Does Alcohol Withdrawal Cause Muscle Twitching and Spasms?

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.