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Muscle weakness is a common issue that can be caused by a variety of factors, ranging from a tough workout to more serious conditions such as multiple sclerosis or amyotrophic lateral sclerosis. It is characterised by a reduction in the force a muscle can exert and can manifest as a lack of muscle strength or fatigue. If you are experiencing muscle weakness, it is important to consult a doctor, especially if the weakness is sudden and severe. A doctor will conduct a physical examination to assess the affected muscles and determine whether the weakness is true or perceived. They may also recommend further tests such as blood tests, nerve studies, or muscle biopsies to identify the underlying cause and suggest appropriate treatment options.
| Characteristics | Values |
|---|---|
| Definition | Muscle weakness occurs when your full effort doesn't produce a normal contraction or movement. |
| Types | Muscle weakness can be of three types: the inability to perform normal actions with the muscle; a reduction in the force the muscle can exert; and the muscle not working properly, becoming abnormal. |
| Causes | Muscle weakness may be caused by a chronic condition, an infection, or a tough workout. Conditions that can cause muscle weakness include Addison's disease, anemia, diabetes, fibromyalgia, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and many others. |
| Diagnosis | Doctors may perform muscle strength testing to evaluate weakness and differentiate it from other problems like pain, balance, or endurance. They may also test for neurological deficits, especially in patients with stroke, brain injury, spinal cord injury, or neuropathy. |
| Treatment | Treatment options include physical therapy, exercises, over-the-counter pain relievers, and assistive devices. |
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What You'll Learn
Common causes of muscle weakness
Muscle weakness is a common condition, but the causes can vary widely. It can be caused by something as simple as a tough workout or a lack of exercise. However, persistent muscle weakness without an apparent cause could indicate an underlying health condition.
Some common causes of muscle weakness include:
- Neuromuscular disorders: These include muscular dystrophies, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), and autoimmune diseases such as Graves' disease, myasthenia gravis, and Guillain-Barré syndrome.
- Neurological conditions: These affect how a person's nerves transmit messages to their muscles. Examples include cervical spondylosis, age-related changes to the spinal disks in the neck, and Lambert-Eaton myasthenic syndrome, an autoimmune disorder that interferes with nerve and muscle communication.
- Chronic conditions and infections: Conditions such as Addison's disease, anemia, diabetes, fibromyalgia, and chronic fatigue syndrome can cause muscle weakness. Infections such as the flu, Lyme disease, meningitis, and HIV can also lead to muscle weakness.
- Medications: Certain medications, such as statins, antibiotics, and anti-inflammatory painkillers, can cause muscle weakness as a side effect or allergic reaction.
- Injury and inactivity: Muscle weakness can be caused by a lack of exercise, ageing, muscle injury, or pregnancy. It can also be a result of an inactive lifestyle, leading to muscle wasting and reduced bulkiness.
- Stroke and spinal cord injuries: These can interrupt communication from the nerves to the muscles, resulting in muscle weakness.
If you are experiencing muscle weakness, it is important to consult a healthcare professional for a proper diagnosis and treatment plan. They will assess your symptoms, medical history, and may perform examinations or refer you to specialists for further tests.
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Medical tests for muscle weakness
Patient History and Physical Examination
Determining the cause of muscle weakness often begins with a detailed patient history, including differentiating weakness from conditions like fatigue or asthenia. Physicians will inquire about the pattern and severity of weakness, associated symptoms, medication use, and family history. A physical examination involves objectively documenting the patient's loss of strength, conducting a neurological survey, and assessing functional activities such as standing and writing to determine the extent of weakness.
Laboratory and Radiological Studies
If a specific cause of muscle weakness is suspected, the physician may recommend laboratory or radiological tests. These can include blood tests to check for certain antibodies or infections, CT scans, or MRIs to visualize the affected area.
Muscle Strength Testing
This involves evaluating the patient's muscle strength and neurological function. Common methods include the Medical Research Council Manual Muscle Testing scale (also known as the Oxford Scale), which grades muscle strength on a 0 to 5 scale, and dynamometry, which measures the force a muscle can exert. Functional strength tests, such as squatting or rising from a chair, are also used to assess the patient's ability to perform daily activities.
Nerve Conduction Study
This test assesses how well the body's electrical signals move along the nerves. Electrodes are placed on the skin above the nerve being tested, and mild electrical pulses are sent to trigger the nerve to signal the muscle. This test can help identify nerve damage.
Electromyography (EMG)
EMG examines the electrical signals muscles produce at rest and during activity. A small needle with an electrode is inserted into the muscle to record these signals. If the muscle is damaged, it may show abnormal electrical activity.
Lung Function Tests
In certain conditions, such as myasthenia gravis, muscle weakness may be associated with breathing difficulties. Lung function tests involve breathing into a mouthpiece or machine to measure respiratory function. These tests are typically painless and low-risk.
Muscle Biopsy
In some cases, a small piece of muscle tissue may be surgically removed for testing. This is particularly relevant for diagnosing and determining the treatment plan for myopathies, which are diseases that attack muscle fibers and cause weakness.
It is important to note that the specific tests performed will depend on the suspected underlying cause of muscle weakness and the patient's individual circumstances. A comprehensive evaluation by a healthcare professional is essential for an accurate diagnosis and appropriate treatment plan.
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Exercises to improve muscle weakness
Muscle weakness can be improved through exercise and physiotherapy. Strength and flexibility exercises can help to increase muscle strength, maintain bone density, improve balance, and reduce joint pain.
