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Inflammation of the soft tissues of the hand. Soft tissue diseases

A group of diseases that affect areas located near articular joints are combined under one common name - extra-articular rheumatism. These are different pathological processes in origin and clinical manifestations. A large group of periarticular diseases includes pathologies of tissues located both close to the joints and at some distance from them.

What are rheumatic diseases of periarticular soft tissues?

Extra-articular rheumatism is a group of soft tissue diseases of the musculoskeletal system. Rheumatic processes affect tendon sheaths, synovial bursae, fascia, subcutaneous tissue, ligaments, aponeuroses, entheses, neurovascular formations. The most studied to date are diseases of the periarticular tissues, which have a clear localization and certain clinical manifestations.

Non-rheumatic soft tissue diseases have less clear symptoms and a more uncertain location, which makes diagnosis and treatment difficult. According to statistics, damage to the periarticular apparatus is observed in 8% of the world's population. More often, the disease occurs in women aged 34 to 54 years who engage in heavy physical labor.

Types of extra-articular rheumatism

All inflammatory processes in the periarticular area can be divided into 2 groups: primary lesions (occur on the basis of intact joints or osteoarthritis) and secondary lesions (formed due to systemic diseases). The leading role in the origin of pathologies of group 1 is given to sports, professional or domestic stress, inferiority of the ligamentous apparatus at birth, the presence of vegetative-vascular, neuro-reflex and endocrine-metabolic disorders. In case of secondary damage, changes in the epithelium are usually caused by system process:

Reiter's syndrome;
hygroma (subcutaneous tumor the size of a pea);
rheumatoid or gouty arthritis;
hip periarthrosis;
plantar fasciitis;
rheumatoid synovitis;
ulnar styloiditis;
subdeltoid bursitis;
tendoperiostitis of the Achilles tendon;
rotator cuff tendonitis and others.

By location

Types of extra-articular rheumatism are also distinguished by the place of its localization. Doctors identify several painful conditions:

tendinitis is degenerative lesion tendons;
tenosynovitis - the second phase of the inflammatory process, developing after contact of the inflamed tendon with synovial tissue;
aponeurositis - aponeurosis;
fibrositis – fascia and aponeurosis;
fasciitis - fascia;
capsulitis - fibrous capsule at the joint;
myotendinitis - an area of muscle adjacent to the tendon;
enthesitis - places where the ligamentous apparatus is attached to the bone (enthesis);
ligamentitis – inflammation of extra-articular ligaments;
bursitis is a local inflammation of the serous bursa that develops after contact with an inflamed tendon (tenobursitis).

According to the nature of pathological changes

Diseases of periarticular soft tissues can be degenerative or inflammatory in nature. Primary independent pathologies are based on the process of degeneration, when the development of inflammation is associated with microtraumas of tendons and ligaments due to excessive loads and/or when trophism in the epithelium is disrupted. In inflammatory diseases, the painful process moves from adjacent structures, so this type of pathology is often secondary.

Causes of inflammation of periarticular tissues

Diseases of periarticular tissues occur for a number of reasons. More often, inflammatory and degenerative processes occur as a result of repeated microtrauma or prolonged physical overload. Doctors note other factors in the development of the disease:

prolonged exposure to dampness or hypothermia, especially of the lower extremities;
violation metabolic processes in organism;
menopause period in women (40-55 years);
infectious pathologies(flu, hepatitis and others);
changes hormonal levels (diabetes, obesity, etc.);
chronic or recurrent form of arthrosis, gonarthrosis or arthritis with inflammation and degeneration;
vascular and heart diseases, especially due to poor blood supply to the periarticular tissues;
prolonged nervous tension provokes vasospasm, promoting epithelial degeneration.

Risk factors

In addition to the direct causes, risk factors contribute to the development of the disease. Among them:

congenital underdevelopment of the ligamentous-tendon apparatus (articular hypermobility syndrome);
professional sports;
high physical activity at work;
an inactive lifestyle, which weakens the ligamentous apparatus;
long-term repeated movements with stereotypical amplitude;
presence of osteoarthritis;
previous myocardial infarction.

