Cramp

A cramp is a sudden, involuntary, painful contraction of one or more skeletal muscles, or an overshortening of such associated with electrical activity. While generally temporary and non-damaging, they can cause significant pain and a paralysis-like immobility of the affected muscle. A cramp usually goes away on its own over several seconds or (sometimes) minutes. Cramps are common and tend to occur at rest, usually at night (nocturnal leg cramps). They are also often associated with pregnancy, physical exercise or overexertion, and age (common in older adults); in such cases, cramps are called idiopathic because there is no underlying pathology. In addition to those benign conditions, cramps are also associated with many pathological conditions. Cramp definition is narrower than the definition of muscle spasm: spasms include any involuntary abnormal muscle contractions, while cramps are sustained and painful. True cramps can be distinguished from other cramp-like conditions. Cramps are different from muscle contracture, which is also painful and involuntary, but which is electrically silent. The main distinguishing features of cramps from dystonia are suddenness with acute onset of pain, involvement of only one muscle, and spontaneous resolution of cramps or their resolution after stretching the affected muscle. Restless leg syndrome is not considered the same as muscle cramps and should not be confused with rest cramps. Cramps are sometimes also called a "Charley horse", which is a lay term used by people in the United States. Under normal circumstances, skeletal muscles can be voluntarily controlled, and any of them can be affected by cramps. Skeletal muscles that are most often affected by cramps are the calves, thighs, and arches of the foot. Gentle stretching and massage, putting some pressure on the affected leg by walking or standing, or taking a warm bath or shower may help to end the cramp. If the cramp is in the calf muscle, dorsiflexing the foot (lifting the toes back toward the shins) will stretch the muscle and provide almost immediate relief. There is limited evidence supporting the use of magnesium, calcium channel blockers, carisoprodol, and vitamin B12.