TREATMENTS &
RESEARCH

Search the
latest
treatment
information
here.

Dr. Huntley's
Diagnosis
Checklist

Have a symptom?
See what questions
a doctor would ask.
 
Next Prev
Diseases » Muscle cramps » Causes
 

Causes of Muscle cramps

Contents
  1. Muscle cramps: Introduction
  2. Drugs/substances (267 causes)
  3. Drug interaction (13 causes)
  4. Excerpts from book chapters
  5. Complication causes
  6. Causes of symptoms
  7. Related cause information

Muscle cramps Causes: Book Excerpts

Muscle cramps as a complication of other conditions:

Other conditions that might have Muscle cramps as a complication may, potentially, be an underlying cause of Muscle cramps. Our database lists the following as having Muscle cramps as a complication of that condition:

Muscle cramps as a symptom:

Conditions listing Muscle cramps as a symptom may also be potential underlying causes of Muscle cramps. Our database lists the following as having Muscle cramps as a symptom of that condition:

Medications or substances causing Muscle cramps:

The following drugs, medications, substances or toxins are some of the possible causes of Muscle cramps as a symptom. This list is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

See full list of 267 medications causing Muscle cramps


Drug interactions causing Muscle cramps:

When combined, certain drugs, medications, substances or toxins may react causing Muscle cramps as a symptom.

The list below is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

  • Bumex (Bumetanide) and Lanoxin (Digoxin) interaction
  • Diachlor (Chlorothiazide) and Lanoxin (Digoxin) interaction
  • Diuril (Chlorothiazide) and Lanoxin (Digoxin) interaction
  • Diucardin (Hydroflumethiazide) and Lanoxin (Digoxin) interaction
  • Saluron (Hydroflumethiazide) and Lanoxin (Digoxin) interaction
  • more interactions...»

See full list of 13 drug interactions causing Muscle cramps

Related information on causes of Muscle cramps:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Muscle cramps may be found in:

Causes of Muscle cramps: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Muscle cramps.

Muscle Weakness – Distal: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

  • Guillain-Barré syndrome (GBS)
    –Acute, acquired, or monophasic
    –Ascending weakness and parasthesias
  • Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP)
    • Compression neuropathy
      –Trauma
      –Neoplasm (e.g., plexiform neurofibroma in neurofibromatosis type 1)
    • Charcot-Marie-Tooth
      –Defect in peripheral myelin protein
      –Causes distal segmental demyelination
      –Manifested by distal muscle atrophy and weakness
  • Drug-induced
    –Phenytoin
    –Isoniazid
    –Nitrofurantoin
    –Vincristine
    –Zidovudine
  • Spinal muscular atrophy
  • Juvenile segmental spinal muscular atrophy
    • Miller-Fisher syndrome
      –Clinical triad of ataxia, ophthalmoplegia, and areflexia
  • Tick paralysis
  • Juvenile amyotrophic lateral sclerosis
  • Giant axonal neuropathy
  • Vitamin B12 deficiency
  • Toxic neuropathy
    –Arsenic
    –Lead
    –Mercury
    –Thallium
    –Glue sniffing
  • Uremic neuropathy
  • Idiopathic axonal neuropathy
  • Hereditary distal myopathy
  • Inclusion body myopathy
  • Rheumatoid arthritis
  • Refsum disease
  • Metachromatic leukodystrophy
  • Krabbe disease
  • Cockayne syndrome
  • Conversion reaction
    –Usually fluctuating and unpredictable

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Muscle Weakness – Proximal: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

  • Duchenne and Becker muscular dystrophy
  • Spinal muscular atrophy
  • Spinal cord disorders
    –Trauma
    –Myelitis
    –Neoplasm
    –AVM
    –Hemorrhage
    –Tansverse myelitis
  • Limb-girdle myasthenia
  • Dermatomyositis
  • Congenital myopathies
    –Central core disease
    –Myotubular
    –Nemaline (rod)
    –Congenital fiber-type disproportion
  • Facioscapulohumeral syndrome
  • Limb-girdle muscular dystrophies
  • Glycogen storage myopathies
  • Endocrine myopathies
    –Hypo- and hyperthyroidism
    –Hyperparathyroidism
    –Adrenalism
  • Polymyositis
  • GM2 gangliosidosis
  • Pompe disease
    –Glycogen storage disease type II
    –Acid maltase deficiency
  • McArdle disease
  • Carnitine deficiency
  • Fatty acid oxidation defects
  • Mitochondrial disorders
  • Steroid-induced myopathy
  • Slow channel syndrome
  • Toxins
    –Organophosphates
    –Aminoglycosides
    –Tetrodotoxin (pufferfish)
  • Conversion reaction
  • Myasthenia gravis

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Muscle flaccidity [Muscle hypotonicity]: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Amyotrophic lateral sclerosis

Progressive muscle weakness and paralysis are accompanied by generalized flaccidity. Typically, these effects begin in one hand, spread to the arm, and then develop in the other hand and arm. Eventually, they spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle cramps and coarse fasciculations, hyperactive DTRs, slight leg muscle spasticity, dysphagia, dysarthria, excessive drooling, and depression.

Brain lesions

Frontal and parietal lobe lesions may cause contralateral flaccidity, weakness or paralysis and, eventually, spasticity and possibly contractures. Other findings include hyperactive DTRs, a positive Babinski’s sign, loss of proprioception, stereognosis, graphesthesia, anesthesia, and thermanesthesia.

Guillain-Barré syndrome

Guillain-Barré syndrome causes muscle flaccidity. Progression is typically symmetrical and ascending, moving from the feet to the arms and facial nerves within 24 to 72 hours of its onset. Associated findings include sensory loss or paresthesia, absent DTRs, tachycardia (or, less commonly, bradycardia), fluctuating hypertension and orthostatic hypotension, diaphoresis, incontinence, dysphagia, dysarthria, hypernasality, and facial diplegia. Weakness may progress to total motor paralysis and respiratory failure.

