Myositis of muscles - Causes, symptoms and treatment. MF.
Myositis is an inflammatory, traumatic or toxic muscle injury that occurs as a result of various factors and manifests itself in pain, the development of muscle weakness and sometimes their atrophy. By myositis is meant the inflammation of one or more skeletal muscles: neck muscles, back muscles( lumbar muscles), chest muscles. If a lot of muscles are involved in the pathological process, talk about the development of polymyositis. In some cases, the lesion affects not only the muscles, but also the skin, the disease is called dermatomyositis.
Causes of myositis
Myositis develops as a result of infectious diseases( influenza, chronic tonsillitis, tonsillitis, rheumatism, etc.);parasitic infections( trichinosis, echinococcosis);toxic effects( metabolic disorders, gout, diabetes mellitus);occupational diseases among violinists, pianists, typists, chauffeurs whose work is related to the tension of one and the same group of muscles, or for long working in an uncomfortable position. Perhaps the emergence of the disease after injury, excessive cooling or muscle tension, severe muscle cramps during swimming.
Most often, the cause of myositis is infectious diseases, such as influenza, chronic cold sore tonsillitis. In addition, myositis can cause parasites and various toxic substances. A group of patients is distinguished, in which myositis develops due to professional activity - these are drivers, PC operators, pianists, violinists, i.e.people who every day for hours working in an uncomfortable position. Factors such as hypothermia, muscle cramps, trauma can also contribute to the onset of myositis. A number of pathologies in which connective tissues are affected are sometimes associated with myositis( lupus erythematosus, rheumatoid arthritis, rheumatism).Purulent myositis develops as a result of local infection, for example, when hygiene rules were violated during medical manipulations( intramuscular injections).
A frequent cause of myositis is muscle strain due to unusual physical activity or muscle injury.
Classification of myositis
There are acute and chronic myositis, in the prevalence they are divided into localized and diffuse.
Let's consider in more detail some varieties of myositis: dermatomyositis, polymyositis.
Dermatomyositis most often occurs in women of young and middle age. The origin of the disease is not exactly defined, presumably the pathology can be initiated by the virus, or by genetic factors( hereditary predisposition).The trigger mechanism is stress, colds, hypothermia and even sunlight. The defeat of the skin is expressed in the appearance of a characteristic rash on the hands, face, upper body. Eruptions have a red or purple color, in addition, sometimes there is swelling of the eyelids. Associated symptoms - weakness, chills, fever( usually subfebrile), a sharp weight loss. Deterioration of well-being can be either rapid or gradual. Dermatomyositis has a lot of unpleasant consequences for the patient - so, the flabbiness and shortening of muscles can last for a long time, and accumulations of calcium salts, which cause pain to the patient, are possible under the skin.
In polymyositis, as already mentioned above, several muscle groups are affected. In this case, unlike local myositis, pain is less pronounced, and the main symptom is muscle weakness. First, the patient is difficult to climb the stairs, then he can not get up from the chair, later the neck muscles are atrophied and the patient is unable to keep even the head in an upright position, the last stage of the disease is the atrophy of swallowing, chewing muscles, and muscles involved in the act of breathing. Sometimes polymyositis is accompanied by swelling of the muscles and swelling of the joints - arthritis develops. All of the above symptoms with a timely begun treatment pass, and a full recovery comes.
Myositis has two stages - acute and chronic. As a rule, the untreated acute myositis is chronicized and then the patient periodically bothers - the pain intensifies with supercooling, changes in weather conditions, manifested at night and with a prolonged static position of the body.
Chronic myositis can result from an infectious disease, for example, a cold. Sometimes a patient does not even realize that he was struck by this disease until the symptoms become too obvious. Acute myositis develops after local infection of the muscle with generalized acute infection, as well as due to injuries and muscle overstrain( especially in combination with hypothermia).
