Rhabdomyolysis

When muscles are overworked or injured, they can cause a rare condition called rhabdomyolysis. This condition causes muscle tissue to break down and release harmful substances into the bloodstream. While rare, if not treated quickly, rhabdomyolysis can lead to kidney failure and even death.

At Banner Health, we provide the care and support you need to manage rhabdomyolysis. 

What is rhabdomyolysis?

Rhabdomyolysis, or rhabdo, is a serious medical condition caused by damaged muscle cells. This damage releases proteins like myoglobin and electrolytes such as potassium, calcium and enzymes such as creatine kinase (CK) into the blood.

• Myoglobin is a protein that carries oxygen to your muscles. When it is released into the bloodstream in high amounts, it can clog the kidneys and lead to serious problems. 
• High potassium levels can affect heart rhythms and lead to dangerous cardiac issues. 
• Calcium imbalances can cause muscle weakness or life-threatening conditions.
• CK is an enzyme found in muscle tissue. High CK levels can cause muscle weakness, pain and dark-colored urine.

Rhabdo can range from mild to severe, but quick medical care can prevent complications.

Signs and symptoms of rhabdomyolysis

The symptoms of rhabdo vary depending on how severe the condition is. Symptoms can appear quickly, sometimes within hours of muscle damage. Common signs include:

• Muscle pain, weakness or swelling
• Dark urine (pee), which may look like cola or tea
• Feeling very weak or tired
• Nausea or vomiting

Some people may not notice signs right away. Symptoms may develop one to three days after the injury. Other symptoms, such as a fast heart rate, trouble breathing, swelling in the hands or feet or unexplained bleeding, may occur as the condition worsens.

If you experience any of these symptoms, especially after intense exercise or injury, call 911 or go to the nearest emergency department.   

What causes rhabdomyolysis?

• Intense exercise: Extreme physical activity, especially if you are not used to it, is a common cause of muscle damage. Running long distances, lifting heavy weights or doing high-intensity workouts can damage muscles. 
• Trauma: Car accidents, falls or crush injuries can cause muscle injury and lead to rhabdo.
• Infections: Muscle infections can trigger rhabdo.
• Medications or drugs: Certain prescription medicines or illegal substances can trigger muscle breakdown. 
• Heatstroke: High body temperatures from extreme heat or exercise can harm muscles.

Risk factors for rhabdomyolysis

Some people are more likely to develop rhabdo due to certain risk factors:

• Endurance athletes: Athletes who push their bodies to the limit are at higher risk.
• Dehydration: Not drinking enough water makes it harder for the body to handle muscle stress.
• Pre-existing health condition: People with conditions like diabetes, kidney disease or neuromuscular disorders are more likely to develop the condition.
• Low potassium levels: People who exercise vigorously and have low potassium levels are at higher risk. 
• Substance use disorder: People who use illegal substances like heroin or cocaine or abuse alcohol are at greater risk.
• Older adults: As people age, their muscles can be more vulnerable to damage.

How is rhabdomyolysis diagnosed?

A health care provider will diagnose rhabdo through a physical exam, lab tests and sometimes imaging. 

Here’s what to expect:

• Medical history and exam: Your provider will ask about recent activities, injuries or medications.
• Blood tests: To check for high levels of CK and myoglobin.
• Urine tests: Dark-colored urine and proteins in urine help confirm the diagnosis.
• Imaging: Sometimes, your provider may use imaging tests to check for muscle damage.

Treatment for rhabdomyolysis

Treatment for rhabdo depends on the severity of the condition. The main goals are to protect the kidneys and prevent muscle damage. 

For mild cases, you may be able to treat it at home with rest, hydration and monitoring. 

However, most people with rhabdo — especially those with high CK levels, kidney problems and muscle damage — will need hospital treatment. Treatment may include:

• Intravenous (IV) fluids: You will likely get fluids through an IV. This helps flush out the harmful substances in your body and keeps your kidneys working.
• Monitoring: Health care specialists will check your kidney function and perform blood and urine tests to ensure everything works well.
• Rest: Resting is important. Your muscles need time to heal.
• Medications: Sometimes, you may receive medications to help with pain or prevent complications.
• Dialysis: If the rhabdo is severe and causes kidney failure, you may need more advanced treatments, like dialysis. Dialysis helps your kidneys filter out waste, extra fluids and toxins from your blood. 

The earlier you get treated, the better the chances of recovery. Always seek emergency medical care if you think you have rhabdo.

Complications of rhabdomyolysis

If rhabdo is not treated quickly, it may lead to serious complications. These complications can cause kidney damage and affect other parts of the body.  

Here are some of the main risks:

• Kidney failure: The breakdown of muscle tissue can harm the kidneys (acute kidney injury), leading to kidney failure.
• Compartment syndrome: This happens when swelling in muscles increases pressure and cuts off blood flow. It can cause severe pain and damage.
• Electrolyte imbalance: Changes in electrolytes like potassium, sodium and calcium can lead to heart arrhythmia (irregular heartbeat) or cardiac arrest (heart stops).
• Permanent muscle damage: Severe rhabdo can cause lasting damage to muscles, leading to weakness or loss of movement.
• Shock or death: In the most serious cases, rhabdo can be fatal if not treated in time.

Can rhabdomyolysis be prevented?

While not all cases can be avoided, you can lower your risk by taking these steps:

• Stay hydrated: Drink plenty of water before, during and after exercise and/or in hot weather. 
• Pace yourself: Slowly increase the intensity of your workouts. Avoid pushing your body too hard too quickly.
• Protect yourself: Wear appropriate gear to prevent injuries during physical activity.
• Be mindful of medications: Talk to your health care provider about side effects that could harm your muscles.
• Know your limits: Rest if you feel unwell. Listen to your body.

Simple changes to your routine can make a big difference in keeping your muscles healthy. 

Your partner in recovery

Rhabdomyolysis can be scary, but you don’t have to face it alone. At Banner Health, we are committed to helping you get back on your feet. We're here for you whether you need emergency care, hydration therapy or long-term care. Our state-of-the-art facilities provide advanced diagnostic tools and treatments.