How does myositis hurt? Myositis. Causes, symptoms and signs, diagnosis and treatment of pathology. Video: If your neck is cold, your neck hurts, what should you do? Instant pain relief. Oh how simple
Muscles allow you to be not only strong, but also mobile. It is the muscles and tendons that are involved in the process of moving the bones that a person moves when moving his body. It becomes much more difficult to move when your muscles hurt. Everyone can remember muscle pain after physical exercise or unusual sitting. No matter how strong the muscles are, it is difficult to move them, strain them, which...
What is myositis?
What is myositis? This is an inflammation of the muscle structure that is involved in the musculoskeletal system. Many residents of megacities suffer from it. Why? Because they are the ones who often lead a sedentary lifestyle. Myositis is an office disease, as well as those of people who strain the same muscle group for a long time. It affects musicians, office workers, machine operators, etc.
Types of myositis
The disease has a varied classification because muscles are located throughout the body and can be affected for various reasons. Let's look at the types of myositis:
The causes of myositis are conventionally divided into:
Autoimmune pathology occurs when the body damages itself. The immune system produces antibodies against the tissue (connective tissue that makes up muscle fibers) on which the antigen (virus, bacteria, fungus) is located. In some systems, it is quite normal for some harmful microorganisms to exist. In this case, the person does not get sick. If the body reacts abnormally to their existence, then these diseases are called autoimmune. This cause often becomes a factor in the development of polymyositis in people with a genetic predisposition.
Intoxication of the body, affecting muscle fibers, often occurs due to the abuse of alcohol, drugs and insect bites.
When injured, the muscles first rupture, then swelling occurs, gradual scar formation and, as a result, shortening of the muscle. Sometimes areas of ossification form at the site of the rupture.
Symptoms and signs of muscle myositis
Signs of muscle myositis are often considered by type. Polymyositis manifests itself in the following symptoms:
- Fatigue and muscle weakness;
- Symptoms develop over weeks and even months;
- Weakness intensifies and turns into moderate pain;
- Motor activity is slow and passive. It becomes difficult to get out of bed, raise your arms, legs, strain them;
- Symptoms occur, as with laryngotracheitis or tonsillitis: pain when swallowing, difficulty breathing and hoarse speech.
With dermatomyositis, along with all the signs, skin rashes appear, few protruding above the skin and having a purple tint.
With neuromyositis, the following symptoms appear:
- Decreased or increased sensitivity;
- Severe pain that intensifies with muscle movement. Soon the pain occurs at rest;
- Muscle tension;
- Joint pain;
- Decreased muscle strength and tone.
Polyfibromyositis is characterized by the following symptoms:
- Hardening of the affected muscles;
- Formation of nodules;
- Pain upon palpation and movement;
- Pathological muscle contractions;
- Decreased mobility and range of motion;
- Swelling and enlargement of muscles.
Myositis ossificans is characterized by the following symptoms:
- Muscle tightness;
- Limited movement;
- Deformation of limbs;
- The occurrence of pain when moving.
Common symptoms and signs of muscle inflammation are:
- Bruises, wounds, contusions and other signs of injury;
- Pain;
- Changes in the color and shape of the skin;
- Weakness and rapid muscle fatigue;
- Change in sensitivity;
- Reduced (limited) mobility;
- Abnormal placement of limbs. In the cervical form - curvature of the neck - torticollis; in the chest form – scoliosis;
- Changes in muscle tissue.
In acute myositis after injury, the following symptoms will be observed:
- Redness of the skin;
- Soreness;
- Hematoma;
- Edema;
- Subcutaneous hemorrhages;
- Increase in local temperature.
The pain that occurs with lumbar myositis is often confused with radiculitis. However, with radiculitis the pain is more intense, and with lumbar myositis it is moderate.
Myositis in children
Polymyositis does not appear often in children. Most often it manifests itself in a skin rash in children 5-15 years old, which is called dermatomyositis. Observed after injuries and wounds - myositis ossificans, which is sometimes congenital and develops over the years.
Myositis in adults
Polymyositis occurs more often in women than in men. It is more often observed in mature adults (30-60 years). Myositis ossificans occurs in men (30-40 years old) as a result of frequent muscle injury.
Diagnostics
Diagnosis of muscle myositis begins with the patient contacting the doctor in which area he is experiencing pain: to a therapist - for pain inside the neck and sternum, to a neurologist or dermatologist - for dermatomyositis, etc. By collecting complaints and a general examination, the doctor will conduct additional procedures and send the patient for examination to those doctors who are associated with the area of inflammation:
- Rheumatic tests;
- Blood analysis;
- Biopsy and analysis of muscle tissue;
- Electromyography to assess muscle mobility;
- Ultrasound of muscles.
Treatment
General treatment for muscle inflammation is as follows:
Treatment of myositis depends on the type and form of the disease. It is carried out in a hospital. The main complex of drugs consists of non-steroidal anti-inflammatory and painkillers.
How to treat a non-purulent infectious form of myositis?
- Ointments: fastum gel, apizartron, dolobene;
- Injections: diclofenac, meloxicam, mydocalm;
- Medicines: aponil, traumeel S.
How to treat polymyositis and dermatomyositis?
- Prednisolone injections;
- Tablets: prednisolone, methotrexate, azathioprine.
How to treat myositis ossificans?
- Hydrocortisone;
- Massages and rubbing of ointments are prohibited.
Polyfibromyositis is treated with the following procedures:
- Rubbing in ointments: gevkamen, traumeel gel;
- Giving lidase injections;
- Anti-inflammatory drugs;
- Tablets: butadione, ibuprofen.
Treatment of the purulent infectious form of myositis includes antibiotics, antipyretics and painkillers. Sometimes surgery occurs. Rubbing with ointments is contraindicated as it can spread pus to nearby tissues. What is the treatment?
- Injections of penicillin, cefazolin, tetracycline;
- Medicines: amidopyrine, reopirine.
Treatment of the autoimmune form of myositis is carried out as follows:
- Prescribing anti-inflammatory and painkillers;
- Bed rest;
- Ointments: nise gel, voltaren, finalgel;
- Injections: Ambene, Baralgin M;
- Medicines: ketoprofen, nurofen, flugalin.
At home, treatment with folk remedies is possible, but these procedures are not a replacement, but rather complementary to the main treatment in a hospital.
- Compresses from chamomile, sweet clover, linden, horsetail, cabbage, boiled potatoes;
- Herbal ointments: ginseng or horsetail and lard;
- Tinctures of onion and camphor oil, from lilac flowers;
- Pepper oils, herbal collection;
- Decoctions from willow bark or physalis fruits.
As a form of prevention, following a special balanced diet is suitable:
- Consumption of polyunsaturated fatty acids: salmon fish, tuna, halibut, herring;
- Products containing salicypathates: potatoes, beets, carrots;
- Eating easily digestible proteins: chicken, soy, almonds;
- Increase calcium levels through fermented milk products, celery, currants, parsley, gooseberries;
- Beans and cereals;
- Drink at least 2 liters of fluid per day.
Treatment is mainly carried out in the following areas:
- Elimination of stagnation in muscles;
- Increasing local immunity;
- Elimination of inflammation and pain;
- Elimination of spasms and decreased muscle tone;
- Restoration of nervous functionality;
- Elimination of waste and toxins from muscles;
- Improving lymph and blood circulation;
- Improving metabolic processes;
- Normalization of blood supply and tissue nutrition;
- Increasing general immunity.
The physiotherapy complex includes the following procedures:
- Acupuncture (acupuncture);
- Electrophoresis;
- Acupressure, relaxation, lymphatic drainage massage;
- Magnetotherapy;
- Laser therapy;
- Pharmacopuncture;
- Mud applications;
- Breast therapy;
- Electromassage;
- Vacuum therapy;
- Electropuncture;
- Vibration massage.
In the purulent form, surgery is performed to remove the suppuration.
Life forecast
How long do people live with myositis? This disease does not affect the life prognosis. People can only suffer the consequences of a disease that is not treated. There may be limited movement and improper alignment of bones, muscle atrophy, or spread of infection to adjacent tissues. To prevent this from happening, you should lead an active life, especially if you have a sedentary job, avoid hypothermia, do not sit in a draft, and avoid prolonged stress on one muscle group.
Myositis refers to a group of pathological processes in skeletal muscles that are very different in etiology. In a narrow sense, myositis is an inflammation of the skeletal muscles, that is, the muscle tissue that provides movement of the musculoskeletal system ( and not the smooth muscles of internal organs). However, myositis can be not only inflammatory, but also traumatic or toxic.
Myositis can be an independent disease ( myositis ossificans), and one of the manifestations of other pathologies ( for example, tuberculosis). Very often, myositis accompanies autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. One of the most severe forms of myositis is dermatomyositis or Wagner's disease, in which the skin, along with muscle and connective tissue, is affected.
If myositis affects several muscle groups, then it is called polymyositis, but if one muscle is affected, then it is called local myositis. Together with muscle tissue, the skin may be affected ( dermatomyositis), or nerve fibers ( neuromyositis).
The most common type of myositis is cervical myositis, which accounts for more than half of cases ( 50 – 60 percent). In second place is lumbar myositis, which is the most common cause of lower back pain.
Today myositis is considered an office disease. For representatives of “sedentary” professions, the risk of developing this pathology is much higher than for representatives of “mobile” professions. An uncomfortable and forced posture, for example, at a computer for 6 to 8 hours with an air conditioner blowing behind your back, is fraught with the development of lumbar or cervical myositis.
Some types of myositis are considered professional, for example, in violinists or pianists, which is caused by constant tension in the muscles of the hand, neck or back.
It is believed that more than half of the residents of megacities suffer from various types of myositis.
Causes of myositis
Conventionally, the causes of myositis can be divided into endogenous ( causes that arise within the body itself) and exogenous ( causes originating outside the body).The name “autoimmune” reflects the pathogenesis and nature of the disease. With this pathology, the body itself produces antibodies to its own tissues ( in this case to the connective tissue) on which the antigen is fixed. An antigen can be a virus, bacteria, fungus. When an antigen-antibody complex is formed, a cascade of inflammatory reactions is triggered, with further tissue damage. As a rule, myositis of this etiology ( most often this is the so-called rheumatic myositis), has a subacute or chronic course and is characterized by nagging pain.
