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Facts you should know about muscle spasms
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An illustration shows the three types of muscle in the body: cardiac, skeletal, and smooth.Source: Getty Images What are the different types of muscle?
Muscles are complex structures that cause movement in the body. There are three types of muscle in the body:
What is skeletal muscle?Skeletal muscles are anchored to bone, either directly or by a tendon. When the muscle contracts, the associated body part moves. This allows arms to lift, legs to run, and the face to smile. Most of these muscles are under the willful or conscious control of the brain. This type of muscle is striated or striped with dark-colored muscle fibers containing large amounts of myoglobin, the protein that helps carry oxygen, and light-colored fibers that have lesser amounts of protein. The contraction of a skeletal muscle requires numerous steps within its fibers and cells. The nutrients required to produce energy, oxygen, electrolytes, and glucose are supplied by the bloodstream.
A man lifts weights at the gym, and a callout illustrates the muscle and tendon. Smooth muscle is located in the walls of hollow internal structures in the body, like the arteries, intestines, bladder, and iris of the eye.Source: iStock, Getty Images What is smooth muscle?Smooth muscle is located in the walls of hollow internal structures in the body, like the arteries, intestines, bladder, and iris of the eye. They tend to circle the structure and when they contract, the hollow structure is squeezed. These muscles are involuntary and are controlled by the unconscious part of our brain function using the autonomic nervous system. The autonomic nervous system always runs in the background, regulating processes within the body. There is a balance between the sympathetic system (adrenergic nerves) that speeds things up and the parasympathetic system (cholinergic nerves) that slows things down. These names are based on the type of chemical that is used to transmit signals at the nerve endings. Adrenaline (epinephrine from the sympathetic nervous system) allows the body to respond to stress. Imagine seeing a bear in the woods; your heart beats faster, your palms get sweaty, your eyes dilate, your hair stands on end, and your bowels move, all because the sympathetic nervous system is activated. Acetylcholine is the chemical that is anti-adrenaline and is involved in the parasympathetic nervous system that acts to calm us down. Smooth muscle has the same basic contraction mechanism as skeletal muscle, though different proteins are involved. What is a muscle spasm?A muscle spasm, or muscle cramp, is an involuntary contraction of a muscle. Muscle spasms occur suddenly, usually resolve quickly, and are often painful. A muscle spasm is different than a muscle twitch. A muscle twitch, or fasciculation, is an uncontrolled fine movement of a small segment of a larger muscle that can be seen under the skin.
An illustration shows a smooth muscle (intestines) in a relaxed state and spasm or contracted state. Spasms may occur when a muscle is overused, tired, previously injured, or strained.Source: OpenStax College, Bigstock What are common causes of muscle spasms?
There are a variety of causes of muscle spasms, and each depends upon predisposing factors, the part of the body involved, and the environment that the body is in. Spasms may occur when a muscle is overused, tired, previously injured, or strained.
Overuse as a cause of skeletal muscle spasm is often seen in athletes who are doing strenuous exercise in a hot environment.
Overuse can also occur with routine daily activities like shoveling snow or mowing or raking grass, causing muscle spasms of the neck, shoulder, and back. See a medical illustration of the foot plus our entire medical gallery of human anatomy and physiology See Images
A woman experiences a muscle spasm in her leg. Several causes of muscle spasms are described.Source: Getty Images Other causes of muscle spasms
Dystonias are movement disorders where groups of muscles forcefully contract and cause twisting.Source: iStock, Getty Images Dystonias cause muscle spasms
What are risk factors for muscle spasms?Most people are at risk for developing a muscle spasm at one time in their life, from infant colic to kidney stones. The risks differ depending upon the person's past medical history, their occupation, and level of physical activity. Examples include the following:
A woman with a muscle spasm (dystonia) in her neck.Source: Getty Images What are the symptoms and signs of muscle spasms?
The symptoms and signs of muscle spasm depend upon the muscle involved and the circumstances leading up to the spasm.
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A man experiences a spasm in his arm while golfing. The diagnosis usually begins with a history and physical examination. It is helpful to know the circumstances surrounding the muscle spasms.Source: Getty Images How do health care professionals diagnose muscle spasms?Most people have experienced a skeletal muscle spasm due to overexertion, especially in a warm environment, and are able to self-diagnose. However, if the spasms are severe, last a long time, or keep recurring, it is reasonable to see a health-care professional for an evaluation. The diagnosis usually begins with a history and physical examination. It is helpful to know the circumstances surrounding the muscle spasms.
