Logan Steele
Muscle weakness can be a symptom of many chronic conditions and acute infections. It can also be a side effect of certain medications. Some conditions that affect the nervous system can cause muscle weakness. These conditions are often chronic and affect how a person's nerves transmit messages to their muscles. Examples of neurological conditions that can cause muscle weakness include cervical spondylosis, Guillain-Barré syndrome, and multiple sclerosis (MS). In addition, certain infections are linked to muscle weakness, such as Lyme disease, HIV, and rabies. Muscle weakness can also be caused by myopathies, which are diseases that attack muscle fibers, and muscular dystrophy, which is characterized by progressive degeneration of muscle tissue.
| Characteristics | Values |
|---|---|
| Prevalence | Occurs in about 5% of U.S. adults 60 years and older |
| Causes | Addison's disease, anaemia, acute infections, chronic conditions, certain medications, ALS, spinal cord injuries, endocrine disorders, electrolyte imbalances, muscular dystrophy, myopathy, multiple sclerosis, stroke, myasthenia gravis, flu, Lyme disease, and more |
| Diagnosis | History, physical examination, targeted laboratory evaluation, electromyography |
| Treatment | Physical therapy, medication, and other treatment options depending on the underlying cause and severity of symptoms |
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What You'll Learn
Infections and viruses
Muscle weakness can be a symptom of many chronic conditions, acute infections, and viruses. Infectious conditions that can cause muscle weakness include Lyme disease, meningitis, HIV, polio, rabies, and the flu.
Myositis, a disease that causes the immune system to attack the muscles, can also be caused by bacterial or viral infections. In the case of bacterial infections, antibiotics are required to stop the infection from spreading. Viral infections that can cause myositis include dengue, parvovirus B19, and polyomaviruses. COVID-19 can also cause myositis and rhabdomyolysis, which can lead to permanent kidney damage.
In addition to infections, muscle weakness can be caused by electrolyte imbalances, thyroid conditions, neurological conditions, sleep disorders, and medications.
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Neurological conditions
Muscle weakness can be caused by a variety of neurological conditions, which often affect how an individual's nerves transmit messages to their muscles. These conditions are often chronic and progressive, meaning they tend to worsen over time.
Neuromuscular Disorders
Neuromuscular disorders are a broad category of conditions that involve the dysfunction of peripheral nerves, muscles, or the communication between them. This breakdown in communication between the nervous system and muscles can cause muscle atrophy, or wasting away, in addition to weakness. There are hundreds of types of neuromuscular disorders, some of which include:
- Metabolic myopathies: caused by issues with genes that instruct enzymes needed by muscles.
- Mitochondrial myopathies: caused by defects in muscle mitochondria, the energy-producing part of cells.
- Toxic myopathies: caused by toxins or medications that interfere with muscle structure or function.
- Peripheral neuropathy: an umbrella term for nerve diseases affecting nerves outside of the brain and spinal cord.
- Myasthenia gravis: an autoimmune disorder causing the immune system to attack a person's muscles, impacting movement and breathing.
- Guillain-Barré syndrome: a rare neurological disorder that can cause mild to severe muscle weakness.
- Lambert-Eaton myasthenic syndrome: an autoimmune disorder that interferes with nerve and muscle communication.
- Multiple sclerosis (MS): an autoimmune disorder where the immune system attacks the nerves in the brain and spinal cord.
- Amyotrophic lateral sclerosis (ALS): a condition leading to degeneration of nerve cells in the brain and spinal cord.
- Muscular dystrophies: characterised by progressive degeneration of muscle tissue due to insufficient structural support proteins.
Other Neurological Conditions
There are also other neurological conditions that can cause muscle weakness, including:
- Lyme disease: an inflammatory condition caused by the bite of an infected tick.
- Cervical spondylosis: age-related changes to spinal disks in the neck that put extra pressure on nerves.
- Polio myositis: which can cause muscle weakness and sensitivity.
- Spinal cord injuries: interrupting communication from nerves to muscles.
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Muscular dystrophy
There are several types of muscular dystrophy, including Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and myotonic dystrophy. DMD is the most common form, primarily affecting boys, but girls can also exhibit milder versions of the disease. BMD is the second most common type, usually affecting boys, but girls can also experience milder symptoms. Myotonic dystrophy is the most common type diagnosed in adulthood, affecting men and women equally. Those with myotonic dystrophy experience difficulty relaxing their muscles after use, and it can also affect the heart and lungs.
