Debility

Medical Definition of debility

: the quality or state of being weak, feeble, or infirmespecially : physical weakness

General debility is a state of general weakness or feebleness that may be a result or an outcome of one or more medical conditions that produce symptoms such as pain, fatigue, cachexia and physical disability, or deficits in attention, concentration, memory, development and/or learning.

Common medical conditions not included in this document that may result in general debility are:

  • Anorexia nervosa or other related eating disorders
  • Chronic fatigue syndrome
  • Malabsorption syndromes (e.g. cystic fibrosis, Crohn’s disease) and malnutrition
  • AIDS
  • Chronic infections (e.g. TB, HIV)
  • Malignancies, and
  • Conditions resulting in chronic pain
  • Metabolic diseases such as: thyroid diseases, pituitary diseases and adrenal diseases

Asthenia, also known as weakness, is the feeling of body fatigue or tiredness. A person experiencing weakness may not be able to move a certain part of their body properly. Asthenia is best described as a lack of energy to move certain muscles or even all muscles in the body.

Lack of stamina

Stamina is the physical or mental strength to resist fatigue and tiredness and maintain functional ability over time.  Lack of stamina is not the same as general debility. While drivers with general debility do not have sufficient stamina to drive, drivers suffering from a lack of stamina may not be suffering from general debility.

Difference between Debility and Lack of stamina

A driver suffering from a lack of stamina may experience:

  • Fatigue
  • Physical disability, and/or
  • Cognitive impairment such as loss of attention, concentration and memory.

A driver suffering from general debility may experience:

  • Pain
  • Fatigue/poor stamina
  • Cachexia – a condition marked by loss of appetite, weight loss, muscular wasting, and general mental and physical debilitation
  • Physical disability, and/or
  • Cognitive impairment such as loss of attention, concentration and memory

What are the symptoms of asthenia?

Isolated weakness

If you feel weak in one area of your body, you may find that you can’t move that part of your body efficiently. You may also experience:

Full-body weakness

Full-body weakness causes you to feel run down, similar to the feeling you get when you have the flu. This is known as fatigue, but it’s also possible to experience full-body weakness without feeling tired.

Some people who experience full-body weakness also experience:

  • fever
  • flu-like symptoms
  • pain in the affected area

Emotional or psychological causes of weakness

Weakness may be caused by emotional or psychological disturbances including:

  • Depression
  • Fatigue
  • Lack of sleep
  • Overwork
  • Stress

What is weakness?

Weakness is a feeling of being tired or exhausted, or experiencing a loss of strength. Weakness may not always be accompanied by obvious or visible illness. Short-term weakness may occur because of overwork, stress, or lack of sleep. You may also feel weakness after overcoming an illness, such as a cold or the flu. Some weakness may occur after vigorous physical activity.

Weakness may occur throughout your entire body or in a specific area, such as your arms or legs. Weakness may also be localized to a single muscle such as a calf muscle in your leg.

You may also feel weakness as a symptom of depression. Depression is defined as feeling blue, miserable or sad. While occasional periods of sadness are normal, long-term depression, called clinical depression, may indicate serious emotional or psychological problems. Weakness or fatigue that is persistent always requires the prompt attention of your health care provider.

Weakness may also occur because of physical diseases or toxic disorders. Long-term (chronic) conditions, such as multiple sclerosis or an underactive thyroid, may cause weakness. Short-term (acute) conditions, such as a pinched nerve or a urinary tract infection, may also cause weakness. Other possible causes of weakness are toxic disorders (botulism), exposure to an insecticide, or shellfish poisoning.

Weakness that is related to an acute condition may require emergency attention. Seek immediate medical care (call 911) if you experience sudden onset of weakness on one side of your body or face; weakness with shortness of breath or palpitations; or weakness with loss of consciousness, severe chest pain, back pain, or abdominal pain. Seek prompt medical care if you have malaise along with other symptoms, such as abdominal pain or cramping, fever and chills, foul-smelling urine, or a general ill feeling.

What other symptoms might occur with weakness?

Weakness may accompany other symptoms that vary depending on the underlying disease, disorder or condition. Weakness that is related to a physical disorder may differ from weakness that is related to an emotional or psychological condition.