Huntington’s disease

Besides flaccidity, progressive mental status changes up to and including dementia and choreiform movements are major symptoms. Others include poor balance, hesitant or explosive speech, dysphagia, impaired respirations, and incontinence.

Muscle disease

Muscle weakness and flaccidity are features of myopathies and muscular dystrophies.

Peripheral nerve trauma

Flaccidity, paralysis, and loss of sensation and reflexes in the innervated area can occur.

Peripheral neuropathy

Flaccidity usually occurs in the legs as a result of chronic progressive muscle weakness and paralysis. It may also cause mild to sharp burning pain, glossy red skin, anhidrosis, and a loss of vibration sensation. Paresthesia, hyperesthesia, or anesthesia may affect the hands and feet. DTRs may be hypoactive or absent.

Seizure disorder

Brief periods of syncope and generalized flaccidity commonly follow a generalized tonic-clonic seizure.

Spinal cord injury

Spinal shock can result in acute muscle flaccidity or spasticity below the level of injury. Associated signs and symptoms also occur below the level of injury and may include paralysis; absent DTRs; analgesia; thermanesthesia; loss of proprioception and vibration, touch, and pressure sensation; and anhidrosis (usually unilateral). Hypotension, bowel and bladder dysfunction, and impotence or priapism may also occur. Injury in the C1 to C5 region can produce respiratory paralysis and bradycardia.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Muscle weakness: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Amyotrophic lateral sclerosis (ALS)

ALS typically begins with muscle weakness and atrophy in one hand that rapidly spread to the arm and then to the other hand and arm. Eventually, these effects spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency.

Anemia

Varying degrees of muscle weakness and fatigue are exacerbated by exertion and temporarily relieved by rest. Other signs and symptoms include pallor, tachycardia, paresthesia, and bleeding tendencies.

Brain tumor

Signs and symptoms of muscle weakness vary with the location and size of the tumor. Associated findings include a headache, vomiting, diplopia, decreased visual acuity, a decreased level of consciousness (LOC), pupillary changes, decreased motor strength, hemiparesis, hemiplegia, diminished sensations, ataxia, seizures, and behavioral changes.

Guillain-Barré syndrome

Rapidly progressive, symmetrical weakness and pain ascends from the feet to the arms and facial nerves and may progress to total motor paralysis and respiratory failure. Associated findings include sensory loss or paresthesia, muscle flaccidity, loss of DTRs, tachycardia or bradycardia, fluctuating hypertension and orthostatic hypotension, diaphoresis, bowel and bladder incontinence, facial diplegia, dysphagia, dysarthria, and hypernasality.

Herniated disk

Pressure on nerve roots leads to muscle weakness, disuse and, ultimately, atrophy. The primary symptom is severe low back pain, possibly radiating to the buttocks, legs, and feet — usually on one side. Diminished reflexes and sensory changes may also occur.

Hypercortisolism

Hypercortisolism may cause limb weakness and eventually atrophy. Related cushingoid features include buffalo hump, moon face, truncal obesity, purple striae, thin skin, acne, elevated blood pressure, fatigue, hyperpigmentation, easy bruising, poor wound healing, and diaphoresis. The male patient may be impotent; the female patient may exhibit hirsutism and menstrual irregularities.

Myasthenia gravis

Gradually progressive skeletal muscle weakness and fatigue are the cardinal symptoms of myasthenia gravis. Typically, weakness is mild upon awakening, but worsens during the day. Early signs include weak eye closure, ptosis, and diplopia; blank, masklike facies; difficulty chewing and swallowing; nasal regurgitation of fluid with hypernasality; and a hanging jaw and bobbing head. Respiratory muscle involvement may eventually lead to respiratory failure.

Osteoarthritis

Osteoarthritis is a chronic disorder that causes progressive muscle disuse and weakness that lead to atrophy.

Parkinson’s disease

Muscle weakness accompanies rigidity in Parkinson’s disease, a degenerative disorder. Related findings include a unilateral pill-rolling tremor, a propulsive gait, dysarthria, bradykinesia, drooling, dysphagia, masklike facies, and a high-pitched, monotone voice.

Peripheral nerve trauma

Prolonged pressure on or injury to a peripheral nerve causes muscle weakness and atrophy. Other findings include paresthesia or sensory loss, pain, and loss of reflexes supplied by the damaged nerve.

Potassium imbalance

With hypokalemia, temporary generalized muscle weakness may be accompanied by nausea, vomiting, diarrhea, decreased mentation, leg cramps, diminished reflexes, malaise, polyuria, dizziness, hypotension, and arrhythmias.

With hyperkalemia, weakness may progress to flaccid paralysis accompanied by irritability and confusion, hyperreflexia, paresthesia or anesthesia, oliguria, anorexia, nausea, diarrhea, abdominal cramps, tachycardia or bradycardia, and arrhythmias.

Rhabdomyolysis

Signs and symptoms include muscle weakness or pain, a fever, nausea, vomiting, malaise, and dark urine. Acute renal failure, due to renal structure obstruction and injury from the kidneys’attempt to filter myoglobin from the bloodstream, is a common complication.

Rheumatoid arthritis

With rheumatoid arthritis, symmetrical muscle weakness may accompany increased warmth, swelling, and tenderness in involved joints; pain; and stiffness, restricting motion.

Seizure disorder

Temporary generalized muscle weakness may occur after a generalized tonic-clonic seizure; other postictal findings include a headache, muscle soreness, and profound fatigue.

Spinal trauma and disease

Trauma can cause severe muscle weakness, leading to flaccidity or spasticity and, eventually, paralysis. Infection, tumor, and cervical spondylosis or stenosis can also cause muscle weakness.

