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Does Alcohol Withdrawal Cause Muscle Twitching and Spasms?

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Muscle twitching and muscle spasms are two forms of involuntary contraction. Whereas twitching is a short-lived, jerky movement, spasm is a more intense, sustained muscle tightening that causes pain. Twitching and spasms can be the result of inappropriate nerve activity in the central nervous system (CNS) or factors like dehydration, fatigue, intense exercise, stress, and electrolyte imbalances.

Drinking places stress on the neuromuscular system, leading to loss of muscle mass and appropriate functioning. Additionally, chronic alcoholic myopathy (muscle dysfunction) affects approximately 0.5% to 2% of people with alcohol use disorder (AUD), making it the most common clinical sign of AUD. Understanding the impact of drinking on your system is crucial to appreciate the health benefits of recovery.

If you are experiencing muscle spasms due to substance use or withdrawal, it is important to seek medical attention for sudden, severe, or new symptoms. A trusted healthcare provider should always address ongoing physical effects of withdrawal.

Treatment for alcohol use disorder is available to assist you on the path to total wellness. Guardian Recovery offers programs such as alcohol detox and nutrition therapy to treat the emotional and physical components of alcohol use.

Our treatment advisors are available 24/7 to answer any questions you have about our program model and specific therapies. Reach out today to discover how we can work with you on your journey to sobriety.

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Why Does Alcohol Withdrawal Cause Muscle Spasms?

Alcohol causes muscle twitching and spams by interfering with the chemical messages your brain sends to your skeletal muscle, in addition to promoting dehydration and electrolyte imbalances responsible for involuntary muscle movement.

How Alcohol Affects the Brain

The effects of drinking on the brain are well-established. The CNS, consisting of the brain and spinal cord, is altered in numerous ways by intoxication. Alcohol acts as a CNS depressant, reducing brain activity that leads to loss of muscle coordination, slow breathing, decreased blood pressure and heart rate, sleepiness, delayed reaction time, and feelings of happiness and relaxation. However, these effects are short-lived unless you consume additional alcohol.

Once your body has fully broken down the alcohol in your system, the depressant effects wear off and give way to the excitatory brain activity responsible for muscle spasms and twitching. If your alcohol use is chronic, these effects are more common and intense. Not only does alcohol withdrawal reverse physical relaxation, it also produces symptoms that can be physically distressing and uncomfortable.

Brain chemicals, called neurotransmitters, are responsible for muscle movement, mood, energy levels, sleep, stress, and pain. Several of these neurotransmitters are implicated in alcohol use and muscle dysfunction.

The Neurotransmitters Impacted by Alcohol Use Include:

  • Gamma-aminobutyric acid (GABA) – the primary inhibitory or “downer” chemical.
  • Glutamate – an excitatory or “upper” chemical.
  • Serotonin – promotes muscle contraction.
  • Dopamine – responsible for healthy muscle tone and coordinated functioning.
  • Norepinephrine – increases the force of skeletal muscle contraction.

Alcohol increases the activity of GABA and decreases the activity of glutamate, causing sedation and muscle relaxation. It also promotes greater utilization of serotonin, dopamine, and norepinephrine. During alcohol withdrawal, the inhibitory effects of GABA are reversed. Excessive excitatory messages are sent to muscle tissue, triggering spasms and twitching.

Tremors vs. Seizure From Alcohol Withdrawal

Muscle tremors are sustained misfirings of the CNS affecting one or more isolated muscle groups, such as those in the hands, arms, legs, head, and trunk. They are involuntary and usually occur when the muscle is at rest. Likewise, they can be temporarily stopped by flexing the muscle.

Common Symptoms of Tremor Include:

  • Difficulty with movement, such as writing or walking.
  • Trouble holding objects or controlling fine muscle movements.
  • Shaky voice.
  • Rapid, rhythmic, uncontrollable movements in the head, trunk, or extremities.