Physical symptoms that may occur along with weakness

Weakness may accompany other symptoms affecting the body including:

Other symptoms that may occur along with weakness

Weakness may accompany symptoms related to emotional or psychological disturbance including:

  • Anxiety
  • Changes in mood, personality, or behavior
  • Depression
  • Difficulty with memory, thinking, talking, comprehension, writing or reading
  • Irritabilityor mood changes
  • Lack of energy
  • Malaise or lethargy
  • Severe fatigue
  • Sleep disturbances

Serious symptoms that might indicate a life-threatening condition

In some cases, weakness may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Abdominal, pelvic, or lower back painthat can be severe
  • Difficulty speaking or swallowing
  • Fainting, change in level of consciousness, or lethargy
  • High fever(higher than 101 degrees Fahrenheit)
  • Inability to stand
  • Incontinence of urine or feces
  • Seizures
  • Sudden balance problems, difficulty walking, and falls
  • Sudden loss of vision or changes in vision
  • Sudden weakness or numbnesson one side of the body
  • Vomiting, including multiple episodes
  • Worst headacheof your life

What causes weakness?

Weakness is a feeling of being tired, exhausted, or experiencing a loss of strength. Weakness may or may not be accompanied by obvious or visible sickness. Short-term weakness may occur because of overwork, stress, or lack of sleep. You may also feel weakness after overcoming an illness, such as a cold or the flu. It is normal to feel some weakness after some physical activity.

You may also feel weakness as a symptom of depression. Long-term depression may indicate more serious emotional or psychological problems.

Weakness may also occur because of physical diseases or toxic disorders. Long-term (chronic) conditions, such as multiple sclerosis or an underactive thyroid may cause weakness. Short-term (acute) conditions, such as a pinched nerve or a urinary tract infection, may also lead to weakness. Other possible causes of weakness are toxic disorders, exposure to an insecticide, or shellfish poisoning.

Emotional or psychological causes of weakness

Weakness may be caused by emotional or psychological disturbances including:

  • Depression
  • Fatigue
  • Lack of sleep
  • Overwork
  • Stress

Physical causes of weakness

Weakness can also be caused by chronic physical disorders including:

  • Amyotrophic lateral sclerosis(ALS, also known as Lou Gehrig’s disease; a severe neuromuscular disease that causes muscle weakness and disability)
  • Anemia(low red blood cell count)
  • Cancerand anticancer therapies
  • Diabetes
  • Exposure to toxic substances or poisons
  • Fibromyalgia(chronic condition that causes pain, stiffness and tenderness)
  • Hashimoto’s thyroiditis (autoimmune disease resulting in hypothyroidism and low production of thyroid hormone)
  • Hypothyroidism(underactive thyroid)
  • Infections (Lyme, hepatitis, HIV/AIDS)
  • Malnutrition
  • Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems)
  • Muscle breakdown (rhabdomyolysis)
  • Muscular dystrophy (inherited disorder that causes a progressive loss of muscle tissue and muscle weakness)
  • Myasthenia gravis(autoimmune disorder that causes a progressive loss of muscle tissue and muscle weakness)
  • Polymyositis (widespread inflammation and weakness of muscles)
  • Respiratory conditions (asthma, COPD)

Serious or life-threatening causes of weakness

Common causes of weakness include:

Other causes of weakness include:

  • cancer
  • stroke
  • heart attack
  • nerve or muscle injuries
  • diseases affecting the nerves or muscles
  • medication overdose
  • vitamin overdose
  • poison
  • dehydration

Complications

1.Weakness may accompany symptoms related to emotional or psychological disturbance including:

  • Anxiety
  • Changes in mood, personality, or behavior
  • Depression
  • Difficulty with memory, thinking, talking, comprehension, writing or reading
  • Irritabilityor mood changes
  • Lack of energy
  • Malaise or lethargy
  • Severe fatigue
  • Sleep disturbances

2.Serious symptoms that might indicate a life-threatening condition

In some cases, weakness may be a symptom of a life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Abdominal, pelvic, or lower back painthat can be severe
  • Difficulty speaking or swallowing
  • Fainting, change in level of consciousness, or lethargy
  • High fever(higher than 101 degrees Fahrenheit)
  • Inability to stand
  • Incontinence of urine or feces
  • Seizures
  • Sudden balance problems, difficulty walking, and falls
  • Sudden loss of vision or changes in vision
  • Sudden weakness or numbnesson one side of the body
  • Vomiting, including multiple episodes
  • Worst headacheof your life

General debility

General debility is a state of general weakness or feebleness that may be a result or an outcome of one or more medical conditions that produce symptoms such as pain, fatigue, cachexia and physical disability, or deficits in attention, concentration, memory, development and/or learning.

Some of the medical conditions included in this part may be commonly associated with general debility (e.g. end stage renal disease), and in these cases this is noted in the medical condition chapter.  However, general debility is more usually associated with multiple medical conditions or extreme old age.  Medications used to treat various medical conditions may also produce effects that contribute to general debility.