Stroke

Depending on the site and extent of damage, a stroke may produce contralateral or bilateral weakness of the arms, legs, face, and tongue, possibly progressing to hemiplegia and atrophy. Associated effects include dysarthria, aphasia, ataxia, apraxia, agnosia, ipsilateral paresthesia or sensory loss, vision disturbances, an altered LOC, amnesia and poor judgment, personality changes, bowel and bladder dysfunction, a headache, vomiting, and seizures.

Other causes

Drugs

Generalized muscle weakness can result from prolonged corticosteroid use, digoxin, and excessive doses of dantrolene. Aminoglycoside antibiotics may worsen weakness in patients with myasthenia gravis.

Immobility

Immobilization in a cast, a splint, or traction can lead to muscle weakness in the involved extremity; prolonged bed rest or inactivity results in generalized muscle weakness.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Muscle spasms [Muscle cramps]: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Amyotrophic lateral sclerosis (ALS)

With ALS, muscle spasms may accompany progressive muscle weakness and atrophy that typically begin in one hand, spread to the arm, and then spread to the other hand and arm. Eventually, muscle weakness and atrophy affect the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle flaccidity progressing to spasticity, coarse fasciculations, hyperactive deep tendon reflexes (DTRs), dysphagia, impaired speech, excessive drooling, and depression.

Arterial occlusive disease

Arterial occlusion typically produces spasms and intermittent claudication in the leg, with residual pain. Associated findings are usually localized to the legs and feet and include loss of peripheral pulses, pallor or cyanosis, decreased sensation, hair loss, dry or scaling skin, edema, and ulcerations.

Cholera

Muscle spasms, severe water and electrolyte loss, thirst, weakness, decreased skin turgor, oliguria, tachycardia, and hypotension occur along with abrupt watery diarrhea and vomiting.

Dehydration

Sodium loss may produce limb and abdominal cramps. Other findings include a slight fever, decreased skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, muscle twitching, seizures, nausea, vomiting, and oliguria.

Hypocalcemia

The classic feature is tetany — a syndrome of muscle cramps and twitching, carpopedal and facial muscle spasms, and seizures, possibly with stridor. Chvostek’s and Trousseau’s signs may be elicited. Related findings include paresthesia of the lips, fingers, and toes; choreiform movements; hyperactive DTRs; fatigue; palpitations; and cardiac arrhythmias.

Muscle trauma

Excessive muscle strain may cause mild to severe spasms. The injured area may be painful, swollen, reddened, or warm.

Respiratory alkalosis

The acute onset of muscle spasms may be accompanied by twitching and weakness, carpopedal spasms, circumoral and peripheral paresthesia, vertigo, syncope, pallor, and extreme anxiety. With severe alkalosis, cardiac arrhythmias may occur.

Spinal injury or disease

Muscle spasms can result from spinal injury, such as a cervical extension injury or spinous process fracture, or from spinal disease such as infection.

Other causes

Drugs

Common spasm-producing drugs include diuretics, corticosteroids, and estrogens.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Muscle flaccidity [Muscle hypotonicity]: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Amyotrophic lateral sclerosis

Progressive muscle weakness and paralysis are accompanied by generalized flaccidity. Typically, these effects begin in one hand, spread to the arm, and then develop in the other hand and arm. Eventually, they spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle cramps and coarse fasciculations, hyperactive deep tendon reflexes, slight leg muscle spasticity, dysphagia, dysarthria, excessive drooling, and depression.

Brain lesions

Frontal and parietal lobe lesions may cause contralateral flaccidity, weakness or paralysis, and eventually, spasticity and possibly contractures. Other findings include hyperactive deep tendon reflexes, positive Babinski’s sign, loss of proprioception, stereognosis, graphesthesia, anesthesia, and thermanesthesia.

Cerebellar disease

With this disease, generalized muscle flaccidity or hypotonia is accompanied by ataxia, dysmetria, intention tremor, slight muscle weakness, fatigue, and dysarthria.

Guillain-Barré syndrome

This disorder causes muscle flaccidity. Progression is typically symmetrical and ascending, moving from the feet to the arms and facial nerves within 24 to 72 hours of onset. Associated findings include sensory loss or paresthesia, absent deep tendon reflexes, tachycardia (or, less often, bradycardia), fluctuating hypertension and orthostatic hypotension, diaphoresis, incontinence, dysphagia, dysarthria, hypernasality, and facial diplegia. Weakness may progress to total motor paralysis and respiratory failure.

Huntington’s disease

Besides flaccidity, progressive mental status changes up to and including dementia and choreiform movements are major symptoms. Others include poor balance, hesitant or explosive speech, dysphagia, impaired respirations, and incontinence.

Muscle disease

Muscle weakness and flaccidity are features of myopathies and muscular dystrophies.

Peripheral nerve trauma

Flaccidity, paralysis, and loss of sensation and reflexes in the innervated area can occur.

Peripheral neuropathy

Flaccidity usually occurs in the legs as a result of chronic progressive muscle weakness and paralysis. It may also cause mild-to-sharp burning pain, glossy red skin, anhidrosis, and loss of vibration sensation. Paresthesia, hyperesthesia, or anesthesia may affect the hands and feet. Deep tendon reflexes may be hypoactive or absent.

Poliomyelitis

Damage to the anterior horn cells in the spinal cord and brain stem causes flaccid weakness and loss of reflexes. The large, proximal muscles of the limbs are most commonly affected.

Seizure disorder

Brief periods of syncope and generalized flaccidity commonly follow a generalized tonic-clonic seizure.

Spinal cord injury

Spinal shock can result in acute muscle flaccidity or spasticity below the level of injury. Associated signs and symptoms also occur below the level of injury and may include paralysis; absent deep tendon reflexes; analgesia; thermanesthesia; loss of proprioception and vibration, touch, and pressure sensation; and anhidrosis (usually unilateral). Hypotension, bowel and bladder dysfunction, and impotence or priapism may also occur. Injury in the C1 to C5 region can produce respiratory paralysis and bradycardia.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Muscle weakness: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Amyotrophic lateral sclerosis

This disorder typically begins with muscle weakness and atrophy in one hand that rapidly spread to the arm and then to the other hand and arm. Eventually, these effects spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency.