Infections
Most infections occur with the development of myositis. In this case, the infection from the main focus ( be it tonsils or lungs) spreads with blood or lymph flow to muscle tissue. Subsequently in the muscle ( or muscle group) inflammation of a specific or nonspecific nature develops.There are infectious purulent and non-purulent myositis. Non-purulent myositis develops during the period of influenza, various respiratory diseases, syphilis, typhoid fever, and tuberculosis. A special form of non-purulent myositis is Bornholm disease or epidemic myalgia. This is an acute infectious disease caused by the Coxsackie enterovirus, which primarily affects the muscular system. The leading symptom of this disease is severe pain in the abdomen and chest along with fever.
Purulent myositis develops against the background of a generalized purulent infection ( most often staphylococcal or streptococcal) or osteomyelitis. In this case, the pathogenic microorganism is carried through the bloodstream to the muscles, where localized purulent foci subsequently form. Thus, accumulations of pus, areas of necrosis and phlegmon are formed in the muscle tissue. Purulent myositis is a very serious disease and requires surgical intervention.
Various intoxications
Myositis can develop as a result of exposure to various toxic substances in the body. Most often, toxic myositis is observed in alcoholism, but it also occurs when taking certain medications, poisoning, and insect bites.The mechanism of development of toxic myositis is the direct toxic effects of alcohol, medication or poison.
The following have a direct muscle-destroying effect:
- alcohol;
- antimalarial drugs;
- colchicine;
- corticosteroids;
- isoniazid.
Injuries
At the site of injury, muscle fibers rupture, with the further development of inflammatory edema. Subsequently, as healing progresses, the swelling is replaced by scar tissue, and the muscle shortens.Also, the result of injuries can be the development of so-called myositis ossificans. At the same time, areas of ossification develop in the thickness of the muscle, namely in the area of connective tissue areas.
Constant muscle tension
This reason is typical for professional myositis. As a result of prolonged tension or an uncomfortable position, the muscle becomes tense and hardened. At the same time, the nutrition process in it is disrupted, since the blood flow in the tense muscle slows down. Impaired blood circulation as a consequence causes a lack of oxygen and the development of degenerative processes in the muscle.Hypothermia
Drafts, of course, are the most common cause of myositis. Most often, the muscles of the back, lower back and neck are susceptible to hypothermia. In this case, not only muscles, but also nerve fibers can be involved in the process.Types of myositis
There are two main forms of myositis – local myositis and polymyositis. Local myositis is characterized by inflammation of one muscle. With polymyositis, the inflammatory process spreads to several muscles or muscle groups. Areas in which myositis occurs more often are:
- small of the back;
- hands;
- legs;
- maxillofacial region.
Cervical myositis
Myositis of the cervical spine occurs more often than in other areas of the body. In this case, pain appears in the neck area, which can spread upward ( to the back of the head, ears), and down between the shoulder blades. The pain can be so severe that it restricts neck movement.
Myositis in the lumbar region
Lumbar myositis affects the psoas muscles along the spine. The pain is less pronounced than with cervical myositis and is aching in nature. When palpating the lumbar region, muscle tightening and increased pain are noted. Myositis of the lumbar region is more common among the elderly population.
Myositis of the muscles of the arms and legs
Myositis of the muscles of the arms and legs is rare in the form of local forms. More often, inflammation of the muscles of the limbs is observed with polymyositis. It is difficult for the patient to move his legs and raise his arms above his head. A decrease in muscle strength is accompanied by the appearance of pain when tense.
Myositis of the masticatory muscles is often observed in the maxillofacial area. With this form, pain occurs or intensifies when chewing.
Polymyositis is more common than localized forms of myositis.
Polymyositis with signs of dermatitis is called dermatomyositis. Due to a long-term inflammatory process, the muscles become thinner and atrophy.
Polymyositis occurs more often in middle-aged people ( 30 – 60 years). However, there is a separate form of polymyositis that appears only in children between 5 and 15 years of age. Females are susceptible to the disease twice as often as males. The onset of the disease may be preceded by various viral infections, hypothermia, decreased immunity, heavy physical exertion and injury. The disease develops slowly over weeks and months. The first manifestation is fatigue and weakness of the muscles of the distal parts of the body ( especially the thigh, shoulder and neck muscles). Weakness intensifies and sometimes even turns into moderate pain. All movements are difficult and slow. Patients find it difficult to raise their arms, walk, or get out of a chair or bed. Dysphagia appears ( difficulty swallowing), difficulty breathing and speaking. With dermatomyositis, purple skin rashes appear that rise slightly above the skin. Damage to internal organs with polymyositis is rare.
Neuromyositis
Neuromyositis is one of the forms of polymyositis, characterized by damage to muscle fibers and nerves that are located in this area. Intramuscular nerve fibers are most affected, but often the distal parts of the nerves are also affected ( especially when the disease progresses). During inflammation, muscle cells are destroyed and various substances are released that have a toxic effect on nerve fibers. Nerve fibers are also exposed to T-lymphocytes, which are released during an autoimmune reaction. Under the influence of these cells and all components of the inflammatory response, the myelin sheath of the nerve is destroyed. If the process is not stopped, then the axial cylinder of the nerve fiber is soon destroyed.The main signs of neuromyositis are:
- paresthesia in the affected area ( decreased sensitivity);
- hyperesthesia ( increased sensitivity);
- severe pain;
- tension symptoms;
- decreased muscle tone and strength;
- joint pain.
Pain with neuromyositis progresses. At first it is moderate, then intensifies with light loads. Pain may appear or intensify when breathing, when turning and bending the body, when moving the arms and legs. Gradually, pain appears even at rest. The pain syndrome is severe when the distal parts of the nerves are affected.
Also an important sign of neuromyositis is the symptom of tension. Palpation of muscles in a tense, tense state causes pain. Neuromyositis is usually accompanied by joint pain, and less often by skin lesions.
Polyfibromyositis
Polyfibromyositis is another form of polymyositis, the main feature of which is the replacement of muscle tissue with connective tissue.Due to a long-term inflammatory process in muscle tissue, muscle cells are destroyed and fibrosed ( replaced by connective tissue cells). In other words, a scar appears in place of damaged muscle tissue. Scar tissue compacts in the form of nodules, which are clearly felt when palpating the muscles. When scar tissue forms, adhesions often form between muscles. When scars form near tendons, various contractures appear and mobility decreases.
The main signs of polyfibromyositis are:
- hardening of the affected areas of the muscle;
- formation of nodules;
- contractures and abnormal muscle contractions;
- decreased range of motion, decreased mobility;
- pain when moving and palpating muscles.
Myositis ossificans
Myositis ossificans is a very rare form of polymyositis that can develop after injury ( bruises, dislocations, fractures, sprains and tears). This can be the result of either an acute injury or chronic muscle damage. For example, when riding horses, horsemen constantly injure their thigh muscles, and fencers constantly injure their chest muscles. There are also cases of congenital disease that progresses with age. Males aged 30–40 years are more at risk of the disease.Myositis ossificans develops gradually against the background of fibromyositis. The connective tissue, which replaces damaged muscle fibers, gradually transforms into a heterogeneous mass and is impregnated with various minerals and substances. When large amounts of phosphoric acid, potassium, and calcium salts accumulate, the process of ossification begins. Ossified areas of muscle often fuse with nearby bones, deforming the skeleton.
The main signs of polyfibromyositis myositis ossificans are:
- thickening of muscle areas;
- limb deformity;
- decreased mobility;
- the appearance of severe pain, especially when moving.
Symptoms of myositis
Symptoms that indicate myositis are:
- general signs of injury, infection;
- weakness and fatigue;
- pain;
- decreased mobility;
- change in muscle consistency;
- skin changes;
- changes in sensitivity;
- the appearance of contractures and abnormal positions of the limbs.
In the first days the following appear:
- hyperemia ( redness) skin;
- edema;
- soreness;
- subcutaneous hemorrhages;
- hematomas;
- sometimes the local temperature rises.
When an inflammatory process develops in a muscle, muscle tone is the first to suffer. Muscle fibers lose the ability to quickly and fully contract and relax. The patient feels increasing weakness in the affected part of the body. With myositis of the extremities, it is difficult to raise your arms above your head or move your legs. Weakness can reach such a degree that it becomes difficult for the patient to get out of a chair or bed.
The main characteristic of myositis is pain in the affected muscle or muscle group. The inflammatory process leads to the destruction of muscle fibers and the accumulation of a large amount of active substances at the site of inflammation, which irritate the nerve endings. Pain varies from moderate to severe depending on the location of the lesion and the stage of the disease.
With cervical myositis, acute pain appears when turning the head or when chewing. Sometimes it spreads to the back of the head and temples or down to the interscapular area.
With thoracic myositis, pain occurs with movements of the chest ( with deep inhalations and exhalations) and when turning.
Myositis of the lumbar region causes moderate pain, aching in nature. It is often confused with sciatica. But the pain with radiculitis is more intense.
Myositis of the extremities causes increased pain when walking and when lifting objects. Often patients try to keep the affected limb in a position that brings less pain.
Any pain intensifies with movement, with uncomfortable positions, with palpation, with new injuries, with exposure to low temperatures, with changes in weather conditions.
With chronic myositis, during the period of remission, the pain subsides and may even disappear.
Several factors influence the mobility of the affected area. Firstly, severe pain hinders movements, their amplitude decreases. Secondly, the destruction of a large number of muscle fibers and their replacement with connective tissue reduces muscle elasticity, and contractility decreases accordingly. Movements become slow and incomplete. Also, movements are limited when ossification of the damaged muscle area begins. If ossified ( ossified) areas fuse with the bones, movements are reduced to a minimum.
With polymyositis, vital muscle groups may also be affected ( diaphragm, pharynx muscles). At the same time, it becomes difficult for the patient to swallow, speak and breathe.
Depending on the stage of the process, the consistency of the muscles is different. During inflammation, when muscle fibers are destroyed and various substances accumulate in the intercellular space, the muscle becomes dense and slightly increased in volume. When does reabsorption occur? reverse absorption) of all these substances, the muscle becomes decrepit and soft. When the muscle structure is replaced by connective tissue, slightly compacted nodules are detected by palpation, which can increase in size. With myositis ossificans, palpation reveals hard structures that are located deep in the muscles or connected to the bone. With any type of myositis, palpation causes pain.
Often myositis is accompanied by skin changes, and then it is called dermatomyositis. The inflammatory process involves all nearby tissues, especially the skin. Various rashes appear on the skin, reddish and purple in color. They rise slightly above the surface of the skin, giving it a bumpy appearance.
When intramuscular nerve fibers and distal nerve endings are involved in the inflammatory process, sensitivity changes. Sometimes there is hypersensitivity to any external irritants.
