Introduction
Muscle weakness is a lack of strength in the muscles. They may not contract or move as easily as before. Some chronic medical conditions can cause the muscles to wear out more quickly or cause a person to feel fatigued. In other cases, an infection may cause the muscles to falter. If a person has a sudden, severe onset of muscle weakness, it is an alarming sign of a medical condition. Neurological conditions are often progressive, which means that they get worse over time. Some of these conditions also go through stages of remission, when symptoms lessen or even disappear, before flaring up again.
Signs & symptoms
Weakness of the affected area or whole body
Aches and pain may be associated with weakness of muscles.
Inability to do activities
Restricted movements
Heaviness
Swelling
Causes
Many health conditions can cause muscle weakness.
Examples include:
- neuromuscular disorders, such as muscular dystrophy, multiple sclerosis, amyotrophic lateral sclerosis etc.
- Auto-immune diseases such as Grave’s disease, myasthenia gravis and Guillain Barre syndrome.
- Thyroid conditions such as hypothyroidism or hyperthyroidism.
- Electrolyte imbalances such as hypokalaemia (potassium deficiency), hypomagnesemia (magnesium deficiency), and hypercalcaemia (elevated calcium levels in the blood)
Other conditions that may cause muscle weakness include:
- Stroke
- Herniated disc
- Chronic fatigue syndrome
- hypotonia, a lack of muscle tone that’s usually present at birth
- peripheral neuropathy, a type of nerve damage
- neuralgia or sharp burning or pain following the path of one or more nerves.
- prolonged bed rest or immobilization
- alcoholism which can cause alcoholic myopathy
Infections, such as:
Influenza
Lyme disease
Epstein Barr virus
Polio
Syphilis
Rabies
AIDS
Meningitis
West Nile virus
Botulism, a rare and serious illness caused by Clostridium botulinum bacteria, can also lead to muscle weakness.
Rare causes of muscle weakness include:
- Dermatomyositis: This is an inflammatory muscular disorder that can cause stiff, sore, and weakened muscles.
- Polymyositis: This usually causes weakness in the muscles near the body’s trunk, such as the hip, thigh, neck, and shoulder muscles.
- Rheumatoid arthritis: This is a chronic, inflammatory autoimmune disorder that attacks the lining of the joints. Commonly affected areas include the hands and feet.
- Sarcoidosis: This inflammatory condition usually affects the lung and lymph glands, causing irritated masses of tissue.
- Secondary hyperparathyroidism: This condition often affects the lower extremities and causes bone and joint pain.
- Becker muscular dystrophy: This genetic disorder usually affects males and younger people and results in rapid, progressive muscle weakness.
- Systemic lupus erythematosus: Also known as lupus, this condition can affect various areas of the body, including the joints, brain, heart, and lungs. Muscle weakness is a common symptom of a lupus flare-up.
Examples of medications that can cause muscle weakness include:
- antithyroid medications, such as methimazole (Tapazole) or propylthiouracil
- antiretroviral medicines, such as lamivudine (Epivir) or zidovudine (Retrovir)
- chemotherapy medications
- cimetidine (Tagamet)
- corticosteroids
- fibric acid derivatives, such as gemfibrozil (Lopid)
- interferon
- leuprolide acetate (Lupron)
- nonsteroidal anti-inflammatory drugs (NSAID’s), such as ibuprofen or naproxen
- penicillin
- statins
- sulfonamide antibiotics
Some illicit drugs, such as cocaine, can also cause muscle weakness.
Pathophysiology
Muscle weakness happens when a person’s voluntary and complete effort doesn’t produce a normal muscle contraction or movement.
It’s sometimes called:
- reduced muscle strength
- muscular weakness
- weak muscles
Short-term muscle weakness happens to nearly everyone at some point. It can be as simple as a hint that the person has to take rest. After a workout, for instance, the muscles may need to recover with rest.
If the muscle weakness is persistent, or if it develops with no apparent cause or normal explanation, it may be a sign of an underlying health condition.
Voluntary muscle contractions are usually generated when the brain sends a signal through the spinal cord and nerves to a muscle.
If the brain, nervous system, muscles, or the connections between them are injured or affected by disease, the muscles may not contract normally. This can produce muscle weakness.
Voluntary movement is initiated in the cerebral motor cortex, at the posterior aspect of the frontal lobe. The neurons involved (upper motor or corticospinal tract neurons) synapse with neurons in the spinal cord (lower motor neurons). Lower motor neurons transmit impulses to the neuromuscular junction to initiate muscle contraction.
