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Muscle Spasms What You Should Know

Muscle Spasms What You Should Know

One of the many things to “go wrong” as we age is the unwanted and often painful involuntary contraction of muscles in our legs and sometimes other areas. The medical definition of this is the contraction of a muscle or muscle group that is unintentional. If the contraction is sustained for more than several seconds it moves from being a muscle spasm to a muscle cramp.

In other words the process begins as a muscle spasm which is a tightening of the muscle and if it persists it becomes a cramp. Neither of these conditions is voluntary, meaning we did not intentionally tighten the muscle as we might when lifting a weight

A muscle spasm is a sudden, involuntary movement in one or more muscles. People may also call it a charley horse or a muscle cramp or twitch.

Occasional muscle spasms are normal, but here’s how to tell if your muscle spasms may be something more.

Most people have experienced a muscle spasm at one time or another in their lives. Have you ever noticed that sometimes, as you’re trying to go to sleep and just about to drift off, your entire body will suddenly twitch uncontrollably? Well, that unexpected wake-up call is actually a muscle spasm.

Muscle spasms can occur as a result of a lot of different things, from being tired to stress to certain medical conditions. In many cases, occasional muscle spasms are nothing to be concerned about, but read on for more information about when your muscle spasms might warrant a check-up with your doctor. 

What Are Muscle Spasms?

A muscle spasm is a painful, involuntary movement or contraction of a muscle. A muscle spasm is also known as a muscle cramp. Muscle spasms and cramps are not the same as muscle twitching, which refers to very fine involuntary movements (fasciculations) of a small segment of muscle.

Skeletal muscles are muscles attached to bones that you control to move your body. Normally your skeletal muscles create movement by voluntary contraction. This occurs when muscles respond to a message sent from the brain through the nerves, which causes the muscles to contract, then relax. Normal voluntary muscle contraction involves a series of steps and requires normal amounts of oxygen, electrolytes (such as potassium and calcium), and glucose, all of which are supplied by your blood. Problems with the brain and nervous system, as well as the other required elements, may result in muscle spasms.

Skeletal muscle spasms are common and most people experience a temporary skeletal muscle spasm at some point in their life. The skeletal muscles that most commonly contract involuntarily include:

  • Back of thigh (hamstrings)
  • Calf muscle (gastrocnemius)
  • Front of thigh (quadriceps)

Leg cramps, sometimes called charley horses, are sudden and uncontrollable muscle contractions or spasms. They can occur with exercise or while sleeping and usually resolve just as quickly as they came. The pain from muscle cramps can be intense, but can often be relieved with gentle stretching and massage.

Skeletal muscle spasms and cramps are usually caused by overuse of the muscle, either from exercise or a repetitive motion. Spasms can also occur if a muscle is overstretched or held in the same position for too long. The muscle essentially becomes hyperexcitable and fails to relax. In some cases, the muscle may need to be massaged in order to release the contraction. Muscle cramps are often caused by or worsened when you are dehydrated and not getting enough fluids.

Muscle spasms and cramps can also be caused by neuromuscular disorders, such as multiple sclerosis or a spinal cord injury. Movement disorders called dystonias also lead to forceful contractions. Dystonias can also be a complication of stroke. Certain medications can cause involuntary muscle contractions as well.

What Are The Different Types Of Muscle?

Muscles are complex structures that cause movement in the body. There are three types of muscle in the body:

  • Heart muscle pumps blood (cardiac muscle).
  • Skeletal muscle moves the external body parts, like the arms and legs, neck, back, trunk, and face.
  • Smooth muscle moves portions of hollow structures inside the body. Examples include the muscles that line the esophagus, stomach, and intestines, muscles that line large arteries, and the muscles of the uterus.

Other Types Of Muscle Spasms

Although we often think of skeletal muscle spasms or cramps, other kinds of muscle, such as smooth muscle, can spasm or cramp. Smooth muscles are found in the walls of hollow organs in your body, such as your stomach, bladder, and blood vessels, and play an important role in normal organ function. For example, the muscles in your esophagus, the hollow tube that connects your throat to your stomach, are vital to swallowing, but they can suddenly contract and spasm and cause severe pain in the chest.

