What Causes Leg Cramps: Cardiac Risks with Leg Pain

By: Dr. George H. Mueller, III

There are many everyday reasons for leg cramps: dehydration, nerve compression, or just sleeping in the wrong position for too long. But some leg cramps may be a sign of a more serious condition. Read on to learn more about the cardiac risk factors tied to leg cramps, and what you can do to address them.

How Leg Pain and Heart Disease Are Related

Most leg cramps are unlikely to be anything serious. But under certain conditions, a leg cramp may be a sign of Peripheral Arterial Disease. PAD is a blockage that causes pain with exertion (and, in more serious cases, at rest). PAD may be the first sign of undiagnosed heart disease, and is often treated as synonymous with heart disease because the blockage causes pain -- just as blockage in the heart causes chest pain.

The risk factors for peripheral arterial disease are the same as those for heart disease: smoking, obesity, high blood pressure, high cholesterol, and diabetes. Of these, smoking is one of the most impactful (and most reversible) risk factors.

Many things can be done to slow the progression of PAD. But it helps if the condition is caught early.

Other Causes of Cramps

Sometimes a leg cramp is just a leg cramp. There may be any number of causes for such a cramp, including:

  • Dehydration
  • Overuse or overexertion of muscles ("weekend warriors" are particularly susceptible)
  • Sleeping or staying in one position too long
  • Muscle strain

However, if you notice muscle cramps appearing on their own while at rest, or combined with any of the following conditions, it may be time to see a doctor:

  • Severe discomfort
  • Skin redness
  • Muscle weakness
  • Frequent or recurring cramps
  • Lack of improvement with home remedies
  • Cramps appearing without apparent cause (such as exercise)

Treatment Steps

When patients come in to see us for leg cramps, we start by discussing their symptoms and doing a physical exam. This is followed by a diagnostic treatment plan for addressing the problem.

At VCS, we prefer to start with non-invasive testing first, such as checking the blood pressure in the legs (called an ABI), or performing an ultrasound to check the blood flow in the legs.

If these tests turn out normal, then the cramp is likely not related to a blockage. In the case of abnormal test results, there are various follow-up strategies for dealing with the problem:

  • In the case of severe blockage, we may pursue invasive strategies, such as a catheter, to address the issue quickly and minimize further risks.
  • For mild to moderate risks, we often use additional imaging techniques to observe the blood flow and draw up a plan for medical therapy, home exercise, or more invasive strategies if required.

Risk Factors

Peripheral arterial disease and heart disease go hand-in-hand. The risk factors for both conditions are the same -- and in both cases, early detection is key to minimizing your risk.

If you're experiencing ongoing, severe, or unexpected leg cramps, ask yourself: What would you do if this was chest pain? Would you get it evaluated?

If you have questions or concerns about leg cramps, PAD, or heart health, contact Virginia Cardiovascular Specialists at 804.288.4827 today to make an appointment and discuss your symptoms.


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