Dominic Stone
Muscle wasting or atrophy is the loss of muscle mass and strength. It is caused by a decrease in the number and size of muscle fibres. There are several factors that can lead to muscle atrophy, including malnutrition, ageing, genetics, nerve problems, disease, and a lack of physical activity. The type of muscle atrophy depends on the cause. Physiologic atrophy, for example, is caused by not using muscles enough, while neurogenic atrophy is caused by nerve problems or diseases. Sarcopenia, another type of atrophy, is specifically caused by the ageing process. While muscle atrophy is reversible with exercise and better nutrition, it can greatly impact one's quality of life, making everyday tasks difficult.
| Characteristics | Values |
|---|---|
| Muscle atrophy | Loss or thinning of muscle tissue |
| Physiologic atrophy | Caused by not using muscles enough |
| Neurogenic atrophy | Caused by nerve problems or diseases |
| Pathologic atrophy | Seen with aging, starvation, and diseases |
| Malnutrition | Inadequate nutritional intake |
| Ageing | Loss of muscle mass due to hormonal changes |
| Sedentary lifestyle | Lack of physical activity |
| Genetic disorders | Muscular dystrophy, Charcot-Marie-Tooth disease |
| Medical conditions | Amyotrophic lateral sclerosis (ALS), Guillain-Barre syndrome, Carpal tunnel syndrome, Spinal cord injury, Multiple sclerosis, Cushing disease, Cancer |
| Sarcopenia | Age-related progressive loss of muscle mass and strength |
| Muscular dystrophy | Genes that make proteins needed for healthy muscles are affected |
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What You'll Learn
Malnutrition and ageing
Muscle atrophy is the loss or thinning of muscle tissue and mass. It can be caused by ageing, malnutrition, genetics, lack of physical activity, or certain medical conditions. Ageing is a major cause of muscle atrophy, and it can lead to a decrease in muscle strength and function, impacting an individual's ability to perform daily tasks. This condition is known as sarcopenia, a type of muscle atrophy that specifically affects older individuals.
Ageing bodies undergo changes that contribute to sarcopenia. For example, the body may produce fewer proteins essential for muscle growth, resulting in smaller muscle cells. Additionally, hormonal changes associated with ageing, such as alterations in testosterone and insulin-like growth factor (IGF-1) levels, can affect muscle fibres, accelerating muscle loss. While everyone experiences some muscle loss with age, sarcopenia causes this loss to occur at a faster rate.
Malnutrition is also a significant factor contributing to muscle atrophy. It is prevalent among older adults and is associated with increased mortality, morbidity, and physical decline. Malnutrition in older individuals can be a result of involuntary weight loss or a low body mass index. Hidden deficiencies, such as micronutrient deficiencies, are common in this population and can be challenging to identify. Protein intake is often below the recommended level, and older adults with malnutrition or certain diseases may require even higher protein intake to counteract catabolism.
The relationship between malnutrition and muscle mass is bidirectional, as low muscle mass can also be a risk factor for malnutrition. Studies have shown that older hospitalised patients are at a higher risk of malnutrition and often exhibit low muscle strength and mass. This highlights the importance of addressing malnutrition and its impact on muscle health in the elderly population.
The prevention and management of malnutrition in older adults are crucial. Dietary counselling, nutritional supplements, and novel dietary approaches, such as the Mediterranean diet, have been explored as potential interventions. Additionally, combining nutritional therapy with different exercise regimens may help mitigate muscle loss. However, further research is needed to develop effective treatments for malnutrition and its associated muscle atrophy in the ageing population.
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Lack of physical activity
Muscle atrophy is the loss or thinning of muscle tissue and mass. It can be caused by a lack of physical activity, also known as disuse or physiologic atrophy. This type of atrophy occurs when muscles are not used enough, and the body begins to break them down, leading to a decrease in size and strength.
Disuse atrophy commonly affects individuals with sedentary lifestyles, desk jobs, health problems limiting movement, or reduced overall activity levels. It is important to note that muscle atrophy can also be caused by neurogenic conditions, aging, genetics, malnutrition, and certain medical conditions.
The good news is that disuse atrophy can often be reversed through regular exercise and improved nutrition. Progressive resistance-based strength training, such as resistance training, can help improve muscle strength and reverse muscle loss. Additionally, maintaining a healthy diet, especially one rich in protein, can aid in rebuilding muscle mass.
To prevent or treat disuse atrophy, individuals can work with healthcare professionals, such as physical therapists, to develop suitable exercise plans and nutritional guidelines. Ultrasound therapy, for instance, is a treatment method that utilizes sound waves to promote muscle healing. While regaining muscle mass takes time and dedication, it is possible to recover from muscle atrophy and improve overall health.
It is worth noting that muscle atrophy can also be a natural part of the aging process, known as sarcopenia. This condition primarily affects older individuals and is characterized by a progressive loss of muscle mass and strength. However, physical inactivity and an unhealthy diet are believed to contribute to the development and progression of sarcopenia. Therefore, maintaining a physically active lifestyle and a nutritious diet are crucial in preventing and managing muscle loss, regardless of age or other factors.
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Nerve problems
Muscle atrophy, or muscle wasting, is the loss or thinning of muscle tissue, resulting in a decrease in muscle mass and strength. Neurogenic atrophy, or muscle atrophy caused by nerve problems, can be further classified into central or peripheral nerve damage.
