Muscle atrophy is a process that develops in the muscles and leads to a progressive decrease in volume, as a result of which they degenerate. In other words, gradually muscle fibers, due to prolonged immobility or inactivity, become thinner, their number decreases, in severe cases they completely disappear.

Types and causes of muscle atrophy

Distinguish between primary and secondary muscle atrophy.

The primary is caused by damage to the muscle itself. It may be due to unfavorable heredity, manifested in metabolic disorders, which is expressed by high permeability of cell membranes or congenital defects in muscle enzymes. The onset of the pathological process can also be provoked by environmental factors, such as injuries, infectious processes, and physical overstrain.

The most pronounced primary atrophy of the muscles, including the legs, with myopathy (muscular dystrophy).

Neurogenic muscular atrophy, which is also secondary, occurs against the background of damage to the peripheral nerves, the anterior horns of the spinal cord. The cause may be trauma, an infectious process that affects the motor cells of the anterior horns of the spinal cord (for example, polio).

There are several forms of secondary muscle atrophy:

• Neural amyotrophy (Charcot-Marie atrophy) is characterized by damage to the muscles of the legs and feet. As a result, the feet are deformed, and the gait takes on the character of a “steppage”, when a person, so that the feet do not cling to the floor, raises his knees high in the process of walking. After a few years, muscle atrophy from the legs spreads to the hands and forearms.
• Progressive muscle atrophy (Werdnig-Hoffmann atrophy) is characterized by a severe course of the disease, which most often begins in early childhood. Accompanied by fibrillar twitches, a sharp decrease in muscle tone, loss of tendon reflexes.
• Arana-Duchene atrophy is seen only in adults. The initial process develops in the distal parts of the hands: the interosseous muscles, the elevations of the little finger and thumb atrophy. Tendon reflexes disappear, but sensitivity remains. The hand acquires the characteristic appearance of a “monkey hand”. The process of atrophy progresses, spreading first to the muscles of the neck, and then to the trunk.

Symptoms of leg muscle atrophy are manifested by fatigue during physical exertion (long walking, running), spontaneous muscle twitching. Outwardly, an increase in the calf muscle is noticeable.

Primarily, atrophies are localized in the proximal muscle groups of the legs, hips, and pelvic girdle; they are always symmetrical. Symptoms of muscle atrophy are manifested by limitation of motor functions - difficulty in lifting, getting up from a prone position. Over time, the gait also changes.

Treatment of muscle atrophy

The method of treatment of muscle atrophy depends primarily on the form and severity of the disease.

Drug therapy involves the use of such means:

• 1% solution of disodium salt of adenosine triphosphoric acid (30 injections of 1-2 ml each);
• vitamin E (1 tsp 1-2 times / day);
• vitamin B 5% and vitamin B 12 0.01% (intramuscularly every other day, the course at the discretion of the doctor is 15-20 injections);
• 0.25% solution of galanthamine (from 0.3 to 1 ml subcutaneously every other day, the course is 10-15 injections);
• oksazil or dibazol (children 1 time per day at the rate of 0.001 gna 1 year of life);
• prozerin (2-3 times a day 0.015 g for adults, children - 1 time per day at the rate of 0.001 g per year of life.

Also, in the treatment of muscle atrophy, blood transfusion (up to 200 ml), electrotherapy, therapeutic exercises, physiotherapy, and massage are practiced.

To achieve improvements, the full course of treatment for muscle atrophy is repeated over several months.

Muscular atrophy is a process that develops in the muscles and leads to a progressive decrease in their volume and degeneration. Muscle fibers gradually become thinner, in severe cases their number decreases sharply, sometimes they completely disappear. There are primary, or simple, and secondary, or neurogenic, muscle.

Primary muscle atrophy depends on the damage to the muscle itself. It is apparently based on hereditary metabolic disorders in the form of a congenital defect in muscle or an increase in muscle membranes. However, environmental factors that contribute to the development of the disease (physical overstrain, infections, injuries) also play a significant role. Primary muscular atrophy is most clearly expressed in myopathy (see).