Symptoms of pathology

When periarticular tissues are damaged, restriction of movement and pain are observed only after the subdeltoid serous bursae and tendon sheath are included in the pathological process. Primary pathology does not manifest itself with clinical symptoms. Pain occurs only with movements associated with the lesion. In other cases, the patient’s physical activity does not cause pain due to the lack of contraction of the affected tendon.

The formation of diseases of periarticular tissues can be learned over time by developing signs:

presence of effusion (accumulation of biological fluid);
foci of necrosis (cell death);
formation of hematomas at the site of the lesion;
puffiness, swelling of the skin;
limited movement, radiating pain;
uncharacteristic excessive mobility;
local increase in temperature;
there is no flexion-extension ability of the limbs;
inflammatory process in the heels (talalgia);
pain that increases with movement or palpation;
when the periarticular elements of the lower extremities are deformed, an unnatural gait or lameness is sometimes observed.

An inflammatory disease of the tissues that surround the shoulder joint is called glenohumeral periarthritis. The work of the shoulder is ensured by: supraspinatus, teres minor, infraspinatus, subscapularis and biceps muscles (biceps), rotator muscles. During illness, calcium and lime salts (calcifying form) are deposited in the subacromial bursa, tendons or periosteum, which is why the limb is limited in movement.

Humeral periarthritis develops slowly, but it dystrophic changes greatly affect the quality of life. Adduction or abduction of the arm becomes impossible due to severe pain (locked shoulder symptom or Dowborn's sign). When the pathology is neglected, the patient, in addition to physical and moral suffering, becomes disabled. Humeral periarthritis, like all diseases of periarticular tissues, occurs secretly. The pathology does not appear until a provoking factor appears.

The main signs of the disease are limited arm mobility and pain. Other symptoms of shoulder tendon inflammation:

Very severe pain (radicular) syndrome is expressed in the acute period. Even at rest, debilitating pain occurs in the shoulder and shoulder blade, interfering with proper rest and sleep.
With a long course of the disease, spondylosis of the cervical spine develops, in which spinous processes grow on the edges of the vertebrae. Osteoporosis often begins humerus.
Destructive changes affect the hand. The skin of the hand becomes bluish, the muscles gradually atrophy, and it is difficult to bend the fingers.

Periarthritis of the elbow joint

In terms of the frequency of manifestations of diseases of periarticular tissues, the first is shoulder periarthritis, followed by elbow periarthritis. Diagnosis is complicated by the slow progression of the disease. More often, older people suffer from periarthritis of the elbow joint. Serious sports can also lead to the development of pathology. This disease is popularly called “tennis or golfer’s elbow” because it is an occupational disease of athletes.

As a result of injury or previous infectious or endocrine diseases Disorganization of the elbow tendons occurs, which is accompanied by the following symptoms:

the upper layers of the skin swell;
infiltration with an admixture of blood and lymph accumulates;
fibers formed by collagen merge;
sclerotic areas are formed;
The structure of the cells of the periarticular bursa changes, its walls grow together, and calcium salts accumulate in them.

Sometimes periarthritis is accompanied elbow bursitis- a non-inflammatory disease that affects the bursa of the elbow. In this case, upon palpation, a voting protrusion is determined. If the pathological process occurs in the periarticular bursa, then reactive bursitis develops, causing redness, swelling of the tissue, and the appearance of a serous infiltrate inside the source of inflammation.

Symptoms of hip inflammation

Compound femur and the pelvis is the location of the hip joint. The main elements of this part are the head of the femur, covered with cartilage tissue for soft sliding, and the socket of the pelvic bone. Because the femoral neck is deeply embedded in the joint cavity, the leg can move in all planes. Pressure on the hip joint top part body, which makes it susceptible to damage and deformation. Even a minor inflammatory process in the gluteal, sciatic muscles or upper outer thighs is manifested by pain.

