The modern “office disease” is myositis, the symptoms of which are familiar to most. This collective term refers to pathological conditions that are accompanied by severe pain in the skeletal muscles. Not every muscle pain indicates myositis, but each such lumbago makes you think. The article will understand the causes and symptoms of myositis. And also in the types of this disease, the consequences and methods of treatment. No matter how insidious myositis, you will find out which doctor to contact and how to get rid of it.
Clinic of the disease
Myositis (from the Greek. Μύος - muscle + Latin suffix -itis - inflammation) is a common name for a group of pathologies that are characterized by inflammation of the skeletal muscles. The origin of inflammation can be different, and, accordingly, myositis will have different symptoms and clinical course. According to the International Classification of Diseases (ICD), myositis is assigned the code M60.
The main symptom of this inflammatory process is a sharp pain at the site of the lesion, which increases over time. The intensification of pain is felt when moving the affected areas of muscle tissue, which causes protective tension of the opposite muscles. Without treatment, the muscles acquire skeleton, which leads to restrictions on articular movements, muscle weakness, and even atrophy of the affected area.
Myositis classification
According to the type of source of inflammation, the following types of disease are distinguished : infectious myositis (ICD - M60.0), parasitic, toxic, and traumatic. At different schools, classifications may vary. In accordance with various pathogenesis, myositis is distinguished (ICD - M60.1-M60.9): polymyositis, dermatomyositis, neuromyositis, fibromyositis and ossifying myositis. At the site of localization of inflammation, myositis of the neck, back, limbs, thoracic region and so on are secreted. The most common is cervical myositis (60%), behind it in frequency of occurrence is lumbar myositis.
Muscle myositis can occur acutely or chronically, can be short-term and disturbing throughout life, are found in adults and children. Dermatomyositis is more common in children, women mostly suffer from polymyositis. And in people of the older age group, fibromyositis is more often diagnosed. This disease can be independent and manifest as a consequence of other diseases.
Myositis: inflammation in the muscles
The causes of myositis can be exogenous and endogenous factors, namely:
- Infections of a viral and bacterial nature. In this case, inflammation usually spreads from other organs (for example, tonsils) with blood flow. Purulent muscle myositis are provoked by generalized purulent infections (staphylococcal, streptococcal, osteomyelitis or fungal infections). They have a severe course, are accompanied by abscesses and require surgical intervention. The non-suppurative course of infectious myositis can be triggered by influenza, acute respiratory viral infections, syphilis, and tuberculosis. Direct muscle damage develops when exposed to toxins secreted by pathogenic microorganisms.
- Autoimmune diseases (arthritis, lupus, scleroderma, collagenosis) can cause myositis, the symptoms of which occur in an acute and subacute form, or provoke the transition of the disease into a chronic form.
- Invasions of parasites (toxoplasmosis, cysticercosis, echinococcosis, trichinosis) can lead to the introduction of the microorganism into the muscles and the development of toxic-allergic reactions. The disease proceeds in waves that correlate with the life cycle of the parasite. In the clinic, there is pain, low-grade fever, in blood tests - eosinophilic leukocytosis.
- Exposure to toxins. Alcohol, drugs, insect venom, cocaine, corticosteroids can increase the risk of myositis.
- Traumatic factors. In places of ruptures of muscle fibers, edema always develops. Then normal muscle tissue is replaced by scar tissue, which leads to muscle shortening. Minor damage to muscle fibers usually heals quickly, but with serious abnormalities (such as polymyositis), tissue necrosis can develop.
- Professional myositis. This form of inflammation occurs as a result of a prolonged stay in one position, which is typical for drivers, computer scientists, musicians.
Symptoms: how it hurts
Myositis is manifested by the main symptom - muscle weakness and pain. Myositis is characterized by bilateral symmetry of the inflammatory process. The pain can be constant or manifest when certain movements are performed. Muscle weakness develops gradually, involving all large areas of skeletal muscle. The most severe and painful myositis are the shoulder girdle and pelvic muscles, in which there is a violation of gait and coordination of movements. Other symptoms of myositis may include:
- Skin rashes in places of inflammation.
- Increasing general fatigue.
- Aching pain, increasing with palpation and movements.
- Sometimes low-grade fever, fever, headaches.
- Symptoms of myositis may be the appearance of joint pain during exacerbations of the disease. But there is no joint edema, which distinguishes myositis from arthritis and arthrosis.
