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Alcohol withdrawal can cause extreme muscle spasms, along with a host of other symptoms. Alcohol addiction causes physical and emotional changes in the body, and when a person stops drinking, they may experience withdrawal symptoms, including muscle spasms and aches and pains. This is known as alcohol myopathy, which is a common issue in people who struggle with alcohol use disorder. Alcoholic myopathy can lead to damage to the heart muscle, sudden kidney failure, and even a potentially life-threatening condition called rhabdomyolysis. In severe cases, muscle spasms and other symptoms of alcohol withdrawal can be fatal if not addressed, and seizures are a potentially life-threatening bout of abnormal electrical activity in the brain.
| Characteristics | Values |
|---|---|
| Muscle spasms | Muscle spasms are one of the most common symptoms of AWS |
| Muscle twitching | Muscle twitching is a short-lived, jerky movement |
| Muscle pain | Muscle pain is typically duller but steadier over time |
| Muscle cramps | Muscle cramps are involuntary contractions of the muscle |
| Muscle seizures | Muscle seizures are potentially life-threatening bouts of abnormal electrical activity in the brain |
| Muscle tremors | Muscle tremors can be mild or more serious, like a full-body seizure |
| Muscle weakness | Muscle weakness is a symptom of alcoholic myopathy, a common issue in people with alcohol use disorder |
| Muscle wasting (atrophy) | Muscle wasting (atrophy) is a symptom of alcoholic myopathy |
| Nutritional deficiencies | Alcohol can cause nutritional deficiencies and prevent the body from properly absorbing nutrients |
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What You'll Learn
Alcohol withdrawal syndrome (AWS)
One of the most common symptoms of AWS is muscle tremors or spasms. These muscle spasms are involuntary contractions of one or more muscles that can be painful. They are caused by the hyperexcitability of the nervous system, which initiates jerky muscle movements. The excitatory brain activity responsible for muscle spasms and twitching occurs when the body has fully broken down the alcohol in the system, and the depressant effects wear off.
The brain maintains neurochemical balance through inhibitory and excitatory neurotransmitters. The main inhibitory neurotransmitter is gamma-aminobutyric acid (GABA), which is enhanced when drinking alcohol. This results in decreased overall brain excitability. However, chronic exposure to alcohol leads to a decrease in the GABA response, requiring increasing amounts of alcohol to achieve the same effect. When alcohol consumption is abruptly stopped, the brain becomes hyperexcited due to increased glutamate and decreased GABA levels.
The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scale is a validated tool used to quantify the severity of AWS. Scores of 8 points or fewer indicate mild withdrawal, 9 to 15 points correspond to moderate withdrawal, and scores above 15 indicate severe withdrawal with an increased risk of delirium tremens and seizures.
It is important to seek medical attention when experiencing muscle spasms due to alcohol withdrawal. AWS can lead to serious and potentially life-threatening complications, and medical professionals can help manage withdrawal symptoms in a clinical environment.
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Neurotransmitters and brain chemical changes
Alcohol withdrawal can cause muscle spasms, twitching, and tremors. These symptoms are a result of changes in brain chemistry, specifically in the neurotransmitters that control muscle movement.
Neurotransmitters are brain chemicals that carry signals between brain cells and play a crucial role in various bodily functions, including muscle movement, mood, energy levels, sleep, stress, and pain. Several neurotransmitters are implicated in alcohol use and muscle dysfunction.
The main inhibitory neurotransmitter is gamma-aminobutyric acid (GABA), which acts through the GABA-alpha (GABA-A) neuroreceptor. GABA is the primary inhibitory or "downer" chemical, and its effect is enhanced when drinking alcohol, resulting in decreased overall brain excitability. When a person stops drinking suddenly, the brain experiences a rebound effect, receiving less GABA than it has grown accustomed to, leading to brain hyperexcitability.
Glutamate, on the other hand, is one of the major excitatory neurotransmitters, often referred to as an "upper" chemical. It acts through the N-methyl-D-aspartate (NMDA) neuroreceptor. Alcohol inhibits these NMDA receptors, and chronic alcohol exposure results in an up-regulation of these receptors. When alcohol is removed from the brain, these previously inhibited receptors are no longer suppressed, contributing to brain hyperexcitability.
Other neurotransmitters impacted by alcohol use include serotonin, which promotes muscle contraction, and dopamine, which is responsible for healthy muscle tone and coordinated functioning.
The changes in these neurotransmitter systems during alcohol withdrawal lead to a range of symptoms, including muscle spasms, twitching, and tremors. These symptoms can vary in severity, with some people experiencing only mild hand tremors, while others may have more serious problems like full-body seizures. The severity of these symptoms is influenced by the length of time a person has been drinking, the volume of alcohol consumed, and individual differences in brain chemistry.
It is important to note that alcohol withdrawal can be a dangerous process, and it is recommended to seek medical supervision when undergoing detoxification to manage these neurotransmitter changes and withdrawal symptoms effectively.