Common mechanisms of weakness thus include dysfunction of
- Upper motor neurons (corticospinal and corticobulbar tract lesions)
- Lower motor neurons (e.g., due to peripheral polyneuropathies or anterior horn cell lesions)
- Neuromuscular junction
- Muscle (e.g., due to myopathies)
The location of certain lesions correlates with physical findings:
- Upper motor neuron dysfunction disinhibits lower motor neurons, resulting in increased muscle tone (spasticity) and increased muscle stretch reflexes (hyperreflexia). An extensor plantar (Babinski) reflex is specific for corticospinal tract dysfunction. However, upper motor neuron dysfunction can decrease tone and reflexes if motor paralysis is sudden and severe (e.g., in spinal cord transection, in which tone first decreases, then increases gradually over days to weeks) or if the lesion damages the motor cortex of the precentral gyrus and not nearby motor association areas.
- Lower motor neuron dysfunction disrupts reflex arcs, causing hyporeflexia and decreased muscle tone (flaccidity), and may cause fasciculations; with time, muscles atrophy.
- Peripheral polyneuropathies tend to be most noticeable in the longest nerves (i.e., weakness is more prominent in the distal limb than the proximal and in legs more than arms) and produce signs of lower motor neuron dysfunction (e.g., decreased reflexes and muscle tone).
- The most common disorder of the neuromuscular junction—myasthenia gravis—typically causes fluctuating weakness that worsens with activity and lessens with rest.
- Diffuse muscle dysfunction (e.g., in myopathies) tends to be most noticeable in the largest muscle groups (proximal muscles).
Diagnosis
Detailed case history including family history
Physical examination including
- reflexes
- senses
- muscle tone
If needed, more tests will be done, such as:
- CT scan
- MRI scan
- nerve tests
- Electromyography
- Blood tests to check for signs of infection or other conditions
Treatments
Treatment of muscle weakness depends upon the cause of it as well as the severity of symptoms.
There are many options for treatment of muscle weakness including:
Physical therapy
Progressive resistive exercise to help MS patients to strengthen weak muscles.
Stretching and range of motion exercises to prevent muscle stiffness.
Occupational therapy
Occupational therapy can be especially helpful during the rehabilitation after stroke. This includes exercises to address weakness in one side of the body and help with motor skills.
OT can help patients to strengthen each part of the body. OT includes devices and tools to help with day-to-day activities.
Medication
Analgesics, such as ibuprofen or acetaminophen, can help manage pain associated with conditions such as:
- peripheral neuropathy
- CFS
- neuralgia
Thyroid hormone replacement is used to treat hypothyroidism.
Dietary changes
It is needed in electrolyte imbalances. Supplements like iron, calcium or magnesium oxide will be advised based on the blood test reports.
Surgery
Surgery may be used to treat certain conditions, such as a disc herniation.
Prognosis
Short term muscle weakness without any underlying disease usually shows excellent prognosis. But chronic disease conditions need long term treatment and the prognosis is not so good. In most cases, it is only possible to arrest progress but not to reverse the damage happened.
Complications
- Loss of mobility.
- Paralysis.
- Permanent loss of sensation.
- Permanent nerve damage.
- Spread of infection.
Disease & Ayurveda
Peseedourballyam
Nidana
Causative factors for the vitiation of Vaata and Kapha
Kshata-injury
Purvaaroopa
Not mentioned
Samprapti
Due to various reasons, the vitiated Kaphadosha gets lodged inn raktadhatu, mamsaddhatu and medodhatu which are very closely related and the circulation of Vaatadosha and bodyfluids are affected. Due to defective circulation and nervous supply, vitiated Kapha and Vaata doshas when get lodged in muscles, develop weakness, heaviness & pain of the muscles and restricts the body movements and locomotor functions.
Lakshana
Weakness of muscles
Heaviness of muscles
Pain & tenderness in the affected area
Inability to move and limited locomotor functions
Divisions
Not mentioned
Prognosis
Sadhyam in new and without associated diseases
Yaapyam in chronic and complicated conditions
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam
Mardanam (in completely vaatika)
Udwartanam
After the blockage of channels are removed by Rookshana&langhana, application of oils and nourishing therapies should be done.
Sodhana
Abhyangam
Swedanam
Virechanam
Asthapanavasti
Anuvasanavasti
Commonly used medicines
Maharasnadi kashayam
Yogarajaguggulu
Shaddharanam choornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Measures that may provide relief from muscle weakness include:
- Regular stretching exercises
- Traction and pulling
- Sonabath, steam bath etc.
- avoiding weight lifting sessions until the problem is resolved
- stress-relief activities and exercises such as yoga and meditation to relieve tension
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil, Ragi, Flax seeds
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Regular stretching and mild cardio exercises are advised according to the strength of the patient. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/31939642/
Author information
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