Brief description of the types of disease
Different types of myositis have different symptoms. Pain sensations in cervical myositis are aggravated by turning the head and are given to the head, shoulders, back and shoulder blades. The pain does not stop during the resting period, and the cold aggravates the situation. Pain in myositis of the spinal muscles increases in the morning. Myositis of the extremities is more common in diseases of other skeletal muscles (back or chest). Thoracic myositis is very painful, since there is no way to limit the movement of the ribs during inspiration. In severe cases, the muscles of the larynx and pharynx are involved in inflammation, which causes difficulty in swallowing.
Polymyositis captures large muscle groups in the process of inflammation, accompanied by joint pain, arthritis and dermatitis (dermatomyositis), in which there are rashes of purple and purple in the neck, trunk, face. This is a systemic disease of connective tissue.
Neuromyositis is characterized by involvement in inflammation of not only muscles, but also nerve endings. It is accompanied by paresthesia (decreased sensitivity), hyperesthesia (increased sensitivity), severe pain, decreased muscle tone.
Polyphibromyositis is characterized by the replacement of muscle tissue with connective tissue. Inflammatory processes lead to the formation in the muscle tissue of nodules of scar tissue (contractures), which are well palpable. They can appear and disappear, as the process is neglected, the muscles become deformed, which is accompanied by severe pain.
The most common is lumbar myositis. Symptoms can be easily confused with lumbago, but the pain is less acute. They are aching in nature, do not stop at rest and amplify when pressed and movements.
Very rare form of myositis
Ossifying myositis has three forms of manifestation: traumatic (consequences of trauma), progressive (hereditary disease) and trophoneurological (physiological disorders). All forms have a different course and symptoms. But most often it develops as a result of polyphibromyositis. Scar tissue becomes heterogeneous and is saturated with minerals and salts of phosphate acid, calcium and potassium. As they accumulate, the process of ossification begins. The clinical picture consists of deformation of the extremities, the appearance of tightened muscles, impaired mobility and severe pain. The traumatic form of such myositis has a predominantly favorable prognosis. Hereditary forms of the disease begin spontaneously, the course is unpredictable and often leads to the death of the patient due to ossification of the respiratory and swallowing muscles.
Children's myositis
Inflammation of muscle fibers in children has the same causes and symptoms as in adults. The most common form of the disease in children is cervical myositis. Moreover, the younger the child, the more dangerous this disease is, because it can affect not only the neck, but also the muscles of the larynx and esophagus. In addition, dermatomyositis with severe rash appears more often in children. At the same time, children often complain of leg pain when walking. Especially strong pain in the lower leg. The development of acute myositis in children is often preceded by sore throats and colds. It is children who are susceptible to this disease due to a prolonged stay in one position while studying. Especially if the posture in this position is incorrect. Fixation of the muscular skeleton can lead not only to inflammation of the muscles, but also to osteochondrosis, kyphosis and lordosis of the spine, vegetovascular dystonia and insufficient oxygen supply to the brain.
The basis for the prevention of childhood myositis is adequate dressing of the child, avoiding drafts. It is very important to properly arrange a place to sleep so that the position of the neck and head is physiologically correct. Proper posture at the table during work, playing sports and walking in the fresh air will be the key to the health of the child.
Danger of complications
Even mild forms of myositis not only violate the quality of life of a person and limit his freedom, in the absence of timely measures, they threaten to cause quite serious consequences. Myositis can cause the following complications:
- Spread to neighboring muscles and involve vital organs in the inflammatory process.
- If myositis is not treated, it progresses and can lead to muscle atrophy, up to and including disability and disability.
- Muscle tissue ossification can cause patient death.
- Purulent myositis leads to the formation of abscesses and phlegmon, which can cause sepsis and death.
- Complications of cervical myositis can lead to pathologies of ENT organs, followed by shortness of breath and increased stress on the heart muscle and vascular system.
First aid
It is worth sitting in the winter by a poorly closed window or in the summer under a stream of air from the air conditioner - and now we already have a cold myositis. Its light forms usually pass without consequences within 10-14 days. However, this painful disease requires care, and the following measures will become our first emergency aid:
- Warming up the inflamed muscle will only aggravate the situation. In the early days of illness, give your muscles maximum rest.
- Do not let the muscle catch a cold even more. A natural wool scarf is very suitable.
- For grinding, you can use alcohol solutions and any ointments for athletes with a warming effect.
- Along with local anesthesia, help the muscle relax from the inside - herbal infusions and drugs of a general relaxing nature will relieve muscle tension and tightness.