It is recommended to do muscle-strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) two or more days a week. Each training session can take less than 20 minutes and should work the muscles to the point where a short rest is needed before continuing. For example, if you're lifting weights, you would need to put the weight down after a number of lifts before continuing.
- To strengthen the muscles in your legs, buttocks, and core, take a big step forward with one leg and bend your knee so that it's at a 90-degree angle with the floor. Bring your other leg down until it's almost touching the floor. Push yourself back up to the starting position. Alternate legs with each rep.
- To strengthen the muscles in your arms and shoulders, hold weights or a full water bottle and bend your elbows, keeping your arms close to your body. Then, bring them straight up over your head and back down.
- To strengthen your core and improve motor coordination, do two to three sets of 15 to 30 jumps, resting for about a minute between each set.
- To strengthen the muscles in your abs and back, get into a push-up position on the floor, resting your weight on your forearms and toes, and hold your body above the floor. Your body should form a straight line from head to feet. Hold this position for 15 to 60 seconds. Do two to three sets, resting for about a minute between each set.
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Neurological causes of muscle weakness
Muscle weakness can be a symptom of many chronic conditions and acute infections. It can also be a side effect of certain medications. Neuromuscular disorders, for example, are a group of conditions that involve dysfunction of the peripheral nerves, muscles, or the communication between them. These disorders result in muscle weakness and fatigue that progress over time. Some neuromuscular disorders are inherited, while others are caused by spontaneous gene mutations or immune system disorders.
There are several neurological causes of muscle weakness, including:
- Cervical spondylosis: Age-related changes to the cushioning spinal disks in the neck can cause cervical spondylosis, which puts extra pressure on the nerves and results in muscle weakness.
- Guillain-Barré syndrome: This rare neurological disorder can cause mild to severe muscle weakness.
- Botulism: A rare condition caused by exposure to botulinum toxin, resulting in progressive muscle weakness.
- Lambert-Eaton myasthenic syndrome: An autoimmune disorder where the immune system interferes with how nerves and muscles communicate, leading to muscle weakness.
- Multiple sclerosis (MS): An autoimmune disorder where the immune system attacks and damages nerves in the brain and spinal cord.
- Amyotrophic lateral sclerosis (ALS): This condition leads to the degeneration of nerve cells in the brain and spinal cord, causing progressive muscle weakness.
- Myasthenia gravis: An autoimmune disorder where the immune system attacks a person's muscles, affecting movement and breathing.
- Spinal cord injuries: Injuries to the spinal cord can interrupt communication from the nerves to the muscles, resulting in muscle weakness.
- Inclusion body myositis: This condition can cause simultaneous proximal and distal weakness, which may be due to inflammation or compression of the peripheral nerves.
- Neuropathic disorders: These can be caused by nerve compression, inflammatory neuropathy, myopathy, or muscle damage due to toxins or medications.
- Mitochondrial myopathies: These occur when there is a defect in muscle mitochondria, the energy-producing part of cells.
- Metabolic myopathies: These are caused by issues with genes that give instructions for enzymes that muscles need.
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Muscle weakness and medication
Muscle weakness can be a symptom of many chronic conditions and acute infections. It can also be a side effect of certain medications. It is important to determine the cause of muscle weakness to rule out any serious underlying health conditions.
Medications that can cause muscle weakness as a side effect include:
- Cholesterol-lowering drugs such as statins and fibrates
- Antiarrhythmic medicines used to treat heart rhythm problems, such as amiodarone and procainamide
- Corticosteroids, such as prednisone, especially when taken at high doses and for prolonged periods
- Medicines used to treat high blood pressure, such as beta-blockers and labetalol
- Antimalarial medicines, such as chloroquine and hydroxychloroquine
- Loop diuretics and thiazide diuretics (water pills), which can cause muscle weakness by causing hypokalemia or low potassium levels
- Medicines used during general anaesthesia, such as propofol
- Immune checkpoint inhibitors used for cancer treatment, such as nivolumab and pembrolizumab
- Immunosuppressive agents used to prevent organ rejection after a transplant
- Antiepileptic drugs such as lamotrigine and phenytoin
- Omeprazole, a medication for gastroesophageal reflux disease (GERD)
- D-penicillamine, a chelating agent used to treat Wilson's disease
If you are experiencing muscle weakness, it is important to consult a doctor or healthcare provider. They will ask about your medical history, conduct a physical examination, and may order blood tests, X-rays, or other diagnostic procedures to determine the underlying cause of your muscle weakness.
It is important not to stop taking any prescribed medications without first consulting your doctor, as discontinuing medication can have serious health consequences.
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Frequently asked questions
Muscle weakness is a lack of muscle strength, meaning the muscles may not contract or move as easily as they used to. It can be caused by a variety of factors, ranging from a tough workout to an underlying health condition.
If you are experiencing muscle weakness, you should consult a doctor. They will likely perform a physical exam, which may include muscle strength testing, to evaluate the cause of your muscle weakness.
Muscle strength testing is used to evaluate weakness and differentiate it from other issues such as poor endurance or imbalance. It can be performed by various medical professionals and is an important component of the assessment for patients with suspected neurological problems.
Muscle strength testing can involve testing functional movements such as squatting or rising from a chair, or more precise measurements of muscle strength using specialised equipment such as a handgrip dynamometer. The choice of tests will depend on the suspected diagnosis and the aim is to characterise the strength deficit in various limbs.
Muscle weakness can be caused by various factors, including age, inactivity, medication side effects, and underlying health conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or myasthenia gravis. It can also be caused by infectious conditions such as the flu, Lyme disease, or COVID-19.