Anemia

Varying degrees of muscle weakness and fatigue are exacerbated by exertion and temporarily relieved by rest. Other signs and symptoms include pallor, tachycardia, paresthesia, and bleeding tendencies.

Brain tumor

Signs and symptoms of muscle weakness vary with the location and size of the tumor. Associated findings include headache, vomiting, diplopia, decreased visual acuity, decreased level of consciousness, pupillary changes, decreased motor strength, hemiparesis, hemiplegia, diminished sensations, ataxia, seizures, and behavioral changes.

Guillain-Barré syndrome

Rapidly progressive, symmetrical weakness and pain ascends from the feet to the arms and facial nerves and may progress to total motor paralysis and respiratory failure. Associated findings include sensory loss or paresthesia, muscle flaccidity, loss of deep tendon reflexes, tachycardia or bradycardia, fluctuating hypertension and orthostatic hypotension, diaphoresis, bowel and bladder incontinence, facial diplegia, dysphagia, dysarthria, and hypernasality.

Head trauma

Severe head injury can cause varying degrees of muscle weakness. Other findings include decreased level of consciousness, otorrhea or rhinorrhea, raccoon eyes and Battle’s sign, sensory disturbances, and signs of increased intracranial pressure.

Herniated disk

Pressure on nerve roots leads to muscle weakness, disuse, and ultimately, atrophy. The primary symptom is severe low back pain, possibly radiating to the buttocks, legs, and feet—usually on one side. Diminished reflexes and sensory changes may also occur.

Hodgkin’s lymphoma

Muscle weakness may accompany the classic sign of painless, progressive lymphadenopathy. Other findings include paresthesia, fatigue, and weight loss.

Hypercortisolism

This disorder may cause limb weakness and eventually atrophy. Related cushingoid features include buffalo hump, moon face, truncal obesity, purple striae, thin skin, acne, elevated blood pressure, fatigue, hyperpigmentation, easy bruising, poor wound healing, and diaphoresis. The male patient may be impotent; the female patient may exhibit hirsutism and menstrual irregularities.

Hypothyroidism

Reversible weakness and atrophy of proximal limb muscles may occur in hypothyroidism. Accompanying findings commonly include muscle cramps; cold intolerance; weight gain despite anorexia; mental dullness; dry, pale, doughy skin; puffy face, hands, and feet; impaired hearing and balance; and bradycardia.

Multiple sclerosis

Muscle weakness in one or more limbs may progress to atrophy, spasticity, and contractures. Other findings typically wax and wane and may include diplopia and blurred vision, vision loss, nystagmus, hyperactive deep tendon reflexes, sensory loss or paresthesia, dysarthria, dysphagia, incoordination, ataxic gait, intention tremors, emotional lability, impotence, and urinary dysfunction.

Myasthenia gravis

Gradually progressive skeletal muscle weakness and fatigue are the cardinal symptoms of this disorder. Typically, weakness is mild upon awakening but worsens during the day. Early signs include weak eye closure, ptosis, and diplopia; a blank, masklike facies; difficulty chewing and swallowing; nasal regurgitation of fluid with hypernasality; and a hanging jaw and bobbing head. Respiratory muscle involvement may eventually lead to respiratory failure.

Osteoarthritis

This chronic disorder causes progressive muscle disuse and weakness that lead to atrophy.

Paget’s disease

As this disease progresses, muscle weakness or paralysis may develop, along with paresthesia and pain. The patient may also have bowed tibias, frequent fractures, and kyphosis.

Parkinson’s disease

Muscle weakness accompanies rigidity in this degenerative disorder. Related findings include a unilateral pill-rolling tremor, propulsive gait, dysarthria, bradykinesia, drooling, dysphagia, masklike facies, and a high-pitched, monotonic voice.

Peripheral nerve trauma

Prolonged pressure on or injury to a peripheral nerve causes muscle weakness and atrophy. Other findings include paresthesia or sensory loss, pain, and loss of reflexes supplied by the damaged nerve.

Peripheral neuropathy

With this disorder, muscle weakness progresses slowly to flaccid paralysis, generally affecting distal extremities first. It may be accompanied by loss of vibration sense; paresthesia, hyperesthesia, or anesthesia in the hands and feet; hypoactive or absent deep tendon reflexes; mild-to-sharp burning pain; anhidrosis; and glossy red skin.

Poliomyelitis

Rapidly developing asymmetrical muscle weakness, progressing to flaccid paralysis, occurs with paralytic poliomyelitis. Associated signs and symptoms include moderate fever, headache, vomiting, lethargy, irritability, and widespread pain. As the disorder progresses, it may produce loss of superficial and deep reflexes, paresthesia, hyperalgesia, urine retention, constipation, abdominal distention, nuchal rigidity, and Hoyne’s, Kernig’s, and Brudzinski’s signs. Bulbar paralytic poliomyelitis produces symptoms of encephalitis, along with facial weakness, dysphasia, dysphagia, and respiratory abnormalities.

Polymyositis

This disorder produces insidious or acute onset of symmetrical limb and trunk muscle weakness and tenderness. Weakness may progress to facial, neck, pharyngeal, and laryngeal muscles. Associated findings include hypoactive deep tendon reflexes, dysphagia, and dysphonia.

Potassium imbalance

With hypokalemia, temporary generalized muscle weakness may be accompanied by nausea, vomiting, diarrhea, decreased mentation, leg cramps, diminished reflexes, malaise, polyuria, dizziness, hypotension, and arrhythmias.

With hyperkalemia, weakness may progress to flaccid paralysis accompanied by irritability and confusion, hyperreflexia, paresthesia or anesthesia, oliguria, anorexia, nausea, diarrhea, abdominal cramps, tachycardia or bradycardia, and arrhythmias.