Central nerve damage occurs when there is damage to the upper motor neuron (upper MN), such as in the case of a stroke or multiple sclerosis. This can lead to peripheral nerve damage, which affects the lower motor neuron (lower MN). Peripheral neuropathy is an umbrella term for nerve diseases that affect a specific part of the nervous system outside of the central nervous system. Peripheral nerve damage can be caused by a herniated disc, carpal tunnel syndrome, or a traumatic injury.
When nerve damage occurs, the muscles no longer receive signals to contract, so the body starts breaking them down, leading to a decrease in size and strength. This breakdown of muscle is accompanied by elevated myofibrillar protein synthesis rates, which may be the body's attempt to compensate for the muscle loss.
Diseases and conditions that can affect the nerves and lead to neurogenic atrophy include:
- Amyotrophic lateral sclerosis (ALS)
- Guillain-Barre syndrome
- Carpal tunnel syndrome
- Spinal cord injury
- Multiple sclerosis
- Muscular dystrophy
- Spinal muscular atrophy (SMA)
Symptoms of peripheral neuropathy include uncontrolled muscle movements, tingling, numbness, muscle weakness, changes in reflexes, and trouble with walking and balance.
Treatment for neurogenic atrophy caused by nerve problems depends on the underlying cause and may include physical therapy, ultrasound therapy, surgery, or electrical stimulation.
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Genetic disorders
There are several genetic disorders that can cause muscle loss. One of the most well-known and common is muscular dystrophy (MD). MD is a group of more than 30 genetic conditions that cause progressive muscle weakness and degeneration of skeletal muscles. The condition is caused by mutations in the genes responsible for healthy muscle structure and function, leading to a loss of muscle mass and strength. MD can affect people of all ages, with some types starting in early childhood and others not appearing until later in life. It is often inherited, passed down from one or both biological parents, but in rare cases, it can also occur spontaneously due to a de novo mutation.
There are many different types of muscular dystrophy, each with its own unique symptoms, age of onset, and rate of progression. Some common types include Duchenne muscular dystrophy, Becker muscular dystrophy, Emery-Dreifuss muscular dystrophy, and congenital muscular dystrophy. Duchenne MD is the most common type and is typically associated with genetic males, while Becker MD is less severe and tends to progress more slowly. Emery-Dreifuss MD causes stiffness in certain joints and wasting of muscles in the shoulders, upper arms, and calves. Congenital MD, on the other hand, is present at birth or before the age of two and can cause severe muscle weakness and developmental delays.
The symptoms of muscular dystrophy vary widely and can include large calf muscles, muscle pain and stiffness, learning and behavioural challenges, delayed growth, swallowing difficulties, eye problems, mild hearing loss, and progressive weakness. In some cases, MD can also affect the heart, lungs, gastrointestinal system, endocrine glands, spine, brain, and other organs. While there is currently no cure for MD, treatments are available to help manage symptoms and slow the progression of the disease.
Another genetic disorder that can cause muscle loss is Charcot-Marie-Tooth disease. This condition affects the peripheral nerves and can lead to muscle atrophy and weakness. Additionally, certain neurogenic conditions, such as nerve problems or diseases, can also result in muscle atrophy, which is the wasting or thinning of muscle mass. This type of atrophy occurs due to nerve-related issues rather than disuse or inactivity.
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Chronic inflammatory diseases
Inflammatory myopathies, or inflammatory muscle diseases, are a group of rare diseases that involve chronic muscle inflammation, inflammation of tissues associated with the muscles, muscle weakness, and, in some cases, muscle pain. The majority of inflammatory myopathies are considered to be autoimmune disorders, in which the body's immune system misfires, mistaking healthy cells for foreign invaders. Inflammation of the muscles can destroy muscle tissue, and over time, this can cause complete muscle loss, or muscle atrophy.
There are four main types of chronic inflammatory myopathies:
- Polymyositis: This inflammatory myopathy affects the skeletal muscles responsible for movement.
- Dermatomyositis: This causes progressive muscle weakness.
- Inclusion body myositis: This is a degenerative muscle disease characterised by progressive muscle weakness and muscle shrinkage as the muscles deteriorate.
- Necrotizing autoimmune myopathy: This inflammatory myopathy causes weakness in the upper and lower body, as well as dizziness, fatigue, and muscle pain when climbing stairs or standing up quickly.
Inflammatory myopathies can affect both adults and children, with women developing these conditions twice as often as men. Universal symptoms include general muscle weakness, but each type of myopathy also presents with unique symptoms. The hips, thighs, upper arms, and top part of the back (the muscles that move and support the neck) are most affected by this muscle weakness. As the muscles in the neck are impacted, it can be difficult to eat and swallow, which can result in weight loss and malnutrition.
While the specific causes of inflammatory myopathies are unknown, they are associated with several autoimmune diseases, including type 1 diabetes, rheumatoid arthritis, psoriatic arthritis, multiple sclerosis, systemic lupus erythematosus, inflammatory bowel disease, and celiac disease.
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Frequently asked questions
Muscle atrophy is the loss or thinning of muscle tissue. It can occur due to malnutrition, age, genetics, a lack of physical activity, nerve problems, or certain medical conditions.
There are three types of muscle atrophy: physiologic, pathologic, and neurogenic. Physiologic atrophy is caused by not using the muscles enough, pathologic atrophy is associated with aging, starvation, and diseases, and neurogenic atrophy is caused by nerve problems or diseases.
Muscle atrophy can be treated through exercise, physical therapy, ultrasound therapy, and in some cases, surgery. Adopting a healthy diet with sufficient calories, protein, and other nutrients that promote muscle development can also help treat muscle atrophy.
