Muscle Jerking
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Muscle Jerking
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Muscle twitching occurs when nerves misfire, causing groups of muscle fibers to contract. This is common to multiple sclerosis (MS), due to nerve fiber damage that affects signaling between your nerves and muscles.
But there are other possible causes of the various types of muscle twitching too, from fatigue and nutrient deficiency to thyroid disease and more. Some are benign, but others require medical attention.
If you have MS, your muscle twitching may be due to your disease. Or it could be owed to one of these other causes that you may not realize you're living with as well. It's important to sort out the why behind what you're experiencing.
Likewise, for those who have not been diagnosed with MS, it's best not to ignore this symptom, as you may have a condition that requires treatment. There are three types of muscle twitching, each of which has some level of uniqueness to them.
Spasticity describes muscle tightness and stiffness, as well as spasms that can be constant or sudden; some people describe these as a twitch.
Spasticity is a common symptom in MS and often affects one or both of the legs. 1 It results from disrupted signals between the upper motor neurons and the lower motor neurons. In other words, there is impaired nerve transmission from the brain and spinal cord to the nerves that control your muscles.
Other conditions that may cause spasticity include: 2
Clonus describes the repetitive jerking or twitching of muscles and, like spasticity, is thought to be caused by the faulty nerve transmission characteristic of MS. 3 For example, the normal ankle jerk reflex is instead hyperactive and the muscle that controls the ankle shakes rhythmically and uncontrollably.
In more severe cases, the knee-jerk reflex is hyperactive and the muscle that controls the knee shakes rhythmically and uncontrollably.
Lower motor neurons transmit nerve signals from your spinal cord to your muscles. When these nerve signals are disrupted, muscle weakening and wasting will eventually occur, along with uncontrollable muscle twitching called fasciculations.
Fasciculations are a hallmark symptom of diseases that affect the lower motor neurons, like ALS. 6 Other lower motor neuron diseases that may cause fasciculations include post-polio syndrome, spinal muscular atrophy (SMA) , and progressive muscular atrophy.
Multiple sclerosis very rarely involves the lower motor neurons, which is why fasciculations are usually not a symptom of the disease.
Besides neurological diseases, fasciculations may also be a symptom of certain diseases and conditions outside the nervous system, such as: 7
It's important to understand that a run-of-mill muscle twitch here and there is likely nothing to worry about. Twitching can occur in healthy people and rarely signals the presence of an underlying disease, especially if it occurs without other symptoms.
Muscle twitches that are unrelated to an underlying disease or abnormality can be triggered by a number of things, including:
In these instances, muscle twitches are benign and short-lived, meaning they are not a serious health concern, and come and go quickly.
Two uncommon conditions called benign fasciculation syndrome and cramp fasciculation syndrome cause frequent muscle twitches and, in the latter case, muscle cramps. 10 These conditions are believed to be due to hyperexcitable nerves and are not associated with loss or nerve or muscle function.
Every disease and condition has its own set of established or widely accepted criteria for diagnosis.
To determine the underlying cause of your muscle twitching, your healthcare provider will likely do a physical examination and ask you questions such as:
If the healthcare provider suspects your muscle twitching may be due to an underlying condition, they may order blood tests, a magnetic resonance imaging (MRI) scan, a computed tomography (CT) scan, or electromyography to assess the health of your muscles and the nerve cells that control them. 11
Even though it may be likely that muscle twitching is due to your MS, if you've been diagnosed, there's also a possibility that you could be dealing with a secondary issue that's causing this symptom.
Treating the underlying cause of muscle twitches is the primary concern, and it may stop the twitching. What that entails, of course, depends on what condition is at the root of the symptom.
Generally, speaking, medications that may be used to specifically address spasticity and clonus include: 12
It's always disconcerting to develop a new or unexplained symptom. If you experience frequent or troublesome muscle twitches, especially if you are living with MS , be sure to see your healthcare provider.
There may be a simple explanation and relatively easy intervention to control this symptom. If no cause can be identified, at least you'll have the reassurance of knowing it's not something you need to worry about.
