What is a charley horse?
The term “charley horse” is a common American name for a muscle cramp, especially in the calf. The muscle suddenly tightens and cannot relax, causing intense pain and a hard, knotted feeling. Cramps can also affect the thigh, foot and toes, where the toes may curl or splay. The NHS describes leg cramps as common and usually harmless, often happening at night or during rest.
How to stop a cramp fast
- Stretch the calf: straighten the leg and pull the toes up towards your shin.
- Stand up: put weight on the affected leg and press the heel down.
- Walk around on your heels for a minute.
- Massage the muscle firmly.
- For foot and toe cramps: pull the toes back and press the foot flat on a cold floor.
- Heat or a warm shower afterwards can ease lingering soreness.
- Simple pain relief may help soreness after the cramp, but not the cramp itself.
Causes and risk factors
- Often no clear cause (idiopathic).
- Ageing; cramps are more common over 50.
- Pregnancy, especially in the later months.
- Muscle fatigue after exercise.
- Sitting for long periods or sleeping with toes pointed.
- Medicines such as diuretics, statins and some asthma inhalers.
- Conditions such as diabetes, nerve problems, liver disease, kidney disease and thyroid problems.
- Dehydration or low levels of minerals in some cases.
Why cramps happen at night
At night, the legs are often still for long periods with the feet pointed down under the bedclothes, which shortens the calf muscles. This position, combined with fatigue from the day, may make muscles and nerves more likely to trigger a cramp. Keeping the sheets loose at the foot of the bed and stretching before sleep can help. Other causes of leg pain at night are covered in our guide to leg pain at night.
Stretches to prevent cramps
- Wall calf stretch: hands on a wall, back leg straight and heel down, 30 seconds each side, 3 times.
- Bent-knee calf stretch: same position with the back knee bent, for the deeper calf muscle.
- Hamstring stretch: heel on a step, lean forward, 30 seconds.
- Towel stretch: sitting with a towel around the foot, pull the toes towards you.
- Toe stretches: gently pull the toes back, and spread them.
- A randomised trial found that stretching the calves and hamstrings for a few minutes before bed reduced night cramps in older adults over six weeks.
Do magnesium and other supplements help?
Magnesium is widely promoted for cramps, but a Cochrane review concluded that magnesium supplements are unlikely to provide a clinically meaningful reduction in cramps for older adults with typical night cramps. Evidence in pregnancy is conflicting. Quinine was once used, but because of potentially serious side effects it is not recommended routinely, and is only considered in rare cases under medical supervision. Drinking enough fluids and eating a varied diet with fruits and vegetables are sensible, but are not proven to prevent cramps.
Leg cramps in pregnancy
Cramps are common in the second and third trimesters. Stretching the calves before bed, gentle exercise such as walking or swimming, staying hydrated and avoiding standing still for long periods may help. Talk to your midwife before taking supplements. Calf pain with swelling in one leg in pregnancy needs urgent assessment, as pregnancy increases the risk of blood clots.
Other ways to reduce cramps
- Keep active during the day, including regular walks.
- Avoid sitting for long periods; stretch during breaks.
- Loosen tight bedclothes over the feet.
- Wear supportive shoes.
- Warm up and cool down properly when exercising.
- Ask your doctor whether any of your medicines could be contributing.
Conditions that can feel like cramps
- Restless legs syndrome: an urge to move the legs, relieved by movement, rather than a hard, painful muscle.
- Calf strain: sudden pain during sport; see calf strain.
- Deep vein thrombosis: persistent pain, swelling, warmth and redness in one calf.
- Peripheral arterial disease: calf pain on walking that eases with rest.
- Nerve problems causing tingling, burning or numbness.
Three common situations
- Older adult woken by calf cramps several nights a week: daily stretching before bed and a medicines review.
- Runner with cramps late in long runs: build training gradually, and practise fuelling and hydration.
- Toe cramps at night: stretch the toes and foot before bed and check footwear.
Key points to remember
- Charley horses are common and usually harmless.
- Stretching and massage stop most cramps.
- Stretching before bed can reduce night cramps.
- Magnesium is unlikely to help most people; quinine is not routinely recommended.
Questions about charley horses
These answers are general information and do not replace an examination or individual medical advice.
What is the fastest way to get rid of a charley horse?
Stretch the muscle by pulling the toes up towards you or standing on the leg, and massage it.
Does drinking water prevent cramps?
Dehydration may contribute in some people, but drinking water alone does not prevent most night cramps.
Do bananas help leg cramps?
There is little evidence that potassium-rich foods prevent cramps, though they are part of a healthy diet.
Why do I get cramps in my feet at night?
Foot cramps share the same triggers as calf cramps, including pointed-toe sleeping positions and muscle fatigue.
When should I worry about leg cramps?
If they are very frequent, come with weakness, swelling, redness or numbness, or started with a new medicine.
Sources
- NHS · Leg cramps
- Hallegraeff JM, et al. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial. J Physiother. 2012
- Garrison SR, et al. Magnesium for skeletal muscle cramps. Cochrane Database Syst Rev. 2020
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.