According to the United States Bureau of Labour Statistics (BLS), musculoskeletal disorders (MSDs) can be defined as any injury or illness of the musculoskeletal system caused by bodily action, including sprains, strains, tears, soreness, or musculoskeletal system and connective tissue diseases and disorders.1 MSDs represent a diverse group of disorders with respect to their pathophysiology, but they can be classified anatomically on the bases of pain and the associated impaired physical functioning. MSDs comprise problems from acute onset and short duration to long-term disorders, like arthritis, low back pain (LBP). Lifestyle and advanced age increase MSD prevalence.2 There can be a variety of causative factors for MSDs, but, according to the National Research Council and the Institute of Medicine, factors causing MSDs include physical, organisational, and social aspects of work and the workplace; physical and social aspects of life outside the workplace, like sports, exercise etc.; economic incentives and cultural values; and the physical and psychological characteristics of the individual.3

The exact prevalence of MSDs is unknown, but a study showed that MSDs affect 3.4% and 1.7% individuals in all diseases in high- and low-income countries respectively.4 Work-related MSDs are increasing annually from 40% to 95% in Asian and Western countries respectively.5 According to a study, lower back (29-64%), neck (34-63%), and shoulder (17-75%) are the most common affected areas.6 Another study reported an increase in MSD incidence over the preceding 12 months in the neck (55.9%) compared to other parts of the body.7 A study has shown that majority of MSD cases (61%) were non-traumatic, while 39% were traumatic, and in traumatic cases, exercise was the usual cause of injury. Among the traumatically injured patients, 32% had upper extremity injuries, 23% trunk injuries, and 45% had lower extremity injuries.4

It is well-known fact that MSDs symptoms are common among adults. Age plays a vital role in MSDs and the frequency of occurrence of these disorders and the associated physical disabilities increases with age. Approximately one-third of those aged >75 years have marked musculoskeletal issues. Locomotor disability increases from 3.1% in people aged <60 years to almost 50% in those aged <75 years, and these disorders put a huge burden on primary healthcare services.8,9

A cross-sectional study was conducted at the Khyber Teaching Hospital, Peshawar, Pakistan, from September 2018 to March 2019, and comprised patients of either gender having a variety of musculoskeletal disorders. Data was collected using a validated EuroQol-5-Dimension-3-Level scale.  Data was analysed using SPSS 20.

Results: Of the 377 participants, 204(54.1%) were males, and 173(45.9%) were females. The overall mean age was 35.9±12.5 years. Muscular weakness was the most commonly encountered problem 153(40.6%), followed by muscle stiffness 49(13.0%) and adhesive capsulitis 39(10.3%).10

References

  1. United States Bone and Joint Initiative: The Burden of Musculoskeletal Diseases in the United States (BMUS). 3rd ed. Rosemont IL. [Online] 2014 [Cited 2020 Feb 1]. Available from: URL:  http://www.boneandjointburden.org..
  2. Woolf AD, Åkesson K. Understanding the burden of musculoskeletal conditions. BMJ 2001; 322: 1079-80.
  3. Panel on Musculoskeletal Disorders and the Workplace, Medicine Io. Musculoskeletal disorders and the workplace: Low back and upper extremities: NAP; 2001.
  4. Amako M, Yato Y, Yoshihara Y, Arino H, Sasao H, Nemoto O, et al. Epidemiological patterns of traumatic musculoskeletal injuries and non-traumatic disorders in Japan Self-Defense Forces. Inj Epidemiol 2018; 5: 19.
  5. Nur Azma B, Rusli B, Oxley J, Quek K. Work related musculoskeletal disorders in female nursing personnel: prevalence and impact. Int J Collab Res Intern Med Public Health 2016; 8: 294-8
  6. Mäkelä M, Heliövaara M, Sievers K, Knekt P, Maatela J, Aromaa A. Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more. J Clin Epidemiol 1993; 46: 549-59.
  7. Hameed MH, Ghafoor R, Khan FR, Bada SB. Prevalence of musculoskeletal disorders among dentists in teaching hospitals in Karachi. J Pak Med Assoc 2016; 66: S36-8.
  8. McCormick A, Flemming D, Charlton J. Royal college of general practitioners morbidity statistics fourth National Morbidity survey;1991-1992.
  9. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis 1998; 57: 649-55.
  10. Khalid S, Shah SZ, Khalil AA, Ullah I. Impact of musculoskeletal disorders on quality of life of patients visiting tertiary care hospital. Journal of the Pakistan Medical Association. 2021 Dec 29;71(8):1976-9.