Why do my muscles twitch?

man twitching eye
Have you ever been in a stressful situation and then noticed that your eyelid is twitching uncontrollably? Or your arm or leg muscles suddenly twitch, just as you’re falling asleep?
If so, you may be wondering what causes this and how to treat/prevent it.
Muscle twitching happens when of small groups of muscles contract involuntarily. The most common muscles that twitch are face, forearms, upper arms and legs.
Normally, nerve impulses get from the brain and reach the muscles to tell the muscles when to contract or move, which helps us perform body movements.
A certain amount of nerve impulse is needed at a baseline level to keep muscles healthy. Certain daily life situations, as well as diseases, can create imbalance in signal transmission (brain, spine and nerves) or signal reception (muscles), which then causes muscle twitching.
What causes muscle twitching?
Stress – Anxiety and stress can cause twitching by releasing neurotransmitters from the nerves supplying the muscles. Also, anxiety can make you hyperventilate, or breathe faster, which changes the ions concentration and pH in your body, and predisposes you to muscle twitching.
Lack of sleep – Sleep helps us recharge our bodies. Inadequate amounts of sleep can change hormonal balance and can alter the underlying excitability of muscles, making muscles more likely to twitch. Incomplete sleep cycles can also alter the storage ratio of neurotransmitters in the brain, which can also change the excitability of muscles.
Too much caffeine – Caffeine interacts with a molecule called ADP, which is essentially the currency for all energy transfer in our bodies at the cellular level. By changing the concentrations of ADP and ATP, excess caffeine can change the amount of energy at the muscle and cause muscle twitching. Think of this as “excess charge in a battery or spark plug” that causes abnormal firing of nerves and muscles.
Dehydration – Drinking healthy amounts of water allows the muscles to maintain the correct amount of salt in our body, which maintains normal muscle and nerve function. Losing excessive amounts of water can cause muscle twitching.
Poor nutrition – Certain elements and vitamins called “micronutrients” are required in our diet in small quantities to maintain the normal functioning of muscles and nerves. Think of these as “tiny keys” that can open “doors” at the cellular level so material can be moved from one compartment to another. Thus, small quantities of these elements can cause major changes. Imbalances in these micronutrients – either reduced levels or high levels – can cause muscle twitching.
Hormonal – Hormonal imbalances, such as thyroid or cortisol, can also cause muscle twitching by altering excitability of nerves and muscles.
Medications – Medications can alter the ions in our body (pH) and lead to muscle twitching. Never take medications prescribed for others. Always consult your primary care physician if you develop muscle twitching after starting a new medication.
Neurological disorders – Certain diseases of the muscles or nerves, brain and spine can cause muscle twitching. Depending on the location, relationship to activity and pattern of muscle twitching, they can be a signature for particular conditions or disorders.
How can you stop muscle twitching? 

Eat healthy. Eating a good combination of fresh fruits, vegetables, greens and nuts can help your body replenish and maintain the correct amount of salts and micronutrients to prevent muscle twitching. 

Get enough sleep. Adults should aim for at least seven to eight hours of sleep to recharge your body and your systems. 

Avoid energy drinks. These tend to contain extraordinary amounts of caffeine. It’s always a good idea to check the contents of any food or drink. Look at the active ingredients, calories, fat content and expiration dates to maintain a healthy lifestyle.

Drink plenty of water. Try to keep track of how much you’re consuming and adjust water intake when you’re doing physical activity and during warm weather when we tend to sweat and lose more water.

Exercise daily. A moderate amount of daily exercise is required to maintain the correct tone in muscles, which prevents muscle twitching. Try to exercise 30 to 45 minutes per day. 

Talk to your doctor. If you’re taking multiple medications and then develop muscle twitching, let your doctor know.

How are muscle twitches different than muscle cramps?
Muscle twitches can be noticed, observed or felt, but are rarely painful. Muscle cramps tend to be painful.
Muscle cramps occur when large muscle groups undergo involuntary contractions. They can sometime happen if muscles twitches aren’t remedied by the measures mentioned above. In other conditions, muscle cramps maybe a signature of specific conditions.
When should you see your doctor about muscle twitching?
In some cases, you should see your doctor for muscle twitching, especially if they: 
  • Happen at rest
  • Don’t get better with diet, hydration
  • Continue or sustain for a long time
  • Happen in multiple body parts
  • Happen after you start a new medication
  • Happen when you’ve been diagnosed with a new medical condition
  • Are associated with fever, nausea, vomiting, weakness, headaches
Talk to your doctor about these concerns and ask for advice on what kind of lifestyle changes, medications or exercises could benefit your overall health and particular conditions you may have. 
Kiran Rajneesh is director of the Neurological Pain Division in the Department of Neurology at The Ohio State University Wexner Medical Center. He is also part of the Comprehensive Spine and Pain Centers, Neurological Institute at The Ohio State University.

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