DEAR DOCTOR K:
Over the past few months, I’ve been experiencing severe “charley horses.” What causes them? How can I prevent them?
Almost everyone has a “charley horse” at some point in his or her life. These are muscle spasms in which a group of muscles involuntarily contracts. This causes pain and inability to use those muscles. Stretching typically stops the cramp. But you may continue to have soreness for several days.
Often charley horses develop for no clear reason. They can happen while sleeping, or they may develop if you stay in one position for a long period, as in writer’s cramp.
A variety of conditions are associated with such muscle cramps. They include:
- exercise, especially with dehydration
- kidney disease (particularly patients being given dialysis)
- low potassium (this can result from taking diuretics for treatment of either high blood pressure or heart failure)
- low calcium
- low magnesium
- hyperventilation (breathing too fast)
- hypothyroidism (underactive thyroid)
- certain medicines. These include drugs that treat conditions ranging from Alzheimer’s and Parkinson’s disease to high cholesterol, osteoporosis and asthma.
- muscle disease
If your cramps are unexplained, severe, prolonged or frequent, you should see your doctor.
Depending on the cause of your muscle cramps, you may be able to prevent them:
- If you’re getting cramps during exercise, drink water before and during exercise. This should prevent cramps due to dehydration. If drinking water alone is not enough, salt tablets or sports drinks may help replace minerals in your body.
- When you get cramps during exercise, stop your activity to stretch and massage the affected muscle at the first sign of a spasm. Use heat to relax the muscle when the spasm begins. Ice may help after the first spasm and when the pain has improved. If the muscle is still sore after heat and ice, try a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil, Motrin) or naproxen (Aleve) to help with pain.
- If you have recently started a new medicine that could cause muscle cramps, ask your doctor about switching to a different medicine or adjusting the dose.
- If you have an underactive thyroid, you should be taking synthetic thyroid hormone. This should correct many symptoms, including the cramps.
- If your potassium, calcium or magnesium levels are low, taking supplements and correcting the underlying reason for your deficiency may help.
In more severe cases, your doctor can prescribe medications to help prevent spasms. In people who get repeat cramps for no clear reason, and whose kidneys are functioning normally, I often still prescribe potassium and magnesium supplements. That’s true even if a person’s blood levels of these minerals are normal. There aren’t good medical studies of whether this practice is beneficial, but it’s been my experience that it sometimes helps.