Frequent Muscle Cramps? 5 Things to Know

Muscle cramps are common in endurance athletes. But even people who haven't run a marathon recently — or ever — still experience them. And believe us, muscle cramps are not easy to ignore.

"When your skeletal muscles contract suddenly, it can cause intense pain and an inability to move that muscle," says Brady Fleshman, MD, an MU Health Care family and sports medicine physician. "If your muscles are cramping often — whether you're an athlete or not — it could be cause for concern."

To help you make sense of frequent muscle cramping and understand when to seek medical attention, Dr. Fleshman shares five things you should know:

1. No One Really Knows What Causes Muscle Cramping

Muscle cramps can come on quickly. When they do, your first question is likely, "Why is this happening?"

"The truth is, we don't fully understand why muscles cramp," Dr. Fleshman says. "There are a couple of longstanding theories, including dehydration or electrolyte imbalance. But data has shown that people can be well-hydrated and still cramp."

Another common theory is that cramping can be caused by muscle fatigue. This is the more favored theory amongst experts. When muscles get tired, the nerves that control them can become “hyperexcitable” or overactive, causing the muscle to suddenly tighten and cramp.

2. Recurrent Muscle Cramping Can Be a Sign of an Underlying Health Issue

While dehydration and muscle fatigue could be likely culprits for athletes, they rarely cause cramping that's unrelated to exercise. If your cramping is getting worse with less activity or if you also experience sudden weakness in your lower extremities, a medical professional can help you figure out why it is happening.

Possible (and more common) underlying causes include:

• Medications, such as albuterol (to treat asthma or COPD), statins (to treat high cholesterol) and diuretics (to treat high blood pressure or swelling)
• Nerve issues, sometimes caused by a pinched nerve, which can make the interaction between muscles and nerves dysfunctional
• Nutrient deficiency possibly involving vitamin D, vitamin B or magnesium
• Hormonal imbalance, typically involving the thyroid

"To understand what's going on, we evaluate your past medical history and family history," Dr. Fleshman says. "I'll also ask questions and perform lab work to identify any underlying deficiencies, hormone imbalances or neurologic issues that could be causing the cramping.”

Some serious medical conditions may also be mistaken for muscle cramps. Blood clots and rhabdomyolysis — a rapid breakdown of muscle tissue that can cause kidney damage — also involve muscle pain and can be life-threatening.

In athletes, particularly when rhabdomyolysis is suspected, it is important to consider sickle cell trait or sickle cell disease, which can increase the risk of serious complications. If you suspect that your cramp is not just a cramp, or if the muscle pain is persistent and accompanied by swelling or tea-colored urine, seek immediate medical attention.

3. Nighttime Leg Cramping Is Common and Not That Concerning

Nocturnal leg cramps can happen to anyone, but they are most common in older adults. As you age, physical changes to your muscles, tendons and nerves make your muscles more likely to cramp when you are inactive — like when you are sleeping.

"Occasional nocturnal leg cramps don't worry me because they are common and typically attributed to aging," Dr. Fleshman says. "However, if you are cramping every night, are younger or are cramping during typical daily activities, that is more concerning."

4. The Best-Supported and Safest Approach for a Muscle Cramp Is Stretching

There are a lot of tips available for relieving muscle cramps, such as stretching, using electrolyte packets or drinks, adding salt to drinks or drinking pickle juice.

"If those remedies work for you, then great," Dr. Fleshman says. "But some things are proven to work better than others. If you're really hurting from a cramp, the best thing is to gently stretch or rub the cramp to loosen the muscle."

For athletes or cramping that occurs with exercise, certain actions before physical activity may help prevent cramping, such as:

• Adding salt: Adding just a half teaspoon of salt to an electrolyte drink, such as Gatorade, can help replace the sodium you lose when sweating.
• Adequate hydration: Drinking a lot of fluid at least one hour before intense exercise ensures the fluid is absorbed into your system.
• Compression: Squeezing your calf or thigh muscles may regulate how the nerves and muscles interact.

5. Lifestyle Choices Can Affect Muscle Cramping

How you take care of your body can determine how well it functions. If you experience muscle cramps, Dr. Fleshman suggests making lifestyle changes, such as:

• Getting enough sleep so that your muscles have time to rest
• Eating a well-balanced diet to feed your muscles the nutrients they need
• Exercising regularly to keep your muscles active
• Being thoughtful about supplements, which are not regulated in the same way as medications, and their quality and ingredients can vary
• Limiting alcohol, which can cause dehydration

"If you are experiencing muscle cramps, go back to the basics of healthy living," Dr. Fleshman says. "If the cramps are getting worse, happening frequently or interfering with daily life, talk to your provider."

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