At the first stage of the pathology, a person feels slight pain in the thigh when walking. At rest, the pain is short-lived, and joint mobility is not impaired. As the disease progresses, due to the proliferation of osteophytes, pain in the bones increases and lameness appears. If not adequate therapy, inflammation of the hip joint can lead to complete loss of the ability to move. Doctors identify several main symptoms of the disease:

severe pain on the side of the hip;
skin hyperemia and redness in the affected area;
morning paralysis of the leg;
with coxarthrosis, pain increases after physical activity;
With arthritis, the pain disappears while walking.

Knee joint damage

Inflammation of the tissues located near the knee joint is periarthritis. The main symptom of the disease is pain when walking. It often happens that the pain syndrome that occurs during exertion, for example, while going down the stairs, is practically not felt, but sharp pain with a calm step, it subsides until it disappears completely. Patients with periarthritis sometimes experience pain on palpation of the internal condyle, swelling and local hyperthermia in this area.

Periarthritis of the knee is an insidious disease. Often, when you consult a doctor, the symptoms disappear completely, so treatment of the disease is delayed for an indefinite period. Symptoms of the pathology may first appear during the chronic stage of the disease during any provoking factor, for example, when the tendon apparatus is damaged during sports. In this case, others appear characteristic features:

hyperemia and swelling of the epidermis on inner surface knee;
subfebrile body temperature occurs (from 37 to 37.5 ° C), which may persist or increase;
fatigue develops general weakness;
in some cases lameness appears;
the severity of the pathological process is indicated by the limitation of motor functions;
long-term periarthritis of the knee ends with muscle atrophy or complete loss of motor functions of the lower limb.

Diagnosis of diseases

To identify a disease, its type must be determined. During a visit to a specialist, a thorough examination will be carried out and the causes of the pathological process will be analyzed. By palpation, the doctor identifies local pain areas in the areas of tendon attachment or in the muscle area. To confirm the diagnosis you need instrumental methods:

thermographic study based on the temperature difference at the site of inflammation;
arthrography - radiography of the joint with the introduction contrast agent to detect post-inflammatory changes;
computed tomography – a method of layer-by-layer examination of the joint;
magnetic resonance imaging – obtaining a tomographic image of tissue for research.

For accurate diagnosis of periarticular lesions, puncture of the joint, periarticular formations and ultrasonography. By the nature of the punctate it is easy to judge the pathogenesis. In addition, deletion excess liquid alleviates the patient's condition. The advantage of the ultrasound technique is the absence of radiation exposure and the additional ability to visualize periarticular tissues. Ultrasound allows you to determine:

exact location of the lesion;
latent ruptures or tears of ligaments and tendons;
the presence of exudate in synovial vaginas and bursae.

Which doctor should I contact?

As a rule, on the first visit to a district clinic, the registrar refers the patient to a therapist. After initial examination the doctor makes a preliminary diagnosis and refers the patient to more to a specialist. When contacting medical Center You can immediately see a doctor who treats joints - a rheumatologist. After instrumental diagnostics, examination of the affected joints and physical examination, the doctor draws up a therapeutic course and decides on the advisability of hospitalizing the patient.

In case of a severe pathological process or if previously prescribed conservative therapy is ineffective, it is necessary to contact an orthopedic traumatologist. This specialist specializes in surgical treatment of joints. In advanced cases, an orthopedic traumatologist performs surgical intervention, which is divided into organ-preserving surgery (arthrodesis, resection, arthroplasty, arthrotomy) and endoprosthetics (placement of a prosthesis instead of a joint).

