By Dr. Mercola
A charley horse, or muscle cramp particularly in your calf muscles, is an incredibly common condition that results in your muscles becoming tight, stiff and extremely painful. If you're an adult, there's a good chance you've had one at some point (and likely multiple points) during your lifetime.
In case you're a trivia buff and wondering why these muscle cramps are referred to as "charley horses" (a name that's primarily used in North America), it's said to be a tribute to Charley "Old Hoss" Radbourne, an 1880s-era baseball pitcher who often suffered from muscle cramps during games.1
Another version states the term came from a lame work horse named Charley who limped around doing various jobs around the baseball park (also in the 1880s).
Whenever a baseball player would get injured or have a cramp in the lower legs, thus limping around like Charley the horse, teammates would call the player "Charley Horse."2 Regardless of the name's origin, the pain of a charley horse is unmistakable and can be excruciating.
What Causes a Charley Horse?
According to the Cochrane Database of Systematic Reviews, about 1 in every 3 adults is affected by muscle cramps in their lower limbs. In many cases, the pain is temporary and goes away on its own, but for some the cramps interfere with sleep, quality of life and daily activities.3
In one study of more than 500 people aged 60 years and older, 31 percent reported being woken up by muscle cramps and 15 percent had cramps more than three times a month.4 Anyone can get a charley horse, but they're most common in the following populations and scenarios:5
- During exercise
- At nighttime, especially in the elderly
- In pregnant women
- In people with neurological disease
- During kidney dialysis
It's not clear what triggers a charley horse to occur, but it is thought the cramp may be related to a rapidly firing nerve (up to 150 electrical dischargers per second), which causes the muscle to tense up, as opposed to an issue with the muscle tissue itself.6,7
Many medications are also associated with muscle cramps, including statin cholesterol-lowering drugs, ACE inhibitors (blood pressure drugs), certain asthma drugs, diuretics and more.8 In addition, the following factors may also increase your risk of a charley horse:
- Poor blood circulation in your legs
- Muscle fatigue
- Mineral deficiencies, including magnesium, potassium or calcium
Is Magnesium Deficiency Causing Your Charley Horses?
By some estimates, up to 80 percent of Americans are not getting enough magnesium and may be deficient. Other research shows only about 25 percent of U.S. adults are getting the recommended daily amount of 310 to 320 milligrams (mg) for women and 400 to 420 for men.9
Magnesium is often thought of primarily as a mineral for your heart and bones, but this is misleading. Researchers have now detected 3,751 magnesium-binding sites on human proteins, indicating that its role in human health and disease may have been vastly underestimated.10
Further, if you suffer from charley horses, low levels of magnesium could be to blame. Magnesium is necessary for activating muscles and nerves, and a key sign of ongoing magnesium deficiency can be muscle contractions and cramps like charley horses.
Magnesium deficiency may be particularly problematic for your muscles in the presence of an overabundance of calcium. Americans in general tend to have a higher calcium-to-magnesium ratio in their diet, averaging about 3.5-to-1.
If you have too much calcium and not enough magnesium, your muscles will tend to go into spasm. According to Dr. Carolyn Dean, a medical and naturopathic doctor:
"What happens is the muscle and nerve function that magnesium is responsible for is diminished. If you don't have enough magnesium, your muscles go into spasm.
Calcium causes muscle to contract. If you had a balance, the muscles would do their thing. They'd relax, contract and create their activity."
This underscores the importance of eating a nutritious diet, which will naturally give you optimal amounts of the minerals and other nutrients your body needs.
Eating plenty of organic leafy green vegetables, nuts and seeds every day, and drinking fresh green vegetable juice will help keep your magnesium stores replenished. In addition, Epsom salt is a magnesium sulfate that can absorb into your body through your skin.
Soaking in a bath with Epsom salts is an excellent way to not only help prevent magnesium deficiency but also to soothe and relieve the pain of a charley horse.
Low Potassium Levels May Also Trigger a Charley Horse
Potassium, a mineral and electrolyte, is essential for your cells, tissues and organs to function properly. It plays a vital role in heart health, digestive and muscular function, bone health and more. One of the symptoms of low potassium levels is muscle cramps.
While potassium is found in many foods commonly consumed in the U.S. — including fruits, vegetables, dairy products, salmon, sardines and nuts — only 2 percent of U.S. adults get the recommended daily amount of 4,700 mg.11
This is especially problematic because potassium is a nutrient that needs to be kept in proper balance with sodium in your blood. If you consume too much sodium, which is common if you eat a lot of processed foods, you'll have an increased need for potassium.
Others who are at particular risk of low potassium, or hypokalemia, are those with chronic malabsorption syndromes, such as Crohn's disease, or those taking heart medicine (particularly loop diuretics).12 However, anyone who eats a poor diet — an excess of processed foods and not enough fresh, whole foods — is potentially at risk of inadequate potassium levels and related muscle cramps.
Green vegetable juicing is an excellent way to ensure you're getting enough nutrients for optimal health, including about 300 mg to 400 mg of potassium per cup. Some additional rich sources of potassium are:
- Lima beans (955 mg/cup)
- Winter squash (896 mg/cup)
- Cooked spinach (839 mg/cup)
- Avocado (500 mg per medium)
Too Little Calcium May Trigger Muscle Cramps
While too much calcium in the absence of magnesium can be problematic for muscle cramps, so too can a calcium deficiency. Low blood levels of calcium (as well as magnesium) may increase the excitability of nerve endings and the muscles they stimulate.13
This may be a trigger for muscle cramps, especially in the elderly and during pregnancy. If you're deficient in vitamin D, meanwhile, your body may have inadequate calcium absorption, again predisposing you to muscle cramps.
It's very important to maintain a proper balance of calcium, magnesium, vitamin D and also vitamin K2, as these four nutrients perform an intricate dance together, with one supporting the other. If you're calcium deficient, your best bet is to increase consumption of foods high in calcium before opting for a supplement. This is because many high-calcium foods also contain naturally high amounts of vitamin K2; nature cleverly gives us these two nutrients in combination, so they work optimally.
Good sources of calcium include nuts, seeds and raw, organic, grass-fed dairy especially cheeses, and vegetables, although veggies aren't high in vitamin K2. One exception is fermented vegetables where a starter culture specifically designed to produce ample amounts of vitamin K2 was used.
Homemade bone broth is another excellent source. Simply simmer leftover bones over low heat for an entire day to extract the calcium from the bones. You can use this broth for soups and stews or drink it straight.
What to Do If You Get a Charley Horse
A charley horse often occurs without notice, sometimes waking you up from sound sleep. If you're lying down when the pain starts, stand up and put some weight on your foot. Walking around will help to increase blood circulation to your muscles and possibly help to soothe and relax the cramp.
You can also try a simple stretch. If the cramp is in your calf in the back of your lower leg, pull your toes and foot upward until you feel a stretch in the back of your leg. You can also do this sitting down with your legs outstretched. Put a towel around your feet and gently pull both ends toward you until you feel a stretch.
As mentioned, soaking in an Epsom salt bath may also help to relieve pain (and possibly help with prevention). Massaging the area and applying a heat pack, which will increase blood flow to the area, promoting healing and soothing pain, may also help.
Staying well-hydrated is also important for muscle cramp prevention. You'll want to drink enough pure filtered water so that your urine is pale yellow in color. In addition, performing regular stretching exercises on your legs may help reduce your risk of a charley horse.