Muscle Spasms: Understanding Causes, Symptoms, and Management

What is Muscle Spasm

Muscle spasm is an involuntary, sustained contraction of the muscle fibers in response to injury or inflammation, either in the muscles themselves or the nerves that serve them.

Incidence of Muscle Spasm

• Muscle cramps are common and part of the spectrum of normal human physiology, affecting 37% of the healthy population per year
• Many women suffer from cramp during pregnancy
• Affect all age group

Causes of Muscle Spasm

The exact cause of muscle cramp is found to be idiopatic but some contibutory factors may include

• Poor physical condition
• Mineral and electrolyte imbalances
• Tight, inflexible muscles.
• Overtired muscles
• Dehydration
• Certain medical conditions, such as kidney failure or diabetes
• Physical exertion of cold muscles
• Muscle injury
• Muscle fatigue
• Ischemia

Pathophysiology of Muscle Spasm

When a muscle is stimulated to contract, nerve signals are sent from the brain to the muscle fibers. These signals cause the release of calcium ions from storage in the muscle fibers, which bind to proteins in the muscle and trigger the contraction. During normal muscle activity, calcium ions are pumped back into storage in the muscle fibers by an energy-dependent process.
However, if there is an imbalance of electrolytes such as sodium, potassium, and calcium, or if there is an insufficient supply of ATP (the energy source for muscle contraction), the muscle may not be able to relax properly. This can lead to sustained contraction and the development of a muscle spasm.

Signs & Symptoms of Muscle Spasm

• Severe muscle tightening
• Sudden sensation of uncontrollable and painful spasms in the muscle
• Changes in bowel and/or bladder function, resulting in incontinence or difficulty controlling bowel movements.
• Muscle weakness in the arms or legs
• A feeling of instability when walking
• Pain and numbness that travels down the arms and/or legs
• Pain accompanied by fever, weight loss or other signs of illness.

Management of Muscle Spasm

Treatment of muscle spasm depend upon the underlying cause of the spasms. For muscles that have been damaged or strained, medications may be required for short-term pain relief, including

• Anti-inflammatories such as, ibuprofen,
• Narcotics,
• B - complex vitamins,
• Muscle relaxants such as diazepam and baclofen affect GABA receptors.
• Botulinum toxin type A (Botox) may be injected into a specific muscle to paralyze it and relieve the muscle spasm of dystonia, such as for blepharospasms.

Nursing care of Muscle Spasm

The goals of acute treatment are to control pain, minimize swelling, and maintain or regain ROM.

1. Assess patient’s level of pain on a pain rating scale Monitor patient’s vital signs to ascertain baseline figures.
2. Educate the patient how to stretch the affected area.
3. Gently massage the affected area with hands or a massage roller.
4. Engage patient in divertional therapy as appropriate
5. Instruct the patient to avoid or limit intake of caffeine.
6. Apply heat or ice to control, pain, and muscle spasm
7. Administer analgesics such as ibuprofen and acetaminophen as ordered
8. Provide comfort measures to help patient tolerate drug effects.
9. Provide safety measures (e.g. adequate lighting, raised side rails, etc.) to prevent injuries.
10. Educate client on drug therapy to promote understanding and compliance.

Preventions of Muscle Spasm

1. Drink enough fluids to prevent dehydration, especially when you exercise.
2. Take vitamin or mineral supplements.
3. Get regular exercise.
4. Limit caffeine and smoking.
5. Perform flexibility exercises on a regular basis.