Muscle twitches can be very annoying. They can occur, for example, as a nervy leg keeping you awake at night, an irritating tic in the eye, or as a cramp in a muscle. A muscle twitch can have many causes some of which include: stress, physical exertion, caffeine over-load, dehydration and hormonal disturbances. But they may also be associated with more serious health concerns. 

Muscle twitching, medically referred to as muscle fasciculation, is an involuntary firing of a single motor neuron and all of its innervated muscle fibres. This small, spontaneous muscle contraction and relaxation of fine muscles can occur anywhere in the body. Many of these actions go unnoticed and are generally not large enough to register a jerk action. Muscle twitches differ from muscle cramps mainly because they are noticed and felt but are rarely painful.

Causes of muscle twitches

For most people, muscle fasciculations are a benign phenomenon which are usually triggered by some prior  occurrence. This could include:

Psychological stress. This can result in nervous twitches affecting any muscle in the body.

Physical exertion. Muscle twitches and cramps can be due to an accumulation of lactic acid after physical activity, fatigued muscles or as a result of electrolyte imbalances (from heavy perspiration for example).

Caffeine. Too much caffeine, especially in the form of energy drinks, can stimulates the nervous system and cause involuntary tension of muscle fibres. 
Caffeine can also change the amount of energy at the muscle site – causing the muscle to twitch.

Dehydration can cause an imbalance of salts in the body which affect normal muscle and nerve function. Dehydration can result in muscle twitching, amongst many other things.

Sleep deficits. During sleep the body has a chance to recharge and balance. When the sleep cycle is incomplete, the ratio of neurotransmitters in the brain can affect the excitability of muscle.

Hormones. Oestrogen has a major effect on musculoskeletal function and any changes in hormonal balance can cause alterations in the excitability of muscle fibres. Other areas influenced by the hormonal system which affect the excitability of muscles and nerves include imbalances of thyroid hormones and cortisol.

Medication. Many pharmaceutical medicines have side-effects which cause muscle twitches. Check with your doctor if you are on medication and experiencing muscle twitches. 

Toxic exposure. This can include chemical substances such as lead and mercury.

Trauma or pressure on the nerves. Carpel tunnel syndrome for example.

Peripheral neuropathy. Symptoms are described as stabbing, burning, tingling or stinging, along with numbness, weakness and pain. Peripheral neuropathy is a result of damage to the peripheral nerves of the body (not the spinal cord or brain). The peripheral nerves are responsible for sending messages from the brain and spinal cord to the rest of the body and also sensory information to the central nervous system. Damage to nerves can occur for many reasons some of which include: diabetes, metabolic disorders, autoimmune disorders, trauma, infection, tumor or inherited disorders.
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Alcoholism. Alcohol can deplete the body of many vitamin.

Nutritional deficiencies. Micro and macro nutrients are important for nerve and muscle functions. Some nutrient which are important in this role in nerve include:

• Vitamin B - the B group vitamins especially B1, B3, B6 and B12; and vitamin E are vital for the health of nerves
• Vitamin D - deficiency is associated with muscle pain (growing pain in children especially) and hypersensitivity of muscles. Vitamin D is needed for calcium absorption
• Calcium - deficiency symptoms include muscle spasms and cramps
• Magnesium - known as the muscle relaxer

When the condition is not benign

Other reasons muscle fasciculation occurs include:

Neuropathies. Damage to the nervous system such as:

• Motor neuron disease (MSD). These are a group of muscle disorders diseases commonly associated with progressive loss of motor neurons at various sites of the brain stem nuclei, the anterior horn of the spinal cord and cerebral cortex.

Systemic disease such as hyperthyroidism and diabetes.

What can help reduce muscle twitching

Lactic acid, or lactate, is a chemical by-product of anaerobic respiration — the process by which cells produce energy without oxygen.

Anaerobic respiration is a fast energy source used by muscles in intense exercise. Lactic acid is harmless and although it increases in intense exercise, it will return to normal naturally. There are some suggestions to help reduce lactic acid accumulation:

Don’t over-do it when exercising or performing physical activity

Hydrated well throughout exercise and activity (before, during and after)

Electrolyte formula can help if exercising in hot weather or for extended periods 

Warm-up, stretch regularly and warm-down

Rest between activities

Breathe deeply

Magnesium – supplement and topically applied (also works well applied to muscle spasms)

The importance of magnesium

Magnesium is primarily involved in ATP metabolism, the contraction and relaxation of muscles, the correct neurological functioning, and neurotransmitter release. When muscle contracts, calcium re-uptake by the calcium-activated ATPase of the sarcoplasmic reticulum is brought about by magnesium. Put simply, magnesium relaxes muscles and nerve function.

Sleep. Poor sleep quality can affect many systems of the body. Support quality sleep by supplementing with magnesium, valerian, ziziphus, lemon balm, passionflower or chamomile.

Stress response – support how the body response to stress by supplementing with Vitamin B group complex, magnesium and herbs such as withania, ginsengs and passionflower.

Hormonal system. The hormonal system makes many changes in the body through a life-time and at various times such as in adolescence, pregnancy, menopause and when under stress, the equilibrium of hormones may need some help adjusting. Check with your naturopath for help with balancing the hormonal system.

Eat well and hydrate

Reduce caffeine intake

Stay well hydrated

In summary

Muscle twitches are involuntary contractions of small groups of muscles. They commonly occur in muscles of the face, legs and upper arms. Muscles normally contract when told to by nerve impulses from the brain. Lifestyle and disease can cause create imbalances in nerve conductivity (brain, spinal and nerves) and signal reception (in muscles) resulting in muscle twitches. Stress, lack of sleep, too much caffeine, poor nutrition, dehydration, hormonal disfunction, medications and neurological disorders are causes of muscle twitches.

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References

https://www.sciencedirect.com/topics/neuroscience/fasciculation

Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4192433/

https://wexnermedical.osu.edu/blog/muscle-twitching

Vitamin D deficiency promotes skeletal muscle hypersensitivity and sensory hyperinnervation https://pubmed.ncbi.nlm.nih.gov/21957236/

Are Growing Pains Related to Vitamin D Deficiency? Efficacy of Vitamin D Therapy for Resolution of Symptoms https://pubmed.ncbi.nlm.nih.gov/26022378/

https://www.sciencedirect.com/topics/neuroscience/motor-neurone-disease

Lower Motor Neuron Lesions https://www.sciencedirect.com/science/article/pii/B9780123851574011593

https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061

https://www.livescience.com/muscle-cramps.html

The effect of magnesium supplementation on lactate levels of sportsmen and sedanter https://pubmed.ncbi.nlm.nih.gov/17063625/

Electrolytes https://pubmed.ncbi.nlm.nih.gov/31082167/

Effect of Estrogen on Musculoskeletal Performance and Injury Risk https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6341375/