Condition	Clinical features	Diagnosis	Treatment
Claudication	Aching, sometimes cramping, deep pain brought on by exercise; relieved with rest	History Atherosclerotic risk factors Ankle-brachial index Radiographic studies	Risk factor modification Graded exercise Invasive interventions
Exercise-associated muscle cramping	Painful cramps during or immediately after exercise Palpable muscle tightening	History	Graded exercise and stretching
Hypnic myoclonus	Sudden involuntary jerking at the onset of sleep May awaken the patient	History (from bed partner)	Reassurance
Myositis, myalgias	Deep, aching pain unrelated to exertion Weakness and poor exercise tolerance Often occurs in legs, but can affect any muscle	History Elevated creatinine kinase levels (myositis) Statin use Evaluation for polymyositis and dermatomyositis	Treat underlying cause Discontinue statin
Periodic limb movement disorder	Nonpainful, repetitive, rhythmic, slow dorsiflexion of toes, knees, and hips during sleep Daytime fatigue Patient is unaware	History (from bed partner) Polysomnography	Sleep modification, including medications
Peripheral neuropathy	Numbness, tingling, and “electrical” pain with possible secondary cramps Unrelated to exercise, time of day, or sleep	History Diabetes mellitus, low vitamin B₁₂ level, alcoholism, human immunodeficiency virus infection Electromyography Nerve biopsy	Treat underlying condition Pain medications, anticonvulsants, tricyclic antidepressants
Restless legs syndrome	Irresistible urge to move or shake the legs, usually in the evening; relieved by movement Uncomfortable, but not painful No visible muscle cramping	History	Dopaminergic drugs