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Alcoholic Myopathy: Causes, Symptoms & Treatment

Myopathy, or skeletal muscle dysfunction characterized by muscle weakness, is a common issue in people who struggle with alcohol use disorder.1 Alcohol can have a harmful effect on many bodily systems, including the muscular system.1

This article will help you understand more about alcoholic myopathy, its symptoms, causes and risk factors, how it is treated, its prognosis, and whether it is reversible.

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What is Alcoholic Myopathy?

Alcoholic myopathy is a condition involving muscle weakness and loss of muscle due to abnormal breakdown of muscle tissue.2 This muscular degeneration leads to muscle dysfunction, which impacts various parts of the body and their functionality and can be either acute or chronic.2,3

Diagnosing alcoholic myopathy involves a detailed medical and family history as well as bloodwork to rule out any other issues that could be causing symptoms.2 The provider will ask about alcohol or other substance use and most likely conduct drug screening.2 Testing will be done to check your muscle strength and function, and can include electromyography (EMG) and muscle biopsy to measure the functioning of your muscles.2

Between 40% and 60% of individuals with chronic alcohol use disorder develop alcoholic myopathy.1,2 Alcohol use is a major factor in the development of both acute and chronic alcoholic myopathy, although the pattern of drinking can strongly influence which form develops.2 Acute alcoholic myopathy results from binge drinking, while chronic alcoholic myopathy results from long-term, usually heavy drinking.1,2 Alcohol and the product it forms when it is metabolized are toxic to the muscles and nervous system, which can lead to the breakdown of muscle tissue, causing either acute or chronic alcoholic myopathy, depending on your patterns of alcohol use.3

Symptoms of Alcoholic Myopathy

The symptoms of alcoholic myopathy can vary between people, and not everyone will experience all symptoms.3 In addition, the symptoms of acute alcoholic myopathy are significantly different from chronic alcoholic myopathy.1,3 Symptoms associated with acute alcoholic myopathy include:1,2,3

  • Cramping.
  • Dark urine.
  • Muscle tenderness.
  • Muscle weakness.
  • Pain.
  • Swelling in affected muscles, usually in the extremities.
  • Kidney failure in severe cases.

Chronic alcoholic myopathy symptoms include:1,2,3

  • Abnormal walking.
  • Dark urine.
  • Increasing weakness affecting the muscles surrounding the pelvis and shoulders that progresses over a period of weeks or months.
  • Muscle wasting (atrophy).
  • Tightness of the muscles.
  • Twitching of the muscles.
  • Usually painless, although some people may complain of muscle cramps.

Alcoholic Myopathy Treatment & Outlook

Alcoholic myopathy can lead to major complications. When muscle fibers break down, they release proteins and electrolytes into the blood, which can cause other issues.2,4 This can lead to high levels of potassium in the blood (hyperkalemia), which can make the heart beat abnormally and is potentially fatal.4  Alcoholic myopathy can also cause failure of the kidneys or other organs, which can be fatal if untreated.2 In addition, alcoholic myopathy is a progressive condition that can cause muscle atrophy and lead to an abnormal way of walking.2

When alcohol use is stopped, the symptoms of alcohol-related myopathy often improve significantly.2,3 If cutting down on alcohol use or quitting alcohol altogether is difficult, you may have an alcohol use disorder and need to attend treatment to address it.2 For people who are experiencing more severe symptoms or complications associated with their myopathy, hospital care may be needed and can involve intravenous fluids vitamin supplementation and dialysis.2,3 Recovery is possible, although the treatment is tailored to each patient’s unique needs.2,3

Is Alcoholic Myopathy Reversible?

In most cases, alcoholic myopathy is a reversible condition. Total abstinence from alcohol can often help reverse the symptoms.1,2 For acute alcoholic myopathy, symptoms can typically be reversed within a few days to weeks, while chronic alcoholic myopathy can often take between 2 months to a year to be reversed.1,2 Recovery from alcoholic myopathy can be supported by addressing any imbalances in vitamins and electrolyte levels.1

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    1. Simon, L., Jolley, S.E., & Molina, P.E. (2017). Alcoholic myopathy: Pathophysiologic mechanisms and clinical implications. Alcohol research: Current reviews, 38(2), 207-217.
    2. Lanska, D.J. (2020). Alcoholic myopathy.
    3. Chaudhuri, A., & Behan, P.O. (1999). Alcoholic myopathy. Proceedings of the Royal College of Physicians of Edinburgh, 29, 236-242.
    4. American Heart Association. (2017). What is hyperkalemia (high potassium)?
Last Updated on Jul 1, 2022
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