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Everyone feels tired after a hard workout. True muscle weakness is different: your muscles cannot produce the force you expect, so climbing stairs, lifting a bag or opening a jar becomes difficult. It can build slowly with age or inactivity, or appear suddenly as a sign of something that needs urgent attention. Knowing which is which helps you act at the right time.
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Weakness, fatigue or both?
Muscle weakness is a measurable loss of strength. Fatigue is a feeling of tiredness where strength may be normal at first but runs out quickly. Many people have both. Describing exactly what you notice, such as which muscles, how quickly it started and what makes it better or worse, helps your doctor find the cause.
Common causes
- Lack of use: muscles lose strength within weeks of bed rest, injury or a sedentary routine
- Ageing (sarcopenia): gradual loss of muscle mass and strength, accelerating after 60
- Nutritional problems: low protein intake, vitamin D, B12 or potassium deficiency, and dehydration. Vitamin D deficiency is common in the Gulf despite the sunshine
- Bone, joint and spine conditions: a pinched nerve from a disc problem, spinal stenosis, arthritis and tendon injuries
- Nerve conditions: peripheral neuropathy, stroke, multiple sclerosis and Parkinson’s disease
- Muscle diseases: inflammation of the muscle (myositis) and inherited conditions
- Hormonal and metabolic conditions: thyroid disease and diabetes
- Medicines: such as cholesterol-lowering statins and long-term steroids
- Illness and infection: flu, anaemia and long-term illness
- Mental health factors: anxiety, depression and chronic fatigue
Warning signs that need urgent care
Go to a casualty department or call 999 if muscle weakness:
- Comes on suddenly, especially on one side, with drooping face, slurred speech or confusion (possible stroke)
- Spreads quickly upward from the legs or comes with difficulty breathing or swallowing
- Occurs with severe back pain and loss of bladder or bowel control
- Follows a head or spine injury
- Comes with dark urine and severe muscle pain after intense exercise
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When to book an appointment
See a doctor if weakness lasts more than a few days without a clear reason, is getting worse, affects only one limb, comes with numbness, tingling, twitching, cramps or muscle wasting, or limits daily activities. Weakness that begins after starting a new medicine should also be reviewed.
How doctors find the cause
Assessment starts with a detailed history and an examination of strength, reflexes, sensation, balance and walking. Depending on findings, tests may include blood tests for thyroid, vitamin levels, electrolytes, blood sugar and muscle enzymes, nerve conduction studies and EMG to check nerves and muscles, and imaging of the spine or joints. Our Neurology department offers nerve conduction studies (NCS), electromyography (EMG) and EEG, with evaluation, diagnosis and treatment of neurological disorders.
Treatment options
Treatment is aimed at the cause:
- Treating the underlying condition, such as correcting a vitamin deficiency, balancing thyroid hormones, adjusting a medicine or controlling diabetes
- Exercise and rehabilitation: targeted strengthening, flexibility and balance work
- Medication: for inflammation, nerve pain or specific neuromuscular conditions
- Procedures or surgery: when a structural problem such as a compressed nerve, torn tendon or damaged joint is the cause, with support from our Orthopedic team
- Nutrition support: adequate protein, vitamins and hydration
Building and protecting muscle strength
- Do resistance exercise two to three times a week
- Add walking, swimming or cycling for heart and muscle health
- Eat enough protein with each meal, and include vitamin D and calcium
- Stay hydrated, especially when exercising in warm weather
- Avoid long periods of inactivity, even during recovery
- Review long-term medicines with your doctor if you notice new weakness
