How to prevent rhabdomyolysis
Rhabdomyolysis is a very serious condition caused by the breakdown of your muscles due to damage. This breakdown releases a protein called myoglobin into your blood, which can lead to kidney damage. It can also increase potassium levels, which can cause heart problems.
Rhabdomyolysis can cause disability or even death if left untreated. But treatment options are available, and there are ways to prevent it from developing, like staying hydrated when you exercise.
Rhabdomyolysis is the medical term for the breakdown of damaged muscles in your body. Any damage or injury to your muscles can trigger rhabdomyolysis, but direct injury, such as through exercise or in the workplace, is among the most common.
According to the National Institutes of Health (NIH), there are two categories of causes: Physical or traumatic and nonphysical or nontraumatic.
Examples of physical causes include:
- injuries, especially crush injuries, due to car or workplace accidents, for example
- being still for a long time, like being in a coma or recovering from a surgery
- electric shock or being struck by lightning
- intense exercise, especially lifting heavy weights, being untrained, or working out in very hot conditions
Nonphysical causes include:
- drug use or misuse, including alcohol and cocaine, but also statins and corticosteroids
- infections like HIV, flu, toxic shock syndrome, and septic shock
- heat stroke
- rarely, genetic factors like inherited metabolic disorders or muscular dystrophy
This is not a complete list, and many more factors can trigger or cause rhabdomyolysis. According to the NIH, up to 10% of people might not have an easily determined cause.
The symptoms of rhabdomyolysis are often nonspecific, and a doctor might easily mistake them for other conditions. It’s important to tell your doctor about your personal health history, for example, whether you’ve had an injury recently or if you have a history of drug use.
The three most common symptoms to look out for are:
- muscle pain
- muscle weakness
- dark, tea-colored urine and infrequent urination
But according to the NIH, over half of people don’t have all three of these.
Other symptoms include:
- a general unwell feeling
- confusion and agitation
- nausea and vomiting
If you think you have rhabdomyolysis, seek medical attention immediately.
- bloody bowel movements
- pain in your torso
- easy bruising
- shaky hands
- nausea and vomiting
- slowed movements
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Preventing rhabdomyolysis is not always possible because of the nature of its causes. For example, accidents are unpredictable, so you can’t always avoid them. But there are some steps you can take to try to prevent some of its causes.
- Hydration: Staying hydrated and drinking plenty of water is essential in preventing some causes of rhabdomyolysis.
- Warm up before exercising: Warm-ups can reduce the risk of muscular injury and damage during exercise.
- Exercise safely: Make sure you don’t lift weights that are too heavy for you and stay adequately hydrated.
- Stay safe at work: If you work somewhere where you might be at risk of injury, like a construction site, carefully follow the health and safety protocols to avoid injury.
- Stay safe in the heat: Avoid spending too much time in the sun to prevent heat stroke, and drink plenty of water if you’re in the sun for an extended time.
The main treatment goal for rhabdomyolysis is to prevent further complications like acute kidney infection.
Doctors will likely give you fluids through your veins (intravenous fluids) to keep you hydrated. If the cause is physical, they might also give you a fluid called mannitol, which can increase the urine you produce and help avoid acute kidney infection.
If rhabdomyolysis affects your potassium levels, doctors might prescribe insulin, such as insulin aspart (Novolog) or insulin lispro (Humulin), alongside a sugar drip to balance your blood sugar levels. They might also prescribe albuterol.
If the potassium affects your heart’s electrical conductivity, doctors might prescribe calcium gluconate to stabilize it.
Sometimes, a doctor might prescribe a class of medications called diuretics. A common example is furosemide (Lasix).
If your condition does progress to acute kidney infection, you might need to receive dialysis, which is a procedure that filters your blood when your kidneys can’t.
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Rhabdomyolysis happens when your muscles are damaged physically due to an injury, infection, or a genetic condition. It can lead to serious complications and can be fatal. If you notice symptoms of rhabdomyolysis, you should seek medical attention immediately.
Rhabdomyolysis is often due to injury, so keeping yourself safe when exercising and in the workplace can help prevent rhabdomyolysis and its complications. Staying hydrated is also essential to keep rhabdomyolysis at bay.
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- Kim J, et al. (2016). Exercise-induced rhabdomyolysis mechanisms and prevention: A literature review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6188610/
- Lugo-Fagundo E, et al. (2022). CT of rhabdomyolysis as a sequela of drug abuse. https://www.sciencedirect.com/science/article/pii/S1930043322008093
- Safitri N, et al. (2022). A narrative review of statin-induced rhabdomyolysis: Molecular mechanism, risk factors, and management. https://www.tandfonline.com/doi/full/10.2147/DHPS.S333738
- Scalco RS, et al. (2015). Rhabdomyolysis: A genetic perspective. https://ojrd.biomedcentral.com/articles/10.1186/s13023-015-0264-3
- Stanley M, et al. (2023). Rhabdomyolysis. https://www.ncbi.nlm.nih.gov/books/NBK448168/
- Yoshizawa T, et al. (2016). Heat stroke with bimodal rhabdomyolysis: A case report and review of the literature. https://link.springer.com/article/10.1186/s40560-016-0193-9