Charley Horse: Unraveling Symptoms, Causes, and Risk Factors | Max Hospital

Charley Horse is the name given to uncomfortable involuntary leg cramps/spasms or muscle twitching that some people experience, especially at night.

The origin of the word is not clear, but one of the theories suggests it comes from informal American sports talks about a lame horse. Another theory suggests that it might also have come from the name of a baseball pitcher named ‘Charley’ who used to have severe cramps and had to leave the sport because of this.

Symptoms

People with Charley Horse typically have severely painful spasms in the legs, more so at night. It usually wakes them up from sleep and is a very uncomfortable feeling to have.

Visibly, one may observe gentle twitching beneath the skin of calves. It may affect one side, but more commonly, both sides are involved. The twitches usually subside spontaneously, but sometimes, they are sustained and continue for long, thus jeopardizing sleep.

Causes

Pathophysiology is not clear, but it has been hypothesized that it may be due to hyper-excitability of central motor neurons/nerves or spontaneous discharges or currents in peripheral motor nerves. So, the origin may be central or peripheral.

Athletes who overuse their muscles while playing or working out, use amphetamine medications, consume too much tea and coffee (caffeine), use diuretic medicines, cholesterol-lowering drugs, or statins may experience cramps. 

Additionally, they are more common in patients with diabetes, uremia or kidney disease, liver disease and thyroid problems. Heat strokes and prolonged sun exposure may also cause severe muscle twitching.

Risk Factors

People over 60, athletes who overuse their muscles, or do exercises without adequate warm-ups are more liable to have these cramps. Conditions such as dehydration, sodium–potassium electrolyte imbalance, diabetes, pregnancy, kidney failure, liver failure or cirrhosis, severe thyroid derangement and certain neurological conditions also predispose to this condition.

Treatment options

Immediate relief occurs spontaneously or by gentle stretching. Sometimes, painkillers and muscle relaxants are required for more severe problems. Long-term relief can be provided by Vitamin E and Levocarnitine preparations if the condition is chronic and recurrent. You may need to consult your orthopaedic doctor or physician if it is not resolved by common measures.

Preventive Measures

Adequate warm-up before intensive workouts or sports and adequate hydration usually work for athletes and sportspersons. Avoiding caffeine and amphetamines and controlling underlying predisposing conditions such as diabetes, electrolyte imbalance, and kidney ailments is key. If treatment is taken at the onset of the problem, relief is usually longstanding.

Frequently Asked Questions

Are Charley horse and leg cramps the same thing?
Yes, both terms are synonymously used. Though leg cramps may be caused by other conditions, such as motor neuron disease and polio, charley horse is the term used for conditions without an identifiable cause.