At some point, most of us have had that unfortunate experience of having a cramp. A Charley horse is a painful cramp that usually happens in the leg or the thigh.
The name is derived from an old horse called Charley who used to pull a roller at the White Sox baseball game in Chicago. At times, Charley used to cramp while being on the field. And it was apparent as people could see the muscles in Charley’s legs cramping. The name “Charley Horse'' hence became synonymous with a painful cramp.
Muscle cramps are fairly common in adults. They usually never happen in children; if they do, it almost always requires investigation as it is not normal.
Heavy endurance training can lead to significant overuse of muscles and lead to cramping. Fluid and electrolyte loss (or dehydration) can lead to cramping in this case. Painful Charley horses can happen in muscles of the calf, thigh or even the small muscles of the feet.
In older adults, Charley horses are not necessarily associated with dehydration or electrolyte loss. These kind of muscle cramps happen typically in the night and are called nocturnal leg cramps. The physiology of nocturnal leg cramps in elderly has been poorly understood.
Medications: certain medications such as diuretics (water pills) are one of the leading causes of muscle cramps. These medications are commonly prescribed in patients who suffer from heart failure.
Loss of fluid and electrolytes, particularly of sodium, potassium and magnesium can predispose adults to a painful Charley Horse. Other medications such as statins used for high cholesterol can cause muscle soreness, pain and cramps in some individuals.
Vascular disease: At times, lack of appropriate amount of blood supply to the legs can predispose individuals to cramping. This is typically seen in elderly individuals suffering from peripheral vascular disease or have a history of smoking.
Exercise and overactivity: particularly seen in athletes who are involved in endurance feats. A Charley horse in this group can happen in any group of muscles but most commonly seen in the hamstrings.
Pregnancy: At times, pregnancy can lead to a Charley horse, the reasons of which are not completely well understood.
Disease of the liver and thyroid: these can predispose an individual to painful Charley horses particularly in the feet.
Charley horses can strike very quickly, within seconds without a warning. Frequently, there is no time to treat a Charley horse as it can happen without warning and it stops as quickly and erratically as it starts. Stretching the affected muscle is a natural human response. And it works at times.
When it comes to a Charley horse, prevention is the best therapy. Below are some general principles that can help prevent Charley horses from happening too frequently:
If a deficiency is identified, a magnesium supplement such as magnesium oxide or gluconate salt, or an electrolyte drink mix such as MAGNAK® can reduce the incidence and frequency of Charley horses.
Dr. Kharait is an MD and a practicing Nephrologist in Northern California. He completed his Residency in Internal Medicine and Fellowship in Nephrology from the University of California, San Francisco. He has a PhD in Molecular Physiology from the University of Pittsburgh and specializes in treating patients with electrolyte disorders and kidney diseases.