An MS muscle spasm might feel like a tight muscle or a painful contraction of the muscle. It could make it difficult to bend or straighten your leg, for example. 13
Fasciculations, or muscle twitches, happen where the tips of the nerves, called axons, meet your muscles. A nerve fires an electrical impulse and triggers the release of a chemical between the axon and muscle, causing the muscle to contract. When this happens involuntarily, it could be caused by caffeine or stress or, in rare cases, a medical condition like ALS. 14
If you are starting to notice muscle twitches, you can try the following tips to stop them: 15
If your muscle twitching is constant or has been recurring for a few months, or you have additional symptoms, check with your healthcare provider for an evaluation. 14
National Multiple Sclerosis Society. MS symptoms .
American Association of Neurological Surgeons. Spasticity .
Boyraz I, Uysal H, Koc B, Sarman H. Clonus: definition, mechanism, treatment . Med Glas (Zenica) . 2015;12(1):19-26.
Shawcross DL, Wendon JA. The neurological manifestations of acute liver failure . Neurochem Int . 2012;60(7):662-71. doi:10.1016/j.neuint.2011.10.006
Shulman C, Annetta V. Images in clinical medicine. Clonus after a stroke . N Engl J Med . 2013;368(2):e2. doi:10.1056/NEJMicm1203111
Muscular Dystrophy Association. Amyotrophic lateral sclerosis (ALS) .
Orsini M, Sztajnbok FR, Oliveira AB, et al. Benign fasciculations and corticosteroid use: possible association? An update . Neurol Int . 2011;3(2):e11. doi:10.4081/ni.2011.e11
Miller KC, Stone MS, Huxel KC, Edwards JE. Exercise-associated muscle cramps: causes, treatment, and prevention . Sports Health . 2010;2(4):279–283. doi:10.1177/1941738109357299
National Center for Advancing Translational Sciences. Cramp-fasciculation syndrome .
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Chang E, Ghosh N, Yanni D, Lee S, Alexandru D, Mozaffar T. A review of spasticity treatments: pharmacological and interventional approaches . Crit Rev Phys Rehabil Med . 2013;25(1-2):11–22. doi:10.1615/CritRevPhysRehabilMed.2013007945
National Multiple Sclerosis Society. Spasticity .
TeensHealth. What causes muscle twitches ? The Nemours Foundation.
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By Julie Stachowiak, PhD
Julie Stachowiak, PhD, is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award, Health Category.
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Medically Reviewed by Gabriela Pichardo, MD on May 11, 2022
Myoclonus is sudden muscle spasms that you can’t control. They can be normal -- a hiccup or a "sleep start" when you’re falling asleep, for example -- or they may be a sign of a serious health condition such as multiple sclerosis , dementia, or Parkinson's disease.
Myoclonus might include sudden jerking, quivering, or twitching . You can have one episode or many in a row. And they can last up to a few minutes.
Myoclonus happens because your nervous system isn't working the way it should. Something makes your nerve cells misfire and send the wrong signal to your muscles.
Doctors think several parts of your brain may be involved. But they aren't sure what causes this glitch in your nervous system. Sometimes, there’s no cause.
If you have multiple sclerosis (MS), it could result from lesions, or injuries, on your brain or spinal cord.
Other nervous system conditions that can cause myoclonus include:
Sometimes, the cause is a medical condition, such as:
Your doctor will do an exam and note which parts of your body have spasms. They may recommend tests such as:
They may also check your blood for signs of other causes.
If another health condition is causing the spasms, your doctor will treat it.
Myoclonus itself can be hard to treat. Depending on your case, you may need to take several medicines at the same time. They act on different parts of your brain.
If you don’t have an underlying condition, myoclonus probably won’t be a problem in your daily life. More severe cases can cause trouble with movement, such as eating, talking, or walking. Your doctor will work with you to ease the spasms.
There’s no way to prevent myoclonus. But medical specialists might help you avoid injury from severe spasms.
Your doctor may recommend that you see a neuropsychiatrist. They can help you spot triggers and learn to manage movement problems.
Working with a physical therapist can improve your balance, strength, and coordination.
Mayo Clinic: “Myoclonus: Diagnosis & treatment,” “Myoclonus: Symptoms & causes.”
Cleveland Clinic: “Deep Brain Stimulation: Overview.”
National Institute of Neurological Disorders and Stroke: "Myoclonus Fact Sheet."
Baylor College of Medicine: "Myoclonus."
American Sleep Association: "Sleep Myoclonus."
Neurotherapeutics : "Treatment of Myoclonus."