Violation of the structure of muscle tissue, scarring and ossification leads to shortening of muscles, changes in shape and the formation of various contractures. Because of this, various curvatures and abnormal body positions appear. With cervical myositis, torticollis appears ( curvature of the neck), with thoracic myositis - scoliosis.
Diagnosis of myositis
Treatment of myositis is the responsibility of doctors such as a neurologist, rheumatologist and therapist. Initially, if you experience pain in the back, neck or legs, you should consult a therapist. Further, depending on the etiology of the disease, the family doctor recommends consultation with one or another specialist. So, in case of myositis due to autoimmune diseases, it is recommended to consult a rheumatologist; for myositis during colds - see a therapist; for neuro- and dermatomyositis - see a neurologist. Diagnosis of myositis, in addition to questioning and examination, may include various laboratory and instrumental examinations, so the patient must be prepared in advance for significant time and material costs.
Diagnosis of myositis includes:
- survey;
- inspection;
- laboratory research ( rheumatic tests);
- instrumental studies;
- biopsy.
Survey
Includes information about how the disease began and what preceded it.The doctor may ask the following questions:
- “What are the concerns at the moment?”
- “What was the first symptom?”
- “Was there a fever?”
- “Was the illness preceded by hypothermia or injury?”
- “What other diseases does the patient suffer from?”
- “What was the patient sick with a month or a couple of months ago?”
- “What did you get sick with as a child?” ( For example, did you have rheumatic fever as a child?)
- “Are there any hereditary pathologies in the family?”
Inspection
Initially, the doctor visually examines the site of pain. His attention is drawn to the redness of the skin over the muscle or, conversely, to its paleness. With dermatomyositis on the skin in the area of the extensor surfaces ( joints) red, scaly nodules and plaques form. Your doctor's attention may be drawn to your nails, as one of the early signs of dermatomyositis is changes in the nail bed ( redness and swelling of the skin). Long-term myositis is accompanied by muscle atrophy. Over the atrophied muscle, the skin is pale with a sparse network of blood vessels.Next, the doctor begins palpation ( feeling) affected muscle. This is done to assess muscle tone and identify painful points. In the acute period of the disease, the muscle is tense, as its hypertonicity develops. Hypertonicity is a kind of protective reaction of skeletal muscles, so during colds and stress the muscle is always tense. For example, with cervical myositis, the muscles are so tense that they make it difficult for the patient to move. Sometimes the swallowing process may even be disrupted if the inflammatory process has affected most of the neck muscles.
Muscle soreness can be both general and local. For example, with infectious purulent myositis, local painful points are identified that correspond to purulent foci. With polyfibromyositis, the pain increases towards the joint, that is, at the muscle attachment points.
With polymyositis, the pain syndrome is moderate, but muscle weakness progresses. In the clinical picture of myositis ossificans, the pain is moderate, but the muscles are very dense, and when palpated, dense areas are revealed. Severe pain syndrome is observed with neuromyositis, when nerve fibers are also affected along with muscle tissue.
Rheumatic tests
Rheumatic tests are those tests that are aimed at identifying systemic or local rheumatic diseases.Such diseases may be:
- rheumatoid arthritis;
- systemic lupus erythematosus;
- polymyositis;
- polyfibromyositis;
- myositis with inclusions and others.
In the diagnosis of myositis, rheumatic tests include the determination of the following indicators:
- C-reactive protein;
- antistreptolysin-O;
- rheumatic factor;
- antinuclear antibodies ( ANA);
- myositis-specific autoantibodies.
An increased concentration of C-reactive protein is observed during various inflammatory processes in the body. C-reactive protein is a marker of the acute phase of inflammation, therefore it is determined during acute infectious myositis or during exacerbations of chronic ones. By determining the level of this protein, the effectiveness of the treatment can be assessed. However, in general, C-reactive protein is only an indicator of the infectious process and does not play an important role in the differential diagnosis of myositis.
Antistreptolysin-O
Is an antibody protein), which is produced in response to the presence of streptococcus in the body, or more precisely to the enzyme it produces - streptolysin ( hence the name). It is an important diagnostic criterion for rheumatism and rheumatoid arthritis. Thus, an increased titer of these antibodies speaks in favor of rheumatic myositis.
Rheumatic factor
Rheumatic factor is antibodies that are produced by the body to its own proteins ( immunoglobulins). Increased values of the rheumatoid factor are observed in autoimmune pathologies, dermatomyositis, and seropositive rheumatoid arthritis. However, there are cases when the rheumatic factor is negative. This is seen in seronegative rheumatoid arthritis or in children with juvenile arthritis. Quantitative determination of rheumatic factor before and after treatment is of important diagnostic importance.
Antinuclear antibodies
A family of autoantibodies that develop against components of their own proteins, namely the cell nuclei. Observed in dermatomyositis, scleroderma and other systemic collagenoses.
Myositis-specific autoantibodies
Myositis-specific autoantibodies (
MSA) are markers of such idiopathic myositis as:
- dermatomyositis;
- polymyositis;
- myositis with inclusions.
The most common antibodies are:
- Anti Jo-1 – detected in 90 percent of people suffering from myositis;
- Anti-Mi-2 – seen in 95 percent of people with dermatomyositis;
- Anti-SRP – found in 4 percent of people with myositis.
Biopsy and morphological examination of muscle tissue
Biopsy is a diagnostic method in which pieces of tissue are taken intravitally ( biopsy), followed by their study. The purpose of a biopsy in diagnosing myositis is to determine structural changes in muscle tissue, as well as in the surrounding vessels and connective tissue.Indications for biopsy are:
- infectious myositis;
- polymyositis ( and how is their type dermatomyositis);
- polyfibromyositis.
Ointments for the treatment of non-purulent infectious myositis
| Representatives | Mechanism of action | How is it prescribed? |
| fastum gel ( active substance ketoprofen). Synonyms: bystrum gel. | has an anti-inflammatory effect and also has high analgesic activity | Apply a small amount of gel to the skin above the inflammation site ( 5 cm) and rub two to three times a day |
| apizartron ( ointment is not prescribed in acute periods of rheumatic diseases) | The mustard oil extract included in the drug causes tissue warming, improves local blood flow and relaxes muscles, and also has an anti-inflammatory effect | a 3-5 cm strip of ointment is applied to the inflamed area and slowly rubbed into the skin |
| dolobene is a combination drug that contains dimethyl sulfoxide, heparin and dexpanthenol. | in addition to anti-inflammatory and analgesic effects, it has an anti-exudative effect, that is, it eliminates swelling | A column of gel 3 cm long is applied to the site of inflammation and rubbed in with a gentle movement. The procedure is repeated 3 – 4 times a day |
For extensive myositis, which affects several muscle groups and is accompanied by fever and other cold symptoms, treatment is prescribed in injection form ( injections).
Injections for the treatment of non-purulent infectious myositis
| Representatives | Mechanism of action | How is it prescribed? |
| diclofenac | has an anti-inflammatory and analgesic effect | one injection at a time ( 3 ml) intramuscularly every other day for 5 days. |
| meloxicam | due to selective inhibition of the formation of inflammatory mediators, it has a pronounced anti-inflammatory effect with minimal side effects | one ampoule ( at 15 mg) per day, intramuscularly for 5 days, then switch to the tablet form of the drug |
| mydocalm | has a muscle relaxant ( relaxes tense muscles) action | administered intramuscularly, one ampoule ( 100 mg of substance) twice a day. Thus, the daily dose is 200 mg |
Tablets for the treatment of non-purulent infectious myositis
| Representatives | Mechanism of action | How is it prescribed? |
| aponyl ( active ingredient – nimesulide) | like all non-steroidal anti-inflammatory drugs, it has an anti-inflammatory and analgesic effect, and also has an antipyretic effect | The daily dose of the drug is 200 mg, which equals 2 tablets of 100 mg, or 4 tablets of 50 mg. The dose is divided into 2 – 4 doses, washing down the tablet with a small amount of water |
| traumeel C ( herbal preparation) | has analgesic and antiexudative effects | one tablet three times a day. The tablet is placed under the tongue until completely absorbed |
Most often, the treatment of myositis is combined, that is, medications are prescribed locally ( in the form of an ointment), and systemically ( in the form of tablets or injections).
Treatment of polymyositis and its forms (dermatomyositis)
The main drugs in the treatment of polymyositis and its form of dermatomyositis are glucocorticosteroids. The drug of choice is prednisolone, which is prescribed in the form of injections in the acute period of the disease.Injections for the treatment of polymyositis and its form of dermatomyositis
If the therapy is ineffective, so-called pulse therapy is performed, which consists of administering ultra-high doses of glucocorticoids ( 1 – 2 grams) intravenously for a short period ( 3 – 5 days). This therapy is carried out exclusively in a hospital.
Prednisolone tablets are prescribed as maintenance therapy after achieving remission. Methotrexate and azathioprine are also prescribed in tablet form. These drugs belong to the group of immunosuppressants and are prescribed in the most severe cases and when prednisolone is ineffective.
Tablets for the treatment of polymyositis and its form of dermatomyositis
| Representatives | Mechanism of action | How is it prescribed? |
| prednisolone | has anti-inflammatory, antiallergic and immunosuppressive effects | during the period of maintenance therapy 10–20 mg per day, which equals 2–4 tablets of 5 mg. This daily dose is divided into two doses and taken in the first half of the day. |
| methotrexate | a cytostatic drug that has an immunosuppressive effect | prescribed 15 mg orally per day, gradually increasing the dose to 20 mg. After reaching a dose of 20 mg, they switch to injectable forms of methotrexate. |
| azathioprine | also has an immunosuppressive effect | prescribed orally, starting with 2 mg per kg of body weight per day. Treatment is carried out under monthly blood test monitoring. |
Since diffuse inflammation of the muscles is observed with poliomyositis, the use of ointments is not advisable.
Treatment of myositis ossificans
With myositis ossificans, conservative treatment is effective only at the beginning of the disease, when resorption of calcification is still possible. Basically, treatment for this type of myositis comes down to surgery.Massage and rubbing of ointments are contraindicated.
Treatment of polyfibromyositis
Treatment of polyfibromyositis includes anti-inflammatory drugs, lidase injections, massage and physiotherapy. Ointments for the treatment of polyfibromyositis
Injections for the treatment of polyfibromyositis
Anti-inflammatory drugs are prescribed in tablet form, which are advisable only in the acute phase of the disease.