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Muscle pain and cramps
Alcohol withdrawal can cause muscle pain and cramps, which are often referred to as "the shakes". These muscle spasms are a result of the hyperexcitability of the nervous system, which initiates jerky muscle movements. The excitatory brain activity is caused by the absence of the depressant effects of alcohol, which gives way to neurotransmitters that are responsible for muscle movement.
The neurotransmitters impacted by alcohol use include gamma-aminobutyric acid (GABA), glutamate, serotonin, and dopamine. GABA is the primary inhibitory or "downer" chemical, while glutamate is an excitatory or "upper" chemical. Serotonin promotes muscle contraction, and dopamine is responsible for healthy muscle tone and coordinated functioning. When alcohol use is stopped, the brain is left with very low dopamine levels, resulting in feelings of depression, tiredness, and lethargy.
In addition to muscle pain and cramps, other symptoms of AWS include nausea, vomiting, headaches, sweating, and hallucinations. It is important to seek medical attention if you are experiencing muscle spasms due to substance use or withdrawal, especially if the symptoms are sudden, severe, or new. Attempting to manage alcohol withdrawal without medical help can be dangerous, as it can lead to serious and even life-threatening complications.
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Alcoholic myopathy
Alcohol withdrawal can cause extreme muscle spasms, which are known as "the shakes". These spasms are a result of the hyperexcitability of the nervous system, which initiates jerky muscle movements. This is caused by the brain's chemical changes when a person stops drinking alcohol. The brain becomes very sensitive to glutamate, a neurotransmitter that promotes excitation.
Acute alcoholic myopathy occurs after binge drinking, while chronic alcoholic myopathy results from long-term heavy drinking. Acute alcoholic myopathy is present in 0.5 to 2.0% of alcoholics, with an overall prevalence of 20 cases per 100,000 people in the Western Hemisphere. It usually develops over hours to days and includes symptoms such as pain, weakness, swelling in affected muscles, and tightness of the muscles. Chronic alcoholic myopathy, on the other hand, is much more common, with a prevalence of 2,000 cases per 100,000 people. It presents with progressive proximal muscle weakness over weeks to months.
The symptoms of alcoholic myopathy can vary between people, and not everyone will experience all the symptoms. However, other symptoms may include dark urine, muscle tenderness, increasing weakness affecting the muscles surrounding the pelvis and shoulders, muscle wasting (atrophy), and twitching of the muscles. In some cases, alcoholic myopathy can lead to damage to the heart muscle, known as cardiomyopathy, which can be irreversible.
The best cure for alcoholic myopathy is to stop drinking alcohol. The condition will usually go away within 1 to 2 weeks of a binge-drinking episode. However, it can take longer to recover muscle strength and movement in chronic alcoholic myopathy. About 85% of people recover within 2 to 12 months of quitting all alcohol and are fully recovered within 5 years of sobriety.
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Treatment and recovery
In a medical detox program, doctors can manage your withdrawal symptoms in a clinical environment. Treatment for alcohol use disorder is available to assist you on the path to total wellness. Alcohol detox and nutrition therapy can treat the emotional and physical components of alcohol use. Nutrition therapy can address nutritional deficiencies associated with alcohol use that can have serious medical consequences.
Medications can help manage withdrawal symptoms and improve the chances of successful recovery by reducing cravings and helping prevent relapse. Several medications are useful in helping some people withdraw from alcohol use:
- Benzodiazepines for seizure prevention, sedation, and reducing agitation and anxiety
- Heart and blood pressure medications (such as beta-blockers or clonidine)
- Thiamine and magnesium to treat nutritional deficiencies
In addition to medical treatment, recovery from alcohol use disorder requires a comprehensive approach that addresses the underlying causes of addiction and provides ongoing support. Support groups, therapy, and lifestyle changes can all play a crucial role in the recovery process.
It is important to note that the recovery process may vary depending on individual needs and circumstances. Seeking professional help is the first step towards recovery, and it is crucial to have ongoing support throughout the process.
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Frequently asked questions
Yes, alcohol withdrawal can cause muscle spasms, which is one of the most common symptoms of alcohol withdrawal syndrome (AWS). These spasms are caused by the excitatory brain activity that occurs once the body has fully broken down the alcohol in the system.
AWS can cause a range of mild to severe symptoms, including nausea, vomiting, headaches, sweating, hallucinations, seizures, and in rare cases, full-body seizures. AWS can also cause emotional or behavioural changes, such as intense fear.
AWS symptoms typically start within 6-12 hours of the last drink and can last up to a few days. Muscle spasms and tremors usually begin within a few hours of the last drink, while seizures can occur anywhere from 2 to 20 days after the last drink.
It is important to seek medical help when experiencing alcohol withdrawal, as the symptoms can be dangerous and even life-threatening if not addressed properly. Medical professionals at accredited alcohol rehab centres can help manage withdrawal symptoms in a safe and clinical environment.
