What causes leg cramp pain lasting for days? Related conditions and treatments

Overview: What does persistent leg cramp pain feel like?

Leg cramps or “charley horses” are easily confused with muscle stiffness, pain, tension, or spasms. Muscle stiffness is a loss of flexibility in a muscle, making it harder and more painful to move. Muscle tension, or a “knot,” occurs when a muscle gets tight and rigid and stays that way. Muscle soreness is a dull ache or pain that can last for hours or days. Muscle spasms are any involuntary and sudden muscle contraction, like a twitch. Leg cramps are a type of muscle spasm, but they are sudden, very painful, and last from a few seconds to ten minutes. After the initial sharp pain disappears, leg pain may linger for hours or longer. Leg cramps do not last for days themselves, but they can happen repeatedly. Leg pain can linger for hours afterward before the next cramp strikes. This cycle of repeated cramping followed by muscle pain is what people mean when they call the experience “a leg cramp that lasts for days,” but it’s more properly thought of as frequent leg cramps. 

RELATED: 7 causes of muscle aches

What causes leg cramp pain lasting for days?

Recurrent leg cramps can strike at any time of day, but it depends on the underlying cause. Some medical conditions cause recurrent leg cramps, more commonly at night. Others may cause leg cramps primarily when walking or using the leg muscles.

Some causes of recurrent leg cramps include:

• Electrolyte imbalances: Persistent leg cramps can be a problem for people with low magnesium, low potassium, or low calcium. Depending on the condition and its severity, there may be other symptoms like twitches, muscle weakness, tingling, numbness, tremor, irregular heartbeats, or delirium.

• Underactive thyroid: Hypothyroidism can cause a range of chronic muscle problems, including weakness, pain, and cramps. Exercise may make these problems worse. 

• Kidney disease: People with moderate to severe kidney disease often have recurrent leg cramps along with other symptoms such as swelling of the feet and ankles, dry skin, urination problems, and insomnia. Leg cramps often happen during or following dialysis.

• Cancer: People with cancer may experience frequent leg cramping either because of the effects of cancer itself or as a side effect of cancer treatments.

• ALS: Amyotrophic lateral sclerosis (ALS) is a severe degenerative nerve disease that causes muscle weakness and paralysis. Muscle cramps are a common symptom in people who have ALS.

• Spinal nerve compression: Conditions like spinal stenosis can compress the spinal nerves in the lower back. That may cause frequent muscle cramps and other symptoms like numbness, tingling, and lower back pain.

• Medication side effects: Some drugs can cause persistent leg cramps, like cancer drugs. Statin cholesterol medications may cause muscle pain, but persistent muscle cramps are a rare side effect. Taking diuretics (water pills) may be a risk factor for leg cramps because of changes in electrolytes and dehydration. Some other common medications that may be associated with leg cramps include raloxifene (Evista), estrogens, and naproxen.

Some health conditions cause recurrent leg cramps that happen more often at night. These include:

• Peripheral neuropathy: Peripheral nerve damage can be caused by diabetes, infections, liver disease, kidney disease, injuries, alcohol abuse, nutritional deficiencies, and medication side effects. Besides recurrent nocturnal leg cramps, there may be other symptoms like muscle twitching, weakness, and numbness.

• Leg vein problems: Sometimes the veins in the legs can’t return all the blood to the heart. Nighttime leg cramps are common, but there will probably be other symptoms like varicose veins and leg swelling.

• Parkinson’s disease: Parkinson’s disease is a degenerative brain disorder. Various muscle problems are associated with Parkinson’s, including tremors, muscle stiffness, and slow movements. Leg cramps may be due to Parkinson’s disease itself, or occur as a result of the effect of Parkinson’s medications wearing off.

• Liver cirrhosis: Besides repeated nighttime muscle cramps, liver cirrhosis has other prominent symptoms, such as fatigue, bruising, itchy skin, and yellowing skin (jaundice).

• Pregnancy: Healthcare professionals are unsure why repeated leg cramps are common in the later stages of pregnancy, but it may be an effect of leg swelling. Leg cramps in pregnancy happen more commonly at night.

Some health conditions cause repeated leg cramps when the leg muscles are used, such as when walking or climbing stairs. These causes include:

• Peripheral artery disease: Peripheral artery disease reduces blood flow to the legs, so leg cramps are commonly experienced when walking, climbing, or engaging in activities involving the legs. The cramps get better when resting.

