What Are Muscle Twitches?
Muscle twitching is when muscles contract involuntarily. Also called muscle fasciculation, twitches can occur on any part of the body. Most of the time twitches are harmless, but in some cases, they may be a sign of a problem with the nervous system.
Unlike tics, which are usually repetitive with numerous continuous occurrences of the same action, muscle twitches are isolated occurrences, and not repeated actions.
What Causes Twitches?
Causes of muscle twitches that usually go away on their own include:
- Consumption of caffeine or other stimulants
- Stress or anxiety (“nervous ticks”)
- Lack of sleep
- Nicotine from smoking and tobacco use
- Eye irritation or dryness (eyelid twitching)
- Physical activity due to accumulation of lactic acid (lactic acidosis) or electrolyte deficiency
- Nutrient deficiencies such as vitamin D, vitamin B, and calcium
- Dehydration
- Side effects of medications such as corticosteroids, estrogen pills, diuretics, antidepressants, some seizure medications, and certain drugs used to treat psychosis
Serious causes of muscle twitches include:
- Bell's palsy
- Multiple sclerosis
- Tourette's syndrome
- Muscular dystrophy
- Amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease)
- Spinal muscular atrophy
- Kidney disease
- Neuropathy (nerve damage)
- Isaac’s syndrome
What Symptoms May Accompany Twitches?
Other symptoms that may accompany twitches include:
- Physical activity
- Bell's palsy
- Weakness and paralysis of facial muscles
- Drooping of the mouth
- Drooling
- Inability to close eye (causing eye dryness)
- Excessive tearing in one eye
- Facial pain or abnormal sensation
- Altered taste
- Intolerance to loud noise
- Significant facial distortion
- Multiple sclerosis
- Numbness in the feet
- Problems walking
- Difficulty speaking or concentrating
- Fatigue
- Muscle spasms
- Weakness
- Vision problems
- Dizziness and spinning sensation (vertigo)
- Bladder problems
- Sexual dysfunction
- Constipation
- Tourette's syndrome
- Vocalizations such as repetitive throat-clearing, sniffing, or grunting
- Sniffing or touching objects, hopping, jumping, bending, or twisting
- Motor movements that result in self-harm such as punching oneself in the face
- Vocal tics including coprolalia (such as swearing) or echolalia (repeating words or phrases of others)
- Muscular dystrophy
- Frequent falls
- Muscle weakness and cramps
- Difficulty standing up, climbing stairs, running, or jumping
- Waddling
- Curved spine (scoliosis)
- Droopy eyelids
- Heart problems
- Vision problems
- Problems breathing or swallowing
- Amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease)
- Muscle cramps
- Tight and stiff muscles (spasticity)
- Muscle weakness
- Slurred and nasal speech
- Difficulty chewing or swallowing
- Spinal muscular atrophy
- Progressive muscle weakness and atrophy
- Difficulty swallowing or breathing
- Inability to sit without support
- Joint deformities (contractures)
- Kidney disease
- Tiredness
- Trouble concentrating
- Trouble sleeping
- Dry and itchy skin
- Urinary frequency
- Blood in the urine
- Foamy urine
- Puffiness around the eyes
- Swelling of ankles and feet
- Decreased appetite
- Muscle cramping
- Neuropathy (nerve damage)
- Muscle weakness and cramps
- Muscle shrinking
- Loss of reflexes
- Loss of position sense that can lead to difficulty walking or fastening buttons or maintaining balance with eyes shut
- Problems feeling pain or changes in temperature
- Excess sweating
- Heat intolerance
- Gastrointestinal symptoms
- Isaac’s syndrome
- Progressive muscle stiffness
- Muscle cramping
- Increased sweating
- Delayed muscle relaxation
What Is the Treatment for Twitches?
For less serious and often temporary causes of muscle twitching, no treatment may be needed and twitching will usually go away on its own. If treatment is needed, it may include:
- Consumption of caffeine or other stimulants
- Reduce or avoid caffeine or stimulant use
- Stress or anxiety (“nervous ticks”)
- Practice stress reduction techniques such as mediation, deep breathing, or yoga
- Lack of sleep
- Try to maintain good hygiene and get adequate sleep
- Nicotine from smoking and tobacco use
- Don’t smoke or use tobacco
- Eye irritation or dryness (eyelid twitching)
- If there is no underlying medical condition causing eye irritation or dryness, lubricating eye drops may help
- Physical activity due
- Accumulation of lactic acid (lactic acidosis)
- Reduce intensity or duration of exercise
- Get adequate fluid intake
- Rest
- Electrolyte deficiency
- Drink enough water while exercising
- Consume coconut water or sports drinks with electrolytes
- Accumulation of lactic acid (lactic acidosis)
- Nutrient deficiencies such as vitamin D, vitamin B, and calcium
- Dietary modifications or nutritional supplements
- Dehydration
- Increase water intake
- Side effects of medications such as corticosteroids, estrogen pills, diuretics, antidepressants, some seizure medications, and certain drugs used to treat psychosis
- Talk to your doctor about changing to another medication that may not cause the side effects
- Do not stop taking any medications without first talking to your doctor
For more serious and chronic causes of muscle twitching, treatment involves addressing the underlying cause:
- Bell's palsy
- Steroids
- Antiviral agents, in addition to steroids
- Pain relievers such as aspirin, acetaminophen, or ibuprofen
- Eye protection, including lubricating eye drops, such as artificial tears or eye ointments or gels, and eye patches
- Physical therapy
- Facial massage
- Acupuncture
- Decompression surgery (controversial and not often recommended)
- Multiple sclerosis
- Medications to reduce the severity and frequency of relapses
- High dose corticosteroids for attacks
- Rehabilitation for fitness and energy levels
- Tourette's syndrome
- Neuroleptic medications such as haloperidol and pimozide
- Alpha-adrenergic agonists such as clonidine and guanfacine
- Stimulants such as methylphenidate and dextroamphetamine to reduce ADHD symptoms
- Serotonin reuptake inhibitors (SSRIs) such as clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline for obsessive-compulsive symptoms
- Muscular dystrophy
- Physical therapy and occupational therapy
- Speech therapy and respiratory
- Medications to ease symptoms
- Eteplirsen (Exondys 51)
- Anti-seizure drugs
- Blood pressure medicines
- Immunosuppressants
- Steroids such as prednisone and defkazacort (Emflaza)
- Creatine
- Surgery
- Amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s disease)
- Spinal muscular atrophy
- Kidney disease
- Medications to treat high blood pressure such as ACE inhibitors, angiotensin receptor blockers (ARBs)
- Diet low in sodium, protein, potassium, and phosphate
- Dialysis
- Kidney transplant
- Neuropathy (nerve damage)
- Healthy lifestyle habits such as maintaining an optimal weight, eating a balanced diet, and correcting vitamin deficiencies
- Quit smoking
- Exercise regularly
- Control blood sugar (in patients with diabetes)
- Immunosuppressive drugs such as prednisone, cyclosporine, or azathioprine
- Plasmapheresis
- Rituximab, immunoglobulins, and antibodies that alter the immune system
- Nortriptyline, newer serotonin-norepinephrine reuptake inhibitors, and epilepsy medications for pain
- Local anesthetics and narcotics (opioids) for pain that doesn’t respond to other pain-control medications
- Surgery for some types of neuropathies such as disk problems in the back or trigeminal neuralgia on the face
- Transcutaneous electrical nerve stimulation (TENS)
- Isaac’s syndrome
- Anticonvulsants, including phenytoin and carbamazepine
- Plasma exchange
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