Symptoms of muscular dystrophy vary depending on the type and can include muscle pain and stiffness, learning or behavioural challenges, delayed growth, and scoliosis. The symptoms of Becker muscular dystrophy are similar to those of Duchenne muscular dystrophy, but they tend to be milder and progress more slowly. In general, symptoms begin in the teens or early adulthood but can also occur later in life. Some types of muscular dystrophy are defined by specific features or the parts of the body where symptoms first appear. For example, Emery-Dreifuss muscular dystrophy causes joint stiffness, and the muscles in the shoulders, upper arms, and calves slowly waste away and weaken.
There is currently no cure for muscular dystrophy, but treatments can help manage symptoms and improve quality of life. Treatments may include physical and occupational therapies to strengthen and stretch muscles, corticosteroids to delay muscle weakness and improve lung function, mobility aids such as canes and wheelchairs, surgery to correct spine curvature, and heart care to slow the progression of cardiomyopathy.
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Medication side effects
Medication can be a cause of muscle weakness, and this is known as drug-induced myopathy. This can be caused by statins, fibrates, and antiarrhythmic medicines, as well as corticosteroids, which are often prescribed to treat autoimmune diseases. Corticosteroids, such as prednisone, are a common cause of muscle weakness, especially when taken for long periods or at high doses.
Other medications that can cause muscle weakness include:
- Cholesterol-lowering drugs, such as statins (e.g. simvastatin and atorvastatin) and fibrates (e.g. fenofibrate and gemfibrozil).
- Antiarrhythmic medicines used to treat heart rhythm problems (e.g. amiodarone and procainamide).
- Antiretroviral drugs like zidovudine, which is an older HIV medication.
- Chemotherapy treatments, such as the immune checkpoint inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda).
- Beta-blockers and other blood pressure medications.
- Diuretics or water pills, which cause hypokalemia or low potassium levels.
- Alcohol and recreational drugs, such as cocaine, can also contribute to muscle weakness.
It is important to note that medication-induced muscle weakness may be more likely or severe in older adults, as they may be more susceptible to the effects of certain medications. Additionally, long-term use of oral steroids or high doses of steroids can cause muscle weakness and wasting. This is an expected side effect, and doctors usually try to avoid prescribing them long-term due to this reason.
If you are experiencing muscle weakness and think it may be due to medication, it is important to speak to your doctor. They may advise lowering the dose, switching to an alternative medication, or discontinuing treatment.
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Stroke
A stroke is a medical emergency that occurs when the brain does not receive enough blood flow, often due to a blocked blood vessel or bleeding in the brain. Strokes are the second leading cause of death worldwide and can result in permanent disabilities or even fatality. As such, seeking immediate medical attention is crucial to increase the chances of survival and reduce the risk of long-term damage.
Rehabilitation and therapy play a crucial role in stroke recovery. Physical therapy, including active exercises and electrotherapy, helps strengthen muscles, improve balance, and regain use of affected limbs. Cognitive rehab focuses on improving mental abilities, such as memory and concentration, while occupational therapy assists individuals in safely performing daily tasks. Speech therapy is also an important aspect of rehabilitation, aiding individuals in regaining control of the muscles involved in speaking, breathing, eating, and swallowing.
To facilitate recovery, healthcare professionals can design personalized rehabilitation routines that provide consistency and positive reinforcement. Additionally, neuromuscular electrical stimulation devices, such as the SaeboStim Micro, can be used to trigger muscle relaxation and contraction, aiding in muscle strengthening and re-education. It is important to remain active and perform repeated practices to enhance control, flexibility, and nerve circuitry.
Depression and anxiety are common mental health challenges following a stroke. It is important to prioritize mental well-being during the recovery process and seek support as needed. Overall, stroke recovery is a challenging journey that requires dedication to rehabilitation and therapy, but even small progress can lead to significant improvements.
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Frequently asked questions
There are several diseases that can cause muscle weakness, including myopathy, muscular dystrophy, multiple sclerosis (MS), myasthenia gravis, Guillain-Barré syndrome, and myositis.
Myopathy refers to diseases that attack muscle fibres, causing weakness. There are two types of myopathy: inherited and acquired. Mitochondrial myopathy, for example, is caused by a defect in the mitochondria, which are the energy-producing parts of cells.
Muscular dystrophy causes muscles to waste away and weaken over time. Symptoms can include joint stiffness, trouble walking and using arms, and heart rhythm issues. The most common type, Duchenne, usually affects young boys.
Multiple sclerosis is an autoimmune disorder where the immune system attacks the nerves in the brain and spinal cord. This can cause numbness or weakness in one or both arms and legs.
Yes, muscle weakness can be caused by various infections, such as the flu, Lyme disease, HIV, and COVID-19. It can also be a side effect of certain medications, ageing, or nerve conditions.
