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Muscle loss, or muscle atrophy, is a decrease in muscle mass and strength. It can be caused by ageing, malnutrition, genetics, lack of physical activity, nerve damage, or certain medical conditions. Muscle loss is often associated with muscle weakness and reduced endurance. While muscle fatigue is a common symptom of muscle loss, it can also be caused by other factors such as exercise, illness, or underlying health conditions. Fatigue is characterised by a decrease in the force generated by muscles, leading to weakness and exhaustion. The treatment for muscle fatigue depends on the underlying cause and may include rest, hydration, and a healthy diet. In some cases, muscle fatigue can indicate a more serious disorder, especially if it persists or is accompanied by other symptoms. Therefore, it is important to consult a healthcare professional for a proper diagnosis and treatment plan.
| Characteristics | Values |
|---|---|
| Muscle loss terminology | Sarcopenia, Muscle atrophy, Disuse atrophy, Neurogenic atrophy |
| Muscle loss causes | Ageing, malnutrition, genetics, lack of physical activity, nerve problems, disease, illness, medications |
| Fatigue causes | Exercise, physical activity, nerve problems, disease, illness, medications, cancer treatments, psychological distress, depression, pain, sleep disturbance, chemotherapy, radiotherapy |
| Muscle loss symptoms | Muscle weakness, loss of stamina, difficulty performing daily activities, walking slowly, trouble climbing stairs, poor balance, falls |
| Fatigue symptoms | Decreased force of muscle movements, weakness, exhaustion, soreness, localized pain, shortness of breath, muscle twitching, trembling, weak grip, muscle cramps |
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What You'll Learn
Muscle loss and fatigue in cancer patients
Muscle loss and fatigue are common in cancer patients, with muscle dysfunction affecting patients across all stages of the cancer trajectory. This phenomenon is not limited to palliative or advanced-stage patients but is also found in newly diagnosed patients with low tumor burden.
Cancer-related muscle dysfunction is a broad clinical challenge with a highly complex etiology. It can be caused by a wide range of tumor-, therapy-, and/or lifestyle-related factors, depending on the individual patient's clinical setting. For instance, in patients with esophagus or gastric cancer, neoadjuvant chemotherapy resulted in a 10-cm2 reduction in L3 muscle area, increasing the prevalence of sarcopenia from 57% to 78%. Chemotherapy may also induce fatigue and a severe decrease in muscle strength, especially in striated muscles.
The mechanisms underlying cancer-related muscle wasting are diverse and not yet fully understood. Cancer cachexia, a severe and disabling clinical condition that frequently accompanies many cancer types, is characterized by a progressive loss of skeletal muscle mass and significant functional impairments. It is associated with muscular fatigue and cannot be fully reversed by conventional nutritional support. Available evidence suggests that increased muscle protein degradation, impaired muscle protein synthesis, and defective myogenesis may contribute to cancer-induced muscle wasting. Additionally, alterations in energy metabolism, mitochondrial dysfunction, inflammation, autophagy, and disrupted protein synthesis/degradation have been implicated in the wasting process.
The current lack of effective therapies for cancer-associated muscle weakness highlights the urgent need for novel interventions. While most research has focused on improving muscle mass, recent evidence suggests that loss of muscle function precedes atrophy. Exercise training has been proposed as a potential intervention to prevent and/or mitigate cancer-related muscle dysfunction. Studies have shown that physical exercise may have beneficial effects on cancer patients during and after active treatment, improving quality of life and reducing fatigue. Both aerobic and resistance exercises, or a combination of both, may contribute to improving muscle strength in cancer patients.
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Sarcopenia and muscle weakness
Sarcopenia is a type of muscle atrophy that specifically affects people as they grow older. Muscle atrophy is the loss or thinning of muscle tissue. The two conditions share common features of muscle loss, but the processes behind them are different. A decrease in the size and number of muscle fibres causes sarcopenia. With muscle atrophy, there is a reduction in the size of the fibres, but the amount of fibres stays the same. Sarcopenia is the age-related progressive loss of muscle mass and strength. The main symptom of the condition is muscle weakness.
The rate of muscle loss in sarcopenia is dependent on exercise level, co-morbidities, nutrition, and other factors. The muscle loss is related to changes in muscle synthesis signalling pathways. It is distinct from cachexia, in which muscle is degraded through cytokine-mediated degradation, although the two conditions may co-exist. Sarcopenia is considered a component of frailty syndrome. Sarcopenia can lead to reduced quality of life, falls, fractures, and disability. Sarcopenia is a factor in changing body composition. When associated with ageing populations, certain muscle regions are expected to be affected first, specifically the anterior thigh and abdominal muscles.
The pathologic changes of sarcopenia include a reduction in muscle tissue quality as reflected in the replacement of muscle fibres with fat, an increase in fibrosis, changes in muscle metabolism, oxidative stress, and degeneration of the neuromuscular junction. The failure to activate satellite cells upon injury or exercise is also thought to contribute to the pathophysiology of sarcopenia. Additionally, oxidized proteins can lead to a buildup of lipofuscin and cross-linked proteins, causing an accumulation of non-contractile material in the skeletal muscle and contributing to sarcopenic muscle. In sarcopenic muscle, the distribution of the types of muscle fibres changes with a decrease in type II muscle fibres, or "fast twitch," with little to no decrease in type I muscle fibres, or "slow-twitch" muscle fibres.
The hallmark sign of sarcopenia is the loss of lean muscle mass, or muscle atrophy. Sarcopenia may also cause reduced strength, functional decline, and an increased risk of falling. Sarcopenia may also have no symptoms until it is severe and is often unrecognized. Hypertrophy may occur in the upper parts of the body to compensate for this loss of lean muscle mass. An early indicator for the onset of sarcopenia can be significant loss of muscle mass in the anterior thigh and abdominal muscles.
