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Muscle atrophy is the thinning or loss of muscle tissue, which can cause a loss of strength and movement. It is usually caused by a lack of physical activity, but can also be caused by malnutrition, underlying health conditions, or nerve damage. The good news is that muscle atrophy can often be reversed through regular exercise, physical therapy, and a proper nutrition plan. In some cases, surgery may be required.
| Characteristics | Values |
|---|---|
| Type | Physiologic, Pathologic, Neurogenic |
| Causes | Lack of physical activity, inadequate nutrition, prolonged illness, neurological disease, injury, genetic disorder, old age |
| Symptoms | Tingling, numbness, weakness in arms and legs, difficulty in speaking or swallowing |
| Diagnosis | Physical exam, blood test, muscle or nerve biopsy, electromyography (EMG), nerve conduction studies, CT scan, MRI scan |
| Treatment | Physical therapy, ultrasound therapy, electrical stimulation, surgery, exercise, healthy diet |
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What You'll Learn
Lack of physical activity
Muscle atrophy is the wasting or loss of muscle tissue and can be caused by a lack of physical activity. It is a decrease in muscle size and strength. A sedentary lifestyle and a lack of regular physical activity can cause disuse atrophy and weakness. The atrophy is usually mild to moderate in severity, but it can occur very quickly when a limb is immobilized. For example, if you have ever had your leg in a cast, you will know how fast you can lose muscle in that leg.
If you are bedridden due to an illness or injury, you can also lose muscle very quickly. This is because your body breaks down muscle to conserve energy. Physiologic or disuse atrophy occurs when you don't use your muscles enough. It can often be reversed with exercise and better nutrition. However, it won't happen overnight and may take several months to see improvement.
To prevent muscle atrophy, you can try to incorporate more movement into your everyday activities. Even if you are recovering from an injury or illness, your healthcare provider may recommend exercises you can do with a brace or splint. They may also recommend physical therapy or an exercise plan.
If you are experiencing muscle atrophy, it is important to consult a doctor or healthcare provider for a physical examination and advice. They may refer you to a physical therapist, who can teach you the correct ways to exercise and recommend specific stretches and exercises to prevent immobility.
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Neurogenic atrophy
The diagnosis of neurogenic atrophy involves a physical examination by a healthcare provider, who will assess symptoms, medical history, and measure muscle mass in the arms and legs. They may also recommend additional 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 neurogenic atrophy typically cannot be reversed due to the physical damage to the nerves, some treatment options are available to manage the condition. One option is a specialised form of physical therapy called electrical stimulation, where electrodes are placed on the skin over the affected muscles to send electrical impulses that stimulate muscle contractions and help maintain muscle mass and strength. Ultrasound therapy, which uses sound waves to promote muscle healing, may also be recommended. In some cases, surgery may be necessary to correct contractures, a condition where muscle tissues become fibrous, making it challenging to stretch and move the muscles.
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Malnutrition
In older hospitalized patients, malnutrition is prevalent and associated with adverse outcomes. Studies have shown that malnourished patients experience a decline in mid-thigh muscle cross-sectional area (CSA) and a loss of handgrip and knee extension strength during hospitalization. Malnutrition is a significant independent risk factor for the reduction of muscle CSA, leading to acute muscle wasting.
To counteract malnutrition-related muscle atrophy, adequate nutrition and exercise are crucial. Nutritional strategies should focus on calorie control and the optimal intake of macro- and micronutrients, especially protein. Additionally, resistance exercises and physical therapy can help improve recovery and build muscle mass.
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Underlying health conditions
Muscle atrophy is the loss or thinning of muscle mass. It can be caused by underlying health conditions, including malnutrition, ageing, nerve damage, and a wide range of injuries or diseases that impact the musculoskeletal or nervous system.
Malnutrition
Malnutrition first causes fat loss but may progress to muscle atrophy in prolonged starvation. It can be reversed with nutritional therapy. Dumping syndrome, for example, causes malnutrition.
Ageing
Age-related muscle atrophy, also known as sarcopenia, is caused by a reduction in the proteins that promote muscle growth. Sarcopenia can be slowed by exercise.
Nerve damage
Neurogenic atrophy is caused by an injury to or disease of a nerve that connects to the muscle. This type of atrophy can be treated with a special kind of physical therapy called electrical stimulation. Examples of diseases affecting the nerves that control muscles include amyotrophic lateral sclerosis (ALS), carpal tunnel syndrome, and peripheral neuropathy.
Diseases
Pathologic atrophy is caused by diseases such as Cushing disease, cancer, severe infections, and malnutrition. Cachexia is a wasting syndrome caused by an underlying disease such as cancer, HIV/AIDS, or multiple sclerosis (MS) that causes dramatic muscle atrophy.
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Ageing
Muscle atrophy is the thinning or loss of muscle mass, which can occur due to malnourishment, genetic disorders, consistent sitting, being bedridden, or natural ageing. Age-related muscle atrophy is called sarcopenia, a common condition among people over 65 years old. Sarcopenia is likely a multifactorial condition that impairs physical function and predisposes individuals to disability. It is characterised by a loss of muscle mass, strength, and function. The loss of muscle fibres has been observed in cadaveric studies using anatomical fibre counts and iEMG studies demonstrating motor unit loss.
The loss of muscle mass with age is due to atrophy and the loss of individual muscle fibres. The plasticity of both factors should be considered in future research. Age-related muscle atrophy is associated with physical frailty and an increased risk of morbidity (chronic diseases) and all-cause mortality. The loss of muscle mass occurs from middle age (1%/year), and in severe cases, can lead to a loss of up to 50% by the 8th or 9th decade of life.
The mechanisms of muscle fibre atrophy in humans relate to imbalances in muscle protein synthesis (MPS) and breakdown (MPB). There is limited evidence for basal alterations in muscle protein turnover, suggesting that "anabolic resistance" to fundamental environmental cues regulating diurnal muscle homeostasis (physical activity and nutrition) underlies age-related catabolic perturbations in muscle proteostasis. Mitochondrial DNA deletion mutations subsequent to oxidative damage and reduced mitochondrial protein synthesis have also been reported as probable contributors to muscle atrophy.
To prevent and reverse sarcopenia, staying active is key. This includes simple exercises like walking, or resistance exercises such as using resistance bands, lifting weights, and calisthenics such as squats, push-ups, and sit-ups. For those unable to do intense exercise, less intensive exercises like chair yoga, water aerobics, dumbbell strength training, or daily walks are recommended. In addition to exercise, consuming enough calories and high-quality protein may also slow down the rate of muscle loss. Omega-3 and creatine supplements may also help fight sarcopenia.
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