Sometimes the physical examination may be normal since the muscle spasms may not be present during the visit. However, the physical examination may useful in detecting underlying health issues that may be helpful in making the diagnosis. For example, if the patient is complaining of leg muscle cramps, the examination may include palpating or feeling for pulses in the feet. Atherosclerosis, or hardening of the arteries, may be associated with the loss of arterial pulse in the involved extremity. For those having pain from smooth muscle spasms, the pain may be severe enough to present to an emergency department. The history and physical examination will be directed to finding the source of the pain, while at the same time trying to control the symptoms. Kidney stone pain (renal colic) and gallbladder pain sometimes require anti-inflammatory or narcotic pain medication. They are often associated with nausea and vomiting and these symptoms may also require treatment. Some patients with irritable bowel conditions may also present with significant intestinal spasms, abdominal pain, and constipation or diarrhea. For patients with recurrent muscle spasms where the cause is not easily diagnosed by history and physical examination, testing may be necessary to give direction as to potential causes. Blood tests may or may not be indicated depending upon the situation and whether or not the diagnosis can be adequately attained by history and physical examination. Blood tests may include a complete blood count (CBC) looking for anemia, electrolytes (especially sodium, potassium, calcium, and magnesium), glucose, and creatinine (to check for kidney function). Thyroid function tests may also be considered. If muscle spasms are prolonged and ongoing, there may be a concern that muscle breakdown and damage are occurring. A creatine phosphokinase (CPK) blood test can be used to detect this. It is an enzyme released into the bloodstream by irritated or damaged muscle tissue. Rhabdomyolysis can lead to kidney failure. If there is concern that the spasms are due to a nerve or muscle disorder, electromyography (EMG) may be done to determine whether there may be an abnormality of the muscle, of the nerves, or both. If there is concern about the potential for peripheral artery disease, tests of blood flow to the legs may be considered, including an ankle-brachial index (ABI) which compares blood pressures in the arms and legs and ultrasound and angiography (often using CT or MRI) to directly assess the blood vessels. If nocturnal leg cramps are thought to be associated with a sleep disturbance, sleep studies might be indicated.
A doctor examines a man experiencing muscle spasms. Prevention is the key to most skeletal muscle spasm episodes.Source: Bigstock What are treatment options for muscle spasms?
Prevention is the key to most skeletal muscle spasm episodes. Since they are often associated with dehydration and electrolyte disturbances, it is important to keep the body well hydrated. If the fluid loss is due to an illness with fever or vomiting and diarrhea, controlling the symptoms will help limit the fluid loss and prevent spasms. Similarly, for those who work or exercise in a hot environment, drinking enough fluids to keep hydrated is very important. It is often helpful to hydrate prior to activities in warm environments. Muscles should also be prepared for the activity that they are expected to do. Just as athletes stretch and warm-up before the game, nonathletes should warm-up before heavy labor, including jobs like raking, mowing, and shoveling snow. Should a large skeletal muscle go into spasm (often referred to as a charley horse), the initial treatment is to gently stretch the muscle back to length to break the spasm cycle and resolve the acute situation. For example, first aid for a hamstring spasm (where the muscles in the back of the thigh are affected) includes straightening the knee joint and flexing the hip, which stretches the muscles and helps resolve their spasm. Further treatment will depend upon the underlying cause of the muscle spasms. For muscles that have been damaged or strained, medications may be required for short-term pain relief, including anti-inflammatories (ibuprofen [Advil, Motrin]), narcotics, and muscle relaxants. The treatment of smooth muscle spasms, such as bowel spasm, depends upon diagnosing and treating the underlying cause. Nocturnal leg cramps are difficult to control and treat. Historically, quinine has been prescribed to help with the muscle spasms, but this drug can have side effects including abnormal bleeding problems. Other medications, including B-complex vitamins, gabapentin, and diltiazem, may be helpful. Many possible treatments are available for dystonias. The decision as to which medication to use depends upon the individual situation. It may take trial and error to find the right medication in the right dose to control symptoms.
A male and female stretch in the park before their workout.Source: Getty Images What types of health care professionals treat muscle spasms?Primary-care providers treat patients with muscle spasms. Often, the spasms tend not to cause prolonged symptoms that require emergent or urgent care, and the patient sees their regular health care provider for evaluation and treatment. However, some situations require more aggressive intervention, depending upon the situation, and emergency providers often see those with illnesses associated with smooth muscle spasm, including abdominal or chest pain that may ultimately be diagnosed as kidney or gallbladder colic, irritable bowel syndrome, or esophageal spasm. Skeletal muscle spasm might be evaluated by emergency physicians when there is also heat-related illness present or there is concern regarding muscle damage. Different situations may require the services of specific specialists. For example, patients who have leg cramps may have a sleep disorder and may need care by a sleep specialist. Neurologists care for patients with movement disorders. Endocrinologists help control diabetes. Vascular surgeons may be required to discuss treatment options for patients with peripheral vascular disease. What is the prognosis for muscle spasms?Most people experience infrequent muscle spasms and do well with prevention (keeping well hydrated and not overusing their body). However, those who have an underlying medical condition as a cause of muscle spasms often need to treat the original medical problem to help control the muscle spasms. This is especially true for those with peripheral artery disease or movement disorders. How long do muscle spasms last?Skeletal muscles cramps or spasms tend to last only a few seconds, and the patient feels the need to stretch the muscle to resolve the spasm. Smooth muscle cramps may last for a prolonged period of time until the underlying problem that caused the spasm is resolved. Renal colic can last for hours, as can colicky pain with diarrhea or menstrual cramps. Involuntary muscle twitching is a significant problem because it may last for prolonged time frames and need medications to control or resolve the spasm and the associated pain.
Medically Reviewed on 2/10/2022 References Bucholz, R.W., J.D. Heckman, and C.M. Court-Brown. Rockwood and Green's Fracture in Adults, 6th Ed. Philadelphia: Lippincott, Williams & Wilkins, 2006. Daroff, R.B., et al. Bradleys' Neurology in Clinical Practice, 6th Edition. Philadelphia: Elsevier Saunders, 2012. Kasper, D., et al. Harrison's Principles of Internal Medicine, 19th Edition. McGraw Hill Education/Medical, 2015. Rakel, Robert E., and David P. Rakel. Textbook of Family Medicine, 9th Edition. Philadelphia: Elsevier Saunders, 2015. |