Muscle Spasms (cont.)
What causes a muscle spasm?
There are a variety of causes of muscle spasms, and each cause depends on certain
predisposing factors and anatomic areas of involvement.
Spasms can 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 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, especially roofers. Usually, the spasms will
occur in the large muscles that are being asked to do the work.
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 requires enough water, glucose, sodium,
potassium, calcium, and magnesium to allow the proteins within muscle cells 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 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. Leg spasms are often seen related to
exercise but cramps may also be seen at night involving calf and toe muscles.
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. Should a kidney stone attempt to pass,
the smooth muscles that
are in the walls of the ureter may spasm
and cause significant pain. Often this type of pain may be associated with
nausea and vomiting. Colicky pain is often associated with diarrhea, where the
muscles within the colon wall go into spasm just before the 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.
Next: What are the symptoms and signs of muscle spasms? »
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