Treatment of inflamed periarticular tissues

Diseases of the periarticular tissues are treated differently, but the therapeutic principles are similar. Overload and injury play a major role in the development of pathologies, so the main thing in their treatment is to eliminate the factors leading to damage to the joints. Occupational therapy consultations sometimes provide such tangible benefits that the costs are completely justified. The specialist develops an individual program of measures to protect and improve joint function and prevent disability. Groups of prescribed drugs:

Besides drug therapy, the patient is prescribed: physical therapy, massage, physiotherapy, therapeutic baths with iodine, bromine and other means. Orthopedic devices are prescribed to immobilize the affected limb. If the carpal tunnel is affected in a neutral position, the hand is splinted, with lateral epicondylitis a bandage is applied to the shoulder, and if there is valgus deformity of the foot, if the tendon is affected posterior muscle apply fixation ankle joint. In case of inflammation of the knee, special knee pads are required.

Anti-inflammatory therapy with NSAIDs

The main treatment of periarticular tissues with medications is the use of non-steroidal anti-inflammatory drugs (NSAIDs). These are medicines that have analgesic, anti-inflammatory, and antipyretic effects. The mechanism of action of NSAIDs is based on blocking proteolytic enzymes responsible for the production of chemicals - prostaglandins, which contribute to fever, inflammation, and pain. The word “nonsteroidal” emphasizes the fact that medications in this group are not analogues of steroid hormones. The most common NSAIDs:

NSAIDs are prescribed for pain during attacks of joint diseases and for their further treatment. The dosage and duration of treatment are prescribed individually. New drug, as a rule, is prescribed first in the smallest dose. If the medicine is well tolerated, then the daily dosage is increased after 2-3 days. In some patients, the therapeutic effect is achieved with very high doses of NSAIDs.

Local treatment

Therapy for inflammation of the periarticular bursae is always supplemented with gels and ointments local application. It should be remembered that during the progression of inflammatory processes in the joints, local irritating and warming ointments should not be used, since they dilate blood vessels, which contributes to the aggravation of symptoms. Topical medications must be prescribed by a doctor. Almost all ointments for eliminating inflammatory processes are based on NSAIDs. Sometimes drugs are used in combination with a chondroprotector. The most popular topical medications:

Fastum-gel. Reduces swelling, reduces local temperature, promotes rapid recovery joint Cannot be used during pregnancy or during childhood up to 6 years old.
Dolgit. Relieves severe pain and relieves severe swelling. Recommended for infiltration. The therapeutic effect lasts 3-4 hours. The minimum age for using the gel is 1 year.
Diclofenac gel. It has pronounced analgesic and anti-inflammatory properties. Causes relief of joint pain during movement and at rest. Cannot be used in the 3rd trimester of pregnancy, during lactation and in children under 6 years of age.

Periarticular tissue block

If you inject the drug with a needle directly into nearby tissues using an injection, then the desired result can be achieved faster and with minimal risks. Depending on the location of the lesion and the degree of the disease, they can be used for blockade. different drugs– from anesthetics (Novocaine, Lidocaine) to glucocorticosteroids (Betamethasone, Diprospan, Hydrocortisone). The procedure is performed only by a highly specialized doctor. Medicines are administered into the periarticular space by a neurologist, neurologist, traumatologist or surgeon.

Periarticular blockade is done in combination with the main therapy. The procedure alleviates the patient’s condition and preserves strength for further treatment, which for this pathology is long-lasting. Patients with intolerance to the required medications are not allowed to undergo the blockade. If infection of the skin at the injection site is detected, then deep injection of drugs into this area is prohibited.

Physiotherapy

For the treatment of rheumatic pathologies of periarticular soft tissues, physiotherapy is required. This is an integral part complex therapy and the primary means of helping patients recover. The most common physiotherapeutic procedures:

