Muscle Weakness and Atrophy
Muscle weakness and atrophy can have various causes, including physical injury, infections, chronic diseases, and neurological conditions. In Chinese medicine, muscle weakness and atrophy are often attributed to deficiencies or imbalances in the organ systems involved in the production and circulation of qi and blood, such as the Lungs, Kidneys, and Spleen. Treatment may involve the use of acupuncture and herbal remedies to support the function of these organ systems and improve circulation to the muscles. In some cases, Chinese medicine may be able to slow down the progression of the condition and improve physical function.
Muscular weakness and atrophy can be caused by the invasion of external pathogens, both in acute and slowly progressing cases. In traditional Chinese medicine, the most common cause of paralysis and muscle wasting is a strong wind-heat or warm disease pathogen, similar to poliomyelitis. This pathogen is thought to invade the qi level, affecting the Lungs and Stomach. The heat in the qi level can damage fluids and yin, depleting normal qi and Kidney yin, leading to a lack of nourishment for muscles and sinews. This typically leads to weakness in the lower limbs a week or so after the onset of the wind-heat pattern.
Additionally, dampness and damp-heat can also contribute to muscle weakness. Dampness does not typically cause acute illness, but rather gradually seeps into the tissues, compromising the circulation of qi and blood and the strength and function of the peripheral muscles. Dampness in the muscles can block qi and blood movement, leading to heat and damp-heat. This dampness can be contracted through chronic exposure to damp or humid conditions, such as living in a damp house, prolonged habitation in damp climates, or frequent exposure to water.
Damp-heat is typically the result of chronic dampness in the muscles, leading to gradual weakness and atrophy. However, it can sometimes be more acute when a seasonal damp-heat pathogen invades the qi level.
There are several dietary habits that can lead to weakness and atrophy. These include restrictive or fad diets, which can cause Spleen qi and yang deficiency, and diets low in protein, which can lead to blood deficiency. Prolonged starvation or digestive insult can also damage the Spleen yang qi. Overuse of slimming aids that suppress the appetite can have the same effect. A diet that includes a lot of cold or raw foods can weaken the Spleen qi and yang. Additionally, some herbs and medications, such as heat-clearing herbs and antibiotics, can weaken the Spleen, deplete Spleen yang qi, and generate dampness.
Eating irregularly, missing meals, or eating at odd hours can weaken the Spleen and Stomach. Overconsumption of alcohol or rich, heating, or tonifying foods and herbs can contribute to dampness and damp-heat. Excessive consumption of heating foods, such as chiles, coffee, and fats, can introduce heat and damp-heat, potentially damaging yin. Inappropriate or excessive use of tonifying or hot herbs, like aconite or red ginseng, can also contribute to internal heat and yin damage.
Emotions that have an impact on the Spleen, Kidneys, and Liver are the most significant in causing weakness and atrophy. Anger, frustration, and repressed emotion affect the Liver, while worry, rumination, obsessive thinking, sadness, and prolonged concentration, combined with a sedentary lifestyle and poor diet, weaken the Spleen. When prolonged or extreme, these emotions can disrupt the function of the Liver and Spleen, or cause the Liver to invade the Spleen, leading to deficiency of qi and blood, the creation of dampness, and a failure of the Spleen to nourish muscles. Chronic Liver qi constraint can also result in blood stasis, phlegm accumulation, or heat that can deplete yin.
Sudden shock, extreme fear, or a major life upheaval, such as an accident, the death of a loved one, or a profound physical or emotional trauma, can damage the Kidneys and Heart, draining them of vitality and damaging yang qi and yin.
Injury to a limb, the spine, or the head can cause weakness and muscle atrophy due to impaired blood flow in the affected area. This can lead to a decreased supply of oxygen and nutrients to the muscles, resulting in tissue damage and decreased function. In severe cases, prolonged blood stasis can also lead to complications such as infection or tissue death. It is important to seek medical attention immediately after a traumatic injury to prevent further complications and to ensure proper treatment.
A person with a weakened constitution, particularly in the kidneys or spleen, may be more susceptible to developing weakness and atrophy due to factors such as poor diet and exposure to harmful pathogens.
The weakness and atrophy described affects the skeletal muscles and tendons. It can affect the muscles alone, although it is more common for the condition to affect a mix of muscles and internal organs. By the time symptoms of weakness or wasting have developed, the functions of the Spleen, Liver, and Kidneys are likely to be compromised. In practice, people usually present with a combination of different patterns. The progression of the condition typically starts with excess in the early stages and then moves to a mix of excess and deficiency in the middle and later stages. The pathology of the early stages contributes to the pathology of the latter stages. For example, heat in the Lungs and Stomach or damp-heat damages yin, leading to deficiency in the Liver and Kidneys. Dampness in the muscles gradually weakens the Spleen, causing qi deficiency, qi and blood deficiency, or deficiency in the Spleen and Kidneys.
Although excess pathology is most commonly seen in the early stages of weakness and atrophy, deficiency can sometimes occur suddenly or quickly, leading to muscle weakness that has recently developed. This can happen after a significant loss of blood, leading to sudden deficiency in qi and blood. The late stages of a weakness and wasting condition are most commonly associated with profound deficiency. However, there are cases in which excess is the main feature, for example, the blood stasis and phlegm that often complicate yin and yang deficiency.
Muscular weakness and atrophy can be a chronic, progressive condition or one that comes and goes with periods of active disease and remission. During active phases, treatment should be consistent, with at least two acupuncture treatments per week and herbal therapy to stabilize the condition and prevent further deterioration. In remission, constitutional treatment is used to address the underlying imbalance. As the maintenance phase begins, treatments can be spaced out as needed, with a focus on maintaining the immune system and quickly addressing any acute external pathogenic invasions to prevent relapse.
Treatment for muscular weakness and atrophy typically lasts for several months, with a minimum of 3-6 months needed for significant improvement in long-standing cases. At least six to eight weeks of treatment is needed to determine its effectiveness. Change in these cases is often slow, so persistence is key to success. In addition to acupuncture and herbal therapy, physical activities such as tai ji quan and qi gong can help improve muscle control and balance and calm the mind.
The outlook for muscular weakness and wasting patterns varies depending on the underlying biomedical diagnosis. In cases of severe nerve and muscle damage, a cure may not be possible. However, many people can still experience significant benefits in terms of improved well-being and function, a slowing of the progression of the condition, and a better quality of life. Early treatment is crucial for the best outcome, with ongoing treatment and lifestyle changes necessary to maintain any benefits achieved.