UpToDate: "Treatment of myoclonus."
BMC Neurology : "Spinal segmental myoclonus in multiple sclerosis."
Therapeutic Advances in Neurological Disorders : "Myoclonic disorders: a practical approach for diagnosis and treatment."
National Organization for Rare Disorders: "General Myoclonus."
Journal of Neurology, Neurosurgery & Psychiatry : "Propriospinal myoclonus in multiple sclerosis."
Cleveland Clinic: "Deep Brain Stimulation: Overview."
Multiple Sclerosis Discovery Forum: "Deep Brain Stimulation Helpful in Some Patients with MS Tremor."
Merck Manual Consumer Version: “Myoclonus.”
Ohio State University Wexner Medical Center: “Myoclonus.”
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I have a couple questions.
I have had muscle twitches for nearly a year now. It was my presenting symptom. It started out as the full body jerk you get when you fall asleep, except that it progressed to happening every night and I was wide awake.
Those stayed and then I started having the twitches (little muscle twitches like you eyes twitch) but it was primarily ocurring on the left side of my body - my bicep, my quad, my calf, the bottom of my foot. Those progressed and at my worst they were all over my body... I felt them EVERYWHERE... yes, even in very private areas. They still primarily ocurr on the left side of my body but I'll sometimes get them on the right as well.
The part that is concerning to this is they haven't gone away - they get better for a bit, then get worse when I'm not feeling well or near my cycle.
I also get what I would refer to as random tics. It's not a tic more like a muscle jerk. I can feel the sensation of energy starting and then my arm or left will move. It is almost always my right arm and my left leg - sometimes my right foot.
I am also really concerned about a couple new symptoms:
My muscles ache lately (a deep ache that seems to radiate but doesn't specifically start or end anywhere) these are usually in my bicep or leg and sometimes my forarm. I will rub it but it keeps coming back. Is that spasticity?
The most worrisome is a sensation that my fingers and hands feel tight (I am stretching them several times a day.) I am really concerned about the sensation that a few of my fingers feel like they are trying to lock up, cramping (?), or become super stiff they don't want to move normal. It's worse in my left hand where I have left arm/hand tremors.
I am normally extremely flexible - one of the people that the doctor's are shocked at my flexibility (I can bend my thumb all the way to my wrist - so this is not normal for me. I'm a bit worried this isn't an MS thing. I also can bend over and touch my toes without working at stretching.) Does anyone have any idea what this could be?
Has anyone else had these?
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I have had weird foot symptoms for many years. I thought it was restless leg because it subsides when I move around. But when I walked a distance, then my feet would become numb. I have been diagnosed with a slight case of sleep apnea and very little deep sleep, so I consented to a CPAP machine. I left my management position because the symptoms in my feet were worsening. When on vacation with my family one year, We did so much walking that my feet were completely numb and I fell. Despite constant stretching, the symptoms would return. Finally went to see a neurologist who ruled out many diagnoses and treated me for restless leg. On Requip for a year, but every 6 months my symptoms worsened to sharp stabbing pain and more jerking, and waking up more often at night. When I finally hit 1mg of Requip, my heart rate was increased, my skin was red, my blood pressure was elevated, and I had pitting edema, as well as numbness everywhere. I had another EMG which showed neuropathy this time. So switched to other meds, that did not work. Amitriptyline worked for awhile, but when uping the dose, I became a zombie. Tried Neurontin, Tegratol, Lyrica, no on Cymbalta. Cymbalta seems to quiet the sharp stabbing pains in my feet, but every now and then my feet or hands jerk. Having fast heart rate again with reddened skin, ear pain, joint pain, muscle soreness. MS has been ruled out. I did switch to a Paleo diet which seemed to work, but now that the cold weather is setting in, things are worse. Ultram and Tizanedine seem to help, but neurologist says those are not meds to take all the time. Now trying Peppermint oil on my feet, which I think works sometimes. Any other suggestions? I have looked into environmental issues that can cause this neuropathy and have concerns now about our wall to wall vinyl flooring and our chlorinated swimming pool. Any suggestions?
Are you still having this and if so, what medicine did the doctor give you?
I am having the same that you described and it is unbearable.
My jerking only happens at night or when I lay down to sleep. It feels like a build up of pressure and the only release for that pr
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