There are ways to treat and even reverse the effects of sarcopenia. Your healthcare provider can diagnose the condition and develop a treatment plan for you to revert the muscle loss and improve your condition. Progressive resistance-based strength training can help improve your strength and reverse your muscle loss. Healthy diet plans, when paired with regular exercise, can also help reverse the effects of sarcopenia. It is especially important to increase protein intake through food or supplements.
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Neurogenic atrophy
Muscle atrophy is the loss or thinning of muscle mass. It can be caused by disuse of muscles or neurogenic conditions. Disuse atrophy occurs when muscles are not used enough, leading to a decrease in size and strength. On the other hand, neurogenic atrophy is caused by nerve problems, injuries, or diseases that affect the nerves connecting to the muscles. When these nerves are damaged, they cannot trigger the necessary muscle contractions, leading to a decrease in muscle size and strength.
Diseases and conditions that can lead to neurogenic atrophy include Amyotrophic Lateral Sclerosis (ALS), Guillain-Barre Syndrome, Carpal Tunnel Syndrome, spinal cord injuries, and Multiple Sclerosis. The symptoms of neurogenic atrophy can include reduced muscle mass, weakness, numbness, and tingling in the limbs, as well as trouble walking or balancing, and difficulty swallowing or speaking.
To diagnose neurogenic atrophy, a healthcare provider will conduct a physical examination and evaluate the patient's symptoms. They may also order specific tests, such as blood tests, muscle or nerve biopsies, electromyography (EMG), nerve conduction studies, computed tomography (CT) scans, and magnetic resonance imaging (MRI) scans.
While there is currently no cure for neurogenic atrophy, treatments are available to help manage the condition. These treatments may include physical therapy, ultrasound therapy, and, in certain cases, surgery to correct contractures. An exercise program, including exercises in a swimming pool to reduce muscle workload, can also be beneficial.
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Disuse atrophy
The symptoms of disuse atrophy include a noticeable decrease in muscle mass, with one limb sometimes appearing smaller than the other. Individuals may experience weakness, numbness, or tingling sensations in their arms and legs. These symptoms can lead to difficulty in performing daily activities, such as walking or balancing, and may even affect swallowing or speaking.
The progression of disuse atrophy is influenced by various factors, including age, fitness level, and the underlying cause of the atrophy. Older individuals may experience more rapid muscle loss due to ageing-induced anabolic resistance, which amplifies the effects of reduced physical activity. Understanding the specific causes and individual characteristics is essential for developing effective treatment plans.
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Treatments for muscle fatigue
Muscle fatigue is a commonly experienced phenomenon that limits athletic performance and other strenuous or prolonged activity. It is also associated with various pathological conditions, including neurological, muscular, and cardiovascular disorders, as well as ageing and frailty. While there are no official recommendations for treating muscle fatigue, several treatment options can help manage and alleviate the condition. Here are some treatments for muscle fatigue:
Rest and Recovery
Taking breaks and allowing your body to rest is crucial in managing muscle fatigue. Always include rest days in your exercise routine and ensure proper cool-down periods after intense physical activity. Light aerobic exercises, such as jogging or biking, can help your body transition from a state of high intensity to recovery.
Hydration and Nutrition
Staying hydrated is essential for muscle recovery. Drinking plenty of water helps flush out toxins and delivers nutrients to your muscles. Maintaining a healthy and balanced diet is also crucial. Consult a healthcare professional or a nutritionist to ensure you're getting the right nutrients to support muscle health.
Stretching and Exercise Modification
Stretching before and after physical activity can help prevent and alleviate muscle fatigue. It improves blood flow to the muscles and reduces soreness. Additionally, it's important to listen to your body and adjust your exercise routines accordingly. If you're experiencing soreness or fatigue, consider reducing the intensity or modifying your exercises to prevent further fatigue and potential injury.
Nutritional Supplements
Nutritional supplements, such as vitamins, minerals, and creatine, can help improve muscle performance and reduce fatigue. Consult a healthcare professional to determine which supplements are suitable for your specific needs.
CNS-Exciting Drugs and Natural Products
In some cases, central nervous system (CNS)-exciting drugs may be recommended to improve muscle performance and reduce fatigue. Additionally, natural products like American ginseng and rhodiola rosea have been clinically studied and shown potential in treating muscle fatigue.
It is important to consult a healthcare professional to receive a proper diagnosis and develop a treatment plan tailored to your specific needs and health status. They can assess your medical history, perform tests, and rule out any underlying health conditions that may be contributing to your muscle fatigue.
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Frequently asked questions
Muscle loss, or muscle atrophy, is the loss or thinning of muscle tissue. This results in a decrease in muscle mass and strength.
Muscle loss is primarily caused by aging, but it can also be caused by malnutrition, genetics, physical inactivity, nerve problems, or certain medical conditions.
Muscle weakness is a common symptom of muscle loss. Other symptoms may include loss of stamina, difficulty performing daily activities, and trouble with balance.
Muscle loss can lead to muscle fatigue, which is characterized by a decrease in the force behind muscle movements, causing weakness. However, muscle fatigue can also be caused by other factors such as exercise, illness, or certain medical conditions.
Treatment for muscle loss and fatigue depends on the underlying cause. In some cases, muscle loss and fatigue can be improved through progressive resistance-based strength training, a healthy diet, and increasing protein intake. Staying hydrated, stretching, and getting adequate rest can also aid in recovery.
