Why a muscle cramp or charley horse hurts

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There’s nothing worse than waking up in the middle of the night with what feels like the jaws of death clenched around your hamstring. The medical term for this is a muscle cramp or spasm, but you may know this painful paralysis — not-so-lovingly — as a ‘charley horse,’and well, it hurts. A lot.

Charley horse?
Although the origins of the name aren’t clear, some say the ‘charley horse’ got its name from, that’s right, a horse. “In the 1890s, an old horse named Charley was used in the old Chicago White Sox ballpark to pull a roller across the infield,” according to The Journal Times. The horse was old with stiff muscles that would make it difficult for him to walk. Apparently, when players and spectators had a cramp they started calling it a charley horse.

What is a muscle cramp?
A muscle cramp is a sudden and involuntary contraction of one or more muscles.

According to a 2019 Live Science article, “Muscles constantly communicate with the nervous system, telling it whether they are stretched or contracted. When a muscle becomes fatigued, the signals between the tendon and the central nervous system essentially become confused. Instead of signalling for the muscle to contract, and then relax, the central nervous system sends more signals for the muscle to keep contracting. The signal to relax doesn’t get through and the muscle cramps.”

Muscle spasms are most common in the thighs, calves, feet, hands, arms and abdomen.

Why do muscle spasms occur?
Muscle spasms are often caused by dehydration, muscle fatigue, exercising in the heat, too much high-intensity exercise or a lack of stretching.

According to Harvard Medical School, spasms can also happen when the muscles aren’t allowed to relax properly, when irritated by a buildup of lactic acid, or due to reduced blood flow from a narrowing of the arteries. Reduced blood flow in the legs, in particular, can be a sign of an underlying health condition such as atherosclerosis.

A lack of minerals such as potassium, calcium or magnesium are also a common culprit, while compression of the nerves in your spine can cause muscle spasms to occur in the neck and legs.

The toes are a notorious spot for cramping and spasms. Usually, the toe cramps are due to poor circulation, possibly combined with other factors such as dehydration or ill-fitting footwear. However, joint or nerve damage could also be responsible for your toe twitch. Twitching muscles can also be a symptom of many central nervous system conditions such as ALS and Parkinson’s.

What are the risk factors?
Interestingly, risk factors for muscle spasms include both not exercising enough and exercising too vigorously. A sedentary lifestyle can contribute to a higher risk of muscle spasms — the Cleveland Clinic lists sitting improperly and for long periods of time and as possible causes. People who carry extra weight have more stress on their muscles and are at a higher risk for experiencing muscle cramps. Same with older people — we lose muscle mass we age which makes the muscles susceptible to spasming.

Athletes are also likely to experience spasms and cramps because their muscles are often overworked. In fact, it’s quite common for athletes to cramp up in the middle of their sporting events — usually due to dehydration, hot weather, or both. Basketball great LeBron James made headlines in 2014 during the NBA finals when after a play that brought the Miami Heat closer to a win against the San Antonio Spurs, he became paralyzed with pain on the baseline. Exertional muscle cramps was the diagnosis — the result of dehydration and in turn, the rapid loss of essential minerals, like salt.

Pregnant women also commonly experience some muscle spasms, particularly leg cramps. And while the causes are not fully understood, HealthLink BC says they may be caused by reduced levels of calcium or increased levels of phosphorus in the blood.

How to treat
Since muscle cramps are commonly associated with dehydration, the first step for treating them is staying hydrated. Stretching before exercise as well as warming up can also help with prevention, while massage and applying heat or ice the affected area can help to relieve pain and discomfort. Other suggestions include trying anti-inflammatories like Advil, muscle relaxants or B-complex vitamins.

Nick Beare is a writer with Healthing.ca.

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