Magnetotherapy. Activates blood circulation in altered periarticular spaces, relieves swelling, and promotes rapid cell regeneration. The method is based on the action of direct or alternating low-frequency current. For achievement therapeutic effect the patient must undergo 10-12 procedures.
Laser therapy. Promotes rapid restoration of bone and cartilage tissue. During the procedure, the body is affected by lasers of different powers. The time of exposure to the sore joint is 5-8 minutes. The duration of the session is about 30 minutes. Laser therapy is carried out in a course of at least 30 procedures, if necessary - twice a year.
Electrophoresis with Dimexide or Lidaza. A common method of hardware administration of drugs directly to the lesion. Helps achieve a pronounced anti-inflammatory and antibacterial effect. Prescribed to patients who are contraindicated for injections of anti-inflammatory drugs.
Mud applications. Mud therapy has a positive effect on destruction processes connective tissue. The advisability of mud applications is due to the general analgesic effect.
Ozocerite treatment. Thermal procedures are prescribed during the period of remission of inflammation of the periarticular space. Ozokerite is a natural hydrocarbon from petroleum bitumen, the use of which reduces pain, improves nutrition and blood circulation of the affected joints.
Paraffin therapy. Paraffin is a wax-like substance that perfectly warms the skin. At rheumatic diseases use wax heated to 60 degrees.
UHF. The therapy consists of exposing the inflamed joint to high-frequency magnetic field, which helps reduce pain. UHF prevents the formation of free radicals in the joint and relieves swelling.
Phonophoresis. Complex method, combining ultrasonic vibrations with medications. The essence of the procedure is application to the affected area. medicinal substance with further processing by an ultrasound sensor for deep penetration into the tissue.

Therapeutic exercise and massage

In the active phase of extra-articular rheumatism, physical therapy (PT) and massage are prescribed biological points. Even with strict bed rest, the patient must exhibit physical activity. As the condition improves, more difficult exercises for large muscle groups are included with incomplete amplitude and the same intervals. Physiotherapy exercises and massage are prescribed by a rheumatologist, and the training methods are introduced by a specialist in exercise therapy. It is not recommended to start classes on your own - this will only worsen the condition.

Video

The group of inflammatory diseases of soft tissues (IID) consists of individual nosological forms of general etiopathogenesis. Inflammation of soft tissues can be of several types. All of them will be the object of attention in this article, as well as methods of their treatment.

The clinical picture of inflammation of soft tissues, despite the variety of nosological forms and localization of the process, has common manifestations for all of them, significant for the tactics of physiotherapeutic treatment and caused primarily by the presence of an inflammatory process. This is the development of an inflammatory, painful infiltrate with edema, hyperemia of the skin above it (with a small depth of the process) and local hyperthermia, an increase in body temperature.

With purulent-necrotic inflammation of soft tissues, the symptom of fluctuation is characteristic, the general reaction in the form of intoxication syndrome with severe fever of purulent-resorptive origin increases.

The development of this syndrome is due, in particular, to the pathogenicity of the infectious agent. Lymphangitis and lymphadenitis, being independent nosological forms, often complicate the course of all soft tissue inflammations. The inflammations in question on the face are especially severe and life-threatening. In this case, purulent foci can spontaneously open.

The main symptoms of soft tissue inflammation:

inflammatory,

lymphostasis,

metabolic and trophic disorders.

Types of soft tissue inflammation and symptoms

The group of soft tissue inflammations includes:

boil - acute purulent-necrotic inflammation of the hair follicle and surrounding connective tissue;

furunculosis is a chronic recurrent skin disease characterized by the appearance of multiple boils (at different stages of development);

phlegmon is a diffuse purulent inflammation of soft tissue tissue. Unlike an abscess, which is delimited from surrounding tissues by a pyogenic membrane, phlegmon tends to spread throughout the cellular spaces.

carbuncle - acute purulent-necrotic inflammation of several hair follicles And sebaceous glands, spreading to the skin and subcutaneous tissue;

abscess - a localized collection of pus in various fabrics and organs;

bursitis - inflammatory disease bursae, accompanied by the accumulation of exudate in their cavities; mastitis - inflammation of the parenchyma and interstitium of the mammary gland;

panaritium - acute inflammation of the soft tissues of the finger. This group includes almost all forms of panaritium, with the exception of articular, bone and pandactylitis, which affect the dense structural tissue formations of the finger.

Paraproctitis is an inflammatory process of peri-rectal tissue, caused by the presence of a focus of infection in the wall of the rectum.

