Why You Keep Getting a Charley Horse

Many of us have experienced a Charley horse at some point. Have you ever given any thought, though, to what a Charley horse actually is?

At OrthoNeuro, our sports medicine specialists take great care in helping those who may be feeling the excruciating pain associated with a charley horse. If you are experiencing this regularly, make an appointment at one of our offices in Columbus, Ohio, so that we can reduce your discomfort!

What is a Charley Horse?

A charley horse is another name for a muscle spasm—an involuntary and sudden contraction of a muscle that can range from mildly uncomfortable to intensely painful. These cramps typically target the legs, but neck muscles, arms, feet, or back can also be affected.

Although many charley horses happen during rest or sleep, they can also strike during physical activity, particularly if your muscles are fatigued, overused, or dehydrated.

Are Charley Horses Serious?

While occasional leg cramps may be harmless, repeated or unexplained cramps can point to more serious health issues, such as a pinched nerve, poor blood flow, or underlying conditions like diabetes or vascular disease. Chronic episodes can also interfere with your mobility and quality of life.

What Causes a Charley Horse?

The causes of a charley horse are varied and often depend on lifestyle, health, and environmental factors. Common culprits include:

• Overuse or injury to the affected muscle
• Dehydration or low levels of minerals like calcium, potassium, and sodium
• Poor blood flow to your legs, often due to sitting or standing too long
• Not stretching before or after workouts
• Taking diuretics or medications for high blood pressure
• Compression of nerves in the spine (leading to referred pain or spasms)
• Stress, especially in the neck muscles
• Electrolyte imbalances
• Exercising in extreme heat or cold
• Intense exercise

In many cases, multiple factors contribute to the onset of a cramped muscle, which is why personalized treatment is essential.

Risk Factors for Muscle Spasms

Certain people are more prone to frequent muscle spasms, including:

• Athletes who frequently train or compete
• Older adults, whose muscles and circulation may naturally weaken
• Pregnant women, due to increased pressure on nerves and leg swelling
• Obese individuals, often due to reduced blood flow
• Smokers, whose circulation may be compromised
• People with chronic illnesses such as kidney disease, diabetes, or Addison’s disease
• Individuals taking medications like statins or diuretics

What Do Charley Horses Feel Like?

A charley horse typically feels like a sudden tightening or knot in the affected muscle, often in the calf or thigh. The muscle becomes hard to the touch and can cause severe pain lasting from a few seconds to several minutes. Common symptoms include:

• Severe pain that may stop you in your tracks
• Visible muscle spasms or twitching
• Residual muscle weakness or tenderness that lingers for hours
• Discomfort that can disrupt sleep, workouts, or simple daily activities

When and Where Do Charley Horses Happen?

Charley horses happen most often at night, especially while you’re asleep. In fact, nocturnal leg cramps are one of the most common sleep disturbances for adults over 50. Though the exact reason isn’t fully understood, lying in certain positions may shorten or compress the muscle, triggering a cramp.

They can also occur during or after physical activity particularly swimming, running, or biking—when your muscles are taxed or underhydrated.

How Are Charley Horses Diagnosed?

Occasional charley horses don’t typically require medical evaluation. But if you experience frequent or unexplained cramps—especially more than once a week—you should consult a specialist. Diagnosis may include:

• A full medical history and symptom discussion
• A physical exam to identify any cramped muscle groups or areas of tightness
• Blood tests to check for electrolyte imbalances
• Imaging such as X-rays or MRI scans if a pinched nerve or structural issue is suspected

The goal is to determine whether your muscle spasms stem from lifestyle factors or a deeper health condition that requires targeted treatment.

Treatment Options for Charley Horses

The best treatment plan depends on the underlying cause of your muscle cramps and the frequency or severity of symptoms. Here are the most common approaches:

Mild or Occasional Spasms

Occasional cramps can be treated by means of:

• Stretching the cramped muscle gently
• Massaging the area
• Applying heat to relax tight muscles or ice to reduce soreness
• Using over-the-counter anti-inflammatory medication

Moderate or Recurring Spasms

If the non-steroidal anti-inflammatory medication is not bringing any relief, your doctor may prescribe the following:

• Prescription pain medications
• Electrolyte supplements if you’re low on potassium, calcium, or magnesium
• Review and possible adjustment of current medications (especially diuretics or high blood pressure drugs)

Severe or Persistent Spasms

Severe or persistent spasms may require the following treatment:

• Antisposmadic medication
• Physical therapy to strengthen muscle groups and improve flexibility
• Treatment of underlying vascular or nerve conditions
• In rare cases, surgical intervention may be necessary to relieve nerve pressure, especially if caused by a pinched nerve

How to Prevent Leg Cramps and Charley Horses

The good news? You can take steps to prevent cramps and reduce your risk of future Charley horses. Try incorporating these habits into your routine:

• Stretch before and after exercising, especially your calves, hamstrings, and neck muscles
• Stay hydrated by drinking water and electrolyte-rich fluids throughout the day
• Prevent leg cramps at night by stretching before bed
• Avoid sitting or standing in the same position for long periods
• Mix up your workout routine to avoid overusing the same muscle groups
• Avoid working out in extreme heat or cold
• Wear supportive footwear, especially during exercise

If your Charley horses are frequent, extremely painful, or affecting your quality of life, don’t ignore them. At OrthoNeuro, our team can help you uncover the root cause of your muscle spasms and design a treatment plan that works for your unique needs.

Get Expert Help for Charley Horses in Columbus

You don’t have to live with the severe pain of recurring Charley horses. Whether your cramps are disrupting your sleep, workouts, or everyday activities, our board-certified sports medicine specialists at OrthoNeuro are here to help.

Schedule an appointment at one of our many locations in the Greater Columbus area and take the first step toward lasting relief and healthier muscles.

Medically reviewed by Scott A. Smith MD, FAAOS