Protein deficiency

Prolonged protein deficiency may lead to muscle weakness and wasting, chronic fatigue, apathy, anorexia, lethargy, dry skin, and dull, sparse, dry hair.

Rhabdomyolysis

Signs and symptoms include muscle weakness or pain, fever, nausea, vomiting, malaise, and dark urine. Acute renal failure, due to renal structure obstruction and injury from the kidneys’attempt to filter the myoglobin from the bloodstream, is a common complication.

Rheumatoid arthritis

With this disease, symmetric muscle weakness may accompany increased warmth, swelling, and tenderness in involved joints; pain; and stiffness, restricting motion.

Seizure disorder

Temporary generalized muscle weakness may occur after a generalized tonic-clonic seizure; other postictal findings include headache, muscle soreness, and profound fatigue.

Spinal trauma and disease

Trauma can cause severe muscle weakness, leading to flaccidity or spasticity and, eventually, paralysis. Infection, tumor, and cervical spondylosis or stenosis can also cause muscle weakness.

Stroke

Depending on the site and extent of damage, a stroke may produce contralateral or bilateral weakness of the arms, legs, face, and tongue, possibly progressing to hemiplegia and atrophy. Associated effects include dysarthria, aphasia, ataxia, apraxia, agnosia, ipsilateral paresthesia or sensory loss, visual disturbance, altered level of consciousness, amnesia and poor judgment, personality changes, bowel and bladder dysfunction, headache, vomiting, and seizures.

Thyrotoxicosis

This disorder may produce insidious, generalized muscle weakness and atrophy. Other effects include anxiety, fatigue, heat intolerance, diaphoresis, tremors, tachycardia, palpitations, ventricular or atrial gallop, dyspnea, weight loss, an enlarged thyroid, and warm, flushed skin. Exophthalmos may be present.

Other causes

Drugs

Generalized muscle weakness can result from prolonged corticosteroid use, digoxin, and excessive doses of dantrolene sodium. Aminoglycoside antibiotics may worsen weakness in patients with myasthenia gravis.

Immobility

Immobilization in a cast, a splint, or traction can lead to muscle weakness in the involved extremity; prolonged bed rest or inactivity results in generalized muscle weakness.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Muscle spasms [Muscle cramps]: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Amyotrophic lateral sclerosis

With this disorder, muscle spasms may accompany progressive muscle weakness and atrophy that typically begin in one hand, spread to the arm, and then spread to the other hand and arm. Eventually, muscle weakness and atrophy affect the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle flaccidity progressing to spasticity, coarse fasciculations, hyperactive deep tendon reflexes, dysphagia, impaired speech, excessive drooling, and depression.

Arterial occlusive disease

Arterial occlusion typically produces spasms and intermittent claudication in the leg, with residual pain. Associated findings are usually localized to the legs and feet and include loss of peripheral pulses, pallor or cyanosis, decreased sensation, hair loss, dry or scaling skin, edema, and ulcerations.

Cholera

Muscle spasms, severe water and electrolyte loss, thirst, weakness, decreased skin turgor, oliguria, tachycardia, and hypotension occur along with abrupt watery diarrhea and vomiting.

Dehydration

Sodium loss may produce limb and abdominal cramps. Other findings include a slight fever, decreased skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, muscle twitching, seizures, nausea, vomiting, and oliguria.

Fracture

Localized spasms and pain are mild if the fracture is nondisplaced, intense if it’s severely displaced. Other findings include swelling, limited mobility and, possibly, bony crepitation.

Hypocalcemia

The classic feature is tetany—a syndrome of muscle cramps and twitching, carpopedal and facial muscle spasms, and seizures, possibly with stridor. Both Chvostek’s and Trousseau’s signs may be elicited. Related findings include paresthesia of the lips, fingers, and toes; choreiform movements; hyperactive deep tendon reflexes; fatigue; palpitations; and cardiac arrhythmias.

Hypothyroidism

Muscle involvement may produce spasms and stiffness, along with leg muscle hypertrophy or proximal limb weakness and atrophy. Other findings include forgetfulness and mental instability; fatigue; cold intolerance; dry, pale, cool, doughy skin; puffy face, hands, and feet; periorbital edema; dry, sparse, brittle hair; bradycardia; and weight gain despite anorexia.

Muscle trauma

Excessive muscle strain may cause mild to severe spasms. The injured area may be painful, swollen, reddened, or warm.

Respiratory alkalosis

Acute onset of muscle spasms may be accompanied by twitching and weakness, carpopedal spasms, circumoral and peripheral paresthesia, vertigo, syncope, pallor, and extreme anxiety. With severe alkalosis, cardiac arrhythmias may occur.

Spinal injury or disease

Muscle spasms can result from spinal injury, such as cervical extension injury or spinous process fracture, or from spinal disease such as infection.

Other causes

Drugs

Common spasm-producing drugs include diuretics, corticosteroids, and estrogens.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Muscle Cramps: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Ordinary muscle cramp

❑ Overuse

❑ Dehydration

❑ Drugs/toxins

❑ Hypokalemia

❑ Hyponatremia

❑ Hyperventilation

❑ Vascular insufficiency

❑ Restless legs syndrome

❑ Hypocalcemia

❑ Dystonia

❑ Amyotrophic lateral sclerosis

❑ Hemifacial spasms

❑ Spinal cord lesion

❑ Muscle enzyme deficiency

❑ Myotonic dystrophy

❑ Black widow spider bite

❑ Tetanus

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Muscle weakness: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Amyotrophic lateral sclerosis

Amyotrophic lateral sclerosis (ALS) typically begins with muscle weakness and atrophy in one hand that rapidly spread to the arm and then to the other hand and arm. Eventually, these effects spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency.

Brain tumor

Signs and symptoms of muscle weakness vary with the tumor’s location and size. Associated findings include headache, vomiting, diplopia, decreased visual acuity, decreased level of consciousness (LOC), pupillary changes, decreased motor strength, hemiparesis, hemiplegia, diminished sensations, ataxia, seizures, and behavioral changes.

