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Muscle atrophy, or muscle wasting, is the thinning or loss of muscle tissue. It can be caused by a variety of factors, including malnutrition, ageing, genetics, nerve problems, diseases, and lack of physical activity. The most obvious sign of muscle atrophy is reduced muscle mass, which can be measured objectively with a flexible tape measure. This is typically done in centimetres, and measurements are taken at specific points on the limbs, such as the biceps, forearms, thighs, and calves. This measurement process is important for determining the extent of muscle atrophy and assessing its impact on a person's functionality and quality of life.
| Characteristics | Values |
|---|---|
| Definition | Loss of muscle size or mass |
| Common Causes | Inactivity, aging, malnutrition, nerve problems, injury, genetic disorders, certain medical conditions |
| Symptoms | Reduced muscle mass, weakness, numbness, tingling, difficulty swallowing or speaking, pain |
| Measurement | Flexible tape measure to measure limb circumference in centimeters |
| Treatment | Exercise, physical therapy, surgery, lifestyle changes, medication |
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What You'll Learn
Measuring muscle atrophy in the limbs
Muscle atrophy is the thinning or loss of muscle tissue and mass. It can be caused by muscle disuse, nerve problems or diseases, malnutrition, age, genetics, or a lack of physical activity. Symptoms include a decrease in muscle mass, one limb being smaller than the other, and numbness, weakness and tingling in the limbs. Limb circumference is the most common method for measuring muscle atrophy in the limbs. Here is a step-by-step guide:
Upper limbs
To measure muscle atrophy in the upper limbs, use a flexible tape measure to measure the circumference of the biceps and forearms. Measure at the same distance above and below the elbow. For example, the AMA Guides 5th Edition instructs medical evaluators to measure a patient's arms "at the same distance above or below the elbow". When measuring, ensure that the patient's arm is relaxed and that measurements are reported in centimetres.
Lower limbs
To measure muscle atrophy in the lower limbs, use a flexible tape measure to measure the circumference of the thigh and calf. Measure at equal distances from above the joint line or another palpable anatomical structure. For example, the AMA Guides 5th Edition instructs evaluators to measure the leg "at equal distances from above the joint line or another palpable anatomical structure". When measuring, ensure that the patient's leg is relaxed and that measurements are reported in centimetres.
It is important to note that muscle atrophy measurements should be taken at specific points on the limbs, as indicated by a medical professional. These points may include mid-biceps or 10 cm above the knee joint line. Additionally, measurements should always be reported in centimetres, and any measurements in inches should be converted and rounded accordingly.
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Reversing muscle atrophy with exercise
Muscle atrophy is the thinning or wasting of muscle tissue and mass. It can be caused by a variety of factors, including malnutrition, ageing, genetics, lack of physical activity, and certain medical conditions. Physiologic atrophy, caused by insufficient muscle use, can often be reversed through exercise and improved nutrition.
Reversing muscle atrophy through exercise is a viable option for those experiencing muscle wastage. While it requires dedication and consistency, physiologic atrophy can be reversed with regular exercise and physical therapy. It is important to note that the time taken to recover from muscle atrophy varies depending on the severity of the condition and the type of atrophy.
To reverse muscle atrophy, individuals should focus on regular physical activity and specific exercises. This includes aerobic exercise, resistance training, and balance training. Even simple exercises, such as practising getting off the floor without assistance, can improve flexibility, balance, coordination, and muscle power. For those unable to perform intense exercises, any amount of movement or physical activity can be beneficial. Additionally, individuals can work with a physical therapist, who may recommend ultrasound therapy or electrical stimulation to promote muscle healing and contraction.
Exercise programs tailored to an individual's needs can also help treat muscle atrophy. These programs may include exercises performed in a swimming pool to reduce muscle workload, as well as other types of rehabilitation. For those who cannot actively move certain joints, exercises can be performed with the assistance of braces or splints. A healthcare provider can create a personalised exercise plan and provide guidance on specific exercises to ensure safety and effectiveness.
In addition to exercise, addressing malnutrition and inadequate nutrition is crucial for reversing muscle atrophy. A high-protein diet, recommended by a healthcare professional, can help individuals maintain and regain muscle mass. By combining regular exercise with a nutritious diet, individuals can effectively reverse muscle atrophy and improve their overall health.
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Malnutrition and muscle atrophy
Muscle atrophy is the thinning or wasting of muscle tissue, which can cause a person to lose between 20% and 40% of their muscle mass and strength. While muscle atrophy can be caused by a variety of factors, such as inactivity, age, genetics, or certain medical conditions, malnutrition is also a significant contributing factor.
