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The muscles in your legs are made up of bundles of fibers that alternately contract and expand to produce movement. A cramp is a sudden, involuntary contraction (tightening) of one of these muscles, typically in your calf. Cramps can last anywhere from a few seconds to several minutes. They can be mild, or intense enough to wake you out of a sound sleep. A sudden, painful muscle spasm in the leg is called a charley horse, which legend has it is named after baseball player Charlie "Hoss" Radbourn, who reportedly suffered from frequent cramps back in the 1880s.

Sometimes there is no obvious cause for a cramp. Exercise is a common trigger, especially after you've exercised for a long period of time or in the heat. Muscles that are tired or dehydrated become irritated and are more likely to cramp up. A deficiency of electrolytes such as magnesium or potassium in your diet can lead to more frequent cramping, by preventing your muscles from fully relaxing. The risk of a cramp increases during pregnancy, possibly because of circulatory changes and increased stress on the muscles from a growing belly. Age is another factor, with cramps becoming more frequent in middle age and beyond. Older muscles tire more easily, and they become increasingly sensitive to lower fluid volumes in the body. Cramps can also be a side effect of medicines like statins, which are used to treat high cholesterol.

Symptoms of muscle cramps

They can include:

  • Sudden pain and tightness in a muscle, typically in your calf
  •  A temporary hard lump or twitching under the skin

Diagnosing muscle cramps

You should be able to treat a cramp on your own, but see a doctor if your cramps are severe, you get them often, or you have other symptoms (like numbness or weakness) along with them. Rarely, cramps can signal a problem with the spine, blood vessels, or liver.

Treating muscle cramps

Most cramps will go away on their own within a few seconds to minutes. Stretching or massaging the muscle will help it relax. Heat is soothing to tense muscles. Apply a heating pad or warm wet washcloth to help loosen up the muscle.

To avoid leg cramps in the future, drink plenty of fluids before and during exercise. Muscles need fluid to contract and relax properly. Prevent tightness by warming up your leg muscles before you work out with some walking in place or a slow jog. After each workout, stretch out your leg muscles for a few minutes. Do another set of stretches before bed if you tend to get cramps while you sleep. For cramps that are especially severe, frequent, or disruptive to sleep, a prescription muscle relaxant like cyclobenzaprine (Flexeril), metaxalone (Skelaxin), or methocarbamol (Robaxin) may help.

The primary purpose of your legs is to keep you upright and mobile. Yet, your legs can also act as an indicator of your overall health. Although some symptoms you may experience are specific to a leg problem, others can suggest trouble with your heart, nervous system, kidneys, or other organs. Use the following symptom guide to help you decipher what broader problems your leg pain might suggest.

Symptom: Leg cramps
Possible cause: Dehydration

A cramp in your leg after you've been working out, especially in the heat, could be an important sign that your body is low on fluids. To contract and relax normally, muscles rely on water and electrolytes like sodium and potassium. Too little fluid or electrolytes can hypersensitize the nerves that control muscles in the legs, causing the
muscles to contract abnormally, or spasm.

All of your organs rely on fluids to function normally. Dehydration prevents cells from properly using energy, transporting nutrients, and dividing. If not quickly remedied, it can become a life-threatening condition. To avoid getting too low on fluids, drink water or an electrolyte-containing sports drink before, during, and after exercise.

Symptom: Calf pain during activity
Possible cause: Atherosclerosis

Pain in your legs that's triggered by activity—along with weak pulses in your legs and feet, pale skin, and sores on your legs or feet that don't heal well—are signs of peripheral artery disease, a blockage in blood flow to your legs. The most likely cause is atherosclerosis, a hardening and narrowing of the arteries as a result of sticky cholesterol and fat deposits called plaques.

If your legs are suffering from inadequate blood flow, likely your heart is, too. Peripheral artery disease shares risk factors with heart disease—namely, smoking, high cholesterol, diabetes, and high blood pressure. It increases your risk of developing heart disease and of having a heart attack or stroke in the future.

To avoid serious complications, you need to make changes to your lifestyle by losing excess weight, getting more active, eating a heart-healthy diet, and quitting smoking. Sometimes surgery is needed to open up or bypass a blocked artery. Your doctor may recommend blood thinners and vasodilators (medications that help open up blood vessels).

Symptoms: Pain, burning, numbness, and tingling
Possible cause: Diabetes

These feelings in your legs or feet could be signs of diabetic neuropathy—nerve damage due to persistently high blood sugar. High blood sugar damages not only the small blood vessels that send oxygen and nutrients to the nerves, but also the nerves themselves, preventing them from sending the correct signals to your brain.

The keys to preventing neuropathy, as well as other diabetes complications like vision loss, heart disease, and kidney damage, are to keep your blood sugar under good control and modify other risk factors. Don't smoke; also, bring down high blood pressure and cholesterol. Good blood sugar control requires a combination of dietary changes, physical activity, blood sugar monitoring, and sometimes blood sugar-lowering medications.

Symptom: Leg swelling
Possible causes: Heart, kidney, or liver disease

Many things can cause swelling in the legs. At the least worrisome level, it may be the result of an injury, such as a sprain or strain, or venous insufficiency. Or it could point to a more serious problem, such as:

  • a blood clot in the leg
  • heart failure
  • kidney disease or kidney failure
  • liver disease (cirrhosis).

Each of these conditions is unique and requires you to work with your doctor to get a diagnosis and start on a treatment plan.

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