Severe anemia: Severe anemia can cause frequent leg cramps during exercise, but there will be other symptoms, such as fatigue, weakness, shortness of breath, and chest pain.

RELATED: What causes leg cramps? Related conditions and treatments

Should I be worried about leg cramp pain lasting for days?

See a doctor if you have frequent leg cramps and persistent leg pain or muscle stiffness as a result. It may be a symptom of an underlying condition that needs evaluation and treatment. Even if the cause isn’t serious, the cramps and muscle pain will likely interfere with sleep and affect your quality of life. Immediate care is usually not necessary. However, if frequent leg cramps and chronic leg pain are accompanied by severe symptoms like heartbeat abnormalities, get medical attention right away.

How is the cause of persistent leg cramp pain diagnosed?

Most people with persistent leg cramps will start by visiting a primary care provider. Depending on the suspected cause, you may later be referred to a specialist. 

The diagnosis will start with a thorough medical history, physical examination, and a review of your symptoms, risk factors, medications, and current health conditions. The clinician will closely examine the leg, reflexes, and possibly the leg’s blood pressure. Since leg cramps are short-lived and unpredictable, the patient will probably not experience a leg cramp while being examined, but there may be other observable muscle problems. 

Depending on the possible cause, blood tests, urine tests, thyroid function tests, muscle tests, nerve tests, blood flow tests, and walking ability tests may be needed. Some possible causes may require X-rays, CT scans, or similar imaging studies.

How long does persistent leg cramp pain last?

People will experience leg cramping and chronic leg pain for as long as an underlying condition is causing it. Some conditions can be rapidly treated, but others may be chronic or degenerative conditions. Symptoms are likely to be lifelong in those cases but can be managed.

How to stop leg cramp pain lasting for days

Treatments will depend on the underlying condition. As the condition resolves, leg cramping and other symptoms should also fade.

Treatment for an active leg cramp involves conservative measures such as:

• Massaging the affected muscle

• Stretching the affected muscle

• Mild exercise if the cramp happens at rest. Rest if it happens while walking.

• Applying a heating pad to the affected muscle

• Applying ice to relieve some of the pain

Pain relievers will not help a cramping muscle, but they can relieve the muscle soreness that follows a cramp.

Preventive measures such as stretching and mild exercise can reduce the frequency of leg cramps. Drinking enough water helps, too. It may be even more helpful to combine water with electrolytes but talk with your healthcare provider first if you have chronic conditions like kidney problems. 

At one time, healthcare professionals prescribed quinine, a malaria drug, for leg cramps. Although it was effective, it had potentially serious side effects and is no longer FDA-approved for leg cramps. 

No medication has been shown to consistently prevent muscle cramps. But there are treatments that have been shown to work in some people. These include:

• Diltiazem, a calcium channel blocker usually prescribed for high blood pressure 

• B complex vitamins Gabapentin (a nerve pain medication)

• Magnesium supplements (in nonpregnant people)

• Multivitamins 

• Vitamin E

• Orphenadrine, a muscle relaxant. 

You and your clinician will work together to find the best treatment to decrease and prevent leg cramps. Most important is to treat the underlying condition that may be causing them.

Living with persistent leg cramp pain

There are some effective things you can do at home to reduce the frequency of leg cramps. These include:

• Regularly stretching the muscles throughout the day, particularly the calf muscles

• Doing mild exercise during the day

• Drinking eight glasses of water a day 

• Wearing comfortable shoes with good support

• Regularly walk around you sit for long periods

• If nighttime leg cramps are a problem, stretch the leg muscles and do mild exercise before bedtime

• Sleep with loose covers and keep the feet pointing upward

What’s next? Additional resources for people with leg cramp pain lasting for days

Test and diagnostics

• Peripheral artery disease: diagnosis, NIH National Heart, Lung, and Blood Institute 

Treatments

• Nocturnal leg cramps, American Family Physician

• Treatments for nocturnal leg cramps, American Family Physician

• What causes leg cramps? Related conditions and treatments, SingleCare

Scientific studies and clinical trials

• Muscle cramps and diuretic therapy, The Journal of Clinical Hypertension

• The natural history of muscle cramps in amyotrophic lateral sclerosis, Muscle Nerve

More information on related health conditions

• ALS treatments and medications, SingleCare

• Anemia treatments and medications, SingleCare

• Hypothyroidism treatments and medications, SingleCare

• Restless legs syndrome treatments and medications, SingleCare

• Varicose veins treatments and medications, SingleCare