Hidradenitis is a purulent inflammation of the apocrine sweat glands.

Lymphadenitis is an inflammation of the lymph nodes, which usually occurs secondary, and is a complication of various purulent-inflammatory diseases and specific infections.

Symptoms of soft tissue inflammation at different stages

The problem is a process that occurs in three stages. The first stage of inflammation As a rule, it is asymptomatic. Initially, inflammation of the soft tissues causes alteration, that is, a violation of microcirculation, which is associated with changes or damage to the tissue structure. Reduction of capillaries during inflammation of soft tissues, in turn, usually leads to malnutrition, that is, to weakening and reduction in muscle volume. If you do not immediately cope with the first stage of inflammation, it will go into the second - exudation, which is swelling, and then into the third.

Second stage of soft tissue inflammation already causing pain. The soft tissues are literally bursting with accumulated fluid, and they are forced to signal this.

The muscles signal such tissue damage using their receptors through the neuromuscular junction.

So, the source of pain in the body during inflammation of soft tissues is damaged muscles, and in nervous system through the neuromuscular connection only information about these muscle damages is received.

Therefore, it is so important to correctly interpret pain instead of taking painkillers when there is inflammation of soft tissues, as happens in the vast majority of situations. As a result, sooner or later the neuromuscular junction ruptures, and the muscle ultimately cannot communicate information regarding its damage to the motor neuron. Such treatment leads to muscle atrophy and tendon contracture. After all, any pain is a protective reaction of the body.

Third stage of inflammation called proliferation, which is the resorption of edema. It can occur naturally; for this you need to perform specially selected exercises. In this way, it is possible to create the phenomenon of natural drainage during tissue inflammation.

The treatment principles common to all types of soft tissue inflammation are anti-inflammatory (including antibacterial), detoxification and restorative therapy, prescribed against the background of surgical treatment carried out according to indications.

The course of diseases and the tactics of their postoperative treatment of inflammation of soft tissues before surgical or spontaneous opening of a purulent focus are inextricably linked with the treatment of purulent wounds and wound infection. Conservative treatment of purulent infection, including physical methods treatment of soft tissues is carried out in the presence of a dense infiltrate or a small amount of pus and the absence of inflammation transfer to tendon sheaths, joint cavities, serous cavities, organ tissues, symptoms of intoxication, since in these cases immediate surgical intervention is recommended, regardless of the stage of the suppurative process.

Physiotherapy for the treatment of soft tissue inflammation

At all stages of the development of inflammatory disease of soft tissues, the main goal of physiotherapy is to sanitize the source of infection (bactericidal methods) and eliminate the inflammatory process. In the stage of infiltration without signs of purulent fusion of tissues or with a small amount of purulent contents (without pronounced fluctuation and with the absence of general reaction) the goal of physiotherapy is the reverse development of inflammation with resorption of infiltrate and reduction of edema (anti-inflammatory methods of treating soft tissues), relief of pain (analgesic methods).

In cases where the formation of an abscess is slowed down, physical treatment methods can be prescribed to soften the inflammatory infiltrate and accelerate the rejection of necrotic masses (necrolytic methods of soft tissue treatment). Physiotherapy is also prescribed to enhance reparative regeneration (reparative and regenerative methods for treating inflammation of soft tissues), increase the level of nonspecific resistance of the body (immunostimulating methods) and reduce ischemia (antihypoxic methods). These tasks help to implement the following physiotherapy methods:

Bactericidal method of treating soft tissue inflammation: electrophoresis of antibacterial drugs.

Anti-inflammatory methods for the treatment of soft tissue inflammation: UHF therapy, SUV irradiation (erythemal doses), electrophoresis of calcium chloride solution, low-intensity SMV therapy.

Immunostimulating methods: LOK, high-frequency magnetic therapy (thymus), general SUV irradiation (suberythemal doses), DUV irradiation, electrophoresis of immunomodulators, heliotherapy.

