What Causes a Charley Horse and How to Get Relief

author avatar Dr. Eric Berg 05/12/2024

Charley horses are painful, sudden muscle spasms in the legs and feet that often strike at night. But what causes a charley horse? 


While mineral deficiencies are a common trigger for leg cramps, other factors, such as an alkaline blood pH, obesity, and diabetes, may also cause muscle spasms.


Learn what triggers a charley horse and discover how to manage and prevent muscle cramps. 


Calf muscle pain

What is a charley horse? 


Charley horses are muscle cramps that commonly affect the thigh, calf, or foot, though they can occur in any muscle. 


Muscle cramps are characterized by the involuntary, sudden tightening of muscle fibers that lasts from a few seconds to multiple minutes.


These muscle spasms are widely known as nocturnal leg cramps, as a charley horse occurs mostly at night. Although these cramps can be extremely painful and cause muscle soreness, they’re generally harmless and can typically be managed at home.


In severe and persistent cases, healthcare providers may prescribe pain medications and muscle relaxants to manage muscle cramps. 


Watch the video below to learn more about muscle cramps and spasms.

Muscle Cramps & Spasms

What triggers a charley horse?


Though doctors are unsure of the exact cause of muscle cramps, they are closely associated with dehydration. 


Lack of adequate bodily fluids due to insufficient water intake or excessive sweating can lead to electrolyte imbalances


“An electrolyte is a mineral that helps muscles contract and relax,” explains Dr. Berg. “The main electrolytes linked to the development of charley horses are potassium and magnesium.”


Additionally, reduced blood flow to muscle tissue can trigger cramps. This is most commonly linked to conditions that cause the arteries to narrow, leading to poor blood circulation in the legs.


Nerve compression is another potential cause of muscle cramps, as trapped nerve endings can cause impaired muscle function. 


Leg cramps at night may also be linked to excessive muscle use during the day, an awkward sleeping position, or certain medications that can interfere with electrolyte balance.


Foot pain

Charley horse risk factors


Electrolyte deficiency due to sweating, inadequate hydration, or poor dietary habits is the primary risk factor for muscle cramps.


Electrolyte minerals, including potassium, magnesium, and calcium, are vital for muscles to contract and relax, and muscle cramps are among the first symptoms of electrolyte imbalances. 


Sodium is another crucial electrolyte for muscle function, and a low-sodium diet or salt deficiency can increase the risk of leg cramps.


Other risk factors linked to charley horses include:

  • Age

  • Poor vascular health 

  • Type 1 or type 2 diabetes 

  • Alkaline blood pH 

  • Vitamin E deficiency 

  • Obesity 

  • Medications to manage high blood pressure 


Additionally, pregnant women appear at increased risk of charley horses. This is likely caused by pregnancy-related weight gain, which can strain muscles and cause leg cramps. 


A study published in StatPearls found that approximately 50 percent of pregnant women experience leg cramps at night or in the final three months of pregnancy. 


Woman with a leg cramp

Tips for Charley horse relief   


Though most leg cramps only last a few seconds, spasms can cause severe pain and lingering muscle fatigue. Fortunately, there are steps you can take to relieve muscle cramps. 


Here are four tips for fast charley horse relief.


1. Massage the affected muscle

Massaging a cramped muscle can help release tightness, stretch the muscle, and shorten the duration of the spasm. 


Using your hand or a massage tool to rub the muscle causes friction, which improves blood flow to the area. Optimal circulation relaxes tight or stiff muscles by supplying fresh oxygen. 


2. Apply heat

A hot bath or heating pad can help soothe a muscle spasm by increasing blood circulation and reducing stiffness. 


A warm Epsom salt bath can also help relieve pressure. Epsom salt contains magnesium that can be absorbed through the skin, which helps reduce pain, soothe soreness, and support muscle relaxation. 


3. Stretch your legs 

A muscle cramp can occur from sitting for prolonged periods, and standing to stretch the muscle gently may help relax the contraction. 


A simple stretching exercise involves standing on your tiptoes and alternating between lifting and lowering your heels to the floor.


4. Take a walk

Walking at the onset of a muscle cramp enlarges the arteries in the legs, which enhances blood and oxygen flow to leg muscles. Shaking your leg while walking may also signal the muscles to relax.


Electrolyte powder

Charley horse prevention 


Muscle cramps can be debilitating, but various home remedies may help prevent or reduce the severity of a charley horse.  


Here are five natural ways to support healthy muscle function.