Tablets for the treatment of polyfibromyositis
| Representatives | Mechanism of action | How is it prescribed? |
| butadione | has a pronounced analgesic and anti-inflammatory effect. | 150 – 300 mg each ( this is one or two tablets) 3 – 4 times a day 30 minutes after meals. |
| ibuprofen | has a pronounced anti-inflammatory and analgesic effect. | 800 mg each ( these are two tablets of 400 mg or one of 800) two to four times a day. In this case, the daily dose should not exceed 2400 mg, that is, 6 tablets of 400 mg, or 3 of 800. |
Treatment of purulent infectious myositis
Includes the use of antibiotics, painkillers and antipyretics. In some cases, surgery is indicated.Ointments followed by rubbing them over the affected surface are contraindicated, as they can contribute to the spread of the purulent process to healthy tissue.
Injections for the treatment of purulent infectious myositis
| Representatives | Mechanism of action | How is it prescribed? |
| penicillin | has a bactericidal effect by inhibiting the synthesis of the cell wall of microorganisms. Active in relation to gram-positive, and in relation to gram-negative bacteria | intramuscularly 300,000 units. 4 times a day ( every 6 hours) |
| tetracycline | intramuscularly 200,000 units. 3 times a day ( every 8 hours) | |
| cefazolin | has a wide spectrum of antimicrobial action | intramuscularly 1 gram 4 times a day ( every 6 hours) |
Tablets for the treatment of purulent infectious myositis
Treatment of myositis in autoimmune diseases
In parallel with the treatment of the underlying disease, which is accompanied by myositis ( systemic lupus erythematosus, scleroderma) symptomatic therapy of myositis is carried out. It consists of taking painkillers and anti-inflammatory drugs; in the acute phase, a pastel regimen is observed.Ointments for the treatment of myositis in autoimmune diseases
| Representatives | Mechanism of action | How is it prescribed? |
| nise gel | nimesulide, which is part of the ointment, has an analgesic and analgesic effect | Without rubbing the gel is applied in a thin layer to the area of pain. The procedure is repeated 2 to 4 times a day |
| Voltaren ointment and gel ( active substance diclofenac) | has a pronounced anti-inflammatory effect, also eliminates pain | 1 g ointment ( a pea the size of a hazelnut) is applied over the source of inflammation, rubbed into the skin 2 – 3 times a day. Single dose - 2 grams. |
| finalgel | 1 g of gel is applied to the skin over the affected area and lightly rubbed. The procedure is repeated 3–4 times a day. |
Injections for the treatment of myositis in autoimmune diseases
| Representatives | Mechanism of action | How is it prescribed? |
| Ambien | a combination drug that, in addition to its anti-inflammatory effect, produces an antirheumatic effect. | one injection each ( one injection includes 2 ml of solution A and 1 ml of solution B) intramuscularly every other day. The course of treatment is 3 injections, after which they take a break of 3-4 weeks, and then the course can be repeated. |
| baralgin M | in addition to analgesic and anti-inflammatory effects, it produces antispasmodic ( relaxing) Effect. | One injection is administered intramuscularly ( 5 ml) one to two times a day. The maximum daily dose is 10 ml ( 2 injections). |
Tablets for the treatment of myositis in autoimmune diseases
| Representatives | Mechanism of action | How is it prescribed? |
| ketoprofen | produces analgesic and anti-inflammatory effect | in the acute period of the disease, a dose of 300 mg per day is prescribed, which is equal to 3 tablets of 100 mg. During the period of maintenance therapy, 150–200 mg per day is prescribed. |
| Nurofen | has a powerful analgesic effect | prescribed 400–800 mg 3 to 4 times a day. |
| flugalin | has anti-inflammatory and analgesic effects. | orally, one tablet 2–4 times a day after meals with a small amount of food. The course of treatment is 2 – 3 weeks. |
Treatment of myositis with folk remedies
Myositis therapy with folk remedies consists of using ointments, oils, solutions and tinctures with alcohol for rubbing. Anti-inflammatory compresses and heat insulation of the affected muscle area are widely used. Carrying out these manipulations requires limiting physical activity and ensuring maximum rest. Herbal infusions help to cope with the pain syndrome of myositis, before using which you should consult your doctor. To exclude the occurrence of allergic reactions when using folk remedies externally, a test should be performed before treatment. Testing consists of applying the prepared composition to a small area of skin. If redness, blisters or rashes occur, you should stop using the selected recipe.
Compresses
To relieve muscle pain in folk medicine, the following is used:- cabbage compress;
- boiled potato compress;
- compresses using plants such as chamomile, sweet clover, linden, horsetail.
For this procedure you will need: 2 tablespoons of baking soda, 2 leaves of white cabbage, baby soap. The cabbage should be doused with hot water, in which 1 spoon of soda was previously dissolved. Next, you need to soap the leaves with soap, sprinkle with the remaining amount of soda and apply to the place that bothers you. To enhance the effect, apply a warming bandage to the area of the sore muscle. The compress lasts for 30–40 minutes.
Boiled potato compress
Another recipe for myositis is a boiled potato compress, for which you will need: 3 – 5 boiled potatoes in their skins, cologne, a warm scarf, a clean cloth. Mash the potatoes and apply them through 2 layers of cloth to the sore spot, then wrap the potato compress with a scarf. The effect of the compress can be prolonged by gradually removing the tissue layers. After the potatoes have cooled, the mass should be removed and the area causing discomfort should be rubbed using cologne. This procedure is best done at night in order to give the heated muscles a rest.
Herbal compresses
Compresses using plants such as chamomile, sweet clover, linden, and horsetail have a positive effect. Dry plants should be placed in a gauze bag, steamed with boiling water and provided with sufficient heat by covering with plastic and wrapping the diseased area well. Compliance with all recommendations when applying compresses according to traditional medicine recipes allows you to achieve a positive effect and significantly reduce muscle pain.
Ointments
Rubbing ointments prepared at home has a positive effect, reducing pain. Ointments are also used as the main ingredient in compresses, which should be done at night, ensuring good thermal insulation.Ginseng ointment
In order to prepare ginseng ointment, you will need: 20 grams of table salt, 20 grams of dried ginseng root, 100 grams of bear fat ( sold in a pharmacy), which can be replaced with goose or pork lard. Ginseng root should be crushed and mixed with fat and salt melted in a water bath. The resulting composition should be rubbed onto sore spots, using spiral or straight movements from bottom to top.
Ointment based on horsetail and lard
You should take 20 grams of dried herb and 80 grams of fat base and grind the mass in a glass or plastic bowl. Rub the resulting product into the areas that bother you. Also, plants such as lavender, eucalyptus leaves, peppermint, sage, and celandine can be used as an ingredient for making ointments based on lard or butter.
Tinctures
As a rubbing agent in the treatment of myositis, tinctures made with alcohol with the addition of various plant components are used. Tinctures have anti-inflammatory, antibacterial and analgesic effects.Tincture of onion and camphor oil
In order to prepare this remedy, you need to take 2 large onions, 125 milliliters ( half a glass) 70 percent medical alcohol and 1 liter of camphor oil. The onion should be chopped and combined with alcohol. After two hours, add oil to the resulting mass and leave to infuse for ten days, excluding access to light. The composition can be used as a means for rubbing and compresses.
Lilac flower tincture
You will need 100 grams of fresh lilac and 500 milliliters ( two glasses) 70 percent medical alcohol. The flowers are filled with alcohol and stored for a week in a dark place. Use for compresses and rubbing once a day. Dry or fresh chamomile and bodyaga powder can also be used as ingredients for preparing tinctures. One of the advantages of tinctures is their long shelf life.
Oils
Oils made according to traditional medicine recipes are used for massages and rubbing when exacerbations of myositis occur. Oils have a relaxing and warming effect on muscles, helping to reduce pain levels.Pepper oil
In order to prepare it, you should take two small pods of hot pepper and 200 milliliters of vegetable oil. The pepper needs to be chopped with a knife or meat grinder along with the seeds and poured with oil. Pour the composition into a glass container and store in a dark place for 7 - 10 days. As pain occurs, you need to rub pepper oil into the sore spots, taking precautions, since if it gets on the mucous membrane, the composition can cause a strong burning sensation.
Herbal oil
To prepare herbal oil you will need:
- 700 milliliters ( three glasses) unrefined vegetable oil;
- 2 tablespoons of birch mushroom;
- one tablespoon each of such plants as calamus root, adonis grass, immortelle, St. John's wort, lemon balm, yarrow, plantain, string, mountain ash, oats, celandine.
Decoctions
When treating myositis, decoctions prepared from medicinal herbs are taken orally in accordance with the instructions given in the recipe. The main effect of decoctions is their calming effect on the body. Also, herbal infusions help reduce inflammation and reduce pain.Decoction of physalis fruits
To prepare it you will need: 20 pieces of fresh or 20 grams of dried physalis fruits, 500 milliliters of distilled water. The fruits are filled with liquid and brought to a boil. After which you should continue boiling over low heat for 15 - 20 minutes. Next, you should remove the decoction, strain, cool and take a quarter glass, 4 - 5 times a day, before meals. After a month, you should take a break for 10 days, and then continue treatment.
Willow bark decoction
To prepare this remedy, take 1 tablespoon of willow bark and add a glass of water. Next, place the composition in a water bath and bring to a boil. The resulting amount of decoction should be divided into 5 parts, which should be consumed during the day. You need to continue the course for 40 days, after which you should take a break for two weeks.
Prevention of myositis
What do we have to do?
To prevent myositis it is necessary:- maintain a balanced diet;
- maintain water regime;
- lead an active lifestyle, but at the same time avoid excessive physical activity;
- promptly treat colds and other infectious diseases ( You can’t endure diseases on your feet and allow their complications).
Polyunsaturated fatty acids help prevent the inflammatory process in muscles.
A sufficient amount of polyunsaturated acids is contained in:
- salmon fish species ( salmon, pink salmon, chum salmon);
- herring;
- halibut;
- tuna.
These products include:
- carrot;
- beet;
- potato.
Water mode
Drinking regime is very important in the prevention of myositis. The amount of liquid you drink per day should not be less than two liters. In addition to weak green tea, you should diversify your drinking with fruit drinks and compotes. Rosehip decoction helps reduce swelling in tissues.
Physical activity
To prevent myositis, you should adhere to the following points:
- spend more time outdoors;
- alternate physical activity with rest;
- harden the body;
- watch your posture;
- When working at the computer for a long time, do gymnastics for your back and neck muscles every hour.
What should you avoid?
To prevent myositis, you should exclude:- passive lifestyle;
- long-term loads on one muscle group;
- staying in drafts;
- hypothermia of the body.
According to the course, myositis can be acute, subacute and chronic, and in terms of prevalence - localized and diffuse.
Pathological anatomy
Morphological changes in Myositis are represented by alterative, exudative and proliferative processes in muscle tissue (see Inflammation).
