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Thermography by Specialty
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Myopathy refers to disorders with muscle weakness due to dysfunction of muscle fiber. Muscle cramps, stiffness, and muscle spasms can also occur. Pain is not a typical symptom of myopathy. Upon thermal imaging, flaccid myopathies with weakness and muscle disuse appear cool over the involved muscles, while muscular cramps or “tight” myopathies will appear warm due to the heat produced by prolonged, intense muscular contraction. This heat is conducted to overlying skin where it can be viewed thermographically (Figure 11.14). White blood cells and macrophages are generally absent in non-inflammatory myopathy, thus production of NO is not a major feature. The muscular dystrophies, mitochondrial myopathies, and glycogen storage diseases are non-inflammatory myopathies.64
Muscle Cramps/Night (Nocturnal) Cramps
Published in Charles Theisler, Adjuvant Medical Care, 2023
Up to 60% of adults report that they have had nocturnal leg cramps.1 Most of the time, it is not possible to identify an apparent cause for night-time leg cramps or charley horses. Most often, muscle cramps involve a calf, foot, or thigh. Nocturnal leg cramps are quite painful and can leave the muscle tender for up to a day or so. Cramps can be caused by low blood mineral levels of calcium, potassium, or magnesium.2,3 Deficiencies of certain vitamins, including thiamine (B1), pantothenic acid (B5), and pyridoxine (B6), can also cause muscle cramps.3 Medications strongly associated with causing leg cramps include intravenous iron sucrose, conjugated estrogens, raloxifene, naproxen, and teriparatide.1 No prescription medication is recommended for muscle cramps.4
Answers
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
McArdle’s syndrome is another glycogen storage disease, resulting in inefficient use of energy substrate in muscle due to muscle phosphorylase deficiency. Exercise results in cramp that tends to settle with a period of rest. Creatine kinase levels may be elevated. It is generally a benign disorder and may not even be picked up until later in adult life when the individual takes up strenuous exercise. No specific treatment exists but the patient should be advised to stop exercise on the onset of muscle cramps. Failure to do so may result in rhabdomyolysis, myoglobinuria and subsequent renal failure.
Pre- and peripartal management of a woman with McArdle disease: a case report
Published in Gynecological Endocrinology, 2018
Tina Stopp, Michael Feichtinger, Wolfgang Eppel, Thomas M. Stulnig, Peter Husslein, Christian Göbl
Glycogen storage disease type 5, also called McArdle disease, is an autosomal recessive inherited disorder in muscle metabolism caused by the lack or dysfunction of muscle glycogen phosphorylase (myophosphorylase). Due to this condition the ability to break down glycogen into glucose subunits within the skeletal muscle during muscle activity is inhibited. This results in intolerance to strenuous exercise which manifests as fatigue, muscle stiffness and myalgia, in some cases accompanied by myoglobinuria and in severe instances renal failure due to muscle breakdown and rhabdomyolysis [1]. Most Patients experience a period of less painful and more effective exercise after an initial period of muscle cramps. The so-called ‘second wind phenomenon’ is typical of McArdle disease [2]. This phenomenon is believed to be caused by a switch to alternative sources of energy such as fatty acid oxidation and an increased blood flow to the muscle [3]. The metabolic shift is more effective when the patient’s muscles are conditioned through regular aerobic exercise [4].
Physical therapy for nocturnal lower limb cramping: A case report
Published in Physiotherapy Theory and Practice, 2019
Addison Williams Andrews, Richard Pine
Nocturnal muscle cramps are sudden, intensely painful, sustained, involuntary, episodic contractions of skeletal muscle occurring primarily during sleep (Blyton, Chuter, Walter, and Burns, 2012; Hallegraeff, van der Schans, de Ruiter, and de Greef, 2012; Monderer, Wu, and Thorpy, 2010). Broadly defined, cramps are contractions of muscles brought about by sustained recruitment of motor units and may occur when a maximally contracted muscle is stimulated and then shortened beyond physiologic tolerance (Monderer, Wu, and Thorpy, 2010). They are characterized electrically by repetitive firing of motor unit action potentials at high rates of up to 150 per second (Hallegraeff, van der Schans, de Ruiter, and de Greef, 2012). This is more than four times the normal rate in a maximal voluntary contraction The cramps can be sharp and excruciatingly painful, and may last from a few seconds to several minutes (Blyton, Chuter, Walter, and Burns, 2012; Hallegraeff, van der Schans, de Ruiter, and de Greef, 2012; Monderer, Wu, and Thorpy, 2010). After the initial cramp, the individual can experience muscle damage known as delayed onset of muscle soreness (DOMS), such that pain and tenderness may last for up to 2 weeks (Blyton, Chuter, Walter, and Burns, 2012). For patients who experience frequent nocturnal lower limb cramps, these painful episodes can awaken the patient from sleep, delay subsequent return to sleep, cause substantial distress, reduce quality of life, and limit sports participation and performance (Blyton, Chuter, Walter, and Burns, 2012; Hallegraeff, van der Schans, de Ruiter, and de Greef, 2012; Monderer, Wu, and Thorpy, 2010)
Shoulder pain in the Swiss spinal cord injury community: prevalence and associated factors
Published in Disability and Rehabilitation, 2018
Fransiska M. Bossuyt, Ursina Arnet, Martin W. G. Brinkhof, Inge Eriks-Hoogland, Veronika Lay, Rachel Müller, Mikael Sunnåker, Timo Hinrichs
Spasticity and contractures were included as binary variables (“yes”/”no”). The variables were assessed applying the SCI Secondary Condition Scale, which has been found to be reliable and valid to assess different secondary health conditions in SCI [17]. The term “spasticity” was explained to participants as “muscle cramps”, the term “contractures” was explained as “limited range of motion of a joint”. Participants selecting the answer “no problem” for contractures and/or spasticity were assigned as not having contractures and/or spasticity. Participants selecting one of the following answers: “mild, infrequent problem”, “moderate/occasional problem”, or “significant/chronic problem”, were assigned as having contractures and/or spasticity.