Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
There are a variety of causes of muscle spasms, and each depends upon predisposing factors, the part of the body involved, and the environment the body is working in.
Spasms may occur when a muscle is overused and tired, particularly if it is
overstretched or if it has been held in the same position for a prolonged
period of time. In effect, the muscle cell runs out of energy and fluid and
becomes hyperexcitable and then develops a forceful contraction. This spasm may
involve part of a muscle, the whole muscle, or even adjacent muscles.
Overuse as a cause of skeletal muscle spasm is often seen in athletes who are
doing strenuous exercise in a hot environment. This is also an occupational issue with construction workers or others working in a hot environment. Usually, the spasms will
occur in the large muscles that are being asked to do the work.
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.
Unfamiliar exercise activities can also cause muscle spasms to occur. Abdominal spasms can occur when a person decides to begin working their abdominal muscles by doing situps and does too many too quickly.
Writer's cramps are similarly caused by prolonged use of the small muscles in
the hand.
It is commonly thought that dehydration and depletion of electrolytes will lead
to muscle spasm and cramping. Muscle cells require enough water, glucose, sodium,
potassium, calcium, and magnesium to allow the proteins within them to
interact and develop an organized contraction. Abnormal supply of these elements
can cause the muscle to become irritable and go into spasm.
Atherosclerosis or narrowing of the arteries (peripheral artery disease) may also lead to muscle spasm and
cramps, again because adequate blood supply and nutrients are not able to be
delivered to the appropriate muscle. Peripheral artery disease can decrease the flow of blood to the legs causing pain with activity. There may also be associated muscle cramps.
Leg spasms are often seen related to
exercise, but cramps may also be seen at night involving calf and toe muscles. Nocturnal leg cramps and restless legs syndrome are considered a type of sleep disturbance.
Systemic illnesses like diabetes, anemia (low red blood cell count), kidney
disease and thyroid and other hormone issues are also potential causes of muscle
spasms.
Diseases of the nervous system, such as multiple sclerosis or spinal cord
injury, can be associated with muscle spasm.
Smooth muscle can also develop spasm. When a hollow structure filled with air or
fluid is squeezed by the muscle spasm, significant pain can occur since the
fluid or air cannot be compressed. For example, smooth muscle in the intestinal
wall can go into spasm, causing waves of pain called colic. Colicky pain which
tends to be rhythmic (coming and going) may also occur within the bile duct that
empties the gallbladder and may develop after eating.
When kidney stones try to pass, the smooth muscles that are in the walls of
the ureter that connect the kidney to the bladder, may spasm and cause
significant pain. Often this type of pain is associated with
nausea and vomiting.
Muscles that surround the esophagus can go into spasm when
irritation occurs with reflux esophagitis or
GERD.
Diarrhea can be associated
with colicky pain, whereby the muscles within the colon wall spasm just before a
watery bowel movement.
Dystonias are movement disorders where groups of muscles forcefully contract
causing twisting and repetitive movements or the inability to have a normal
posture as a result of muscle spasm and cramping. The symptoms may be very mild
initially but gradually progress to become more frequent and aggressive.
Occasionally, there is no progression. Examples of this type of muscle spasm
include torticollis (where the neck muscles spasm and cause the head to turn to
one side), blepharospasm (where there is uncontrolled blinking of the eyes), and
laryngeal dystonia that affects the muscles that control speech. Dystonias may
be caused by abnormally functioning neurotransmitter chemicals in the part of
the brain called the basal ganglia. These chemicals (serotonin, dopamine,
acetylcholine, and GABA) are required to properly send messages that begin muscle
contraction. Dystonia symptoms may occur as a complication of stroke.
Muscle cramps are involuntarily and forcibly contracted muscles that do not relax. Extremely common, any muscles that have voluntary control, including some organs, are subject to cramp. Since there is such variety in the types of muscle cramps that can occur, many causes and preventative medications are known. Stretching is the most common way to stop or prevent most muscle cramps.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Anemia is the condition of having less than the normal number of red blood cells or less than the normal quantity of hemoglobin in the blood. The oxygen-carrying capacity of the blood is, therefore, decreased.
Pancreatic cancer is a malignant tumor of the pancreas. Pancreatic cancer has been called a "silent" disease because early pancreatic cancer usually does not cause symptoms.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Multiple sclerosis (MS) is a disease which progressively injures the nerves of the brain and spinal cord, reflected by alterations of virtually every sensory or motor function in the body. The cause of MS is primarily unknown. There are different types of MS including relapsing-remitting MS, primary-progressive MS, and secondary-progressive MS. Symptoms of MS rang from mild to severe and examples include visual disturbances, muscle weakness, spasm, and fatigue. Decreased concentration, memory loss, and impaired judgment. Treatment for MS is generally with medications.
Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
Temporomandibular joint disorder, or TMJ, is a disorder of the temporomandibular joint(s) that causes signs and symptoms including ear pain, bite problems, headaches, dizziness, clicking sounds in the jaw, tinnitus and/or locked jaws. Behaviors or conditions that can lead to TMJ include teeth grinding or clenching, fingernail biting, habitual gum chewing, trauma to the jaw, stress, and occupational hazards. Treatment for TMJ may include heat, ice, a soft diet, antiinflammatory medications, physical therapy, stress management, occlusal therapy, correction of bite abnormalities, and surgery.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Parkinson's disease is a slowly progressive neurologic disease characterized by a fixed inexpressive face, a tremor at rest, slowing of voluntary movements, a gait with short accelerating steps, peculiar posture and muscle weakness, caused by degeneration of an area of the brain called the basal ganglia, and by low production of the neurotransmitter dopamine. Most patients are over 50, but at least 10 percent are under 40.
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Scoliosis causes an abnormal curvature of the spine. When the cause of scoliosis is unknown the disorder is described based on the age when the scoliosis develops (infantile, juvenile, or adolescent idiopathic scoliosis). In functional scoliosis, curvature develops due to a problem somewhere else in the body. With neuromuscular scoliosis, there is a problem when the bones of the spine are formed. Treatment typically involves observation, bracing, and surgery and is dependent upon the severity of the curvature.
Hyponatremia is a condition where the level of sodium in the blood is low. Causes of hyponatremia can occur from excess fluid in the body, or a loss of sodium in body fluid. Some of the symptoms of hyponatremia include headache, muscle cramps or spasm, seizures, weakness and confusion. Treatment of hyponatremia depends on the cause.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Rabies is a potentially fatal viral infection. Rabies symptoms include fever, headache, myalgia, and can progress to more serious symptoms such as seizures, coma and death. The rabies vaccine (rabies treatment) should be administered immediately after the person or pet has been bitten.
Vulvodynia or vaginal pain, genital pain is a condition in which women have chronic vulvar pain with no known cause. There are two types of vulvodynia, generalized vulvodynia and vulvar vestibulitis. Researchers are trying to find the causes of vulvodynia, which may include nerve irritation, genetic factors, hypersensitivity to yeast infections, muscle spasms, hormonal changes, and more. The most common symptoms of vaginal pain (vulvodynia) is burning, rawness, itching, stinging, aching, soreness, and throbbing. There are a variety of treatments that can ease the symptoms of vulvodynia (vaginal pain).
Hamstring injuries may range from minor strains to major ruptures. A hamstring injury causes spasm, tightness, and tenderness. More severe injuries may cause swelling and bruising. While most hamstring injuries heal without surgery, a complete rupture would require surgery.
Tetanus is an often-fatal disease caused by nerve toxins produced by the common bacteria Clostridium tetani. In a seven-day period after infection, a person experiences muscle spasms, restlessness, headache, irritability, then lockjaw, and the lungs stop functioning. Tetanus is treatable with antibiotics and drainage. Sedation is often give to stop muscle spasms.
Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement fluids. Warning signs of heat exhaustion include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea or vomiting, and fainting.
Hyperhidrosis is excessive sweating of the underarms, palms, or soles of the feet. Treatment may involve over-the-counter antiperspirants, prescription antiperspirants, iontophoresis, medications, surgery, and Botox.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
Ramsay Hunt syndrome is an infection of a facial nerve that causes a red painful rash with blisters and facial paralysis. The herpes zoster virus causes the infection. The infection is treated with antiviral agents, steroids, and pain medications.
Amyotrophic lateral sclerosis (ALS, Lou Gehrig's disease) is a neurological disease that progresses rapidly. The disease attacks the nerve cells responsible for the control of voluntary muscles. Early symptoms include cramping, twitching, or stiffness of the muscles; slurred nasal speech; difficulty swallowing or chewing, and muscle weakness in an arm or leg. Currently, the cause of ALS is not known. ALS is a fatal disease. No cure has been found for ALS, however, the drug riluzole (Rilutek) is FDA approved, and this drug reduces the damage to motor neurons by decreasing the release of glutamate.
Dystonia disorders cause involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor, and abnormal posture. There are many forms of dystonia. Some types of dystonia respond to dopamine, or can be controlled with dedative-type medications, or surgery.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Hyperthermia is the overheating of the body. Heat-related illnesses like heat stroke, heat exhaustion, heat cramps, heat rash, and sunburn are all hyperthermia conditions. Treatment of these conditions depends upon the condition, environment, and circumstances. Heat stroke is a medical emergency, and may result in death if not treated promptly. Heat exhaustion may lead to heat stroke if not treated properly.
Polio is caused by the poliovirus and is spread through person-to-person contact. In non-paralytic polio, patients experience mild flu-like symptoms such as fatigue, fever, headache, sore throat, and vomiting. In paralytic polio, symptoms include difficulty swallowing and breathing, headache, mood swings, muscle pains and spasms, and paralysis. There is no cure for polio, so treatment focuses on alleviating the symptoms. In 1955, a polio vaccine was developed.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
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