Update: December 2018
Muscular atrophy is a gradual process.
volume reduction, rebirth and thinning of muscle fibers,
decrease in their contractility.
All types of atrophies can be divided into 2 large ones.
- hereditary degenerative – muscle wasting caused by
genetic defects of both the muscles and nerve fibers,
regulating their work. They develop most often in childhood,
progresses rapidly and are practically not treatable.
- simple – atrophies that occur on the background of various diseases,
Causes of the disease in children
- Hereditary Neuromuscular Diseases (Erb-Roth myopathy,
Duchenne myopathy, Charcot-Marie-Tuta amyotrophy, etc.) – main
the cause of muscle atrophy in childhood;
- Birth injuries – damage to peripheral nerves, nerve
plexuses in the process of labor;
- Fractures of the limbs, spine;
- Dermatomyositis is an autoimmune inflammation of the skin and muscles;
- Infections (poliomyelitis, tuberculosis).
Causes of the disease in adults
Adult muscle exhaustion most often develops under
exposure to external damaging factors. Concerning
hereditary diseases, for the most part they are transferred from
childhood, and only rare forms for the first time manifest on average and
The most common reasons include:
- Paralysis after strokes, hemorrhages in the brain;
- Severe head injuries and spinal injuries
- Long-term immobilization of limbs after fractures,
prolonged immobility of patients after heavy operations
- Aging – natural dystrophic changes in all
organs and tissues;
- Inadequate nutrition, fasting;
- Disorders of digestion and absorption (chronic diarrhea,
- Infectious diseases – tuberculosis, chronic dysentery,
- Parasitic diseases (trichinosis, echinococcosis);
- Malignant tumors (lung cancer, breast cancer,
thyroid gland) – cancer depletion;
- Endocrine pathology (thyrotoxicosis, myxedema, disease
Itsenko-Cushing, diabetes mellitus, acromegaly);
- Arthritis, arthrosis;
- Polymyositis, dermatomyositis;
- Chronic alcoholism;
- Taking certain medications
What does muscle tissue look like in normal and different backgrounds?
diseases. (see fig.)
- Diabetes mellitus
- Itsenko-Cushing syndrome
- lupus erythematosus
Regardless of the reasons, all muscular atrophies have similar
manifestations. At the onset of the disease, a slight weakness in
limbs during exercise, after a while
there are difficulties in movements, it is difficult to perform the usual
actions: climbing stairs, running, getting up from a low chair,
buttoning, carrying a bag, etc.
In hereditary diseases, the first symptoms are usually
appear in childhood and grow rapidly enough. AT
for several years and sometimes several months the sick
lose their ability to move independently and
In some diseases, the first legs weaken, in others – the hands,
however, in all cases a symmetrical lesion is characteristic.
limbs. Proximal sufferers (located closer to
trunk) muscle groups. At the same time, the muscles become thinner.
back, chest, abdomen, face.
In hereditary diseases, muscle atrophy is paramount
a symptom that completely defines their clinical picture and
Simple atrophies tend to develop against the background of others.
long current chronic diseases. At the same time to the fore
there are symptoms of the underlying disease. Muscle wasting increases
slowly and often unnoticed by the patient. ATозможно как
symmetrical as well as unbalanced lesion. AT первую очередь
legs, ranging from feet and legs, muscles are involved later
hands and arms in general.
With timely treatment, you can achieve complete
Lower extremity injury
The main clinical manifestations of leg muscle atrophy:
- Weakness in the legs increases, when walking the patients get tired quickly,
cannot lift and hold legs on weight, often fall, they
It is difficult to sit and get up from a chair, climb stairs;
- There is marked muscle thinning, limbs look
thin compared to the body. In case of asymmetrical damage –
one leg is thinner than the other;
- Often affected by the extensors of the foot, and therefore the foot
slack. When walking, patients raise their knees high, the soles when
This fall flat on the ground, making a characteristic sound of a slap –
this walk was called the “cock”;
- Reduced tendon reflexes.
Pelvic girdle and hips
Atrophy of the muscles of the thigh and gluteus muscles is noted:
- weakness in the legs during physical exertion. difficulties arise
when climbing stairs, running, jumping, rising from a sitting position
squatting. Upon attempt take the patient upright as
would climb by itself, with his hands on his own hips or
surrounding objects (rising by a “ladder”);
- hip slimming is not always pronounced due to sediment
- change duck-like gait when the patient is walking
rolls over from side to side;
- with hypotrophy of the quadricepsum
in the knee joints.
Shins and Feet
Typical symptoms of muscle atrophy of the legs:
- first of all the legs lose weight in front because of this limb
acquire a characteristic look, reminiscent of the “stork legs”, over
the time when the entire musculature of the legs is affected,
lower limbs look like inverted bottles;
- some diseases (Duchenne myopathies) occur with
significant thickening of the legs due to the growth in them
connective and adipose tissue. This phenomenon is called
- with paresis of the extensors of the foot, a “cock” is formed
- when the tibial nerve is damaged, patients cannot walk
on the toes, all the support falls on the heels;
- foot has a high arch, the main phalanxes of the fingers while
maximum unbent, and the end bent – “clawed foot”,
- weakness in the legs is often accompanied by cramps, muscular
twitching, tingling, and numbness.