1. Electrolytes

Potassium and magnesium help stimulate muscle relaxation after contracting, which explains why mineral depletion can lead to charley horses. 


While magnesium, potassium, and other electrolyte minerals can be obtained from various whole foods, an electrolyte powder supplement is a convenient way to promote balanced electrolyte levels. 


Opt for an electrolyte product high in potassium to maintain optimal muscle function and prevent charley horses.


2. Vitamin E

Vitamin E is a powerful antioxidant that repairs damaged cells and protects muscles from oxidative stress caused by free radicals. 


Oxidative stress is caused by an imbalance of antioxidants and free radicals and has been shown to increase the risk of muscle cramping.   


Research published in the American Journal of Therapeutics found that vitamin E supplementation reduced muscle cramps by nearly 70 percent in those receiving hemodialysis, a treatment for kidney failure or end-stage renal disease (ESRD). 


Apple cider vinegar

3. Apple cider vinegar

Blood pH that’s too alkaline can cause muscle cramps, twitching, and spasms. A balanced pH is also vital to absorb electrolytes needed for normal muscle function.


Apple cider vinegar (ACV) contains acetic acid that helps regulate the pH of bodily fluids, which explains why it can improve leg cramps. 


It’s recommended to dilute two tablespoons of ACV in eight ounces of water and drink an hour before bed to acidify the body’s pH and lower the risk of nocturnal leg cramps. 


4. Pickle juice

Pickle juice is another excellent source of acetic acid, which has been shown to activate nerves in the back of the throat that alleviate muscle cramps.


A study published in Medicine and Science in Sports and Exercise found thatPickle juice inhibits electrically induced muscle cramps. The rapid inhibition of cramps reflects a neurally mediated reflex that originates in the oropharyngeal region and inhibits the firing of alpha motor neurons of the cramping muscle.”


5. Quinine

Quinine, an alkaloid compound derived from cinchona bark, has been used to relieve charley horses for decades, and many studies have pointed to its effectiveness in managing muscle cramp severity.


A study published in the International Journal of Clinical Practice found that quinine supplementation prevented nocturnal leg cramps in 80 percent of participants without significant side effects.   


Runner with a leg cramp

Key takeaways


Charley horses are muscle cramps that often occur in the legs at night. But what causes a charley horse? 


Nocturnal leg cramps can be caused by electrolyte imbalances, inadequate blood flow, nerve damage, or certain medications.


However, various remedies can help prevent leg cramps, including potassium, magnesium, vitamin E, and quinine. In addition, massaging, stretching, and applying heat may shorten the duration and severity of muscle spasms. 



FAQ


1. Is a charley horse the same as a leg cramp? 

Yes, charley horse is a term widely used for leg cramps. Charley horses are sudden, painful muscle cramps that occur in the thigh, calf, or foot but are otherwise harmless.  


2. What triggers a charley horse?

Charley horses have various causes, including dehydration, improper blood flow, or nerve compression linked to medical conditions such as diabetes. 


In addition, diuretics may also contribute to leg cramps as they trigger excess fluid loss and electrolyte imbalances linked to poor muscle function.   


3. How do you relieve a charley horse naturally?

Massaging the muscle cramp, applying heat, stretching, and walking can help relieve a charley horse. 


Electrolyte supplementation, quinine, and apple cider vinegar drinks may also support a healthy muscular system and reduce the risk of cramps.


4. What triggers a charley horse at night?

Though doctors aren’t entirely sure why charley horses are common at night, there are some factors that could contribute to nocturnal leg cramps, including dehydration, sitting for long periods, or overusing your muscles during the day. 


Sleeping in an awkward position can also result in inadequate blood flow and muscle cramps. 


5. What deficiencies are related to charley horses?

Electrolyte and vitamin E deficiencies are associated with tight or stiff muscles and may increase the risk of charley horses. 


While electrolytes are essential for proper muscle contraction and relaxation, vitamin E plays a role in muscle cell function and repair. 


6. How long does a charley horse last? 

While most charley horses last only a few seconds, severe cases can last up to ten minutes, with lingering muscle soreness up to a full day after the spasm.  



Sources


  1. https://www.ncbi.nlm.nih.gov/books/NBK499895/ 

  2. https://pubmed.ncbi.nlm.nih.gov/19829096/ 

  3. https://pubmed.ncbi.nlm.nih.gov/19997012/ 

  4. https://pubmed.ncbi.nlm.nih.gov/12074203/ 

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