Guillain-Barré syndrome

With Guillain-Barré syndrome, rapidly progressive, symmetrical weakness and pain ascends from the feet to the arms and facial nerves and may progress to total motor paralysis and respiratory failure. Associated findings include sensory loss or paresthesia, muscle flaccidity, loss of DTRs, tachycardia or bradycardia, fluctuating hypertension and orthostatic hypotension, diaphoresis, bowel and bladder incontinence, facial diplegia, dysphagia, dysarthria, and hypernasality.

Head trauma

Severe head trauma can cause varying degrees of muscle weakness. Other findings include decreased LOC, otorrhea or rhinorrhea, raccoon eyes and Battle’s sign, sensory disturbances, and signs of increased intracranial pressure.

Herniated disk

Pressure on nerve roots from a herniated disk leads to muscle weakness, disuse and, ultimately, atrophy. The primary symptom is severe low back pain, possibly radiating to the buttocks, legs, and feet — usually on one side. Diminished reflexes and sensory changes may also occur.

Hodgkin’s lymphoma

With Hodgkin’s lymphoma, muscle weakness may accompany the classic sign of painless, progressive lymphadenopathy. Other findings include paresthesia, fatigue, persistent fever, night sweats, and weight loss.

Hypercortisolism

Hypercortisolism may cause limb weakness and, eventually, atrophy. Related cush-ingoid features include buffalo hump, moon face, truncal obesity, purple striae, thin skin, acne, elevated blood pressure, fatigue, hyperpigmentation, easy bruising, poor wound healing, and diaphoresis. The male patient may be impotent; the female patient may exhibit hirsutism and menstrual irregularities.

Hypothyroidism

Reversible weakness and atrophy of proximal limb muscles may occur in hypothyroidism. Accompanying findings commonly include muscle cramps; cold intolerance; weight gain despite anorexia; mental dullness; dry, pale, doughy skin; puffy face, hands, and feet; impaired hearing and balance, and bradycardia.

Multiple sclerosis

With multiple sclerosis, muscle weakness in one or more limbs may progress to atrophy, spasticity, and contractures. Other findings typically wax and wane and may include diplopia and blurred vision, vision loss, nystagmus, hyperactive deep tendon reflexes, sensory loss or paresthesia, dysarthria, dysphagia, incoordination, ataxic gait, intention tremors, emotional lability, impotence, and urinary dysfunction.

Myasthenia gravis

Gradually progressive skeletal muscle weakness and fatigue are the cardinal symptoms of myasthenia gravis. Typically, weakness is mild upon awakening but worsens during the day. Early signs include weak eye closure, ptosis, and diplopia; a blank, masklike facies; difficulty chewing and swallowing; nasal regurgitation of fluid with hypernasality; and a hanging jaw and bobbing head. Respiratory muscle involvement may eventually lead to respiratory failure.

Osteoarthritis

Osteoarthritis is a chronic disorder that causes progressive muscle disuse and weakness that lead to atrophy. Other findings include crepitation; enlarged edematous joints; Heberden’s nodes; increased pain in damp, cold weather; joint stiffness; limited range of motion; pain relieved by resting joints; and smooth, taunt, shiny skin.

Paget’s disease

As Paget’s disease progresses, muscle weakness or paralysis may develop, along with paresthesia and pain. The patient may also have bowed tibias, frequent fractures, and kyphosis.

Parkinson’s disease

Muscle weakness accompanies rigidity in patients with Parkinson’s disease. Related findings include a unilateral pill-rolling tremor, propulsive gait, dysarthria, bradykinesia, drooling, dysphagia, a masklike facies, and a high-pitched, monotonic voice.

Peripheral nerve trauma

Prolonged pressure on or injury to a peripheral nerve causes muscle weakness and atrophy. Other findings include paresthesia or sensory loss, pain, and loss of reflexes supplied by the damaged nerve.

Peripheral neuropathy

With peripheral neuropathy, muscle weakness progresses slowly to flaccid paralysis, generally affecting distal extremities first. It may be accompanied by loss of vibration sense; paresthesia, hyperesthesia, or anesthesia in the hands and feet; hypoactive or absent DTRs; mild to sharp burning pain; anhidrosis; and glossy red skin.

Potassium imbalance

With hypokalemia, temporary generalized muscle weakness may be accompanied by nausea, vomiting, diarrhea, decreased mentation, leg cramps, diminished reflexes, malaise, polyuria, dizziness, hypotension, and arrhythmias.

With hyperkalemia, weakness may progress to flaccid paralysis accompanied by irritability and confusion, hyperreflexia, paresthesia or anesthesia, oliguria, anorexia, nausea, diarrhea, abdominal cramps, tachycardia or bradycardia, and arrhythmias.

Rhabdomyolysis

Signs and symptoms of rhabdomyolysis include muscle weakness or pain, fever, nausea, vomiting, malaise, and dark urine. Acute renal failure due to renal structure obstruction and injury from the kidneys’attempt to filter the myoglobin from the bloodstream is a common complication.

Rheumatoid arthritis

With rheumatoid arthritis, symmetric muscle weakness may accompany increased warmth, swelling, and tenderness in involved joints; pain; and stiffness that restrict motion. These findings typically occur bilaterally.

Seizure disorder

Temporary generalized muscle weakness may occur after a generalized tonic-clonic seizure; other postictal findings include headache, muscle soreness, and profound fatigue. The patient may experience an aura before the seizure.

Spinal trauma and disease

Spinal trauma can cause severe muscle weakness, leading to flaccidity or spasticity and, eventually, paralysis. Infection, tumor, and cervical spondylosis or stenosis can also cause muscle weakness.