With purulent Myositis of strepto- or staphylococcal etiology, widespread necrotic changes are detected, delimited by a massive leukocyte shaft. Inflammation can be diffuse like phlegmonous M. and limited to the pyogenic capsule with the formation of an abscess. With Pseudomonas aeruginosa infection, putrefactive decay of necrotic tissues is noted. In the muscles adjacent to necrosis, severe circulatory disorders are detected in the form of severe plethora, stasis, hemorrhages and massive fibrinous exudate with a small number of polynuclear cells.
Non-purulent infectious myositis can be serous, perenchymatous-interstitial, proliferative, diffuse sclerotic. Serous M. usually develops as reactive inflammation around a pathological process (eg, tuberculosis, tumors). Viral M. is characterized by vacuolar degeneration, segmental coagulation necrosis with macrophage resorption of muscle fibers, and small-focal lymphoplasmacytic infiltration. Electron microscopy reveals subsarcolemmal paracrystalline viral inclusions in single muscle fibers.
M. in tuberculosis occurs as an interstitial type with tuberculous granulomas or a cold abscess is formed (see Natechnik), in which a focus of coagulation necrosis and granulation tuberculous tissue is determined. Syphilitic M. is characterized by a diffuse sclerotic process; gummas are less common in the thickness of the muscles. M. in rheumatism, depending on the activity of the patol, the process can occur with a predominance of exudative, destructive or proliferative changes and the presence of typical rheumatic granulomas. With polyfibromyositis, serous effusion, lymphoid-histiocytic infiltrates, focal dystrophic and necrotic changes in muscle fibers with subsequent sclerosis of the endo- and perimysium are histologically revealed. With polymyositis, macroscopically the muscles are swollen, pale, with foci of necrosis and hemorrhage; in the chronic course of the disease, they become denser due to the proliferation of fibrous tissue. Histologically, in acute polymyositis, parenchymal-interstitial inflammation is observed with pronounced dystrophic (granular, hydropic, fatty) and necrotic (myolysis, coagulation necrosis) changes in muscle fibers and predominantly perivascular large-focal lymphoid-macrosphagal infiltration (Fig. 1). Signs of macrophage resorption and intracellular regeneration with proliferation of subsarcolemmal nuclei are revealed. With hron, polymyositis (Fig. 2), a combination of processes of atrophy, hypertrophy and destruction of muscle fibers, sclerosis and lipomatosis of endo- and perimysium is noted. Some muscle fibers undergo calcification. Involvement of the perineurium in the inflammatory process leads to destruction of the myelin sheaths and axial cylinders of the nerve trunks with the development of neuromyositis.
In toxic M., necrotic changes in muscle fibers (myolysis, coagulative necrosis) predominate, with preservation of the sarcolemma and a scant inflammatory reaction in the endo- and perimysium. For professional M., caused by prolonged physical exercise. tension, focal dystrophic and atrophic changes in muscle fibers, sclerosis of the endo- and perimysium are determined.
Heterotopic ossification, which is a pathological form of bone formation (see Bone), can develop in many tissues and organs, including muscles. The most important form of heterotopic ossification is ossifying M. In traumatic ossifying M., young connective tissue with actively proliferating fibroblasts is determined in the center of the foci of compaction, and at the periphery there is a calcified ground substance, immature and mature bone crossbars. Ossifying M. of non-traumatic origin is a universal calcification of muscles (see Calcinosis), which is based on fibrodysplasia. Histologically in compaction nodes in the early stages patol. process, actively proliferating fibroblast-like cells are found. Their cytoplasm contains a large amount of glycoprotein rich in mannose. Electron microscopically, the cells resemble tumor cells (hyperchromic nuclei, hyperplastic cytoplasmic reticulum and lamellar complex). In the interstitial tissue, there is an accumulation of glycosaminoglycans (hyaluronic and chondroitin-sulfur acids). The formed node has a zonal structure: in the center there is fibrous tissue made of fibroblast-like cells, along the periphery there are areas of osteoid. Subsequently, lime is deposited into the newly formed bone trabeculae. In addition to metaplasia of connective tissue into bone, metaplasia into cartilage is noted, followed by enchondral ossification. The bone areas take on a branched shape with a spongy structure in the internal sections and compact in the external sections. Bone marrow appears in old bone formations.
Selected clinical forms of myositis
Purulent myositis is most often caused by staphylococcus, as well as streptococcus, pneumococcus, anaerobic infection and other pathogens. It usually develops acutely against the background of a focal purulent process or in connection with septicopyemia (see Sepsis). Sometimes muscle damage occurs some time after the inflammatory phenomena in the primary focus have subsided. Sources of infections can be various pustular skin diseases, carious teeth, purulent processes in the tonsils, paranasal cavities (paranasal, T.), middle ear, in women - in the genitals, etc. Most often, purulent M. is localized, although multiple ones are also observed lesions. The pathogenesis is based on the development of inflammation in muscle tissue in response to a purulent infection. Cooling or injury can contribute to the localization of the inflammatory process in a particular muscle.
Wedge, the picture is characterized by local pain, the intensity of which quickly increases. The pain sharply intensifies with movements that cause contraction of the affected muscles, as well as with palpation. Swelling and swelling of soft tissues appears; sometimes skin hyperemia. Protective muscle tension develops and movement in the joints is limited. As a rule, there are general symptoms in the form of high fever, chills, headache, as well as an increase in regional lymph nodes. In the blood - leukocytosis with a shift to the left, increased ROE. A fluctuation may appear at the site of the developing infiltrate after a few days, and pus is obtained during puncture. Treatment of acute purulent M.: antibiotics, physiotherapy, surgery. The prognosis with proper and timely treatment is favorable.
Infectious non-purulent myositis occurs as a complication after influenza, respiratory diseases, typhoid fever, as well as rheumatism and against the background of chronic infections such as tuberculosis, brucellosis, syphilis. Special forms of information. M. is Bornholm disease, which is caused by a virus from the Coxsackie group (see Epidemic pleurodynia), as well as the so-called. muscular rheumatism. Pathogenesis inf. M. - the appearance of inflammatory changes in muscle tissue of a specific or nonspecific nature. In tuberculous M., a specific process spreads to the muscles lymphogenously or hematogenously. Syphilitic M. is characterized by local damage to any muscle group as a result of solitary gumma or diffuse damage with the development of a sclerotic form of M.
Inf. M. can develop acutely, subacutely, or have a chronic course. For a wedge, the picture is characterized by ch. arr. local pain syndrome. Pain, both spontaneous and with palpation and active movements. The muscle attachment points are especially painful. There may be swelling and muscle tension. The mobility of the corresponding part of the body is sharply limited. When palpating the affected muscles at the site of the most pronounced pathology of the muscle tissue, one can detect painful, mobile to the touch, dense formations ranging in size from millet grains to beans, round or irregular in shape (Cornelius syndrome). Sometimes, especially in the gluteal, calf, trapezius, and deltoid muscles, painful lumps are detected that change their shape when pressed (Müller's hypertonicity syndrome). In the middle or deep layers of muscles, you can also find round or oblong compactions of a gelatinous consistency - myogeloses.
In addition to pain, skin hyperesthesia may be observed in the area of the affected muscles. Muscle weakness is secondary and usually develops in connection with the presence of pain. Muscle atrophy is uncommon for this form of M. General symptoms, as a rule, are absent, although depending on the etiology, manifestations of general inf. process (especially with chronic infections).
Rheumatic pain is characterized by nagging, often “flying” pain in the skeletal muscles, with sharp pain noted on palpation. The pain may worsen at night or when the weather changes. The course of rheumatic M. is subacute or chronic. With this form, muscle atrophy may develop, usually moderately severe.
Treatment for inf. M. - painkillers, drugs such as reopirin, in some cases antibiotics. For rheumatism, as well as for tuberculous or syphilitic M., specific therapy is carried out. The prognosis is favorable.
Polymyositis- inflammatory muscle damage, which is based on an infectious-allergic process (see Infectious allergy). Along with inflammatory reactions, dystrophic changes also develop in muscle tissue. The first case of polymyositis was reported by E. L. Wagner in 1863.
Polymyositis occurs at any age, but most often from 5 to 15 years and from 50 to 60 years. Women get sick twice as often as men. There is evidence of an increase in the frequency of this form of M.
The etiology and pathogenesis of the process are not fully understood. It is possible that polymyositis is a polyetiological disease, since there are a number of factors that precede the development of the wedge, symptoms. Thus, various infections (especially sore throat), trauma, massive insolation, the use of large quantities of various medications, in particular sulfonamides and antibiotics, are considered as factors leading to the development of hypersensitivity (see Allergy). Endocrine changes during pregnancy, childbirth, and menopause are important. Most scientists assign the leading place in the pathogenesis of polymyositis to autoimmune processes with the formation of antibodies to muscle tissue. Clinically, the disease manifests itself as pain (see Myalgia), usually moderately severe, and muscle weakness. Paresis is localized mainly in the proximal muscles of the arms and legs, in the muscles of the pelvic and shoulder girdles. There may be compactions in the muscles, and sometimes moderate atrophy develops. Tendon reflexes (see) usually decrease and sometimes disappear. There are no objective sensitivity disorders, and there are no tension symptoms. Wedge, the picture may resemble Erb-type myodystrophy (see Myopathy). In some cases, muscle tension and even sudden tightening (induration) develop. In the later stages of the process, tendon contractures appear (see), often in the biceps brachii muscle and in the Achilles (calcaneal, T.) tendons. Visceral lesions are rare. Hypotonia of the esophageal muscles is sometimes observed. In some patients, polymyositis is very mild. Patients report only pain, muscle weakness and fatigue. At the same time, severe, acute forms with a rapid increase in pronounced weakness up to tetraplegia may occur.
In children, the picture of dermatomyositis (see) in the form of an acute or chronic form is more common. Often during chronic conditions, calcifications form in the affected muscles. In adults, polymyositis can be combined with carcinoma or be a component of the clinical picture of “dry” Sjögren’s syndrome (hyposecretion of the lacrimal, salivary, gastric and intestinal glands, polyarthritis). In severe cases of acute polymyositis, leukocytosis, neutrophilia, an increase in ROE are observed in the blood, creatinuria and a decrease in urinary creatinine excretion are often observed. The activity of enzymes in the blood serum may be increased, especially creatine phosphokinase, aldolase, and transaminase. In protein fractions, an increase in alpha-2 and gamma globulins is sometimes observed. In mild cases of polymyositis, biochem. there may be no changes. EMG using needle electrodes (see Electromyography) reveals a characteristic triad of changes: 1) short, low polyphasic motor unit potentials, 2) fibrillation potentials and irritation upon electrode insertion, 3) bizarre high-frequency discharges.
