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Who Answers?Excessive alcohol consumption can cause a wide range of medical issues, including alcoholic myopathy. Alcoholic myopathy is a disorder of the skeletal muscles caused by chronic alcohol use.¹ There are certain risk factors for developing this disorder, including if you have alcohol use disorder (AUD). However, treatment is available, and reduction or complete abstinence from alcohol can improve alcoholic myopathy symptoms.
In this article:
- What is Alcoholic Myopathy?
- Risk Factors
- Development and Progression of Alcoholic Myopathy
- Treatment
What is Alcoholic Myopathy?
Alcoholic myopathy causes dysfunction of the skeletal muscles and occurs due to chronic alcohol use. Alcohol-related muscle disorders, like alcoholic myopathy, are five times more likely to occur than liver disease in individuals with heavy alcohol use.
Additionally, it is estimated that 40-60% of individuals with AUD have alcoholic myopathy.¹ Symptoms of this condition may include:¹,²
- Muscle pain and tenderness
- Swelling of the impacted muscles
- Abrupt development of proximal muscle weakness
- Elevation of muscle enzymes in lab work
- Weakness
- Inflammation
- Muscle atrophy (loss) of the hip and shoulder girdles
Acute vs Chronic Alcoholic Myopathy
Acute alcoholic myopathy occurs in individuals after consuming four to five alcoholic beverages within a short time frame or the first day of withdrawal with someone with chronic alcohol use disorder.² The alcohol blood level is 0.08 g/dL or above within this time frame. Symptoms of acute alcoholic myopathy typically resolve within 1-2 weeks after consumption with complete alcohol abstinence.
Acute alcoholic myopathy impacts the muscle strength and functioning of the body’s proximal muscles, including the upper part of the pelvis and hip bone and the shoulder girdle, where the arms are connected on both sides.¹ This form of myopathy can cause a life-threatening disorder called rhabdomyolysis, which releases dead muscle fibers into the bloodstream, causing kidney failure.³
While acute alcoholic myopathy occurs quickly, chronic myopathy results in gradual muscle weakness and functioning from weeks to months. Chronic alcoholic myopathy occurs after significant and long-term alcohol consumption and is typically observed in people between 40 and 60 years of age.¹ This myopathy is more common in individuals with other alcohol-related disorders, like cirrhosis of the liver. Hypoglycemic alcoholic myopathy is a subset of this condition that can occur when there is a loss of potassium in an individual due to excessive drinking.² Chronic infections, inactivity, malnutrition, or critical illnesses may exacerbate related symptoms.
Alcoholic Myopathy vs Neuropathy
Alcoholic myopathy can sometimes be confused with alcoholic neuropathy. However, these disorders affect different parts of a person’s body. Alcoholic neuropathy causes damage to the nerves, while alcoholic myopathy impacts specific skeletal muscles. Both disorders are caused by chronic alcohol consumption. Alcohol can also cause polyneuropathy, or neuropathy involving multiple nerves.
It is estimated that 65% of individuals with AUD have alcoholic neuropathy.⁴ Symptoms of alcoholic neuropathy include sudden burning pain, extreme sensitivity to pain (hyperalgesia), and allodynia, or experiencing pain from activities that don’t normally cause you pain (i.e., brushing your hair).⁵
Risk Factors
Not everyone with AUD, chronic alcohol use, or misuse will develop alcoholic myopathy. However, the disorder is caused by binging alcohol or long-term chronic alcohol use.
Having a diagnosis of cirrhosis of the liver also puts you at greater risk for this musculoskeletal condition.¹ Furthermore, increased risks occur if you engage in chronic alcohol consumption and have also become malnourished due to your alcohol use.² This increased risk is largely due to the malabsorption of certain vitamins and minerals and the deficits that occur in malnourishment. Vitamin D, folate, thiamine, vitamin B6, zinc, and iron are the most reported deficiencies. However, biochemical, metabolic, and epigenetic factors also influence the impact of alcoholic myopathy on you.