Stroke

Depending on the site and extent of damage, a stroke may produce contralateral or bilateral weakness of the arms, legs, face, and tongue, possibly progressing to hemiplegia and atrophy. Associated effects include dysarthria, aphasia, ataxia, apraxia, agnosia, ipsilateral paresthesia or sensory loss, visual disturbance, altered level of consciousness, amnesia and poor judgment, personality changes, bowel and bladder dysfunction, headache, vomiting, and seizures.

Thyrotoxicosis

Thyrotoxicosis may produce insidious, generalized muscle weakness and atrophy. Other effects include anxiety, fatigue, heat intolerance, diaphoresis, tremors, tachycardia, palpitations, ventricular or atrial gallop, dyspnea, weight loss, an enlarged thyroid, and warm, flushed skin. Exophthalmos may be present.

Other causes

Drugs

Generalized muscle weakness can result from prolonged corticosteroid use, digoxin, and excessive doses of dantrolene. Aminoglycoside antibiotics may worsen weakness in patients with myasthenia gravis.

Immobility

Immobilization in a cast, a splint, or traction can lead to muscle weakness in the involved extremity; prolonged bed rest or inactivity results in generalized muscle weakness.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Muscle flaccidity [Muscle hypotonicity]: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Amyotrophic lateral sclerosis.Progressive muscle weakness and paralysis are accompanied by generalized flaccidity. Typically, these effects begin in one hand, spread to the arm, and then develop in the other hand and arm. Eventually, they spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle cramps and coarse fasciculations, hyperactive DTRs, slight leg muscle spasticity, dysphagia, dysarthria, excessive drooling, and depression.

Brain lesions.Frontal and parietal lobe lesions may cause contralateral flaccidity, weakness or paralysis and, eventually, spasticity and possibly contractures. Other findings include hyperactive DTRs, a positive Babinski's sign, loss of proprioception, stereognosis, graphesthesia, anesthesia, and thermanesthesia.

Guillain-Barré syndrome.Guillain-Barré syndrome causes muscle flaccidity. Progression is typically symmetrical and ascending, moving from the feet to the arms and facial nerves within 24 to 72 hours of its onset. Associated findings include sensory loss or paresthesia, absent DTRs, tachycardia (or, less commonly, bradycardia), fluctuating hypertension and orthostatic hypotension, diaphoresis, incontinence, dysphagia, dysarthria, hypernasality, and facial diplegia. Weakness may progress to total motor paralysis and respiratory failure.

Huntington's disease.Besides flaccidity, progressive mental status changes up to and including dementia and choreiform movements are major symptoms of Huntington's disease. Others include poor balance, hesitant or explosive speech, dysphagia, impaired respirations, and incontinence.

Muscle disease.Muscle weakness and flaccidity are features of myopathies and muscular dystrophies.

Peripheral nerve trauma.Flaccidity, paralysis, and loss of sensation and reflexes in the traumatized innervated area can occur.

Peripheral neuropathy.With peripheral neuropathy, flaccidity usually occurs in the legs as a result of chronic progressive muscle weakness and paralysis. It may also cause mild to sharp burning pain, glossy red skin, anhidrosis, and a loss of vibration sensation. Paresthesia, hyperesthesia, or anesthesia may affect the hands and feet. DTRs may be hypoactive or absent.

Seizure disorder.Brief periods of syncope and generalized flaccidity commonly follow a generalized tonic-clonic seizure.

Spinal cord injury.Spinal shock can result in acute muscle flaccidity or spasticity below the level of injury. Associated signs and symptoms also occur below the level of injury and may include paralysis; absent DTRs; analgesia; thermanesthesia; loss of proprioception and vibration, touch, and pressure sensation; and anhidrosis (usually unilateral). Hypotension, bowel and bladder dysfunction, and impotence or priapism may also occur. Injury in the C1 to C5 region can produce respiratory paralysis and bradycardia.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Muscle weakness: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Amyotrophic lateral sclerosis (ALS).ALS typically begins with muscle weakness and atrophy in one hand that rapidly spread to the arm and then to the other hand and arm. Eventually, these effects spread to the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency.

Anemia.With anemia, varying degrees of muscle weakness and fatigue are exacerbated by exertion and temporarily relieved by rest. Other signs and symptoms include pallor, tachycardia, paresthesia, and bleeding tendencies.

Brain tumor.Signs and symptoms of muscle weakness vary with a brain tumor's location and size. Associated findings include headache, vomiting, diplopia, decreased visual acuity, decreased level of consciousness (LOC), pupillary changes, decreased motor strength, hemiparesis, hemiplegia, diminished sensations, ataxia, seizures, and behavioral changes.

Guillain-Barré syndrome.Rapidly progressive, symmetrical weakness and pain ascends from the feet to the arms and facial nerves and may progress to total motor paralysis and respiratory failure. With Guillain-Barré syndrome, associated findings include sensory loss or paresthesia, muscle flaccidity, loss of DTRs, tachycardia or bradycardia, fluctuating hypertension and orthostatic hypotension, diaphoresis, bowel and bladder incontinence, facial diplegia, dysphagia, dysarthria, and hypernasality.

Herniated disk.Pressure on nerve roots of herniated disk leads to muscle weakness, disuse and, ultimately, atrophy. The primary symptom is severe low back pain, possibly radiating to the buttocks, legs, and feet—usually on one side. Diminished reflexes and sensory changes may also occur.

Hypercortisolism.Hypercortisolism may cause limb weakness and eventually atrophy. Related cushingoid features include buffalo hump, moon face, truncal obesity, purple striae, thin skin, acne, elevated blood pressure, fatigue, hyperpigmentation, easy bruising, poor wound healing, and diaphoresis. The male patient may be impotent; the female patient may exhibit hirsutism and menstrual irregularities.

Myasthenia gravis.Gradually progressive skeletal muscle weakness and fatigue are the cardinal symptoms of myasthenia gravis. Typically, weakness is mild upon awakening, but worsens during the day. Early signs include weak eye closure, ptosis, and diplopia; blank, masklike facies; difficulty chewing and swallowing; nasal regurgitation of fluid with hypernasality; and a hanging jaw and bobbing head. Respiratory muscle involvement may eventually lead to respiratory failure.