Secondary, or neurogenic, muscle atrophy develops when cells of the anterior horns, roots, or peripheral nerves are damaged. In the latter case, the atrophic syndrome is accompanied by a sensitivity disorder. Secondary muscular atrophy develops after an injury to the nerve trunks, with infections that affect the motor cells of the anterior horns of the spinal cord (and). In some cases, the process is hereditary. In this case, the predominantly distal location of atrophy is characteristic (muscles of the feet, legs, hands, etc.) with a slower and more benign course of the process. There are several forms of neurogenic atrophy:

With neural amyotrophy, or Charcot-Marie amyotrophy, the muscles of the feet and legs are affected (Fig.), especially the extensor and abductor muscles. The feet are deformed. The gait takes on the character of the so-called steppage: when walking, patients raise their knees high so that the hanging feet do not cling to the floor. Reflexes fade, superficial sensitivity in the distal extremities decreases. A few years after the onset of the disease, atrophy extends to the hands and forearms.

Progressive muscular atrophy of Werdnig-Hoffmann is the most severe. The disease usually begins in early childhood, often in several children in a family of apparently healthy parents. Atrophy is accompanied by loss of tendon reflexes, sharp and fibrillar twitches.

Atrophic syndrome is also observed in progressive adult muscular atrophy - Aran-Duchenne atrophy. Initially, the process is localized in the distal parts of the upper limbs. The eminences of the thumb and little finger and the interosseous muscles atrophy. A very characteristic posture of the hand in the form of a “monkey hand” is formed. Tendon reflexes disappear, sensitivity is preserved. The process is steadily progressing, spreading to the muscles of the neck and torso.

Treatment. In the treatment of muscle atrophy, the following are used: disodium salt of adenosine triphosphoric acid 1% solution of 1-2 ml intramuscularly, for a course of 30 injections; 0.5-1 ml of 5% solution intramuscularly; 0.5-1 ml of 0.01% solution every other day intramuscularly, for a course of 15-20 injections; 1 teaspoon 1-2 times a day; 0.25% solution 0.3 - 1 ml subcutaneously every other day, for a course of 10-15 injections; inside dibazol or oksazil at the rate of 0.001 g per 1 year of a child's life 1 time per day; 0.001 g per 1 year of a child's life 1 time per day (adults - 0.015 g 2 - 3 times a day) orally or subcutaneously 0.05% solution of 0.3 - 1 ml, depending on age, every other day, 10-15 injections. Transfusion of single-group blood (150-200 ml) is also used, and. Such treatment, carried out in separate courses over the course of months, each time brings some improvement, and sometimes can help stabilize the process.

Muscular atrophy is a pathological process that develops in the muscles and leads to a decrease in their volume and degeneration. An early sign of the development of an atrophic process in the muscle is the homogenization of the muscle fiber and the formation of vacuoles as a result of a violation of the colloidal structure and changes in the water exchange of muscle tissue. As the process progresses, the number of muscle fibers in the muscle decreases and their contractile part can be replaced by connective and adipose tissues, forming pseudohypertrophies. In the final stage, a sclerotic process develops in a number of muscles, leading to the development of retractions and contractures.

There are two types of muscle atrophy: primary, or simple, and secondary, or neurogenic.

primary or simple, muscle atrophy occurs due to damage to the muscle itself and develops while maintaining the structure and function of the peripheral motor neuron. It is characterized by quantitative changes in electrical excitability, the absence of fibrillar twitches. The mechanical excitability of the muscles is preserved. With this form, there are often retractions.

The etiology and pathogenesis of simple muscular atrophy has not yet been resolved. It is based, apparently, metabolic disorders. Some enzymatic metabolic defects leading to muscular dystrophies are already known. The factors leading to the development of the disease are varied: alimentary dystrophy, trauma, the monotonous tension of certain muscle groups during work, long-term infections, and many chronic intoxications. The development of muscle atrophy is known in cases of hypothyroidism, after thyroidectomy and in other thyroid dysfunctions, as well as in pituitary disorders, Simmonds cachexia, Addison's disease and other endocrine disorders. Muscular atrophy can also develop as a result of prolonged immobilization of the limbs after the application of gypsum for fractures, orthopedic operations, as well as with prolonged inactivity of the diseased limb, with hemiplegia and monoplegia of central origin. Undoubtedly, severe neuropsychic overstrains are also important, resulting in dynamic disruptions to somatic disorders.

