Are you someone who exercises a lot and runs a lot? Or is it normal to have sore muscles the next day after a hard workout? We call it 'muscle soreness'. But sometimes this muscle pain is not normal, and can be a symptom of a much more serious condition. Today we are talking about such a serious condition, but one that we all need to be aware of. That is Rhabdomyolysis, which we call 'Rhabdo' for short.
Simply put, what is Rhabdomyolysis?
This is a bit of a scientific name, but it's very simple to understand. Imagine that your muscles are made up of a bunch of tiny fibers. In rhabdomyolysis, these muscles are severely damaged and the fibers break down. When they break down, the substances inside those fibers, especially the protein called 'myoglobin', are released directly into the blood. Now here's the problem. The substances that are released into the blood in this way are very toxic to our bodies. These toxins travel through the blood and go to our kidneys. The job of the kidneys is to clean the blood. But when a large amount of toxins comes in all at once, the kidneys can't handle it. It's like when you put a big pile of garbage in the kitchen sink, it gets clogged. This can lead
to kidney failure . That means they can't remove waste. This is a very dangerous situation. If not treated quickly, it can even be life-threatening.
What are the causes of rhabdomyolysis?
There is not one reason for this situation, there could be many reasons. Let's divide them into two main categories.
1. Traumatic Causes - Damage caused by external factors to the body 2. Non-Traumatic Causes
| Reason type | Examples and descriptions |
|---|
| Crush Injury | Severe muscle strain from a car accident, fall from a height, or collapse of a building. |
| Prolonged Compression | Staying in the same position for a long time after a fall, unable to get up, or lying unconscious on a hard surface, such as the floor, for a long time. |
| Other serious injuries | Electric shock, lightning strike, third-degree burn, snake or venomous insect bite. |
| Extreme Muscle Strain | Especially if someone who is not used to doing high-intensity interval training (CrossFit) suddenly does it. This can happen even to athletes who exercise well. If the body has more muscle mass, the damage can be greater. |
| Drugs and alcohol | Drug use such as heroin and cocaine, and excessive alcohol consumption. |
| Certain medications | When taking high doses of certain cholesterol-lowering medications (statins) or certain medications for mental illness (antipsychotics). |
| High body temperature (Hyperthermia) | Sunburn (heat stroke) or high fever. People who work in the sun (farmers, construction workers) are at higher risk. |
| Other medical conditions | Seizures, complications related to diabetes (diabetic ketoacidosis), severe infections (flu, COVID-19, sepsis), and some genetic muscle diseases (myopathy). |
Doctors say that this condition has become more common recently due to extreme exercise trends , so it's important to listen to your body.
What are the symptoms of this? How do you recognize it?
The symptoms of this disease are not the same for everyone. Sometimes it is difficult to recognize the symptoms. But the main ones are the "classic triad": 1.
Severe muscle pain: An unbearable pain, especially in the shoulders, thighs, and lower back. 2.
Muscle weakness: It becomes difficult to move or lift the limbs. 3.
Dark urine: This is
the most important and dangerous sign . The urine turns red-brown, like
the color of cola . The amount of urine you pass may also decrease. But remember,
about half of people with this condition may not have any muscle pain or weakness. So it is important to be aware of the other symptoms.
Other common features:
How do you find this, Doctor?
If you have these symptoms, you should see a doctor immediately. The doctor will run several tests to confirm the diagnosis.
- Creatine Kinase (CK) blood test: CK is the main chemical that is released into the blood when muscle tissue breaks down. In rhabdomyolysis , CK levels are very high. This test is also done several times to see if the levels decrease during treatment.
- Myoglobin urine test : This tests for the protein I mentioned earlier, which is released from muscles, in the urine. However, this is not as accurate as the CK test, because myoglobin is quickly eliminated from the body.
- Other tests: Other tests may be done, such as liver function tests and EKG.
When should you go to the hospital immediately?
This is the most important part. Symptoms usually begin 24 to 72 hours after muscle damage. It's easy to confuse a sore muscle that comes after a normal workout with a sore muscle from rhabdomyolysis.
If you experience unbearable, severe muscle pain, weakness, and notice that your urine has turned dark brown or cola-colored, don't think twice. Go to the nearest hospital's Emergency Department (ETU) immediately.
Starting treatment early is the best way to protect yourself from serious complications.
How is it treated?
If rhabdomyolysis is confirmed, you will definitely be hospitalized and treated.
- IV Fluids (Saline ): The main treatment is to give saline through a vein. This helps to keep the body well hydrated, increase urine output, and 'flush' out those toxins from the kidneys.
- Dialysis: When the kidneys are severely damaged and unable to clean the blood, they may need to undergo dialysis, a blood purification process using a machine.
- Surgery: Sometimes, the injured muscle can swell and press on the surrounding blood vessels and nerves. This is called 'compartment syndrome'. In such cases, a small surgery (fasciotomy) may be performed to relieve the pressure.
- Treating the underlying cause: If the condition is caused by diabetes, an infection, or some medication, appropriate treatment for that cause will also be provided.
Take-Home Message
- Rhabdomyolysis is a serious condition caused by muscle breakdown. This can damage the kidneys.
- The main symptoms are severe muscle pain, weakness, and especially dark brown/cola-colored urine.
- If you notice one or more of these symptoms, don't waste time and go to a hospital's Emergency Department (ETU) immediately.
- When exercising, especially on hot days, drink enough water to keep your body hydrated. Don't exercise more than your body can handle.
- Early diagnosis and treatment can lead to a full recovery. So never ignore the symptoms.
Rhabdomyolysis, muscle breakdown, kidney failure, dark urine, exercise, creatine kinase
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