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Muscle weakness is a common symptom with many possible causes, ranging from muscle injuries to fatigue. It occurs when the muscles can't work with the expected amount of force. This can be due to issues with the muscle cells themselves, or because the nerve signals telling the muscles when to flex and relax are interrupted. In some cases, muscle weakness can be a sign of a serious health condition, such as multiple sclerosis, stroke, or an electrolyte imbalance. Other causes include lack of exercise, ageing, and temporary illness or infection.
| Characteristics | Values |
|---|---|
| Muscle injuries | Muscle strain or tear |
| Muscle atrophy | Loss of muscle mass due to disuse, neurogenic conditions, malnutrition, age, genetics, or lack of physical activity |
| Neurological disorders | Guillain-Barré syndrome, Lambert-Eaton myasthenic syndrome, multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), myasthenia gravis, spinal cord injuries, migraines |
| Autoimmune disorders | Lambert-Eaton myasthenic syndrome, multiple sclerosis (MS), myasthenia gravis, rheumatoid arthritis, Graves' disease |
| Infectious conditions | Flu, Lyme disease, meningitis, HIV, polio, rabies, West Nile virus, dengue fever, COVID-19 |
| Endocrine disorders | Addison's disease, hyperthyroidism, hypothyroidism, Cushing syndrome, diabetes |
| Electrolyte imbalances | Hypokalemia, hyperkalemic periodic paralysis, disturbances in calcium, phosphate, potassium, and sodium |
| Chronic conditions | Chronic fatigue syndrome, rheumatoid arthritis, diabetes, epilepsy |
| Age | Sarcopenia is the loss of muscle mass and strength associated with aging |
| Medication | Prolonged use of certain drugs, such as corticosteroids and cholesterol-lowering statins |
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What You'll Learn
Inactivity, ageing, and injury
Muscle weakness can be caused by several factors, including inactivity, ageing, and injury.
Inactivity
Inactivity is a common cause of muscle weakness. When a person does not use a particular muscle, the body eventually breaks it down to conserve energy. This type of muscle atrophy, or muscle wastage, can occur when a person remains immobile for an extended period due to illness, injury, or a sedentary lifestyle. It typically starts within two to three weeks of not using the muscles. However, inactivity-induced muscle atrophy can be reversed with regular exercise, physical therapy, and a healthy diet.
Ageing
Age-related muscle weakness, known as sarcopenia, is a natural phenomenon that begins around age 40 and accelerates after 75. It is characterised by a decrease in muscle mass and strength, leading to a loss of muscle function. Sarcopenia is a major cause of disability in older adults and can be accompanied by other health conditions that further contribute to inactivity. While there are no established treatments for sarcopenia, regular exercise, especially resistance training, can help prevent and reverse age-related muscle loss. Additionally, adequate nutrition, including sufficient calories, protein, and omega-3 fatty acids, is essential for maintaining and improving muscle mass and strength as we age.
Injury
Injuries such as muscle strains or tears can also lead to muscle weakness. Muscle strains can vary in severity and may be caused by lifting heavy objects or repetitive movements. In less severe cases, icing the injured area and resting can aid in healing. However, more serious injuries may require medical attention and physical therapy to restore muscle strength and prevent future injuries.
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Electrolyte imbalances
Electrolytes are essential for ensuring the proper functioning of the muscles, nerves, heart, and brain. Electrolyte imbalances can cause muscle weakness. Electrolytes are minerals that carry an electric charge and are essential for the body's functioning. Types of electrolyte disorders include hypokalemia and hyperkalemic periodic paralysis.
Risk factors for an electrolyte imbalance include diabetes, which occurs when the body does not produce enough insulin or does not use insulin appropriately. Additionally, Addison's disease, a condition where the adrenal glands do not produce enough of the hormones cortisol and aldosterone, can also lead to electrolyte imbalances and muscle weakness.
Furthermore, electrolyte imbalances can be caused by disturbances in specific minerals, such as calcium, phosphate, potassium, and sodium. These minerals play crucial roles in muscle function, and imbalances can lead to muscle weakness.
While electrolyte imbalances can be a concern, they can often be addressed through proper nutrition and hydration. Consulting with a healthcare professional can help identify specific risk factors and develop strategies to maintain proper electrolyte balance.
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Nervous system conditions
Muscle weakness can be a symptom of nervous system malfunction. For a person to intentionally move a muscle, the brain must generate a signal that travels a pathway from the brain, through the spinal cord, to the nerves and muscles. Therefore, true weakness occurs when one or more parts of this pathway are damaged or diseased.
