The calf ache that comes on during a walk and goes away once you stop to rest is worth raising with your own doctor, even when it hurts less than the cramp that wakes you at night. Pain, aching, heaviness or cramping in the legs that comes when walking or climbing stairs and goes away after rest is called intermittent claudication, and it is the most common symptom of peripheral artery disease. In that disease, plaque made of fat and cholesterol builds up on the walls of the arteries that supply blood to the arms and legs, narrowing or blocking them, which can reduce or stop blood flow, usually to the legs.
What ends a calf cramp while it has hold of you
Stop what you are doing, then stretch and massage the cramping calf muscle; stretching may be enough to end it. The muscle may feel hard or bulging while it cramps. Use heat to relax it as the spasm begins; later, once the pain has started to improve, ice may help.
Muscle cramps are sudden, involuntary contractions, and some people get them at night, especially in the legs. They can last from a few seconds to several minutes, and they usually need no treatment beyond that, though getting more fluids may bring some relief if you are dehydrated. If another medical problem is causing the cramps, treating that problem will likely help. Providers sometimes prescribe medicines to prevent cramps, but those medicines are not always effective and may cause side effects, so talk with your own doctor about their risks and benefits before you try one.
To help prevent the next one, stretch your muscles, especially before exercising, and if you often get leg cramps at night, stretch your leg muscles before bed. Drink plenty of liquids; if you do intense exercise or exercise in the heat, sports drinks can help you replace electrolytes. When a cramp comes on during sport, drinking water often eases it, though water alone does not always help.
When to call your own doctor's office about a cramp
Call your own doctor's office if your cramps:
- are severe
- happen frequently
- do not get better with stretching and drinking enough fluids
- last a long time
- come with swelling, redness or a feeling of warmth
- come with muscle weakness
Any one of them is reason enough on its own. For swelling, redness or warmth, call that office right away: redness, skin that feels warm to the touch, swelling, or pain or tenderness in a leg, most often on one side, can be signs of a blood clot in a deep vein of the leg, which may lead to a life-threatening clot in the lungs, called a pulmonary embolism. If you have those signs and then develop chest pain, coughing up blood, difficulty breathing, fainting, loss of consciousness or other severe symptoms, call 911 or get to the emergency room.
What makes a calf cramp, from an overused muscle to too little fluid
Straining or overusing a muscle is what most often brings on a muscle cramp, though during sport not getting enough fluids is the most common cause. Other causes include:
- compression of your nerves, from problems such as a spinal cord injury or a pinched nerve in the neck or back
- dehydration
- low levels of electrolytes such as magnesium, potassium or calcium
- not enough blood getting to your muscles
- pregnancy
- certain medicines
- getting dialysis
Sometimes the cause is unknown. Drinking more water or eating more potassium can help with at most two of these causes, dehydration and low electrolytes, and not with a strained or overused muscle. Anyone can get muscle cramps, but they are more common in older adults, people who are overweight, athletes, pregnant women, and people with certain medical conditions, such as thyroid and nerve disorders.
If you now eat and drink noticeably less than you once did, tell your own doctor when you see them about the cramps. Dehydration and low electrolytes are both causes a visit can look into, and blood tests may be done to check calcium, potassium or magnesium metabolism, as well as kidney and thyroid function. Bring a list of the medicines you take, and be ready to say whether anything has been dehydrating you.
How the walking ache relates to the night cramp
The walking ache and the night cramp can have different causes, and your own doctor is the one to judge whether they are related. Pain of the walking kind is often in the calf, but you may also feel it in your buttocks, thigh or foot.
Feeling nothing in your legs most days does not mean your arteries are clear. About 1 in 4 people with peripheral artery disease have its typical symptoms, more than half have nontypical ones, and about 1 in 5 report no symptoms at all. Whatever the symptoms, everyone with the disease shares the same high risk of cardiovascular disease.
Smoking is the main risk factor for the disease, and older age, diabetes, high blood cholesterol, high blood pressure, heart disease and stroke are others. Mention whichever of them apply to you when you describe the ache to your doctor. Without treatment, the disease may cause sores, infections and even the loss of a limb.
If you have peripheral artery disease, call 911 right away if you cannot feel or move your foot, if your leg or foot hurts or feels like pins and needles while you are resting, or if one foot is paler or colder than the other. Those are signs of a sudden drop in blood flow to the leg, a medical emergency called acute limb ischemia. If you have the disease and also get night cramps, ask your own doctor at your next visit how to tell a cramp from that kind of pain at rest.
How a doctor tells the two pains apart at a visit
Your doctor diagnoses peripheral artery disease from your medical and family history, a physical exam and the results of tests and procedures. Conditions such as arthritis and vein problems can cause leg pain too, with different symptoms, and the exam and your history can help rule them out (see Can you start moving when your knees already hurt?). Nerve problems can cause pain that may be confused with the artery kind: sometimes a nerve is squeezed where it leaves the spinal column, and the pain spreads from the hips or buttocks down the leg.
To tell artery pain from nerve pain, your doctor may ask you to stand up or change position, because those movements often bring on nerve pain. Pain from narrowed arteries is often brought on by leg exercise and quickly relieved by rest, with no need to change position.
During the exam, your doctor will check for weak pulses in your legs, listen with a stethoscope for an abnormal whooshing sound called a bruit, and look at your legs and feet for swelling, sores or pale skin. The ankle-brachial index is usually the first test. It compares the blood pressure in your ankle with the blood pressure in your arm, using a blood pressure cuff and an ultrasound device, and it is painless.
Before the visit, find out whether anyone in your family has had peripheral artery disease, heart disease or another blood vessel disease, because your doctor may ask about that family history, as well as about chronic kidney disease, smoking now or in the past, and wounds on your legs or feet that are slow to heal.
Ask your own doctor's office for an appointment about the walking ache. Describe it as pain that comes on with walking and goes away with rest, say where in the leg you feel it, and bring up the night cramps at the same visit.
If NicoCares handles your weight care, make that appointment with your own doctor all the same. Then, in Spruce, the app you set up to reach your care team, tell them promptly about side effects, new medications or changes in your health: the new ache, since certain medicines can cause cramps, and eating and drinking less than you used to. A Spruce reply has no set time, so for a swollen, red or warm calf, phone your own doctor's office right away.