In alcohol withdrawal, hyperexcitability of the nervous system initiates these jerky muscle movements. Also referred to as “the shakes,” tremors are not dangerous alone but indicate clinically significant withdrawal that may be fatal if not addressed.

Seizures, on the other hand, are potentially life-threatening bouts of abnormal electrical activity in the brain. These disturbances can cause all-over involuntary muscle movement, behavioral changes, and variations in level of consciousness. They cannot be stopped by flexing muscles or forcibly holding the extremities.

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Symptoms of Seizure Include:

  • Involuntary shaking.
  • Confusion.
  • Visual disturbances (aura).
  • Visual, auditory, and olfactory (smelling) hallucinations.
  • Sensation of deja vu.
  • Sweating.
  • Drooling.
  • Pale skin.
  • Emotional or behavioral changes (e.g., intense fear).

Withdrawal seizures usually begin 12 to 48 hours after the last drink. Typically seen in patients in their 40s and 50s, alcohol withdrawal seizures tend to be short-lived and limited in number, as opposed to epilepsy. They can be treated with benzodiazepines (e.g., Ativan or Valium) to activate GABA receptors and prevent intense excitatory CNS activity during the detox phase. Left untreated, alcohol-related seizures can advance to delirium tremens, a dangerous condition with cardiovascular and neurological instability.

Tremor Due to Brain Damage From Alcohol Use

Alcohol’s influence on neurotransmitters ultimately alters how the brain functions. The brain recovers from these changes quickly for social drinkers with limited alcohol use. Chronic alcohol misuse, however, can lead to permanent damage and altered brain activity.

Studies indicate alcohol misuse can trigger the destruction of multiple brain regions and prevent new brain cell growth. This neurodegeneration impacts the cerebellum, the part of the brain responsible for some movement, balance, and coordination, resulting in an often irreversible tremor. Additionally, prolonged drinking can trigger inflammation that weakens the muscles’ ability to repair damage and grow.

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Muscle twitching and spasms can be bothersome and concerning. Long-term neuromuscular abnormalities interfere with multiple aspects of daily life. While muscle spasms have numerous causes apart from alcohol, perhaps none is more preventable than drinking. Although moderate to severe drinking may lead to changes in muscle activity, some effects are reversible with alcohol cessation.

Guardian Recovery knows that alcohol use affects everyone differently, so your treatment must be tailored to your specific health needs. Our individualized approach allows us to focus on your entire health history and create a plan to help you meet your wellness goals.

Our admission process is simple: Once you reach out, we will provide a free, no-obligation health insurance benefit check and complimentary assessment. The entire process takes just 15 minutes at one of our local facilities. Contact us today for more information about how we can help you heal.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://my.clevelandclinic.org/health/symptoms/15301-myoclonus-muscle-twitch
  2. https://my.clevelandclinic.org/health/diseases/15466-muscle-spasms
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513686/
  4. https://opentext.wsu.edu/biopsychological-effects-alcohol-drugs/chapter/chapter-11-alcohol/
  5. https://jnnp.bmj.com/content/jnnp/75/suppl_3/iii16.full.pdf
  6. https://www.ncbi.nlm.nih.gov/books/NBK551683/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065474/
  8. https://medlineplus.gov/ency/article/000755.htm
  9. https://www.britannica.com/science/norepinephrine
  10. https://news.usc.edu/171679/receptor-protein-gabab-calms-brain-activity-usc-research/#:~:text=When%20GABA%20is%20unable%20to,in%20extreme%20cases%2C%20even%20epilepsy.
  11. https://medlineplus.gov/tremor.html
  12. https://medlineplus.gov/ency/article/003200.htm
  13. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711#:~:text=Overview,generally%20considered%20to%20be%20epilepsy.
  14. https://my.clevelandclinic.org/health/diseases/22789-seizure#symptoms-and-causes
  15. https://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes#H7
  16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860462/
  17. https://www.ninds.nih.gov/tremor-fact-sheet

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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