Neuromuscular disorders are a broad range of conditions that involve dysfunction of 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. For example, in Lambert-Eaton myasthenic syndrome, an autoimmune disorder, the immune system interferes with how nerves and muscles communicate, resulting in muscle weakness.
Myopathies are conditions that directly affect skeletal muscles, attacking muscle fibres and making muscles weak. Some myopathies are genetic, while others can be developed later in life. Muscular dystrophy, for instance, refers to a group of genetic conditions that affect muscle functioning. Autoimmune and inflammatory myopathies are issues with the immune system that cause problems with muscle function.
Neurological examinations can help identify signs of disorders affecting the brain, spinal cord, and peripheral nervous system, including muscles. Doctors will test reflexes, which tend to be strong and easily triggered in brain disorders, and slow or absent in nerve disorders. Muscle strength is also tested by asking the patient to push or pull against resistance or perform strength maneuvers such as walking on tiptoes.
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Infections and illnesses
Muscle weakness can be a symptom of many chronic conditions and acute infections. It can also be a side effect of certain medications.
Myositis
Myositis is a group of conditions that cause inflammation in muscles, resulting in muscle weakness. It can be caused by a wide variety of pathogens, including bacteria, fungi, viruses, and parasites. Some types of myositis, such as dermatomyositis or polymyositis, cause muscle weakness that typically worsens over weeks or months. It affects large muscle groups on both sides of the body, including the neck, shoulders, hips, and back.
Human Immunodeficiency Virus (HIV)
HIV attacks and destroys the immune system, resulting in myopathies that cause slowly progressing and symmetrical muscle weakness.
Influenza
The flu virus, or influenza, can cause myositis, leading to muscle weakness, pain, and difficulty walking.
Lyme Disease
Lyme disease is an infection transmitted by tick bites. It can cause fever, fatigue, pain, vision changes, memory problems, and generalized muscle weakness.
Meningitis
Meningitis is an infection that causes inflammation of the meninges, the membranes surrounding the brain and spinal cord. It can be caused by bacteria, viruses, fungi, or parasites. Meningitis can lead to memory loss, muscle weakness, paralysis, and seizures.
Brain Inflammation
Research has shown that brain inflammation triggers extreme muscle weakness across several diseases, including viral and bacterial infections, as well as neurodegenerative diseases like Alzheimer's and long COVID. This is due to the release of specific proteins that travel from the brain to the muscles and cause a loss of muscle function.
Other Infections
Other infections that can lead to muscle weakness include rabies, botulism, coronavirus (COVID-19), and toxoplasmosis.
Additionally, muscle weakness can be caused by chronic conditions such as anemia, diabetes, fibromyalgia, and rheumatoid arthritis. It can also be related to nerve problems or injuries, spinal cord injuries, multiple sclerosis, and age-related atrophy.
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Medication and medical treatments
Muscle weakness can be a side effect of certain medications and medical treatments. It is often a symptom of a wide range of health conditions, including chronic fatigue syndrome, sleep disorders, depression, and chronic heart, lung, and kidney disease. It can also be caused by altered electrolyte levels, diabetes, fibromyalgia, hypothyroidism, and more.
Medications that are known to cause muscle weakness include cholesterol-lowering drugs such as statins and fibrates, antiarrhythmic medicines, corticosteroids, blood pressure medications, antimalarial medicines, and immune checkpoint inhibitors. In addition, muscle weakness can be a side effect of general anesthesia and immunosuppressive agents used after organ transplants. It is important to note that not everyone who takes these medications will experience muscle weakness, and the frequency and intensity of this side effect can vary.
Corticosteroids, such as prednisone, are another class of drugs that may induce muscle weakness, especially when taken in high doses or for prolonged periods. Steroid injections can also cause muscle pain and weakness around the injection site, which may last for several days to weeks. Aromatase inhibitors, used to treat breast cancer, and colchicine, a medication for gout, have also been linked to muscle pain and weakness in some cases.
If you are experiencing muscle weakness, it is important to consult a healthcare professional. They can guide you on whether you need to adjust your medication, explore alternative treatments, or make lifestyle changes to improve your muscle strength and overall health.
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Frequently asked questions
Muscle weakness can occur due to ageing, lack of exercise, muscle injury, or pregnancy. It can also be caused by long-term conditions such as diabetes, heart disease, or chronic fatigue syndrome.
Muscle weakness can be a symptom of a serious nervous system issue or other conditions. Some serious causes of muscle weakness include stroke, multiple sclerosis, and Guillain-Barré syndrome.
To reduce your risk of muscle weakness, you can incorporate strength training into your fitness routine, avoid overworking your muscles, protect your nervous system by wearing protective gear during risky activities, and manage any chronic conditions.