Gistol is very important, confirming the diagnosis of M. A biopsy reveals necrosis, phagocytosis, atrophy and degeneration of fibers of types I and II, a clear inflammatory infiltration, a picture of vasculitis. Polymyositis should be differentiated from other muscle syndromes accompanied by pain, and primarily from endocrine myopathies (hyperparathyroidism, hypocorticism, thyrotoxicosis). Hron, polymyositis in adults must be distinguished from sporadic forms of myopathy and spinal amyotrophy (see), myasthenia gravis (see), McArdle's disease (see Glycogenosis), as well as granulomatous M. (muscular form of sarcoidosis).
For mild forms of polymyositis, desensitizing agents are used, butadione, resoquine, delagil in combination with ATP, ascorbic acid, vitamin E, and when inflammatory phenomena subside - massage, exercise therapy. In severe forms with clear biochemical changes, especially in combination with damage to internal organs, treatment with steroid hormones is carried out. It is preferable to prescribe prednisolone, since other drugs can aggravate muscle damage (steroid myopathy). A good effect was obtained when using large doses of prednisolone intermittently (a two-day dose of 80-100 mg is taken immediately within 1-2 hours every other day)! The duration of the course of treatment depends on the severity of the process, tolerability of the drug, wedge, effect. As a rule, the maximum dose of the drug is prescribed for 5-6 months, after which it is gradually, very slowly reduced. A maintenance dose of 10-20 mg is prescribed for up to 1.5 years.
If muscle weakness does not disappear when treated with prednisolone for 2 months, a combination of it with methotrexate is recommended at an initial dose of 10-15 mg intravenously. If well tolerated, the dose is gradually increased to 30-50 mg. The interval between infusions is 5-7 days. Duration of therapy is 12-15 months. Daily intake of prednisolone in these cases is gradually reduced (to 20 mg after 6 months and to 10 mg after 12 months).
Simultaneously with taking prednisolone, antacids (see), potassium supplements are prescribed, and blood pressure and blood sugar levels are monitored. Side effects with intermittent steroid therapy, as a rule, do not occur or are mild. The prognosis for mild forms is favorable; for severe forms, it depends on the completeness and timeliness of treatment.
Toxic myositis observed in a number of intoxications. Thus, with severe alcoholism, painful swelling of the muscles with paresis, myoglobinuria and secondary renal failure may occur. The use of certain pharmacological agents can lead to muscle damage. drugs (colchicine, vincristine, etc.), as well as bites of certain animals and insects, especially in tropical countries.
Treatment - it is necessary to exclude the effect of the factor that caused toxic M. and carry out detoxification therapy. In cases of alcoholic etiology, the administration of thiol drugs (unithiol, sodium thiosulfate), as well as large doses of vitamin B1, is indicated. In severe cases, hemodialysis is performed. The prognosis is relatively favorable.
Neuromyositis stands out from the general group of M. due to the fact that in this form, in addition to inflammatory changes in muscle tissue, there are changes in intramuscular nerve fibers, and sometimes in the distal sections of nerve axons.
Clinically, this form is characterized by severe pain; the pain sharply intensifies upon palpation, and Valle's painful points may be noted (see Diagnostic painful points). Symptoms of tension are weakly positive. Confirmation of the diagnosis (in addition to biopsy data) is helped by EMG, which reveals elements of denervation changes.
Treatment - analgesics, anti-inflammatory drugs, physiotherapy (thermal procedures, Bernard currents), sometimes local novocaine blockade. The prognosis is relatively favorable.
Polyfibromyositis Some scientists refer to systemic diseases, in which inflammatory changes in the muscles are accompanied by a pronounced reaction from the connective tissue with the development of fibrous changes in it.
Clinically, the disease manifests itself as pain during movement, severe pain at the points of muscle attachment, and the formation of compactions in the form of nodules and cords. Muscle tendons may suffer, they become sharply painful, often thicken, and contractures develop. Very severe forms of the disease have been described, in which, due to the development of severe muscle fibrosis, a progressive restriction of movements occurs, especially in the muscles of the back and shoulder girdle, and the formation of pathological postures. Confirmation of the widespread fibrosing process, in addition to the histol research data, is the lack of relaxation of the affected muscles during sleep and during general anesthesia. Hron, a form of polyfibromyositis can be a consequence of polymyositis or extensive traumatic myositis.
Treatment - anti-inflammatory drugs, lidase injections, massage, exercise therapy, physiotherapeutic procedures, balneotherapy. The prognosis depends on the severity and extent of the process.
Myositis ossificans(Munchmeyer's disease) is a metaplastic process, in which calcification occurs, and subsequently true ossification of the connective tissue layers in the thickness of the muscles, as well as fascia, aponeuroses, and tendons. There are several hypotheses for the pathogenesis of extraskeletal bone formation - heterotopic ossification: inflammatory, trophoneurotic, endocrine, embryogenetic (as an anomaly of mesenchyme development). Ossifying M., or heterotopic ossifications, can be independent formations, but also arise as a result of injury. Sometimes ossifying M. can be the initial stage of dermatomyositis (see).
Ossifying M. is a progressive disease, observed mainly in childhood, very rarely after 20 years. Males are more often affected. Wedge, the picture is characterized by a gradual restriction of movements, stiffness of the muscles of the neck, back, proximal limbs, and sometimes the muscles of the head. Posture changes, pathology and postures develop. When palpating the muscles, dense formations of various sizes and shapes are determined. Additional trauma worsens local ossification).
Ossifying traumatic M. should be considered as intramuscular fibrositis that occurs as a response to damage to soft tissues. It can develop as a result of a single injury or as a result of frequently repeated trauma to the same muscle, for example, during sports. In the first time after injury, M. is manifested by symptoms of soft tissue contusion in the form of limited and painful hardening, a local increase in skin temperature, redness, and dysfunction of the entire limb or, more often, one segment of it. Gradually, acute phenomena subside, a painless period begins, sometimes lasting several weeks or even months. Subsequently, at various intervals, patients pay attention to a solid formation, sometimes tightly connected to the bone and close to the subcutaneous tissue. There are cases when, before rentgenol, research, these dense formations in the muscles were mistaken for sarcomas of bones or soft tissues, especially for paraosseous sarcoma. The favorite localization of ossifying traumatic M. is the region of the brachial muscle, a group of muscles at the level of the diaphysis of the femur, and the gluteal region.
In addition to ossifying M., heterotopic ossification can manifest itself in the form of calcification and ossification of tendons at their attachments to bones or periarticular ossifications. There are typical localizations of ossifications, for example, Pellegrini-Stied disease (see Pellegrini-Stied disease), ulnar “spur”, the so-called. post-traumatic bones in the adductor muscles of the thigh in equestrians, in the biceps brachii, in the deltoid muscle in gymnasts, etc. These formations should not be confused with calcifications in the mucous bursae.
Progressive (multiple) ossifying M. has a very characteristic rentgenol picture. Shadows of irregular coral-like shape on the radiograph are noted at the beginning of the disease in the muscles of the back, neck, back of the head, and later in the muscles of the limbs and abdomen.
With ossifying M. of trophoneurotic origin (with tabes dorsalis, syringomyelia, injuries of the spinal cord and large nerve trunks, transverse myelitis, polyneuritis), rentgenol, changes are detected in the form of low-intensity flocculent shadows, which subsequently become more dense. They are usually localized at the hip, knee joints, and along the fibula. This longitudinal arrangement of shadows should be taken into account when differentiating ossifying M., for example, with sarcoma, in which the shadows of calcifications are located predominantly in the transverse direction to the length of the bone.
Trophoneurotic bone formations are often combined with lesions, destruction of bones, for example, greater trochanters, ischial tuberosities and other protruding bone formations.
X-ray, the picture of ossifying traumatic M. in most cases is expressed by an irregularly shaped shadow with unclear outlines. At first, the shadow is low-intensity, cloud-like, but over time it becomes denser, and subsequently the bone structure is often distinguished in it. The shadow of ossification usually lies isolated from the bone of the limb, but subsequently often merges with the shadow of the bone. Particularly significant ossification is observed in the muscles of the elbow joint, in the brachial muscle.
Treatment of ossifying progressive M. is ineffective. There are attempts to influence calcium metabolism using complexones (tetacine-calcium). Previously used surgery to remove the parathyroid glands is not effective.
In case of ossifying traumatic myositis in the presence of a hematoma (see), cold and a pressure bandage are prescribed to prevent the increase in hemorrhage; after 2-3 days, dry heat is recommended to resolve the hematoma. In the early stages of the formation of heterotopic ossification, ozokerite applications, physiotherapeutic treatment using ultrasound, and hydrocortisone are used. Conservative treatment of ossification is ineffective. After maturing to bone density, the formation does not grow, as a rule, does not develop back, but may decrease in volume. The most radical treatment method is surgery. Indications for it include dysfunction of the joint, compression and irritation of the nerve trunk, or compression and close proximity of ossification to the great vessels. After removal of the ossification, immobilization of the limb is necessary for up to 10 days.
The prognosis is favorable. There are no relapses without repeated injuries.
Prevention of traumatic ossifying myositis is a careful attitude towards soft tissues, especially when playing sports and during professional loads on certain segments of the skeleton.
Occupational myositis develops as a result of a violation of the trophism of muscles that are subjected to intense overstrain during labor activity, especially when performing monotonous differentiated movements or during prolonged static tension. It is characterized by pain, decreased muscle strength, the development of fibrous formations in certain muscle groups in the form of nodules, cords (fibrositis, cellulite), usually accompanied by damage to the tendon sheaths (tenosynovitis). The muscles of the upper limbs and shoulder girdle are most often affected.
Treatment - massage, local thermal procedures (paraffin, warm baths), diathermy, electrophoresis. However, complete cure is difficult to achieve.