Necrolytic methods: high-intensity UHF therapy, high-intensity microwave therapy, infrared irradiation.

Analgesic methods for the treatment of soft tissue inflammation: SUV - irradiation (erythemal doses), diadynamic and amplipulse therapy (and phoresis of local anesthetic drugs), electrophoresis of local anesthetic drugs.

Reparative and regenerative methods for the treatment of inflammation of soft tissues: infrared laser therapy, microwave therapy (thermal doses), high-frequency magnetic therapy (thermal doses) and low-frequency magnetic therapy, paraffin, ozokerite therapy.

Fibromodulating methods: ultrasound therapy, ultraphonophoresis of defibrosating drugs (iodine, Lidase), electrophoresis of defibrosating drugs, peloid therapy.

Vasodilator methods: infrared irradiation, electrophoresis of vasodilators.

Antihypoxic method: oxygen barotherapy.

Detoxification method: AUFOK.

Anti-inflammatory methods for treating soft tissues

Medicinal calcium electrophoresis. The drug used reduces the permeability of the vascular wall, preventing increased swelling, and helps to delimit the inflammatory focus. For serous inflammation in the subacute period, a 2.5% solution of Calcium chloride is applied to the area of inflammation, transversely or longitudinally, for 15-20 minutes, daily; the course of treatment for inflammation of soft tissues is 5-8 procedures.

Low-intensity SMV therapy. The energy of electromagnetic radiation in the centimeter wave range is absorbed mainly by the membrane structures of cells - protein groups of proteins, glycolipids, as well as dipoles of bound water. The resulting polarization processes on cell membranes in the area of inflammation lead to changes in their structure and function, in particular to the induction of phagocytic activity of macrophages and polymorphic leukocytes. This ensures the removal of cellular fragments and microorganisms from the site of inflammation. Used for serous forms of PID, small amounts of exudate. Impact frequency 2375 MHz, contact or distance technique, non-thermal power (depending on the nature of the emitter), 12-15 minutes, daily; course of treatment of inflammation of soft tissues 5 - 10 procedures.

SUV irradiation UHF therapy. Anti-inflammatory therapy in the presence of a dense infiltrate without signs of purulent-necrotic melting in soft tissues is aimed at increasing local blood flow, eliminating congestion with drainage of the inflammatory focus and rapid removal of inflammatory mediators from it. The methods used also contribute to the disorganization and depolymerization of infiltrate structures, strengthening of thrombolytic processes in this area, inhibit lipid peroxidation, which is associated with universal mechanisms of damage during inflammatory processes, and induce the development of connective tissue at the site of the infiltrate.

When prescribing such treatment for soft tissue inflammation for a number of methods important has an intensity of impact. High-intensity methods of high-frequency electrotherapy with a thermal effect accelerate the resorption of infiltrate and are used in the infiltrative-proliferative phase of inflammation. However, in the presence of viable pathogenic purulent (possibly putrefactive) microflora, high-intensity methods of treating soft tissues can cause progression of the process and a transition from serous to purulent (purulent-necrotic) form of inflammation.

Similar tactics for treating inflammation of soft tissues (UHF, SUV irradiation in erythemal doses) should also be used in case of transition serous exudate into purulent (development purulent form considered nosological forms), but only in the initial period of this process, with an unformed purulent focus with a small amount of exudate. In this case, UHF therapy also helps to delineate the inflammatory focus by stimulating the development of connective tissue.

HF magnetic therapy, IF radiation. Other methods with a thermal effect should be prescribed for complete confidence in the absence of their provoking effect on the progression of the disease, not in the first 2-3 days, but after low-intensity UHF therapy or after SUV irradiation in erythemal doses, during the transition of inflammation from alterative exudative to infiltrative-proliferative phase. For antibacterial purposes in case of serous inflammation, mainly with a superficial location of the lesion, electrophoresis of antibiotics and sulfonamides can be prescribed. Calcium electrophoresis is indicated to delimit the inflammatory focus. However, one should be wary of the generalization of the process due to the vasodilatory effect of galvanic current.