- If the pain does not subside within a few days - a direct road to the hospital with myositis. Which doctor should I go to? To the rheumatologist or therapist. It is better to establish the cause of muscle pain right away. With myositis, the sooner treatment is started, the more favorable the prognosis. But sometimes these pains can be a completely different disease. For example, with myocardial infarction, very often severe pain is observed under the scapula and in the muscles of the left hand.
Diagnosis and treatment strategy
Acute myositis is characterized by a typical clinic, which is the basis of diagnosis. With other forms of myositis, the whole complex of symptoms is taken into account, if necessary, a blood test is performed. A special study is electromyography, which shows the destruction of muscle fibers in various forms of myositis. Which doctor should i contact if symptoms develop? To the rheumatologist, surgeon or therapist. Treatment is prescribed by a doctor, and it will depend on the severity of the pathology.
The treatment regimen is individual. To relieve inflammation, immunosuppressants are prescribed (Prednisolone, Methotrixate). To eliminate the bacterial nature of myositis, drugs are selected in accordance with pathogens (antibiotics). With the viral nature of the infection, complex immunostimulants are prescribed. To relieve pain, it is effective to use topically ointments for myositis (Traumeel C, Diclofenac, Deep Relief gel, Dolaren gel).
Physiotherapy for myositis
Physiotherapeutic techniques are quite diverse, and without them you should not count on successful treatment. They can improve muscle tone and well-being of the patient, prevent muscle tissue atrophy. First of all, it is dry heat (warming up, body wraps) and massage, as well as physiotherapy exercises. Manual therapy, ultrasound, magnetotherapy are often used.
Massage with myositis is aimed at normalizing blood circulation in damaged tissues, relieving swelling and reducing pain. The massage technique involves muscle relaxation. Massage begins above the lesion and ends below it. The methods of vibration, stroking and gentle grinding are used. The duration of the session is 15 minutes, the course is up to eight procedures.
Physiotherapy exercises should be supervised by specialists. Useful pool visits, recommended aerobics. Exercise in the water relaxes muscles, reduces stress and improves overall tone. The unified rules in physiotherapy exercises will be the following:
- To normalize blood flow before exercise, muscles must be warmed up.
- Overexertion does not contribute to recovery, so the pace of exercise should be optimal, and increase smoothly.
- Periods of exercise should alternate with periods of rest.
- Exercise concentrates on the inflamed muscle, but stops when tired.
- During exacerbations, the program is best simplified.
In addition, diet therapy is recommended for patients with myositis, which excludes alcohol, fatty, salty and spicy foods.
What does traditional medicine advise
With myositis, folk remedies help relieve pain, increase blood flow in the affected muscle and warm it. At home, they massage the muscles, apply dry compresses, wrap them up. Rubbing oils are used - lavender, pink, cinnamon. Removing spasm can provide a compress of cooked with peel and mashed potatoes, which are wrapped in cloth, applied to a sore spot and wrapped. The pain will subside if a leaf of cabbage, soaped with laundry soap and sprinkled with soda, is applied to the sore spot, and then a wrap is wrapped.
A folk remedy for relieving inflammation is considered a compress from a decoction of needles. Branches of spruce or pine are chopped and poured with boiling water. The broth insist 10 hours. Then it is mixed with oatmeal and in this form is applied to the focus of inflammation.
With cervical myositis, the pain will help relieve the compress with laurel oil. To do this, the fabric is impregnated with warm water with 10-15 drops of oil dissolved in it and applied for half an hour to the area below the back of the head.
Adonis infusion (pour 10 g of herbs in 1 cup boiling water, wrap, leave for 1 hour) is recommended to be taken orally 1 tablespoon three times a day. An analogue of this folk remedy is the drug "Adonizid". However, its reception is recommended to coordinate with the doctor.
A decoction of physalis (15-20 fruits per half a liter of water, cook over low heat or boil in a water bath for 15 minutes) relieves pain when taken orally by a quarter cup three times a day, a course per month.
General prevention
In everyday life, it is enough to adhere to some rules, and you will not encounter unpleasant symptoms of myositis, namely:
- To temper the body and load with feasible physical activity. Swimming, aerobics, gymnastics, yoga, cycling - all the loads are good when in moderation.
- Monitor your posture, do not always carry the bag on one shoulder and try not to take a static pose for a long period of time.
- When doing sedentary work, do periodic minutes of unloading exercises for the muscles of the back, neck and limbs.
- It is very good to take preventive massage courses at least once a year.
- Do not start diseases, the consequences of which may be myositis.
- Dress according to the weather, avoiding hypothermia, and not be in a draft.
- Hiking in the fresh air in any weather will fill your body with forces in the fight against infections that constantly attack us.