Are my muscle spasms from fibromyalgia or something else? A doctor explains

Muscle spasm, muscle cramp or Charlie horse?  What is the difference?

Before discussing muscle spasms and fibromyalgia, here is a description of a few overlapping and synonymous terms:

  • Muscle spasm – a sudden, painful, involuntary and prolonged contraction of a muscle or group of muscles, lasting from a few seconds to a few minutes, involving usually postural muscles
  • Muscle cramp – another name for muscles in spasm, especially when it occurs in the abdomen, leg, arm or hand
  • Charlie horse – another name for a muscle spasm, specifically when it occurs in the calf or hamstring muscles of the leg
  • Muscle twitch – also called a fasiculation or tic, is an uncontrolled fine, rapid and painless contraction of only a small part or isolated area of a larger muscle that can be seen contracting under the skin, often involving the eyelid, calf, thigh, or thumb, and often related to stress or anxiety


Muscle spasms and fibromyalgia

The subject of muscle spasms is heavily searched on the internet.  This can be explained because muscles go into spasm, or involuntary contraction, for a wide variety of reasons. However, two very common and entirely different problems are the primary reasons people search the internet for help for the cause and relief of their tight and spastic muscles.

The first group of people is made of those who have rather frequent spasm of muscles for no particular reason they can determine, as well as other strange complaints.  They usually do not have an explanation for their tight muscle knots until they dig deeper into a condition called fibromyalgia. The second group interested in learning about spasms of muscles is primarily engaged in heavy work or exercise, and wants to know what causes muscle spasms and how to stop them.  They can make sense out of the painful contractions once they make the connection between overwork and the dehydration and mineral loss it causes that can result in painful muscle cramps.

Fibromyalgia as a cause of muscle spasm

Fibromyalgia is a little understood syndrome whose mechanism of causing all its bizarre symptoms is still mired in controversy.  It primarily affects women over 30 years of age, although children display this syndrome as well as men of all ages. Until recently fibromyalgia was not thought to be a legitimate health problem, but more so an imaginary complaint of someone looking for attention.  Since the late 1980s fibromyalgia has been recognized as a non-life-threatening, chronic pain disorder with muscle spasms, fatigue, sleep disturbances, and tender areas located at certain parts of the body as the primary complaints.  It is a complex problem in which pain and spasms or even twitches can be experienced in all parts of the body in some suffers, or just in certain areas of the muscles around the joints of the neck, shoulders, back and buttocks in other sufferers.

Because of the primary complaints of pain and spasm in muscles, fibromyalgia has been called muscular rheumatism and fibromyositis; it is the second most common problem seen by rheumatologists.

Spasms of muscles and fibromyalgia

The pain that is so typical of fibromyalgia is now commonly agreed to be due to uncontrolled contraction, or muscle spasm, of the muscle cells of the involved areas.  If spinal muscles in the low back and buttock are involved in an individual then low back pain will be reported; if muscles at the base of head are involved then headaches will be the complaint reported.

Currently, three different cellular changes have been demonstrated in the muscles of the majority of people who have fibromyalgia:

  • Changes in the mitochondria of the muscles cells
  • Changes in the micro blood circulation of the affected muscle – such as fewer capillaries and constant constriction of the capillaries within the tissue where the painful muscle spasm is located
  • Irregularity of the metabolism of the pain receptors that would result in greater pain sensitivity

Any of these could explain muscle pain and contraction but when all are present the pain can be intense, yet difficult to detect the source of the pain and spasms.

Muscle spasms location shown on fibromyalgia chart Of interest in understanding how fibromyalgia develops in a person, any muscle can be affected, but most often the central postural muscles (spine, thorax, abdomen and buttocks) are the most usual sites of pain and spasms. These postural muscles have an interesting function in the body in relation to all daily activity and all movement of the body, even though they do not provide a great amount of direct movement by themselves.  Their function happens to be essential to movement because they provide stabilization to central axis of the body so that movement can take place. This means that if we wish to move an arm or a leg, the core muscles will contract just a few milliseconds before the arm or leg muscles contract in order in order to prevent the body from being made unstable by the sudden movement of the limb.  Without this stabilizing effect of the central trunk muscles to prepare the body so it is ready to handle the additional leverage of an arm or leg sticking out away itself we would wobble, sway and perhaps fall over. Because they are so critical to maintaining the upright posture and not falling down every time an arm or leg is extended, they are called “postural muscles.”

When someone with fibromyalgia is in pain the brain misinterprets the pain signals for reasons not yet understood and takes the pain message as a signal to contract these same postural muscles in preparation to move an arm or leg.  In this way the postural muscles of the trunk are being sent brain signals to stay in a state of constant contraction – or muscle spasm – night and day – for as long s there are pain signals being sent.  Producing this constant state of involuntary muscle contraction in one or more postural muscles wastes a lot of energy and explains the intense fatigue people with fibromyalgia feel.

The muscle spasms or muscle twitches of fibromyalgia occur frequently along with many other symptoms. These symptoms of muscles in spasm can come and go without apparent explanation, and can occur at any time without warning and in any muscle.  However, those muscles that go into spasm most often are the postural muscles of the trunk (neck, shoulder, back and buttock).