In the pathogenesis of muscle atrophy, one should also take into account violations of sympathetic innervation associated with dysfunction of the central and peripheral structures of the autonomic nervous system, which also affect changes in the metabolism of muscle tissue. This is evidenced by muscle atrophy of reflex origin, which develops after surgery on the cervical sympathetic nerve or after cervical sympathectomy, as well as as a result of prolonged pain irritation during bruises, bone fractures, with painful scars and inflammatory processes that cause pathological centripetal impulses. In these cases, along with a violation of muscle trophism, other autonomic and animal symptoms develop - hypesthesia, hyperreflexia, cyanosis and coldness of the extremities, sweating, osteoporosis, etc. It is also known that when sympathetic innervation is lost, the proximal muscles, which are richer in sympathetic fibers, suffer first of all .

The group of simple muscle atrophy also includes the so-called arthritic (arthrogenic) muscle atrophy, which develops in diseases of the joints. In this case, the muscles lying near the affected joint atrophy (for example, interosseous - for diseases of the joints of the hand, deltoid - for diseases of the shoulder joint, etc.) (see).

Atrophy of the lower leg is a rare disease that occurs due to a violation of metabolic processes in the muscles. Often it develops in people with impaired motor function, moving in a wheelchair. But it can also affect healthy active people, more often men. As a result, instead of muscles, adipose or connective tissue is formed, which is not able to contract and dries. The disease has very serious consequences, so it is important to start treatment as soon as possible.

Causes of atrophy of the muscles of the leg

Calf muscles: norm and atrophy

Atrophy of the adipose tissue of the lower leg can occur for various reasons:

• Natural aging of the body, in which there is a decrease in the level of metabolism.
• Connective tissue pathology.
• Irrational nutrition, the body does not receive the necessary dose of vitamins and minerals.
• Constant excessive physical activity.
• Diseases of the digestive system.
• Hormonal imbalance, disruption of the endocrine system.
• Tightness in the foot, atrophy of the calf muscle - the causes of these pathologies can be surgeries and injuries.

Allocate primary and secondary atrophy. Primary develops due to damage to the muscle itself. It can be either congenital or acquired due to external factors.

An atrophic process may occur due to injury to the nerve trunks. This is most often due to the development of infectious inflammation, which adversely affects the motor cells of the spinal cord. Against this background, the patient loses sensitivity.

Secondary atrophy, in turn, is divided into several main types:

1. Progressive - symptoms most often appear in childhood. The disease is very difficult, there is a complete loss of tendon reflexes.
2. Neural atrophy - damage to the lower leg and feet. A gait disorder develops, the patient raises his knees high when walking. Subsequently, the foot completely loses its sensitivity, then the disease begins to spread to other parts of the body.

Any infectious disease, physical stress, metabolic disorder or serious injury can trigger the disease.

Symptoms of the disease

Atrophy of the leg muscles

The first symptom is weakness in the legs after the simplest physical exertion. The calf muscles increase in size. Limitations of motor function are felt, for example, the patient cannot climb stairs.

The drying of the calf muscle of the leg occurs gradually, usually the process of atrophy lasts for several years.

The disease can affect both one calf muscle, and two at once.

In addition, it can pass both symmetrically and asymmetrically. The fat layer on the affected limb gradually decreases.

Over time, a more pronounced clinical picture develops:

• Reduction of the calf muscle in volume. The patient's gait changes, it becomes difficult to move without assistance.
• There are periods of exacerbation. Sometimes the patient is tormented by severe muscle pain, then the symptoms may fade away. But this does not mean that the disease goes away.
• The primary form of atrophy is characterized by rapid fatigue in the legs, loss of muscle tone, and twitching of the limbs.
• The secondary form manifests itself as neuropathy. There is a deformity of the feet and lower legs. The leg ceases to obey the person. The foot seems to hang, because of this, when walking, it catches on the floor. The patient has to raise his leg high to take a step. With the progression of the disease, muscle weakness passes from the legs to the hands.

It is important to correctly identify the symptoms in order to correctly prescribe treatment. When making a diagnosis, the general condition of the patient, the symptoms of the disease are taken into account. Treatment methods are always selected individually.

Diagnosis and treatment methods

Massage of the lower extremities to maintain muscle tone

First of all, a thorough examination of the patient is carried out, his hereditary predisposition to atrophy is clarified. A full examination is scheduled to identify chronic diseases, as well as a biopsy of the nerves and muscles.