Cardiac muscle, which makes up the heart and is responsible for pumping blood throughout your body, is another type of involuntary muscle. An immediately life-threatening condition called ventricular fibrillation is rapid, disorganized and ineffective contractions of heart muscle.

Muscle spasms and cramps can be a sign of a serious disease, disorder or condition, such as multiple sclerosis, spinal cord injury, or stroke. In addition, angina and heart attack may be caused by spasms of the coronary arteries that supply blood to the heart. Seek prompt medical care if your muscle spasms and cramps last for a long time, recur, or are causing you concern.

Seek immediate medical care (call 911) if you, or someone you are with, have chest pain, difficulty breathing or swallowing, progressive muscle weakness, change in consciousness, inability to move a body part, or stiff neck.


It is easy to self-diagnose muscle spasms and cramps. The most important sign is intense pain caused by the extreme tightening of the muscle. The pain is localized at the site of the muscle. There may be tenderness on touching the muscle with ones hands. There always is the sensation of a tense or tight muscle that feels very hard compared to other relaxed muscles. The spasm may last only a few seconds or up to 15 minutes. The longer the cramp lasts the more likely the muscle will be sore for a prolonged period after the acute pain has subsided.

The cramps can and often do impair function, for example, writer’s cramp occurs in muscles of the hand making it impossible to write. Or, there can be cramps in leg muscles that make walking or running difficult. The most common site of a cramp as we age is in the calf.

Not all muscle spasms are painful, but some can cause pain. It can feel as though the muscle is jumping or moving on its own, with this feeling typically lasting just a few seconds. Some people might even be able to see the muscle twitching.

Sometimes, it can feel as though the whole muscle has cramped up and cannot move. This effect most commonly happens in the legs, and it can be quite painful. The muscle may feel hard to the touch. While the cramping sensation tends to pass within several minutes or so, the muscle may continue to hurt for some time afterward.

If a muscle spasm is part of a neurological health condition, the person will usually experience other symptoms. These might include:

  • pain in the back, neck, or head
  • weakness in the muscles
  • skin numbness
  • a pins-and-needles sensation
  • a tremor
  • paralysis
  • poor coordination
  • slow movements
  • double vision
  • sleep problems


There are many different things that can cause a muscle spasm. Most of these causes are not serious, although they may require some action on your part to prevent them from happening again (and to correct any injury or pain that resulted). Some of the factors that may lead to a muscle spasm include:

  • Medication. Pseudoephedrine (Sudafed), albuterol (usually found in inhalers for people with asthma), and the stimulant Adderall can all cause muscle spasms.
  • Caffeine. Excess caffeine can lead to muscle “twitching,” such as an eyelid twitch, or even twitches in the muscles of the hand.
  • Stress and fatigue. Stress and exhaustion are two major culprits for muscle spasms, whether it’s because you’re not sleeping enough or if your muscles are actually fatigued from exertion.
  • Overuse of a muscle. Anything from strenuous exercise, to holding a position for a long time, or even performing manual labor can over-exert your muscles and lead to a spasm.
  • Electrolyte imbalances. If you’ve ever been told to eat a banana because you’re having a muscle cramp, it’s because having low potassium—along with other key vitamins and minerals like calcium and sodium—can cause spasms to occur.
  • Dehydration. Along with the right amount of electrolytes, your muscles need adequate hydration to work properly.
  • Improper body mechanics. You may be at risk for muscle spasms in the back if you’re doing a lot of lifting, bending, twisting, or holding your body in unnatural positions, such as leaning backwards.
  • Pregnancy and childbirth. Pregnancy can lead to muscle cramping, especially in the legs, and after giving birth, a weakened core may make you more prone to back spasms as you do things like lift, bend, and twist.
  • Underlying physical problems. Spinal conditions, such as degenerative disc disease, spinal stenosis, or a herniated disc can all lead a muscle spasm in your back. It’s especially important to seek medical attention for back spasms so you can correct the problem and not just hope it will heal on its own.

Rarely, muscle spasms can be the result of a more serious neurological condition. In those cases, however, the muscle spasms that accompany a serious disorder are often repetitive, larger-scale, and accompanied by other serious muscular symptoms, such as weakness, trouble walking, or numbness and tingling.