Prevention and treatment of fibromyalgia and muscles in spasm

There are several methods within Alternative Medicine that can be used to reduce the muscle tension and pain fibromyalgia is known for; these can also be used a prevention protocol to reduce their occurrence and intensity.

  • Gentle stretching exercises done frequently can keep the muscles relaxed and increase blood flow which encourages healing and eases pain
  • Regular full body massage to reduce muscle pain, reduce stress, body tension and increase circulation
  • Hot compresses applied to the area of complaint during acute muscle spasm flare-ups. Keeping the muscles warm in cold weather and avoiding cold drafts are both good ideas, since these will increase blood circulation to the muscles and reduce spasms of muscles. Developing a habit of dressing in layers can also act as a preventive.
  • Regular aerobic exercise program using simple methods like long walks, biking, swimming or floor exercises.
  • Reduce stress in whatever way possible. This is not always possible in all situations, but doing what you can where you can will always be helpful to the total stress level.
  • Supplementing with methyl sulfonyl methane (MSM) has been shown to be effective in reducing the intensity and frequency of muscle spasms. MSM is found naturally within the tissue in high concentration in the skin, joints, hair and nails. MSM demonstrates valuable anti-inflammatory properties, an analgesic quality to reduce pain, an ability to increases blood supply and reduce muscle spasm when taken in high concentration.  A good treatment strategy is to apply MSM topically as well as take it internally as a long-term treatment for anyone with a history of fibromyalgia.


Muscle spasms related to exercise, dehydration and drugs

There are many possible causes for muscles to contract involuntarily besides fibromyalgia, although many of these other causes fundamentally come down to overwork and alerted chemistry of the muscles:

  • Overexertion compared to the current level of physical fitness – the worse your physical condition the easier it is to reach a level of muscular exertion and cause spasms in muscles
  • Working or exercising in excessive heat – even people who are in good physical condition can upset the mineral levels of their blood due to excessive sweating, or insufficient water replacement, or both
  • Prolonged use of small muscles when subjected to greater work than usual – writer’s cramp of the hand is a good example
  • Blood vessel disease – medically known as atherosclerosis or narrowing of the arteries (peripheral artery disease)
  • Nervous system disorders – Parkinson’s disease, myasthenia gravis, multiple sclerosis, spinal cord injury, and pinched nerves in the neck and lower back can cause muscle spasm due to damage to nerve tissue
  • Common drugs list muscle cramps as a possible side effect, often due to reduction of fluid from the tissue:
    • Lasix (furosemide), Thiazide (Chlorothiazide), Microzide (hydrochlorothiazide),      and other diuretics (“water pills”) used to remove fluid from the body
    • Zocor (ssimvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Crestor (rosuvastatin), and Pravachol (pravastatin), treatment of elevated cholesterol
    • Procardia (nifedipine), treatment of angina and high blood pressure
    • Evista (raloxifene), treatment of osteoporosis
    • Brethine (tgerbutaline), and Ventolin (albuterol), treatment of asthma
    • Tasmar (tolcapone), treatment of Parkinson’s disease
    • Aricept (donepezil), treatment of Alzheimer’s disease
    • Prostigmine (neostigmine), treatment of myasthenia gravis
  • Blood circulation that is not adequate for the work demand  – as the work load increases more blood needs to be supplied; a muscle with slightly reduced circulation will function well and not go into spasm during light activity, but will develop severe spasm of muscles during heavy activity
  • Dehydration – reduced body fluid allows the blood to thicken and lower blood pH, leading to reduced circulation and altered ability to deliver minerals and oxygen to the tissue resulting in muscles in spasm
  • Insufficient stretching before exercise – stretching prepares a muscle group for activity by increasing circulation; without adequate preparation the muscles are prone to cramping
  • Magnesium, calcium and/or potassium deficiency – critical minerals needed for healthy muscle activity
  • Pregnancy – common to experience reduced calcium in blood and tissues due to altered hormone levels and demands of supplying nutrients to a growing  baby
  • Diarrhea, vomiting or fever – when any of these are prolonged they can lead to excessive loss of body fluid that leads to dehydration if not rapidly replaced
  • Nerves that send irregular signals to a muscle or group of muscles as they are undergoing regeneration, either dying or being created, or being pinched anywhere along their length
  • Alcoholism – due to systemic effect on all organs and tendency toward poor nutrition
  • Systemic illnesses – diabetes, anemia, kidney, thyroid and endocrine disorders can alter muscle metabolism and result in spasms anywhere in the body.


Treatment of common muscle spasms

Immediate care of spasms in muscles related to exercise, dehydration and drugs:

  • Stop the activity that caused the cramp
  • Stretch the muscle
  • Massage the muscle gently
  • Ice applied to the muscle
  • Warm the muscle to increase circulation

Long-term care of muscle spasms related to exercise, dehydration and drugs:

  • Eat foods high in vitamins and minerals (magnesium, potassium and calcium).
  • Keep hydrated, especially when active and during hot weather
  • Stretch before exercise and heavy work activity
  • Talk to your doctor about the side effects of the drugs you are taking, especially if you are taking more than one, for a possible change in your drug therapy.

If these self-treatment measures are ineffective after a week of use, or if your muscle spasms recur frequently or for no apparent reason, call your doctor. Explain the situation since a more serious health problem that needs medical attention could be the underlying cause of your muscle cramps and contractions.

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