Myopathy is a condition in which an individual suffers from muscle weakness. The cause of this muscle weakness is the muscle fibers not functioning (the muscle fibers being the cells that make up the mass of your muscle and that are involved in the mechanics that cause the muscle to move on a macroscopic level). Myopathy is also known as muscle disease and can be either neuromuscular or musculoskeletal.
Unfortunately treatment for myopathy is not a simple matter as there are many different causes of myopathy and many different categories. These include:
Dystrophies – These are forms of myopathy that are caused by muscle degeneration. These are then usually progressive, and eventually the body will often lose the ability to regenerate the muscle, resulting in the use of a wheelchair and often death due to respiratory weakness.
Myotonias – Conditions in which the muscle is slow to relax after contraction. Thus it is then necessary for the individual to exert effort in order to relax the muscle. Symptoms include the inability to release objects etc.
Nemaline Myopathy – Nemaline is a muscle condition which is non-progressive and that is caused by abnormal ‘thread-like’ rods which are caused nemaline bodies. This results in weakness as well as delayed motor development. It particularly targets the arm, leg, trunk, throat and face muscles.
Inflammatory Myopathies – These are caused by the immune system attacking certain components of the muscles.
Familial Periodic Paralysis – A genetic condition, resulting in short bouts of paralysis.
Glycogen Storage Diseases – A condition that is the result of defects in processing glycogen synthesis. In other words the body has difficulty breaking down glycogen for energy, resulting in less energy in the muscles.
Nonhereditary Myositis Ossificans – Here calcifications occur at the site of an injured muscle, often in the arms or quadriceps.
Glucocorticoid Induced Myopathy – This can be endogenous (such as in Cushing’s disease) or exogenous. This affects the fast twitch muscle fibers (those used for fast anaerobic function) and will affect synthesis while causing slow degradation. This results in the expression of myostatin – a statin used in order to reduce muscle growth and development.
Thus there is not one, but many different treatments for myopathy. Lifestyle changes such as exercise may help to prevent the degradation of muscles and help to strengthen them and increase size. A diet high in protein and the use of growth hormones etc might also help to address the symptoms of myopathy. Physical therapy might also be useful, as might bracing for support which can help to take some of the strain off of the muscles. Meanwhile surgery may be used in some cases.
However treatments that address the cause will depend on the exact form of myopathy, and the above are only some examples. They can however be split into some categories in many cases:
Autoimmune Disorders: Where the immune system is the cause of the myopathy, then the treatment might be the use of steroids, or immunosuppressors. Often these conditions are unfortunately lifelong however and so the treatment tends to be aimed at management.
Dystrophy: Again there is no known cure for dystrophy currently. However physical therapy, orthotics (the use of supports etc), speech therapy, bodybuilding etc may all be useful for helping to address the symptoms and steroids may again be used.
Glycogen/Energy: For energy issues the main goal is to prevent hypoglycemia via an increase in glucose and starch in the diet. The consumption of carbohydrates should be approximately the same as the 24 hour glucose production rate.
Cellular Changes: For conditions such as nemaline myopathy there is again often no cure. However again with aggressive care and management it is usually possible for sufferers to lead full and active lives.
There is currently a lot of research being done into many of the causes of muscular diseases. These include the use of stem cells – which are cells that have yet to have been ‘assigned’ a role (they are generally associated with fetuses, but they have also been shown to exist in adults too). The idea then of course is that stem cells could replace the muscle cells and thereby help to regenerate dystrophies or to help replace nemaline rods etc.
Other studies are looking at genetic modification. In one example scientists knocked out the myostatin producing gene in rats, and as myostatin prevents muscle growth, this then was shown to help increase muscle mass several-fold. Similarly in other studies this same procedure has been seen to help improve muscle diseases.
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