A diagnosis of AUD is also a risk factor for developing alcoholic myopathy. AUD is a chronic medical disorder that makes it difficult to control your drinking, despite strong efforts.
Some research shows that both men and women are equally affected by this conditiony.² However, other research reports that women may be more susceptible to the adverse effects of alcohol misuse due to the absorption, distribution, metabolism, and elimination (ADME) processes. Because women’s bodies metabolize alcohol differently than men’s bodies, women are more likely to have alcohol in their system for longer periods.⁷ This can increase the likelihood of developing myopathy.
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Help is standing by 24 hours a day, 7 days a week.Who Answers?Development and Progression of Alcoholic Myopathy
Acute alcoholic myopathy occurs suddenly after a binging episode and will typically resolve within a few weeks of abstaining from alcohol. The amount of alcohol ingested within a particular time frame, along with not eating, may increase your risk of developing this myopathy due to starvation’s impact on the metabolism and alcohol levels within your body. Muscle cramps, tenderness, and swelling are often the first signs of alcoholic myopathy, and if you are experiencing these, you should contact your doctor immediately.⁸
The onset of symptoms for chronic alcoholic myopathy is a slow progression after long-term chronic alcohol use and misuse.¹,² Typically, the individuals affected by this form of myopathy will also have alcohol use disorder. Proximal weakness and muscle atrophy are often common, but muscle pain and tenderness are usually absent in chronic alcoholic myopathy.⁸
If you have long-term, chronic alcohol consumption, you should be monitored consistently, have your toxicology and blood work screened, and provide a medical professional with an extensive health history. An Electromyography (EMG) should also be performed to check on any neuromuscular abnormalities.²
Treatment
The greatest prevention and treatment for alcoholic myopathy is long-term abstinence from alcohol.² If alcohol consumption is reduced or stopped, symptoms can improve or diminish. For the chronic type, reducing alcohol consumption may improve muscle strength over time, with changes noticed within two to 12 months. And if alcohol use has been stopped completely, up to 85% of individuals have shown complete normalization of strength by the fifth year of abstinence from alcohol.²
With acute myopathy, reduction of symptoms can be seen within days or weeks of alcohol cessation. Being able to improve nutritional deficits and electrolyte balances also helps improve muscle difficulties associated with related symptoms.
While there has been limited research, physical therapy and exercise have been shown to improve range of motion and exercise capacity in individuals with alcoholic myopathy. Additional research is being done on the effects targeting hormonal pathways, muscle-injury pathways, and vitamin deficiencies related to symptoms.²
If you or someone you know has alcoholic myopathy and is struggling to quit or reduce alcohol use, rehab can help. Call our confidential helpline at
800-948-8417
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Resources
- Simon, L., Jolley, S. E., & Molina, P. E. (2017). Alcoholic Myopathy: Pathophysiologic Mechanisms and Clinical Implications. Alcohol research: current reviews, 38(2), 207-217.
- Lanska, D.J. (September 2021). Alcoholic myopathy. Medlink Neurology.
- Tsai, J. P., Lee, C. J., Subeq, Y. M., Lee, R. P., & Hsu, B. G. (2017). Acute Alcohol Intoxication Exacerbates Rhabdomyolysis-Induced Acute Renal Failure in Rats. International journal of medical sciences, 14(7), 680-689.
- Zeng, L., Alongkronrusmee, D., & van Rijn, R. M. (2017). An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. Journal of pain research, 10, 219-228.
- Chopra, K., & Tiwari, V. (2012). Alcoholic neuropathy: possible mechanisms and future treatment possibilities. British Journal of Clinical Pharmacology, 73(3), 348-362.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
- Alleyne, J., & Dopico, A. M. (2021). Alcohol Use Disorders and Their Harmful Effects on the Contractility of Skeletal, Cardiac and Smooth Muscles. Advances in drug and alcohol research, 1, 10011.
- Miller, M. L. (2012). Drug-induced myopathies. Waltham MA.