Myositis, first of all, is affected by the muscles of the neck, waist, shin, and thorax. In the event that there is a local myositis( rather than polymyositis), pain sensations and muscle weakness extend only to a certain group of muscles. The main symptom of myositis is pain, which is noisy and especially aggravated by movement and touching the muscles. When palpation palpable palpable foci - strands and nodules. A small puffiness and hyperemia( reddening) of the skin is found in a number of cases. Sometimes myositis is accompanied by a fever, a headache. The patient's condition without adequate therapy deteriorates sharply.
One of the most common forms of the disease is the so-called.cervical myositis. Its "popularity" is explained by the fact that the neck is most often subjected to hypothermia. The main symptoms are pulling, dull pain in the neck, which pushes back to the neck, spreading between the shoulder blades and covering the shoulder girdle. In this situation it is necessary to differentiate the disease from osteochondrosis of the cervical spine - X-ray studies are performed, in the absence of degenerative lesions, the mobility of the vertebrae is preserved.
Symptoms of myositis
With myositis, aching pains appear in the muscles of the arms, legs, and trunks, which increase with movement. Often in the muscles, dense nodules or cords are probed. With open trauma, due to infection, purulent myositis may develop, which is manifested by fever, chills, gradual pain, swelling, tightness and tension of the muscle, reddening of the skin above it.
Acute myositis occurs immediately, often unexpectedly, during acute infections, after injuries, severe muscle tension.
Chronic myositis may be the outcome of an acute or consequence of an infection. The muscles of the neck, lumbar region, thorax, and calves are often affected.
The clinical picture of myositis is characterized by local pain, the intensity of which increases. Pain sharply increases with movements that cause contraction of the affected muscles, as well as when they feel.
There may be swelling, swelling of soft tissues, sometimes - redness of the skin( for example, with purulent myositis).Develops a protective muscle tension, limiting movements in the joints. In connection with the presence of pain syndrome, muscle weakness develops, less often - atrophy.
Possible temperature increase, headache, increased sensitivity of the skin. With the myositis of the chewing muscles, the jaws are convulsively contracted, the muscles are strongly strained. The pain sometimes becomes so strong that a person is not able not only to chew, but also to talk. Soreness in tight muscles is enhanced not only by movement, but also at rest, at night, when weather changes. In mild cases, pain usually passes in a few days, but with adverse factors such as cooling or excessive physical strain, frequent relapses can occur.
A parasitic myositis that occurs when the muscles are damaged by parasites( trichinella, cysticerci) is a peculiar form and is characterized by fever, pain in the muscles of the limbs, chest, tongue, and chewing muscles.
Treatment of myositis
Treatment of myositis is carried out under the supervision of a doctor and is to fight infection and the correct organization of work, sports and recreation. Treatment of myositis pathogenetic and symptomatic. First of all, it is necessary to determine the cause of the disease. So, with parasitic origin of myositis, anthelmintics are prescribed, in the case of an infectious( bacterial) lesion, antibiotics, and if myositis is a consequence of an autoimmune disease, glucocorticoids and immunosuppressors are shown in long courses.
In any case, analgesics( painkiller) and anti-inflammatory drugs are prescribed, most commonly NSAIDs( diclofenac, nurofen, ketonal) are administered either orally or parenterally, in addition, with local myositis, the therapy with warming ointments( apizarthron, nicoflex, finalgon) has a good effect. These drugs improve muscle trophism, have a local irritant effect and help to reduce muscle tension, and, consequently, reduce the intensity of pain.
A warming ointment of the finalgon type is a good aid, and in the case of myositis, the ointment from the "Doctor Mom" series has proved to be successful in children. It is also useful massage and physiotherapy procedures for the affected muscle. Chronic myositis requires treatment at the spa.
In the acute period of the disease, rest is necessary, with the defeat of the muscles of the back, legs, abdominal wall, it is necessary to adhere to bed rest. Assign painkillers( non-steroidal anti-inflammatory drugs - rheopyrin, indomethacin, brufen, etc.), with purulent myositis - antibiotics. With rheumatism, as well as with tuberculosis or syphilitic myositis, specific therapy is performed. It is necessary to use dry heat, physiotherapy procedures. The duration of treatment depends on the activity of the process and the timely initiation of therapy.
