Dystonia - When Muscle Spasms Should Be a Concern

Aon Health & Wellbeing Conversation #8

Muscular spasms are involuntary contractions of muscles. Short and mild attacks can be negligible. But some can be particularly uncomfortable, debilitating and a significant cause of stress especially when they are persistent and repetitive in nature.
In general, muscular spasm is a normal physiological occurrence. It is a typical reaction when we have overused parts of our body or when we are overfatigued. They also occur when we are dehydrated and lose electrolytes in our bodies. The movements are abrupt, short, and may be painful, but go away in a matter of time. Rehydration, simple stretching, and proper rest can be enough to relieve the discomfort and prevent reoccurrence.
However, dystonia becomes a cause for concern when it begins to impede one’s day-to-day activities.
Causes and Types
Dystonia is a movement disorder in which muscles behave uncontrollably and excessively. It is characterized by involuntary twisting movements which are repetitive and painful, and lead to the contortion of the affected body part or abnormal posture. These movements are called dystonic movements.
The state of a general dystonia is where all parts of the body is affected, while focal or segmental dystonia refers to only a part or area being affected. It is a rare disease and observed to affect women more than men.
While the cause of dystonia is unknown, it is thought to be an abnormality in one’s ability to process neurotransmitters that help in the communication of nerves and cells in areas of the brain. Cases are grouped into three instances:
Other symptoms include:
  • Idiopathic – where there is no clear reason of occurrence
  • Genetic – when it is inherited from a parent who may be a carrier of a defective gene
  • Acquired – where symptoms are brought by environmental causes such as infections or poisoning, trauma and damage to the brain, or is a reaction to certain types of medication
Symptoms of dystonia can occur at any point of a person’s life. Different people may experience varying degrees of the condition, depending on when and where the onset of symptoms happens in the body and the type of case. Some manifestations include:
  • Rapid blinking of the eyes or forced closure of the eyelid
  • Difficulty in speech, swallowing, or chewing due to an affected jaw or tongue
  • Tightening of the voice box giving out a seemingly whispering voice
  • Bent or twisted neck
  • Frozen or deformed extremities
Symptoms may manifest only when a specific activity is conducted and a particularly affected body part is used during the activity, such as when a musician plays an instrument using his arms.
One could experience exhaustion due to pain and constant muscle contractions. Stress or fatigue worsens the condition. Increased anxiety could result from the constant physical discomfort, adversely impacting mental wellbeing too.
While there is no treatment to cure or prevent dystonia, the condition can be managed, based on the type of case. Generally, the following are recommended and/or administered to patients:
  • Injection of botulinum toxin (i.e. Botox) to the affected muscle to reduce or eliminate contractions
  • Prescription of medications to manage excessive contractions
  • Therapy – physical, occupational, speech
  • Massages, stretches and other stress management activities
  • Surgery – either nerve stimulation or denervation
While muscular spasm can be normal, a doctor’s visit is recommended if these spasms become increasingly prevalent and hamper day-to-day activity, as that would indicate the occurrence of dystonia. Dystonia could also be indicative of other underlying health problems, and early detection would be advantageous in arresting or managing the root cause.

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