Bibliography: Biochemical changes in the body during injury, ed. N. N. Priorov and B. S. Kasavina, p. 115, M., 1959; Gauemanova-Petrusevich I. Muscular diseases, trans. from Polish, Warsaw, 1971; Demidova P.V. and Potomskaya L. 3. Muscle syndrome in chronic polymyositis, Zhurn, neuropath, and psychiat., t. 76, century. 2, p. 204, 1976; Dyachenko V. A. X-ray diagnosis of calcifications and heterogeneous ossifications, M., 1960; Eremina L.A. and Tseshkovsky M.S. Myositis ossificans (parostal ossifying hematoma), in the book: Tumors of the musculoskeletal system, ed. N. N. Trapeznikova and L. A. Eremina, V. 5, p. 174, M., 1976; Korzh A. A. Heterotopic traumatic ossifications, M., 1963, bibliogr.; Kupilova Yu. S. and Ilashev A. I. Progressive multiple myositis ossificans, Pediatrics, No. 7, p. 77, 1972; Mutin S.S. and Sigidin Ya.A. Infectious-allergic myositis, Klin. med., t. 43, no. 5, p. 130, 1965; Proskura V.I. and Kostenko I.N. About multiple progressive myositis ossificans, Doctor, case, No. 4, p. 114, 1973; Strukov A.I. and Kopyeva T.N. Dermatomyositis, Arch. pathol., t. 30, no. 9, p. 3, 1968; Watson-Jones R. Bone fractures and joint damage, trans. from English, p. 45, M., 1972; Yumashev G. S. Traumatology and orthopedics, p. 368, M., 1977; Bethlem J. Muscle pathology, Amsterdam-L., 1970; Dermatomyosites and polymyositis, ed. by W. F. Lever, N. Y., 1974; Disorders of voluntary muscle, ed. by J. N. Walton, Edinburgh, 1974; DubowitzY. a. Brooke M. H. Muscle biopsy, L., 1973; Mair W. G. P. a. Tome F. M. S. Atlas of the ultrastructure of diseased human muscle, Edinburgh - L., 1972; Pearson S. M. Polymyositis, Ann. Rev. Med., v. 17, p. 63, 1966; Ricker K., Seitz D. a. Tro-stdorf E. Myositis fibrose generalisata and “stiff-man” syndrome, Europ. Neurol., v. 3, p. 13, 1970.
N. A. Ilyina; V. A. Dyachenko (rent.), M. K. Klimova (trauma), T. N. Kopieva (pat. an.).
symptoms and treatment at home? – this is the question asked by people exhausted by muscle pain of various types. It is the diagnosis of “myositis” of various localizations that is immediately established by the doctor at the appointment.
And this is not surprising, since this pathology includes a large number of diseases of different etiologies. Taking this into account, if myositis is suspected, symptoms and treatment in each case are determined individually, taking into account numerous factors. If myositis is detected, home treatment forms the basis of therapy, but its regimen must be agreed with a doctor.
The essence of pathology
Muscle myositis includes a group of inflammatory skeletal muscle diseases of different localization. This pathology is characterized by pain syndromes, decreased muscle tone and muscle tissue atrophy. In this case, one area of the skeleton may be affected (local myositis) or different muscle groups at the same time (polymyositis). Most often, pathology is found in the neck, lower back, lower leg, and chest. The leader in the frequency of identified pathology is myositis of the neck muscles.
The course of the pathology can occur in acute and chronic form. The acute type of the disease is usually caused by local infection of muscle tissue, injury, or exposure to an external factor (for example, hypothermia). There is an active manifestation of pain syndrome. The chronic form results from the lack of treatment of the disease at the acute stage. Sometimes a person does not even feel the transition of pathology into a chronic form, considering himself completely healthy until the next exacerbation. And the chronic form, precisely, is characterized by alternating exacerbations and periods of remission.
Infectious type of pathology
To develop an effective treatment regimen for myositis, it is important to correctly classify the disease according to the etiological mechanism and pathogenesis of the disease. There are several directions in the etiology of the occurrence of pathology. The most common cause of muscle lesions is infection. The main causative agent of the infectious form of myositis is enteroviruses, as a consequence of the flu. Brucellosis, syphilis, and tuberculosis can provoke pathology. An important role is played by infections such as E. coli, staphylococci and streptococci.
The second direction of development of the infectious etiological mechanism is the autoimmune variant. The main culprit of such damage is streptococci. The essence of the triggering mechanism is that toxins are fixed in the connective tissue, and the immune system produces antibodies to them, which simultaneously attack the connective muscle tissue (stroma). These collagen and elastic structures, tendons, and fibrous membranes are the first to be damaged, after which the process moves on to the muscle fibers.
Other types of pathology
A special form of the disease is myositis ossificans. The cause of this pathology is the accumulation of potassium salts in muscle tissue, which leads to their ossification. One of the representatives of this form is the traumatic type. Severe injuries can lead to ossification of muscle tissue: dislocations, bruises, sprains. The disease can be caused not only by excessive stress, resulting in significant injuries, but also by constant microscopic injury due to regular overload (athletes, musicians). A progressive type of ossifying pathology is distinguished separately. The disease is caused by hereditary and congenital disorders in the musculoskeletal system. The first manifestations of the disease are observed in children, but progression is gradual and ultimately leads to tissue ossification.
Toxic myositis occurs due to internal intoxication or external poisoning. Thus, internal (endogenous) toxins are produced in case of significant disturbances in metabolic processes, in particular in diseases of the cardiovascular system, liver and kidneys, as well as in pathologies of an endocrine nature (diabetes mellitus, thyrotoxicosis). A prominent representative of external toxins is alcohol.
Connecting other structures to the process
If inflammatory reactions in other systems of the human body are connected to the process of damage to muscle tissue, then specific diseases arise. When skin damage is added to the pathology, we can talk about a disease called dermatomyositis. This variety is typical for women aged 20-35 years, but the etiological mechanism of this combination is not fully understood.
It is generally accepted that the provoking causes are stress, frequent colds, hypothermia and excessive exposure to solar radiation. When this myositis develops, symptoms include the following: a reddish or purple rash on the face, arms, and upper body; swelling of the eyelids; general weakness; low-grade fever; weight loss; state of chills. In this case, muscle problems are expressed in a decrease in their tone, flabbiness, and pain.
There may be cases where secondary involvement of other systems in the process is detected: nerve fibers with the manifestation of neuromyositis and joints - myositis in combination with arthritis. With neuromyositis, the nerve fibers inside the muscles and the terminal nerve sections are affected. With this type of pain, the pain is most severe. Another type of pathology may occur – polyfibromyositis. With this disease, the muscle attachment points are most affected. In this case, there is a thickening of the muscle tendons with the development of contractions in them. As a result, the muscles do not relax at night and even during general anesthesia.
Features of the manifestation of pathology of different localizations
Symptoms of myositis depend on the location of the pathology, but the following main signs can be identified:
- pain syndrome;
- redness;
- swelling;
- functional disorders.
Strands and nodules can be clearly felt in the muscle structures. The pain syndrome increases significantly with movement and physical activity. The most important symptom is weakening muscle strength and decreased muscle mass. Taking into account the localization of the process, certain specific circumstances can be identified.
Neck myositis is the most common pathology of this type and is painful. In addition, this type of pathology can be considered the most dangerous, since the processes spread to the temporal area of the head and the cervical spine. Accordingly, pain syndrome can manifest itself in these areas. Cervical myositis can spread to the esophageal smooth muscles, which leads to problems with swallowing and sometimes causes difficulty breathing. If the disease starts, it becomes difficult to hold the head up, and there is a tendency to lower it onto the chest. One of the characteristic causes of cervical pathology is hypothermia - even a small draft sometimes causes an unexpected aggravation. In addition, the etiological mechanism can be triggered by neck turns with extreme amplitude, uncomfortable position at night, and physical overload.
Myositis of the muscles of the pectoral region is much less common and is often caused by human activity associated with prolonged standing in an uncomfortable position. Characteristic symptoms: moderate pain, general weakness, numbness in the morning. When standing for a long time, the pain intensifies.
Myositis of the back muscles is common in people whose work involves being in an uncomfortable position for a long time (for example, truck drivers). Increased risk in pregnant women. The psoas and trapezius muscles are most commonly affected. In the first case, pain in the lower back intensifies when bending over. On palpation, a thickening of the muscle tissue is clearly felt. Nodules can be felt in the trapezius muscle. Somewhat less frequently, damage to the suprascapular and paraspinal muscles can be detected.
Principles of pathology treatment
When myositis occurs, treatment is determined by the etiological features, localization and stage of development of the disease. Naturally, the treatment regimen is individual, taking into account the age and characteristics of the human body. Treatment is prescribed after diagnosis and differentiation of the type of myositis. The primary diagnosis is made based on the results of symptom analysis, examination and palpation. A blood and urine test is performed to identify the inflammatory reaction and the presence of infection. Electromyography gives the most complete picture.
Treatment is usually carried out at home and is aimed at solving the following problems:
- eliminating the causes of pathology and stopping the inflammatory process;
- combating the manifestation of symptoms and, above all, pain;
- restoration of muscle functions and strengthening them.
When neck myositis is diagnosed, treatment is aimed at preventing damage to the spine and main artery. Treatment tactics are based on drug therapy, physiotherapy, and exercise therapy. At home, it is especially important to combine therapy with the possibilities of traditional medicine.
Drug effects
Treatment with medications at home is carried out strictly as prescribed by the doctor. As a rule, systemic medications are prescribed for oral administration and external agents for local therapy. The most common groups of drugs for oral administration and injection are:
- non-steroidal anti-inflammatory drugs: Movalis, Celecoxib, Nimesulide, Etoricoxib, Ibuprofen, Ketanov, Diclofenac, Ketorolac, Indomethacin, Peroxicam;
- analgesics to eliminate pain: Analgin, Antipyrin, Miolgin, Phenacetin, Paracetamol;
- Antibiotics for infectious myositis are prescribed only by a doctor, taking into account the specific pathogen.
An important stage of treatment is the use of warming and anti-inflammatory ointments. For myositis, the use of the following agents is recommended:
- Traumeel S is an anti-inflammatory analgesic composition with immunostimulating properties. The course of treatment is 15-30 days;
- Gevkamen - ointment with an anti-inflammatory effect;
- Mephenate is a non-steroidal ointment with a prolonged action;
- Espol is a warming ointment with anti-inflammatory properties, effective for 2-2.5 hours;
- Fastum-gel is produced on the basis of ketoprofen;
- Roztiran: the ointment contains essential oil (fir, nutmeg, eucalyptus), course - 4-6 days;
- Relief gel based on levomenthol and ibuprofen, course of treatment – 8-12 days;
- Diclak gel based on diclofenac, relieves pain and swelling;
- Dolaren-gel has good penetration ability through the skin;
- Apisatron is an ointment based on bee venom;
- Viprosal is an ointment made using viper venom;
- Vipratox is a drug based on snake venom.
When using external products, you must first consult your doctor. In addition, it is important to avoid allergic reactions, and a sensitivity test should be performed before use.