Treatment is always prescribed individually. It all depends on the cause and course of the disease, the age of the patient. A complete cure is impossible, but with the help of drugs and physiotherapy, it is possible to return the patient to normal life, relieve pain symptoms, and restore metabolic processes.

It is always necessary to treat the patient comprehensively.

Be sure to take not only medicines, but also vitamins, minerals, which contribute to the normalization of metabolism.

Such patients must be prescribed massage. It maintains muscle tone, improves blood flow to the weakened lower leg. You can also use special elastic.

Important! Therapeutic massage should be carried out only by a specialist. What it will be and how long the course will last can only be decided by the attending physician.

Complementary Therapies

Exercise therapy as an additional therapy

In addition to massage and drug treatment, patients are prescribed electrotherapy. The affected areas of the lower leg are affected by a low current. This stimulates tissue repair, while the patient does not feel pain at all.

In order for the lower leg and foot to begin to function normally, it is important to perform therapeutic exercises.

The exercise should be performed under the supervision of specialists.

Weak calf muscles should receive a load gradually, the first time the training is carried out in bed with minimal effort.

Proper nutrition plays an important role in restoring a weakened body.

The patient should receive at least two grams of protein per kilogram of body weight.

In addition, it is important to consume enough carbohydrates. If you do not follow the principles of nutrition, you can aggravate the course of the disease.

Tightness and shrinkage of the calf muscles are symptoms of a serious illness. When they manifest, it is necessary to urgently consult a doctor, since atrophy of the lower leg can lead to serious consequences, up to the death of the limb. The treatment of pathology is complex and long, but it helps to return the patient to a normal life.

Muscle atrophy is a symptom of a certain pathological process that leads to thinning of muscle fibers, and as a result, to immobility of the patient. It should be noted that the development of this pathology is quite long in time - from several months to several years. In fact, there is a replacement of muscle tissue with connective tissue, which entails a violation or complete loss of motor function in humans. Treatment of such a violation should be carried out strictly under the supervision of a specialized medical specialist.

Etiology

Clinicians distinguish two types of etiological factors of muscle atrophy - primary and secondary. The primary form of the disease is hereditary, and any neurological pathology can only aggravate the pathology, but will not become a provoking factor.

Secondary etiological factors include the following:

• constant physical stress, which is a consequence of excessive physical exertion in sports or due to the characteristics of work;
• infectious pathologies;
• nerve ending injuries;
• pathology of the motor cells of the brain;
• infectious diseases with a typical etiology.

In addition to pathological processes that can lead to muscle atrophy, general predisposing factors for the development of this pathological process should be identified:

• disturbances in the work of the peripheral nervous system;
• paralysis;
• mechanical damage to the spine;
• lack of proper nutrition and rest;
• damage to the body by toxic substances;
• violation of metabolic processes in the body;
• prolonged bed rest.

It should be noted that quite often this symptom can be observed after a severe injury to the musculoskeletal system or being motionless. In any case, rehabilitation after such pathologies should be carried out only by a qualified medical specialist. Self-medication (in this case, we are talking not only about taking medications, but also about massage, exercise therapy) can lead to complete disability.

Symptoms

At the initial stage of development, atrophy of the muscles of the back or other parts of the body manifests itself only in the form of increased fatigue from physical exertion. As a result, the patient may experience pain.

As symptoms develop, the clinical picture may be supplemented by the following symptoms:

• with atrophy of the muscles of the limbs is observed;
• restriction of movements of the arms, legs, torso;
• change in habitual gait;
• loss of sensation in the limbs;
• low blood pressure.

If an infectious process has become the cause of atrophy of the muscles of the thigh or other parts of the body, then the clinical picture may be supplemented by the following symptoms:

• - insomnia during the day and increased sleepiness at night;
• especially at night;

In the event that the cause of spinal muscle atrophy was a lesion of the nervous system, then the overall clinical picture may be supplemented by the following signs:

• impaired motor function, up to complete paralysis.

The severity of symptoms in spinal atrophy will depend entirely on the severity of the injury or the degree of deterioration in muscle tone. Therefore, you should consult a doctor at the first signs of damage to muscle tissue. In this case, serious complications can be avoided.

Diagnostics

If you suspect the development of an atrophic process in the muscles, you should immediately seek medical help. The specialization of the doctor during the initial examination will depend on the current clinical picture and the general condition of the patient.