Osteoarthritis.Osteoarthritis is a chronic disorder that causes progressive muscle disuse and weakness that lead to atrophy.

Parkinson's disease.Muscle weakness accompanies rigidity in Parkinson's disease. Related findings include a unilateral pill-rolling tremor, a propulsive gait, dysarthria, bradykinesia, drooling, dysphagia, masklike facies, and a high-pitched, monotone voice.

Peripheral nerve trauma.Prolonged pressure on or injury to a peripheral nerve causes muscle weakness and atrophy. Other findings include paresthesia or sensory loss, pain, and loss of reflexes supplied by the damaged nerve.

Potassium imbalance.With hypokalemia,temporary generalized muscle weakness may be accompanied by nausea, vomiting, diarrhea, decreased mentation, leg cramps, diminished reflexes, malaise, polyuria, dizziness, hypotension, and arrhythmias.

With hyperkalemia, weakness may progress to flaccid paralysis accompanied by irritability and confusion, hyperreflexia, paresthesia or anesthesia, oliguria, anorexia, nausea, diarrhea, abdominal cramps, tachycardia or bradycardia, and arrhythmias.

Rhabdomyolysis.Signs and symptoms of rhabdomyolysis include muscle weakness or pain, fever, nausea, vomiting, malaise, and dark urine. Acute renal failure, due to renal structure obstruction and injury from the kidneys'attempt to filter myoglobin from the bloodstream, is a common complication.

Rheumatoid arthritis.With rheumatoid arthritis, symmetrical muscle weakness may accompany increased warmth, swelling, and tenderness in involved joints; pain; and stiffness, restricting motion.

Seizure disorder.Temporary generalized muscle weakness may occur after a generalized tonic-clonic seizure; other postictal findings include headache, muscle soreness, and profound fatigue.

Spinal trauma and disease.Trauma to the spine can cause severe muscle weakness, leading to flaccidity or spasticity and, eventually, paralysis. Infection, tumor, and cervical spondylosis or stenosis can also cause muscle weakness.

Stroke.Depending on the site and extent of damage, a stroke may produce contralateral or bilateral weakness of the arms, legs, face, and tongue, possibly progressing to hemiplegia and atrophy. Associated effects include dysarthria, aphasia, ataxia, apraxia, agnosia, ipsilateral paresthesia or sensory loss, vision disturbances, altered LOC, amnesia and poor judgment, personality changes, bowel and bladder dysfunction, headache, vomiting, and seizures.

Other causes

Drugs.Generalized muscle weakness can result from prolonged corticosteroid use, digoxin, and excessive doses of dantrolene. Aminoglycoside antibiotics may worsen muscle weakness in patients with myasthenia gravis.

Immobility.Immobilization in a cast, a splint, or traction can lead to muscle weakness in the involved extremity; prolonged bed rest or inactivity results in generalized muscle weakness.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Muscle spasms [Muscle cramps]: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Amyotrophic lateral sclerosis (ALS).With ALS, muscle spasms may accompany progressive muscle weakness and atrophy that typically begin in one hand, spread to the arm, and then spread to the other hand and arm. Eventually, muscle weakness and atrophy affect the trunk, neck, tongue, larynx, pharynx, and legs; progressive respiratory muscle weakness leads to respiratory insufficiency. Other findings include muscle flaccidity progressing to spasticity, coarse fasciculations, hyperactive deep tendon reflexes (DTRs), dysphagia, impaired speech, excessive drooling, and depression.

Arterial occlusive disease.Arterial occlusion typically produces muscle spasms and intermittent claudication in the leg, with residual pain. Associated findings are usually localized to the legs and feet and include loss of peripheral pulses, pallor or cyanosis, decreased sensation, hair loss, dry or scaling skin, edema, and ulcerations.

Cholera.With cholera, muscle spasms, severe water and electrolyte loss, thirst, weakness, decreased skin turgor, oliguria, tachycardia, and hypotension occur along with abrupt watery diarrhea and vomiting.

Dehydration.With dehydration, sodium loss may produce limb and abdominal cramps. Other findings include a slight fever, decreased skin turgor, dry mucous membranes, tachycardia, orthostatic hypotension, muscle twitching, seizures, nausea, vomiting, and oliguria.

Hypocalcemia.The classic feature of hypocalcemia is tetany—a syndrome of muscle cramps and twitching, carpopedal and facial muscle spasms, and seizures, possibly with stridor. Chvostek's and Trousseau's signs may be elicited. Related findings include paresthesia of the lips, fingers, and toes; choreiform movements; hyperactive DTRs; fatigue; palpitations; and cardiac arrhythmias.

Muscle trauma.Excessive muscle strain may cause mild to severe spasms. The injured area may be painful, swollen, reddened, or warm.

Respiratory alkalosis.With respiratory alkalosis, an acute onset of muscle spasms may be accompanied by twitching and weakness, carpopedal spasms, circumoral and peripheral paresthesia, vertigo, syncope, pallor, and extreme anxiety. With severe alkalosis, cardiac arrhythmias may occur.

Spinal injury or disease.Muscle spasms can result from spinal injury, such as a cervical extension injury or spinous process fracture, or from spinal disease such as infection.

Other causes

Drugs.Common muscle spasm-producing drugs include diuretics, corticosteroids, and estrogens.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007


 » Next page: Diagnostic Tests for Muscle cramps

Rate This Website

What do you think about the features of this website? Take our user survey and have your say:

Website User Survey

Medical Tools & Articles:

Next articles:

Tools & Services:

Medical Articles:

Forums & Message Boards
 
HONcode We subscribe to the HONcode principles

By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.

Home | Symptoms | Diseases | Diagnosis | Videos | Tools | Forum | About Us | Terms of Use | Privacy Policy | Site Map | Advertise

Copyright © 2009 Health Grades Inc. All rights reserved.