Questions For Diagnosing

To help diagnose the underlying cause of muscle spasms, your licensed health care provider will ask you several questions related to your symptoms. Giving complete answers to these questions will help your provider diagnose the cause of your muscle spasms:

  • Are you receiving hemodialysis?
  • What is your routine sleep posture?
  • Do you feel spasms in one particular muscle or in several different areas?
  • What body parts are affected?
  • How long have you had spasms? How long do the spasms last?
  • Are you experiencing any other symptoms at the same time, such as a sore throat or fever?
  • What makes your symptoms better or worse?
  • What other medications, if any, are you currently taking?


When a spasm strikes, you might be exercising, simply sitting or even sleeping in the middle of the night. If only there was a magical injection that could instantly relieve your pain! There are, however, five steps you can take to try to get rid of the spasm:

  • Stretch the affected area.
  • Massage the affected area with your hands or a massage roller.
  • Stand up and walk around.
  • Apply heat or ice. Put an ice pack together or apply a heating pad, or take a nice warm bath.
  • Take painkillers such as ibuprofen and acetaminophen.

At Home

In many instances, muscle spasms can be resolved within several days or weeks following a conservative course of treatment, provided there are no serious underlying medical or spinal conditions. Contact your doctor immediately if you are experiencing:

  • Changes in bowel and/or bladder function, resulting in incontinence or difficulty controlling bowel movements.
  • Muscle weakness in your arms or legs; a feeling of instability when you walk or a progressive decrease in the distance that you can walk.
  • Pain and numbness that travels down your arms and/or legs, especially when it is worse with sneezing, coughing, or sitting down.
  • Pain that worsens when you’re lying down or that keeps you awake at night.
  • Pain accompanied by fever, weight loss or other signs of illness.

If none of the above are present, there are some things you can do on your own to both loosen and soothe your painful muscles and reduce the inflammation that’s causing the problem.

Bed Rest Isn’t Best. Going about your normal, everyday activities – but perhaps at a slower pace, and definitely avoiding what may have caused your pain in the first place – is a good way to start the healing process. A little “couch time” won’t hurt, but light activity speeds recovery, so avoiding lying down for long periods of time.

Cold Compresses. For the first 72 hours immediately following the onset of your muscle spasms, wrap an ice pack, cold gel pad (or a bag of frozen vegetables) in a thin cloth to avoid frostbite, and apply to the affected area for up to 20 minutes several times a day. Ice slows inflammation and swelling, numbs tissue and slows nerve impulses to the injured area. Take care, however, not to ice the area too long – cold therapy sessions longer than 20 minutes could potentially cause muscles to tighten even more or tissues to become more inflamed.

Heat Therapy. After the first three days, you can start using heat to loosen muscle tightness and increase blood flow. Waiting at least 72 hours after your spasms start allows the initial swelling and inflammation to go down, and moist heat is generally preferred to dry because it reduces the potential for dehydration. Good heat sources include a moist heating pad or heat pack, or a warm bath, Jacuzzi or shower.

Anti-Inflammatory Pain Relievers. Non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen, acetaminophen or naproxen sodium, can ease pain, swelling and stiffness. There are a number of over-the-counter and prescription options. Your physician or pharmacist can help you determine which is best for you.

External Bracing. Short-term use of a soft brace or corset can help ease muscle spasms by keeping the inflamed tissues or spinal structures immobilized. Worn properly, a brace can relieve pain and provide warmth, comfort and support (consult with your doctor or pharmacist for proper positioning and fit). But, don’t rely on this type of external support too long – allowing it to perform your muscles’ job will eventually weaken them, making re-injury easier.


Proper stretching before and after exercise is key to preventing cramps related to exercise. Calf stretching is particularly important before or after exercise. The other important preventive measure is to hydrate before, during, and after the exercise. It is wise to use a diluted electrolyte solution like Gatorade in this prevention strategy. Always exercise in moderation and build up to increased amounts.

As for nighttime cramps, the best prevention is to stay well hydrated, avoid alcohol or caffeine before bedtime, eat a balanced diet that has the recommended dietary requirements for vitamins and minerals. Foods rich in calcium, potassium, and magnesium are essential. Gently stretch muscles that have caused cramps before going to bed. Avoid assuming positions of the body that seem to cause cramping at night or during the day. Do not smoke.

Read more Muscle Spasm Diet and Home Remedies

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