The diagnostic program consists of the following:

• physical examination with clarification of the general anamnesis;
• clinical and biochemical blood tests;
• electromyography;
• hormonal studies;
• Ultrasound of the thyroid gland;
• biopsy of muscle tissue;
• nerve conduction testing;
• CT and MRI.

Additional diagnostic methods will depend on the current clinical picture and the patient's condition at the time of seeking medical help. Important - if the patient has taken any drugs to eliminate symptoms, this should be notified to the doctor before starting the diagnosis.

Treatment

Basic therapy will depend entirely on the established underlying factor. Treatment, first of all, will be aimed at eliminating the underlying disease, and only then the symptoms.

It is impossible to single out a single treatment program in this case, since muscle atrophy is a non-specific symptom and therapy will depend not only on the etiology, but also on the age of the patient. In any case, almost always, the complex of therapeutic measures includes exercise therapy, massage and optimal physiotherapy procedures.

Prevention

There are no targeted preventive measures, since this is a symptom, and not a separate ailment. In general, you should adhere to the rules of a healthy lifestyle and carry out the prevention of those ailments that can cause such a violation.

Muscle atrophy - weakening of muscle fibers, a decrease in their size or rebirth due to prolonged immobility. Even slight atrophy entails a decrease in muscle mobility and strength. In other words, the disease leads to thinning and even disappearance of muscle fibers, which means long-term immobility or limitation of the patient's motor activity.

Causes

Most often, atrophy is a consequence of a neuromuscular injury or disease. Also, the disease can occur with certain endocrine, metabolic disorders and prolonged immobility of a person. Some muscle atrophy is seen with age. Muscle fibers shorten in length and lose volume without regular exercise. The result of such changes is a decrease in the outlines of the muscles, their size, and deformation of the affected areas.

Forms

The initial stage of the disease is characterized by such symptoms as pathological fatigue of the muscles of the legs when running and walking, less often - spontaneous muscle twitching and an increase in the volume of the calf muscles. The disease is initially localized in the lower extremities, pelvic girdle, thighs, which leads to atrophy of the leg muscles. This causes difficulty in walking, especially on stairs, leading to a change in gait.

Primary muscle atrophy

The main symptom is direct muscle damage. This type of pathology may be due to poor heredity or bruises, injuries, physical overstrain. In this case, the patient gets tired quickly, the tone of his muscles decreases, involuntary muscle twitches are noted, which indicates violations of motor neurons.

Secondary muscle atrophy

This type of pathology develops most often after infections and severe injuries. Patients have atrophy of the muscles of the legs, hands and forearm, which leads to partial or complete paralysis of the limbs. In most cases, the disease progresses slowly, but exacerbations are accompanied by severe pain.

The secondary form of the disease is divided into several types:

1. neural myotrophy, when there is atrophy of the muscles of the legs with deformation of the legs and feet. When walking, a person has to raise his knees high, gait is greatly disturbed. Gradually, the feet lose their reflexes, and the disease progresses to the rest of the limbs;
2. Aran-Duchene muscular atrophy, localized in some parts of the hands. In patients, the fingers and interosseous muscles atrophy, as a result of which the upper limbs take on the appearance of the so-called “monkey hand”. The sensitivity of the hands is preserved, but tendon reflexes are absent. The process is steadily progressing and comes to atrophy of the muscles of the neck and torso;
3. progressive muscle atrophy first manifests itself, as a rule, in children. The disease is extremely severe, characterized by loss of tendon reflexes, hypotension and twitching of the limbs.

Symptoms

The main symptom of muscle atrophy of all types is a visible decrease in the size of the damaged muscle. This is most noticeable in comparison with a healthy paired limb. In addition, the symptoms of the disease, depending on the severity of the process, are pain during palpation of the extremities.

Treatment

The choice of methods and means of treating muscle atrophy depends on the age of the patient, the severity of the process and the form of the disease. Drug therapy usually includes subcutaneous or intramuscular administration of the following drugs:

• Atriphos or Myotrifos (adenosine triphosphoric acid);
• vitamins E, B1 and B12;
• galantamine;
• prozerin.

Of great importance in the treatment is also proper nutrition, therapeutic exercises, massage and physiotherapy, psychotherapy. When muscle atrophy occurs in a child who lags behind peers in intellectual development, neuropsychological sessions are prescribed.