The use of folk remedies for home treatment
The use of folk remedies can be a very useful addition to drug treatment at home. However, it is advisable to coordinate even their use with a doctor. One of the very first folk methods is exposure to dry heat. Such a compress is applied to the affected muscle in the form of a boiled potato, wrapped in a towel, or heated salt placed in a fabric bag. After thermal exposure, the affected area is rubbed with alcohol or an alcoholic infusion of medicinal plants.
- Warming ointment: egg yolk, apple cider vinegar (1 tbsp), turpentine (1 tsp) - rub in before bed, cover with a woolen scarf throughout the night.
- The iodine mesh is applied with a cotton swab to the skin in the affected area.
- Burdock: apply a leaf after the plant, which is fixed on the sore muscle before going to bed.
- A compress from this mixture: 10-15 drops of laurel, fir or sea buckthorn oil are added to water (1 liter), the water is preheated to 48-55 0 C.
- A mixture of bodyaga and butter in equal proportions - rub the sore spot before bed.
- Decoction: prepared from willow bark (2 tablespoons per 0.5 liters of water), heated in a water bath.
- Pine decoction: pine needles are crushed and boiled in water for 45-60 minutes, then infused until completely cooled.
The most popular folk methods include the following procedures:
- applying a cabbage leaf compress;
- rubbing the affected area with apple cider vinegar;
- taking a drink in the form of a mixture of apple cider vinegar and honey;
- a compress of badger or nutria fat with added salt.
When treating at home, it is important to ensure rest and proper nutrition. It is necessary to exclude alcoholic beverages, spicy and salty seasonings, and fatty foods during the treatment period. It is recommended to add foods rich in vitamins E and B to the menu: legumes, lettuce, corn, sea buckthorn, celery, sunflower oil.
Myositis is a large group of muscle diseases that can ruin a person’s life. Timely detection and effective treatment at home will help get rid of these problems.
Every person in his life, to one degree or another, encounters different types of pain, which are equally unpleasant for everyone. However, without pain, our body would not be able to function normally, because with the help of pain, a damaged organ signals us about violations that need to be eliminated. If we feel pain in the muscles, then this may be a sign of an inflammatory process in the tissues.
What is muscle myositis?
A disease of muscle tissue that is inflammatory, traumatic, chronic and is accompanied by pain and weakness throughout the body. Most often, the disease is present in the muscles of the neck, back, shoulders, and chest of a person.
Muscle tissue with myositis
Types of myositis depending on the cause of occurrence
Depending on the cause of occurrence, types of myositis are distinguished:
Dermatomyositis of the hands
According to the nature of the flow, they are distinguished:
- Chronic myositis- inflammation after treatment is not completely eliminated, occurs with sluggish symptoms and can progress as a result of unfavorable factors (overwork, hypothermia, etc.).
- Acute myositis- sudden onset of pain and inflammation after injury or severe stress on the muscles.
Manifestations of polymyositis
According to the nature of the pathology:
- Local myositis- development of the inflammatory process of one muscle. There is a sharp pain when pressing and moving the affected area. As a result of a constant state of tension, the mobility of joints and limbs is limited.
- - damage to a muscle group, in which muscle pain is observed with increasing strength, for example, in the lumbar and shoulder muscles.
There is also myositis ossificans, It is quite rare, appears after injuries, muscle damage, or has a congenital hereditary nature. Symptoms are pain, swelling, redness of the skin.
Myositis of the pectoral muscles
The main sources of the inflammatory process are:
- colds, infections;
- chronic pathology;
- purulent tissue lesions;
- autoimmune diseases and stress.
Often, after an infectious disease, illness may occur. Hypothermia, injury, heavy physical exertion, and poisoning with toxic substances can also trigger the disease.
Diagnostics
An initial examination of the patient by a doctor and compilation of the examination results can confirm or refute the presence of inflammation in the muscles. A study of blood and secretions that were taken from the affected area complements the initial information.
The sequence of diagnostic measures allows us to identify the presence of the inflammatory process, the area of distribution, the degree of damage, and the cause of formation.
Photo of myositis
To make a correct diagnosis, it is necessary to carry out certain types of examinations:
- blood analysis, which shows how fast red blood cells settle;
- electromyography allows you to identify the condition in the affected area; the muscles have nerve fibers;
- CT scan allows you to identify signs of myositis ossificans at an early stage;
- Magnetic resonance imaging shows in detail the condition of the soft tissues.
The diagnostic results will be used to determine the type of myositis and prescribe quality treatment.
Which doctor treats myositis?
The doctor who will treat the disease may have different competences - it all depends on the localization of myositis. Treatment of myositis can be carried out by a therapist, traumatologist, neurologist, orthopedist or surgeon.
At the first manifestations of pain, you should contact a rheumatologist or therapist, who, after conducting an initial examination, will be able to refer you to a specialist for diagnosis and treatment.
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Symptoms and manifestations of myositis
| Type of disease | Description | Symptoms | Manifestations |
| Myositis of the neck | Inflammation occurs as a result of exposure to cold on the muscle tissue of the neck and affects not only it, but also the head area, temporal part and cervical vertebrae. | Neck pain, muscle swelling, headache. | Muscle thickening on the affected area. The most dangerous type of disease. |
| Myositis of the back and lumbar muscles | Inflammation begins in the muscle fibers and can affect the skin and even the spine. | Aching pain that increases with movement. | Fever, migraine, muscle atrophy. |
| Myositis of the chest | The inflammatory process can affect the superficial and deep muscles of the chest. | Muscle spasms, pain when breathing. | Damage to the function of the upper extremities, swelling, changes in the density of muscle tissue. |
| Myositis of the eye muscles, face | A disease that causes pain and swelling. | Severe pain in the orbital area, limited or absent eye mobility. | The orbital fiber is predominantly gray in color, lacks natural shine, and is high in density. |
| Myositis of the cleidomastoid muscle | Inflammation of the cervical spine, which is accompanied by limitation of movement. | Dysfunction of the cervical spine. | Tissue destruction and scar formation. |
| Intercostal myositis | A form of the disease that occurs in muscle tissue. | High fever, cramps, chronic cough, swelling. | Tissue damage in the rib area can, as it progresses, affect the chest area. |
| Myositis of the abdominal muscles | A muscle disease that is accompanied by pain in the affected muscle. | Increased temperature, pain on palpation. | Swelling, the appearance of nodular seals. |
| Myositis of legs and thighsa, knees, legs, feet | A disease that is chronic, traumatic and infectious. | Fever, redness, swelling. | Weakness in the legs; in the chronic form, problems with movement may occur. |
| Myositis of the arm, shoulder, forearm, elbow | An inflammatory process that limits the movement of the arm. | Tension and swelling of the muscles, pain when moving the arms. | Formation of nodules in the muscle. |
How to treat myositis?
To avoid complications, it is necessary to begin treatment under the supervision of a doctor immediately after confirming the diagnosis.
Drug treatment
Drug treatment is prescribed by a doctor to eliminate symptoms and the inflammatory process.
To treat the disease, medications from different pharmaceutical groups can be prescribed:
- NSAID drugs in tablets(Nimesulide, Ibuprofen, Movalis, Peroxicam, etc.).
- Non-steroidal drugs for injection(, Mydocalm).
- Analgesics(Antipyrin, Analgin, Paracetomol).
- Ointments(Turpentine ointment, Traumeel S, Dolaren-gel, Roztiran, etc.).
Nimesulide tablets Movalis is a drug of the latest generation
Ibuprofen tablets Meloxicam tablets Diclofenac tablets
Physiotherapy for myositis restores muscle contraction and significantly increases blood circulation.
The following procedures are recommended: 
- Warming up and wrapping inflamed area.
- Manual therapy- a set of techniques carried out through statistical voltage, the main purpose of which is the diagnosis and treatment of the disease.
- - normalizes blood circulation, relieves pain in muscles, eliminates swelling. The main goal of such therapy is to start the recovery process, to start the work of all limbs. The massage is carried out with increasing effect using a thermal procedure, which allows you to completely relax the sore muscles.
Magnetotherapy
Purulent myositis is the most dangerous type of disease. Self-treatment is prohibited, especially the use of ointments. Myositis seriously impairs the normal functioning of muscles, organs and the very quality of life.
Main symptoms:
- weakness;
- swelling;
- muscle hardening;
- discomfort in the affected area;
- heat.
Conservative treatment for this form of the disease is not effective; surgery is often performed to clean the affected area of pus.
The causes of purulent myositis are:
- staphylococci;
- streptococci;
- pneumococci;
- gonococci.
Timely diagnostics are necessary: MRI, ultrasound, electromyography, tests. When treating purulent myositis, antibiotics, antipyretics and painkillers are prescribed.
Purulent myositis of the legs
Nutrition for muscle myositis
The accumulation of harmful substances in the muscles can neutralize several vitamins (A, C, E).
For this reason, the daily diet should include: 
- Salads(sweet peppers, tomatoes, green lettuce).
- Salad dressing in the form of vegetable or olive oil.
- Fruits rich in vitamins for example, kiwi, tangerines, plums, oranges, apples (preferably green, sweet and sour).
- Add foods rich in salicylates giving fruits an anti-inflammatory effect.
- Carrots, potatoes, beets must be on the menu every day.
- Decoctions of raspberry leaf, peony, marsh cinquefoil will only bring benefits.
- Daily up to 300 grams of sea fish, the method of preparation is not important, boiled or stewed will do.
Spasms are present in any form of myositis.
One of the causes of seizures may be a deficiency of certain substances:
- magnesium(present in cereals, cereals, blackberries, legumes);
- calcium(found in fermented milk, dairy products, garlic, cabbage, parsley, celery);
- zinc(found in liver, cheese, meat, chicken eggs, pumpkin).
- For any form of myositis, the patient is prescribed rest(sometimes bed rest).
- Diet recommended, you must completely avoid spicy, alcoholic, salty and fatty foods. It is better to prefer vegetables, cereals, and fruits during the treatment period.
- Antibiotics must be prescribed if the disease occurs against the background of a previous infection,
- Surgery may be prescribed when purulent myositis is detected.
- Anti-inflammatory drugs mandatory for the use of any type of myositis. The purpose of the ointment is specific to the local affected area.
- Therapeutic massage and physiotherapy necessary for all patients who turn to specialists for help.
Prevention
To avoid the occurrence of myositis, it is necessary to pay special attention to the prevention of the disease:
- Avoid hypothermia and drafts.
- When working sedentarily, do muscle exercises.
- Avoid overstraining your muscles during physical activity.
- Diseases that provoke the occurrence of myositis should be treated in a timely manner.
- Do gymnastics, cycling, swimming.
- Watch your posture.