Lesion of the upper limbs
The following signs are characteristic of an atrophy of muscles of hands:
- it is difficult for patients to do petty work (to sew, to fasten
buttons, thread the needle, turn the key in the lock),
worried about weakness, numbness, tingling in the hands;
- with exhaustion of the shoulder muscles, patients cannot lift and hold
hands in front of him are not able to carry a bag, it is difficult for them to dress and
- With dystrophy of individual muscle groups, various
deformities of the hand of the “monkey paw” type (when not
contrasting the thumb) or “clawed hand” (when IV
and V fingers are re-bent in the metacarpophalangeal and bent in
Muscular atrophy most often develops on one half of the face,
rarely captures it completely, sometimes focal
ATнешне это проявляется выраженной ассиметрией лица, его
angularity, clearly traced outlines of bones.
The appearance of specific symptoms:
- impoverishment of facial expression (face of the Sphinx),
- cross smile (Gioconda smile),
- violation of the mobility of the eyeballs (the patient can not
look sideways, up and down),
- the impossibility of complete closure of the eyelids (lagophthalmos),
- omission of the eyelids, etc.
With some myopathies expense of proliferation of connective tissue
pseudo-hypertrophy of individual facial muscles occurs (tapir lips
– thickening and sagging of the lower lip).
With focal atrophy of the muscles of the face marked areas of zapadeniya
tissues in the form of pits on the face.
Features of the manifestations in children
Since atrophied muscles in children in most cases
due to genetic factors, the first symptoms may
to be detected even in utero – late and weak
fetal movements, after birth, these children usually die in the first
several weeks of life due to paralysis of the respiratory muscles.
With the development of atrophy in infancy is formed
called sluggish child syndrome, these children have
the characteristic “frog pose” – with widely spread hips and
flattened abdomen, marked reduction in overall tone and
motor activity, in some diseases observed
sucking, swallowing and breathing disorder.
Muscular dystrophy in older children
impaired motor activity, specific deformities
When muscle atrophy of any etiology, in the first place,
The main disease is being treated.
Muscle wasting in myopathies and amyotrophies for the most part
is irreversible, so the aim of treatment of such diseases
is slowing the progression of the process.
Simple atrophies are to a certain extent reversible and
timely started therapy possible full recovery.
Patients are shown a diet with a high content of protein and
limiting animal fats and carbohydrates. It is recommended to include in
diet fish, liver, low-fat cottage cheese, soy meat, vegetables.
Drug therapy is applied to repay
energy deficiency, improve blood circulation and metabolism
in atrophied muscles. Assign:
- витамины группы AT, витамин А и Е,
- amino acids
- anabolic agents (potassium orotate, retabolil,
- Drugs that improve peripheral circulation
(pentoxifylline, nicotinic acid),
- nootropic drugs (cerebrolysin),
- drugs that improve the conduct of nerve impulses –
cholinesterase antagonists (prozerin).
Dosed physical exercise significantly improves
functional state of the muscles, increase muscle mass,
have a tonic effect.
- Exercises are performed sparingly from lightweight.
initial position, avoiding pronounced fatigue of the muscles
more 30-45 minutes.
- The course of physical therapy 25-30 times, subject to daily classes on
individual program. Further, the patient should also regularly
- Both passive and various types of active
movements, exercises in the water, stretching exercises.
- If necessary, resort to the help of a methodologist, use
- A good effect is provided by exercises in the water (in the bath or pool).
Exercises 1-4 are performed passively with the help of a methodologist,
Exercises 5 – 10 The patient performs independently.
- 1 – lying on its side is necessary to perform flexion and
leg extension in the knees,
- 2 – in the position on the side it is necessary to bend and
extension of arms in elbows,
- 3 – in position on the back, lead and cast
- 4 – in position on the back, lead and cast
- 5 – the patient lies on his back, slowly tightens his legs to the pelvis, and
then straightens back;
- 6 – lying on your back, you need to slowly raise and lower
- 7 -leading on the side, you need to alternately divert and bring
- 8 – lying on the side, it is necessary to alternately withdraw and bring
- 9 – the patient lies on his stomach with arms stretched along the body,
while slowly lifting and lowering the head and shoulders;
- 10 – raising the pelvis from the supine position with bent
in the knees with their feet.
Massage and physiotherapy
- Massage is carried out according to a gentle technique, with minimal force.
- It is worth massing both the limb and the back. Each limb by
5-10 minutes. The total duration of the massage is 20 minutes.
- A session usually starts with light stroking movements, in
As a massage oil, apply Actovegin ointment. Further
the instructor starts to work with light fingers
muscle bundles and tendons of the limbs starting at the distal
- Massage is done every other day when there is no physiotherapy.
- Курс лечения 12-18 sessions.
- Treatment желательно повторять 3-4 р/год с интервалами 3—5
- In addition to the manual massage, an underwater shower-massage is shown,
- Salt and pine baths are used to treat muscle atrophy.
paraffin and ozocerite wraps, electrophoresis with calcium and