The Causes, Prevention, and Reversal of Muscle Atrophy

Loss of muscle bulk and strength is called atrophy. In some ways, atrophy is the opposite of building up muscles. Good nutrition combined with physical exercise can condition muscles, allowing them to grow, bulk up and become stronger. In contrast, atrophy may result from frailty and physical inactivity of muscles.

Man having physical therapy
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Causes

There are several causes of muscle atrophy.

  • Malnutrition: Severe malnutrition and lack of nutrients and protein can contribute to muscle atrophy because nutrients and proteins are necessary for normal muscle development and function. This lack of adequate nutrition can occur as a result of serious illnesses and may also be associated with strong medications, such as certain cancer drugs.
  • Neurological disease: If you have a neurological condition, such as neuropathy, cerebral palsy, stroke, or spinal cord disease, you may have muscle weakness of the face, arms, or legs. When you don't use your muscles, the lack of stimulation and exercise may cause them to become thinner. This thinning may also cause your muscles to lose strength above and beyond that which is caused by the neurological problem.
  • Prolonged illness/hospitalization: If you have been sick due to a long bout of infection, cancer, or another illness requiring a long stay in the intensive care unit, your decreased mobility and lack of nutrition can contribute to muscle atrophy.
  • Swallowing problems: Swallowing difficulties and tiredness interfere with eating. Even with the best attempts at providing nourishment in the hospital, people who have trouble swallowing tend to lose weight.

Prevention

If you or your loved one has a neurological condition that causes physical weakness, there are ways to prevent atrophy before it happens.

  • Staying active: Most people who are recovering from a severe infection, cancer, or a stroke are not enthusiastic about becoming physically active. Similarly, if you are living with a chronic neurological condition such as multiple sclerosis or Parkinson's disease, you may not be in the mood to be active. However, this lack of physical activity is known to contribute to atrophy, worsening your overall physical capabilities.
  • Physical therapy: Participating in physical therapy and rehabilitation when you have a neurological condition is particularly valuable. Physical therapy ensures that you participate in scheduled and well-planned activities to help you recover and regain strength.
  • Passive movement: One of the ways to get physical activity started before you are ready to actively participate in therapy includes passive movement. With this method, your therapist will move your arms and legs gently. This is often done in the hospital or at a facility for stroke survivors who are not able to start moving on their own.
  • Nutrition: Slowly resuming nutrition and physical activity can help prevent atrophy, allowing muscles to regain their size and shape.

In addition to preventing atrophy, these activities can help you in several other ways. They help prevent bedsores that result from prolonged pressure on one part of the body. They can reduce the chances of developing blood clots in the arms or legs due to lack of movement (although passive movement has been somewhat controversial as a method to prevent blood clots). And they may minimize some of the nerve damage and muscle stiffness that usually occur after long periods of inactivity.

Reversing Atrophy

Physiologic atrophy is a condition that can be reversed. Atrophy is a physical process that occurs gradually. The rebuilding of muscles takes time, as well.

The most effective methods for reversing atrophy are the same as those used to prevent atrophy—staying active, physical therapy, passive movements, and maintaining adequate nutrition.

Once you feel ready to become active again, the muscle weakness of atrophy combined with the weakness of your illness can be a challenging hurdle. Keeping your expectations reasonable and planning on making gradual improvement can help keep you from getting discouraged. Rehabilitation is an important part of recovery, and you should be sure to take advantage of the resources available to you.

A Word From Verywell

Many people living with neurological illness become depressed when they observe their own skinny bodies that appear weak and malnourished. Families often become very concerned about the appearance of a loved one’s thin muscles. But it is important to remember that physiologic atrophy can be reversed.

It may be hard to stay motivated when it comes to preventing or reversing muscle atrophy. Mild or moderate activities, such as walking a few steps with assistance or even bathing, may seem exhausting, but these activities are an important part of regaining strength and rebuilding muscle.

Frequently Asked Questions

  • Is muscle wasting the same as muscle atrophy?

    Yes. Muscle atrophy and muscle wasting are two different terms used to describe a loss of muscle mass and a shortening of muscle fibers. Muscle wasting or atrophy is a slow process that can occur from prolonged illness, malnutrition, or neurological disease. 

  • Can muscle atrophy be reversed?

    In most cases, yes, muscle atrophy can be reversed with proper nutrition and exercise. Atrophy related to neurological diseases, such as a stroke, will require physical therapy to rebuild muscles.

  • How long does it take to reverse muscle atrophy?

    It can take a while to reverse muscle atrophy. Muscle wasting is a slow process and it can take just as long—or even longer—to regain lost muscle. How long it takes to will depend on the amount of atrophy that occurred and your physical condition beforehand.

    It will take at least two weeks of physical therapy before you start to feel a difference in your muscles. It can take several months of physical therapy for muscle size and strength to be fully restored.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Doyle L, Mackay-Lyons M. Utilization of aerobic exercise in adult neurological rehabilitation by physical therapists in Canada. J Neurol Phys Ther. 2013;37(1):20-6. doi:10.1097/NPT.0b013e318282975c

  4. Hosseini ZS, Peyrovi H, Gohari M. The effect of early passive range of motion exercise on motor function of people with stroke: A randomized controlled trialJ Caring Sci. 2019;8(1):39–44. doi:10.15171/jcs.2019.006

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Additional Reading
Heidi Moawad, MD

By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.