In acute myositis, the patient is shown bed rest and physical activity restriction. At high temperature, antipyretic agents may be taken. The affected area( neck, waist, shin) should be kept warm, warming woolen dressings can be used - effectively so-called."dry heat".
In the case of purulent myositis, you should consult a surgeon - it may be possible to open the foci of infection, remove pus, and then apply a draining dressing. In this case, antibiotics are used not only parenterally, but also the place( ointments, powders).
For the treatment of myositis, physiotherapy methods are used, massage( with purulent myositis contraindicated), therapeutic exercise, special diet.
Prevention of myositis
Preventive measures: avoid overstrain of muscles, hard work in the cold, drafts, treat colds and other infectious diseases in time( do not carry the disease on foot).
Nasal neck
Cervical myositis is an acute inflammation of the muscles of the cervico-brachial girdle that can occur in any, even absolutely healthy person, as a result of stress, hypothermia, sleep in an unsuccessful posture or work in an uncomfortable position. But often cervical myositis is triggered by a draft.
Symptoms of myositis of the neck
The disease usually manifests itself in the morning after sleep, a day or two after the previously mentioned traumatic effects. During this time, "chilled" inflamed muscle fibers swell, there is a reflex spasm, which causes irritation of nerve endings and severe pain.
Pain caused by myositis usually spreads over the side of the neck from the occiput to the shoulder;but if the cervico-brachial nervous plexus and large nerves are involved in the process, the pain can spread over the arm to the very fingertips. According to the observations of the doctors of the Zdravia clinic, this occurs in 10-15% of the cases.
Inflammation of nerves in myositis is almost always asymmetrical: pain is stronger on one side than on the other. Regardless of where the inflammatory process has come, the pain in myositis is always very strong: the sufferer absolutely can not turn his head or move his inflamed arm.
In case of correct medical measures in 70% of cases, the attack passes without a trace for a period of 3 days to 2 weeks. In the absence of treatment, the attack is delayed. The pain becomes less intense, but the spasmed inflamed muscles "tip" the neck and provoke the development of further injuries: displacement( subluxation) of the intervertebral joints of the cervical spine or the appearance of a herniated intervertebral disc.
Treatment of cervical myositis
Despite the terrible pain, cervical myositis is treated quite easily( in the event that the treatment is started immediately and the attack does not take a protracted character).
First, an experienced doctor will advise the patient to be as completely as possible, if possible. The patient site should be lubricated with warming ointment, and inside take an anti-inflammatory drug. The best effect is given by the Novocain blockade - the cutting of the most painful areas of the affected muscles with novocaine and the addition of a corticosteroid hormone. The therapeutic effect of the novocaine blockade is manifested almost immediately after the procedure: the inflammation of the muscles decreases and the pain disappears.
However, those who have contraindications for treatment with chemical drugs, the doctor will recommend a series of procedures for post-isometric relaxation( IRP).PIR is one of the most useful procedures in the treatment of cervical myositis. PIR( stretching of muscles and ligaments) is a relatively new therapeutic method of manual therapy, which implies active interaction of the patient and the doctor. The patient is not passive during the procedure, he strains and relaxes certain muscles. A doctor during relaxation, stretches his muscles. During the procedure, the patient is surprised to notice that tension and pain disappear right before your eyes. The number of PIR procedures is assigned depending on the patient's condition.
Myositis of the muscles of the back( lumbar muscles)
Myositis of the lumbar muscles is a common cause of lumbar pain. The disease is characterized by a prolonged course. Pain in the lumbar muscles is not as intense as with lumbago, mostly aching. Muscles are compacted, painful when feeling and stretching. In patients with chronic infections and metabolic disorders, myositis of the lumbar muscles can be combined with pain in the joints.