Malnutrition-related muscle atrophy can develop due to medical conditions that impair the body's ability to absorb nutrients. For example, cachexia, a metabolic condition characterised by extreme weight loss, can be a symptom of underlying diseases such as cancer, HIV, or multiple sclerosis. As people age, their bodies produce fewer proteins essential for muscle growth, leading to a condition called sarcopenia, which is common among older adults and is associated with functional decline and increased risk of injuries.
In a study of frail older hospitalised patients, malnutrition was found to be significantly associated with acute muscle wasting. Malnourished patients experienced a decline in mid-thigh muscle cross-sectional area (CSA) and lost a notable percentage of handgrip and knee extension strength during their hospitalisation. This highlights the impact of malnutrition on muscle atrophy, particularly in vulnerable populations.
The impact of malnutrition on muscle atrophy is also evident in the management of various diseases. For instance, in conditions such as chronic obstructive pulmonary disease, cancer, and cardiovascular disease, low muscle mass due to malnutrition has been linked to adverse health outcomes and increased risk of hospital readmission and mortality. Therefore, managing malnutrition and optimising nutrition to promote muscle mass gain is crucial in the treatment of these diseases.
To diagnose and measure muscle atrophy, healthcare providers will perform a physical examination, assess symptoms, and may utilise diagnostic tools such as blood tests, muscle or nerve biopsies, electromyography (EMG), and imaging techniques like magnetic resonance imaging (MRI) scans. While physiologic atrophy due to inactivity can often be reversed with exercise and improved nutrition, neurogenic atrophy resulting from nerve damage may be irreversible due to the physical damage to the nerves.
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Neurogenic atrophy
The symptoms of neurogenic atrophy include a noticeable decrease in muscle mass, with one limb sometimes appearing smaller than the others. Individuals may also experience numbness, weakness, and tingling in the affected limbs, leading to difficulties in walking, balancing, swallowing, or speaking.
To measure neurogenic atrophy, healthcare providers will typically perform a physical examination, evaluating the affected limbs by measuring muscle size and comparing them to unaffected areas. This helps determine the extent of muscle loss and identify which nerves may be affected. In addition to physical examinations, providers will also take into account the patient's medical history and any reported symptoms.
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Physiologic atrophy
People who are at risk of developing physiologic atrophy include those who lead a sedentary lifestyle, have seated jobs, have health problems that limit movement, have decreased activity levels, or are on bed rest. Age-related atrophy, also known as sarcopenia, is a form of physiologic atrophy that occurs due to the natural ageing process, where the body produces fewer proteins that promote muscle growth.
The symptoms of physiologic atrophy include reduced muscle mass, weakness, and impaired ability to perform daily tasks. One arm or leg may be noticeably smaller than the other, and patients may experience tingling, numbness, or weakness in their arms and legs. If the atrophy is in the face or throat, patients may experience facial muscle weakness, difficulty speaking, or difficulty swallowing.
To diagnose physiologic atrophy, a healthcare provider will perform a physical examination and ask about the patient's symptoms. They will measure the patient's muscle mass and may order additional tests, such as blood tests, muscle or nerve biopsies, electromyography (EMG), nerve conduction studies, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans.
Treatment for physiologic atrophy typically involves regular exercise and improving nutrition. Physical therapy, strength training, cardio workouts, and flexibility exercises can help rebuild muscle mass and strength. A nutrition plan that includes adequate protein and calories is also important. In some cases, patients may be advised to work with a dietitian or take nutritional supplements.
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Frequently asked questions
Muscle atrophy is the wasting or thinning of muscle tissue and loss of muscle size or mass. It can be caused by the disuse of muscles, injury, or a primary disease of the muscle itself.
There are three types of muscle atrophy: physiologic, pathologic, and neurogenic. Physiologic atrophy is caused by not using the muscles enough, which can be due to a sedentary lifestyle, malnutrition, or old age. Pathologic atrophy is associated with aging, starvation, and diseases such as Cushing's disease. Neurogenic atrophy is caused by nerve problems or diseases, and it is the most severe type of muscle atrophy.
Muscle atrophy is objectively measured with a flexible tape measure, and the results are reported in centimeters. For the arms, measurements are taken at the biceps and forearms, at the same distance above or below the elbow. For the legs, measurements are taken at the thigh and calf, at equal distances from above the joint line or another palpable anatomical structure.
The symptoms of muscle atrophy vary depending on the cause and severity of muscle loss. Common symptoms include reduced muscle mass, weakness, numbness, or tingling in the arms and legs, difficulty swallowing or speaking, and trouble walking or balancing.
