Muscle atrophy – Causes and Symptoms

Proven content

Muscle atrophy is associated with many medical conditions that limit mobility and lead to infirmity. It is also the main symptom of several dramatic genetic diseases. It can occur in the course of spinal muscular atrophy or amyotrophic lateral sclerosis.

What is Muscle Atrophy?

Muscle atrophy is a deformation of the fibers and groups of striated muscles, the action of which is subject to our will (this does not apply, of course, to the heart muscle, which has its own automatism center). This leads to a proportional reduction in the muscle mass of the entire body or only in some parts of it. Then, we observe weakening of the muscle strength, difficulty in making certain movements and reducing the circumference of the limbs.

The causes of muscle atrophy

Muscle atrophy most often affects people who are long or chronically lying, and those whose motor functions have been disturbed, e.g. as a result of an injury or stroke. Muscle atrophy will therefore concern, among others, elderly patients, with numerous loads who cannot walk, para- and tetraplegics, patients in terminal states, generally debilitated in the course of cancer or dementia, people after multiple injuries, severe burns, complicated fractures requiring many months of hospitalization. Two mechanisms lead to muscle atrophy in these situations: traumatic muscle denervation and failure to perform any physical effort with their participation. The prescription is early and regular rehabilitation.

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Muscle atrophy and trauma

All kinds of muscle injuries, such as muscle rupture or tear; bone fractures and sprains of joints force patients to temporarily immobilize the damaged part of the body. Then a cast or an orthosis is put on. These activities keep the muscles from moving for a while, reducing their strength and mass. In patients whose muscles are poorly rebuilt, the joints are more likely to suffer secondary injuries. This is how a vicious circle arises. Patients undergoing treatment (despite being immobilized) should cooperate with a physiotherapist who will select the appropriate type of exercise. Usually, at the beginning, these are muscle tension exercises, the duration of which is several or several dozen seconds. These types of exercises can be performed even in the presence of an orthosis or plaster. Exercise difficulty and load should be increased over time to prevent muscle wasting.

Muscle atrophy is also an axial symptom of the following genetic diseases:

1. Duchenne or Becker muscular dystrophy: is a very common genetic disorder that mainly affects boys. The disease usually begins when learning to walk independently, then patients show less mobility. At around four years of age, a child begins to have trouble climbing stairs and getting up from a lying or sitting position. In addition, the disease is associated with muscle atrophy of the lower limbs and pelvis, contracture of the Achilles tendons and hypertrophy of the muscles of the lower limbs. The belly is pushed forward. Muscle weakness and contracture give the gait a “ducks” gait. Unfortunately, these disorders worsen with age, which in turn causes deformation of the figure. In extreme cases, when the disease is at an advanced stage, the child cannot get up and walk. Currently, it is impossible to cure muscular dystrophy of the Duchenne or Becker type. Nevertheless, symptomatic treatment of patients is given B vitamins as well as mono and triphosphates. In addition, an important role is played by a proper diet, which should include as much protein as possible of plant and animal origin. It is recommended to eat plenty of vitamin-rich fruits and vegetables. In turn, rehabilitation consists in performing stretching and non-resistance exercises aimed at preventing contractures and maintaining the greatest possible range of motion.
2. spinal muscular atrophy: is a much rarer genetic disease characterized by deformation of the anterior nuclei of the spinal cord. The symptoms of this ailment include frequent infections of the respiratory system, scoliosis, circulatory and respiratory failure and even limited mobility of the joints. Patients with spinal muscular atrophy experience loss of strength over time and difficulty in movement. Patients have problems with correct body and head posture, and then with swallowing and speaking. Like muscular dystrophy, spinal muscular atrophy is also an incurable disease. However, there are some indications that the therapy with valproic acid, salbutamol and olesoxime brought positive results. Currently, research is conducted in the field of gene therapy and stem cells. Daily physical rehabilitation, and even horseback riding therapy, play an important role in slowing down the development of the disease.
3. amyotrophic lateral sclerosis: is a disease characterized by the destruction of the nerve cells that affect how our muscles work. The neurons of the pyramidal pathway, the anterior horn cells of the spinal cord and the nuclei of the cranial nerves of the medulla are most often damaged. A characteristic symptom is muscle atrophy, which is noticeable when, for example, playing the guitar. The development of ALS makes the simplest movement difficult and much slower than in a healthy person. Patients have difficulty standing up, proper head support is impossible and difficult, as is turning over on the bed. In the advanced stages of the disease, speech difficulties, digestive and swallowing disorders, and respiratory failure are added. The treatment includes rehabilitation, which includes, for example, physical exercise and thermotherapy.

Muscle atrophy and stroke

A stroke is a series of symptoms that appear as a result of brain disorders that last longer than a day. A stroke may occur in the form of an ischemic stroke (lack of blood supply to the brain) or a haemorrhagic stroke (stroke). The type of stroke depends on the part of the brain where it occurred. This ailment causes a number of complications, including:

1. trouble with memory,
2. speech problems,
3. partial sensory disturbance,
4. muscle paresis as well as imbalance and muscle weakness,
5. blurred vision,
6. trouble swallowing (dysphagia)
7. inability to perform previously learned activities,
8. mental disorders (most often post-stroke depression syndrome).

After a stroke, rehabilitation is of great importance and should be started as early as possible. Its type is selected individually for the patient and his condition. At the beginning, a series of breathing exercises (along with a pat on the back), exercises to prevent pressure ulcers and passive therapy of the limbs are performed. With time, the patient is upright and gradually improved. He has to start learning to walk again and recreate the correct movement patterns. In patients with speech disorders, meetings with a speech therapist are implemented.

Muscle atrophy and nerve damage

Peripheral nerve damage can occur as a result of trauma, pressure on the nerve, or existing inflammation and systemic disease. Nerve damage over a long period of time causes tingling, numbness and pain. Added to this are problems with movement. As the disease develops, the muscles begin to gradually weaken and atrophy. The diagnostics includes tests aimed at finding the cause of the disease and the degree of nerve damage. Only after establishing the correct diagnosis, treatment is implemented, which consists in removing the cause of pressure on the nerve, and then properly selected rehabilitation, e.g. exercises, massages.

Muscle atrophy and spine injuries

Back injuries may be caused by, for example, a fall from a height or a traffic accident. Especially young people, through their thoughtlessness, often succumb to them. Quite often, the result of this injury is a rupture of the spinal cord, which clearly means a disability (usually for life). Movement functions return only when, despite the extensive trauma, the long spinal pathways have not been damaged and the deep sensation in the limbs has been preserved. Then, after the swelling and pressure are removed, the patient is able to move around.

The scourge, especially among young people, are back injuries caused by falling from a height, jumping into the water or a traffic accident. It is then very often that the spinal cord is torn, which is associated with disability, unfortunately for the present moment, for the rest of one’s life. Only in a situation where, despite even extensive spinal injury, the so-called long spinal pathways and deep feeling (proprioception) in the limbs will be preserved, then after the swelling is removed and the pressure on the spine is removed, the motor functions return. A rupture of the spinal cord leads to pins and needles, paresis and, consequently, denervation muscle wasting. Moreover, sexual functions are disturbed. There are intestinal disorders.

Treatment is mainly rehabilitation, which consists of both breathing exercises and standing upright. Various types of massages, deep sensation exercises, hydrotherapy and all methods that help restore movement patterns are also used, so that the patient can be as independent as possible.

bow. med. Aleksandra Czachowska

Internist – make an appointment