrual cramps are not uncommonly heard of.

A menstrual cramp warrants a visit to the doctor when it disrupts the woman's life every single month - IE it is too much to handle, even with over the counter medications. If a woman older than 25 starts to experience menstrual cramps, a doctor's visit is warranted. Symptoms of menstrual cramps that get worse over time also warrant a visit to a doctor's office.

Treatment & Therapy

A muscle cramp can be easily fixed at home. One of the best ways to do this is to simply stretch the muscle gently. For a leg cramp, this could mean bending the knee so that your foot touches your calf and back again to work it out. For a hand cramp, it could include making a fist and relaxing the hand.

Other ways to treat a muscle cramp include pressing a hand against the wall with fingers face down, pulling toes towards the head while in bed with the leg as straight as possible, and massaging the cramp. The massage is meant to quickly help relax the muscle that refuses to contract. Heat can also help relax a cramped muscle. Medicines do not often help with a spontaneous cramp. The cramps can go away as spontaneously as they came, and often do so before enough of the medicine would have been absorbed to help loosen the cramp up.

Replenishing sodium, potassium, and magnesium is another treatment that helps when a cramp pops up. This helps when the cramp is caused by exercise. Medicines for extreme cramping can be prescribed after a doctors visit, and can include cyclobenzaprine, baclofen, and botulinum toxin. The botulinum toxin is used to help with dystonic muscle disorders - which are often limited to a specific set of muscles.

It's considered a success if the patient can go a few months before the botulinum toxin needs to be injected into the area again. If a medicine has to be prescribed, it's more often for the underlying cause of the cramp then the cramp itself.

Prevention & Prophylaxis

Hydration is one of the key things to remember when preventing cramps. This means that not only is the person drinking enough water, but there is some way to replace the electrolytes being lost. Sports drinks - though high in sugar and calories - often contain sodium and potassium, if not magnesium as well.

Replenishing sodium and potassium are the priorities when replenishing electrolytes. Bananas are a good way to replenish on potassium, as are the peels. Yes, banana peels can be eaten, but should be fried and cleaned well before they are eaten. Stretching the muscles and doing warm up and cool down exercises during exercise blocks are also worth doing to help prevent cramps.

These warm up the muscles, and help them come down from all the exercise that has been done. All of this is worth considering if the exercise block exceeds an hour, but even if it doesn't exceed an hour, it is important to keep muscles well fed and hydrated. Pre-exercise hydration and replenishment is particularly important during hot weather (such as in the summer) to help prevent muscle cramps. Excess fatigue is not recommended, as it can exacerbate cramps - especially in hot weather.

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