What are muscle cramps?
A muscle cramp is an involuntarily and forcibly contracted muscle
that does not relax. When we use the muscles that can be
controlled voluntarily, such as those of our arms and legs, they
alternately contract and relax as we move our limbs. Muscles that
support our head, neck, and trunk contract similarly in a
synchronized fashion to maintain our posture. A muscle (or even a
few fibers of a muscle) that involuntarily (without consciously
willing it) contracts is in a "spasm." If the spasm is forceful
and sustained, it becomes a cramp. Muscle cramps cause a visible
or palpable hardening of the involved muscle.
Muscle cramps can last anywhere from a few seconds to a quarter of
an hour or occasionally longer. It is not uncommon for a cramp to
recur multiple times until it finally goes away. The cramp may
involve a part of a muscle, the entire muscle, or several muscles
that usually act together, such as those that flex adjacent
fingers. Some cramps involve the simultaneous contraction of
muscles that ordinarily move body parts in opposite directions.
Cramps are extremely common. Almost everyone (one estimate is
about 95%) experiences a cramp at some time in their life. Cramps
are common in adults and become increasingly frequent with aging.
However, children also experience cramps.
Any of the muscles that are under our voluntary control (skeletal
muscles) can cramp. Cramps of the extremities, especially the legs
and feet, and most particularly the calf (the classic "charley
horse"), are very common. Involuntary muscles of the various
organs (uterus, blood vessel wall, intestinal tract, bile and
urine passages, bronchial tree, etc.) are also subject to cramps.
Cramps of the involuntary muscles will not be further considered
in this review. This article focuses on cramps of skeletal muscle
What are the types and
causes of muscle cramps?
Skeletal muscle cramps can be categorized into four major types.
These include "true" cramps, tetany, contractures, and dystonic
cramps. Cramps are categorized according to their different causes
and the muscle groups they affect.
True cramps
True cramps involve part or all of a single muscle or a group of
muscles that generally act together, such as the muscles that flex
several adjacent fingers. Most authorities agree that true cramps
are caused by hyperexcitability of the nerves that stimulate the
muscles. They are overwhelmingly the most common type of skeletal
muscle cramps. True cramps can occur in a variety of circumstances
as follows.
Injury Persistent muscle spasm may occur as a protective mechanism
following an injury, such as a broken bone. In this instance, the
spasm tends to minimize movement and stabilize the area of injury.
Injury of the muscle alone may cause the muscle to spasm
What is
the treatment of skeletal muscle cramps?
Most cramps can be stopped if the muscle can be stretched. For
many cramps of the feet and legs, this stretching can often be
accomplished by standing up and walking around. For a calf muscle
cramp, the person can stand about 2 to 2.5 feet from a wall
(possibly farther for a tall person) and lean into the wall to
place the forearms against the wall with the knees and back
straight and the heels in contact with the floor. (Learn this
maneuver at a time when you don't have the cramp!) Another
technique involves flexing the ankle by pulling the toes up toward
the head while still lying in bed with the leg as straight as
possible. For writer's cramp (contractures in the hand), pressing
the hand on a wall with the fingers facing down will stretch the
cramping finger flexor muscles
Gently massaging the muscle will often help it to
relax, as will applying warmth from a heating pad or hot soak. If
the cramp is associated with fluid loss, as is often the case with
vigorous physical activity, fluid and electrolyte (especially
sodium and potassium) replacement is essential. Medicines are not
generally needed to treat an ordinary cramp that is active since
most cramps subside spontaneously before enough medicine would be
absorbed to even have an effect.
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