It can seem like muscle twitching comes on for no apparent reason. You’re watching TV, and your eyelid starts twitching. You’re settling into bed and your arm twitches. Or you’re working on your computer when you notice a twitch starting up in your leg.
Are these types of twitches normal? Or should you be concerned? Christina Chrisman, MD, a neuromuscular medicine specialist with Banner Brain & Spine, answered some key questions about this common health condition.
What are muscle twitches?
To start, you need to know what twitches are, exactly. “People may use the term ‘muscle twitching’ to describe multiple different involuntary movements,” Dr. Chrisman said. “To most neurologists, ‘muscle twitching’ usually refers to random, involuntary small muscle twitches known as fasciculations.”
Twitches can seem strange, but they’re usually just random misfiring in your nerves that cause a muscle to contract. They typically don’t cause pain and they come and go. You can get them anywhere in your body, but they’re most common in your eyelid and your legs. Sometimes you see them more than you feel them.
Some related movements aren’t the same as twitching, though sometimes people describe them as twitches:
- Spasms are involuntary muscle contractions that last longer than a twitch. They can be painful and involve a bigger muscle group than a twitch.
- Cramps are involuntary muscle contractions that often come on quickly and can feel painful. Like spasms, they affect a more extensive area of muscle. If you get a cramp, you might be able to stretch or massage your muscle to get relief. “Cramps can be benign, but sometimes they’re associated with other neurological conditions,” Dr. Chrisman said.
- Hiccups aren’t the same as twitches because you only have a slight contraction of a few muscle fibers with a twitch. A hiccup is a complicated reflex that involves the brainstem and different muscles and nerves.
What causes muscle twitching?
Most of the time, there’s some type of irritation in the nerve that serves the twitching muscle. “It can be caused by stress, too much caffeine or overdoing it at the gym,” Dr. Chrisman said. Some medications and certain hormone or electrolyte imbalances can trigger them as well.
How can you stop muscles from twitching?
“Identifying the trigger can help you come up with a solution to get muscles to stop twitching,” Dr. Chrisman said. Here are some steps to try:
- Cut back on caffeine. If you drink a lot of coffee or energy drinks, try scaling back and see if your twitches decrease or go away.
- Reduce stress. Try mindfulness or other stress management techniques.
- Evaluate your workouts. You may find that your exercise or physical activity routine puts undue stress on certain muscles in your body.
If you make these adjustments and do not see changes in your twitching, talk to your primary care doctor. They might recommend basic lab tests to check electrolytes and thyroid function.
When should you worry about twitching?
Most of the time, if you don’t have other symptoms with your twitches and they stop on their own, you don’t need to be concerned. They are very common, and you shouldn’t need medication to treat them.
If you notice any of these symptoms along with twitching, see your primary care doctor or a neurologist:
- Trouble gripping objects
- Difficulty walking, talking, breathing or swallowing
- Unexplained weight loss
- Unexplained muscle mass loss
“It’s not common, but twitches associated with other signs could signal a more serious neurological condition,” Dr. Chrisman said.
Preparation before seeing your doctor
When you talk to your doctor about twitches, be prepared to describe what they feel like. “As a neurologist, there have been times patients described their symptoms as a twitch or a spasm, but they actually had tremors, dystonia, a tic, myoclonus, chorea or something else,” Dr. Chrisman said. “It’s important for us to categorize the movements correctly so we can make an accurate diagnosis.”
It can be helpful to make a video of any abnormal movement you would like a doctor to evaluate. “That’s my number one suggestion,” Dr. Chrisman said. “The movement may not happen on the spot when you are with your doctor in the examination room, so the video will be very helpful for them. Assessing involuntary movements is nuanced and complicated, so having a video is better than 1,000 words when it comes to receiving a correct diagnosis.”
The bottom line
Twitches, or what experts call fasciculations, occur when a muscle moves involuntarily and repeatedly. They are common and they don’t cause pain. Usually, they go away on their own and you don’t need to be concerned about them. But if you notice other symptoms along with twitches, talk to your doctor or a neurologist.