Last reviewed by Dr. Raj MD on January 12th, 2022.
What is Rhabdomyolysis?
This is a medical disorder that involves the breakdown of your skeletal muscle at a rapid pace. The word comes from Greek terms which are rhabdomyo which means “skeletal muscle” and lysis which means breakdown. Your skeletal muscle is a type of muscle that is made of muscle fibers and is what helps your skeleton to move at the joints. When a person gets this medical disorder the skeletal muscle starts to break down and is released into your bloodstream. Some of these components can include myoglobin, phosphate, and potassium. Myoglobin is a protein that is found in your urine and when the levels increase due to the destruction of your skeletal muscles, your kidneys can be damaged. If your kidneys find it hard to filter your blood every day it could lead to kidney failure.
People who have this medical disorder will often experience pain, weakness, and swelling in their lower back, arms, or legs. Some of the other symptoms you might have can include:
- The color of your urine could be abnormal. It could even be dark-colored or have blood in it.
- Bruising of your muscles
- Having tenderness in your muscles
- Loss of muscle strength
- Pain in your joints
- Having a fast heartbeat
- Weight gain that is unintentional and unexplainable
As the rhabdomyolysis becomes worse it could harm your lungs which can lead to problems with your breath. If you have swollen feet and hands that could be an indication of fluid retention from your kidneys not working correctly or actual kidney failure. There have even been instances of a person going into shock from having this medical disorder. This could be because your levels of important nutrients that you body needs are particularly low, especially calcium and potassium.
There are many different reasons that a person might suffer from rhabdomyolysis which can include:
- Having a sudden compression of your muscles – this could be due to a severe car accident in which you are trapped inside the car for a long period of time. It could also be caused by being under debris or rubble because of an earthquake. It could also be from a prolonged period of physical abuse where you cannot move about. Any of these can also result in having numbness in your lower extremities.
- An interruption of blood flow to your muscles – this can be due to a presence of the formation of a blood clot. It could also happen if an artery is clamped while having surgery.
- Extreme, prolonged physical exertion without taking the time to stay properly hydrated. Your muscles could be injured if you are engaging in extreme muscle activity. Running in marathons could also be a risk factor.
- Experiencing a seizure(s).
- Withdrawing from alcohol.
- Exposure to a significant amount of electricity – this could be because of being exposed to electroshock weapons like a Taser or coming in contact with lighting.
- Illegal and prescription medication – you have an increase chance of developing rhabdomyolysis if you are taking antipsychotic medications, various forms of neuromuscular blocking agents, or statins. Illegal drugs that can also increase the risk are cocaine, heroin, and ecstasy. There is even a possibility that some medications that are made from snake venom can trigger some deterioration of your skeletal muscles.
- Having a metabolic syndrome – one such syndrome is called ketoacidosis which is marked by the production of excessive ketone bodies. This is a symptom of diabetes mellitus that is not controlled. If a person has an excessive production of ketone bodies they may have a fruity smell to their breath.
- Diseases – these can include too much diarrhea or vomiting, severe asthma, hyperthyroidism.
- Heatstroke – when you spend a considerable amount of time in the hot sun your body’s temperature can go above one hundred four degrees Fahrenheit. If you do not treat heatstroke and continually expose yourself to the sun you could cause your skeletal muscle fiber to rupture.
If you have suffered from any of the above possible causes your physician may suspect that you have rhabdomyolysis. Your physician will also take your medical history of past and recent events to see if any of the possible causes have happened to you along with a physical exam. They will also do urine and blood testing to confirm the diagnosis of rhabdomyolysis. It is confirmed by detecting any elevated muscle enzymes in your blood. If your skeletal muscles have destroyed the levels of these muscle enzymes will start to increase. The level of Creatine Kinase (CK) in your blood is the most reliable test that is used to diagnose rhabdomyolysis with levels five times the normal amount. These higher levels of CK can also indicate that there is a greater chance of having acute kidney failure. There may also be an elevated level of myoglobin in your urine and blood as well.
In the later stages of rhabdomyolysis your physician can diagnose it by identifying deteriorating function of your kidney(s). Your physician can tell this by having an elevated level of urea and creatinine along with having darkened urine that has a red-pink hue, and urine output is failing and decreasing. Your potassium levels may be high along with low calcium levels. Approximately twenty-five percent of the people with rhabdomyolysis have abnormal liver function tests because of damage to their liver.
Once you have been officially diagnosed with rhabdomyolysis in order to get a positive outcome it is important that you have rapid treatment. One easy way to help prevent any life-threatening complications for the disintegration of skeletal muscle is to start practicing generous hydration as soon as you can. Many are treated with intravenous hydration, which is where you will get these fluids directly into your blood vessels through a tub. Doing this will help to reduce any harmful side effects of myoglobin, When you are increasing the fluids intravenously it helps to get rid of the myoglobin, especially the increased amount.
Other treatments can include:
- Blood transfusions – this is to help replace the blood that contains high amounts of myoglobin and any other substances with blood that is healthy.
- Dialysis – this is to get the toxic substances from your blood but only if your kidney’s are not able to clean the blood themselves. Depending on the severity of the condition you may need dialysis for the rest of your life or for only a short period of time.
- Surgery – this treatment will involve cutting the tissues that are covering your muscles to help reduce the pressure on your blood vessels and nerves that are caused by the inflammation of the muscle(s) that are injured.
The most important thing to remember is to keep your body properly hydrated at all times.