The reverse development of the process in soft tissues from the exudative phase of serous or purulent (with an unformed focus with a small amount of exudate) inflammation into the infiltrative-proliferative and reparative-regenerative phases expands the possibilities of physiotherapy. Clinically, this is manifested by a decrease in pain, skin hyperemia, symptoms of lymphadenitis and lymphangitis, and a decrease in body temperature. It is not possible to clearly draw the line between the infiltrative-proliferative phase and the phase of reparative regeneration in soft tissue inflammation that occurs without opening the lesion, and this is not necessary, since most methods are used in both phases. The transition guidelines can be normalization of body temperature, reduction and disappearance of edema, reduction in the size of the infiltrate, and the period from the onset of the disease. In these phases of inflammation, physical methods are prescribed to relieve lymphostasis and correct metabolic and trophic disorders.

Immunostimulating methods for treating soft tissue inflammation

Heliotherapy. Protein photolysis products, formed in small quantities when exposed to SUV and DUV radiation, induce the migration of Langerhans cells into the dermis with subsequent activation of cellular and humoral immunity. Prescribed as preventive physiotherapy in the remission phase of recurrent inflammatory processes, and, if possible, at the stage of convalescence, in weak and medium modes; the course of treatment for inflammation of soft tissues is 10-20 procedures.

Electrophoresis of immunomodulators(0.5-2% solution of Dibazol, 3 - 5% solution of Sodium nucleinate; Interferon - 1 ampoule, 1 ml of 0.01% solution of Timalin, Timagen - from the anode). The drugs provide a thymomimetic effect. Sodium nucleinate stimulates the migration and cooperation of T- and B-lymphocytes, the phagocytic activity of macrophages and the activity of factors nonspecific protection. Dibazol selectively stimulates the regulatory function of T-lymphocytes, enhancing weak function cellular immunity and without affecting the normal one. The method is indicated in any phase of the inflammatory process. Prescribed using the intranasal method, with a current strength of 0.3 to 3 mA, for 10-12 minutes, daily; the course of treatment for inflammation of soft tissues is 10-12 procedures.

Antihypoxic and antioxidant methods for treating soft tissue inflammation

Oxygen barotherapy. The use of this method is advisable for intoxication syndrome (increasing tissue hypoxia, activation of the pro-oxidant system). The method helps to activate enzymes of the antioxidant system and stimulate microsomal oxidation of toxic metabolic products in the liver. As a detoxification therapy, it is prescribed in the acute period of the clinical course in the alterative phase of inflammation.

In addition, to accelerate reparative and regenerative processes, it can also be used in the proliferative phase of inflammation. The procedures are carried out in flow-decompression pressure chambers, dosing atmospheric pressure (up to 0.2 MPa), with an oxygen content in the chamber of 100%, for 45-60 minutes, daily (for severe intoxication syndrome, up to 2-3 times a day); the course of treatment for inflammation of soft tissues is 8-10 procedures.

Detoxification methods for treating soft tissues

AUFOK. EF irradiation of native blood increases its bactericidal activity, the content of immunoglobulins of various classes, leads to the neutralization of toxic products due to the action of reactive radicals and hydroperoxides formed when exposed to UV radiation on the membranes of blood cells and during the destruction of β-tocopherol in the blood. The method is indicated in the acute stage of the purulent-inflammatory process. Used for the treatment of purulent-inflammatory diseases of soft tissues (abscess, phlegmon, mastitis). Blood is irradiated at the rate of 0.5-0.8 ml/kg body weight for 10-15 minutes (the first 5 procedures), then the amount of irradiated blood is increased to 1-2 ml/kg, daily; course of treatment of inflammation of soft tissues 5 - 7 procedures.

Necrolytic methods of treating soft tissues

UHF therapy. In order to form a purulent focus during a sluggish course of the inflammatory process for further surgical intervention or spontaneous rejection of purulent-necrotic masses, physiotherapy can be used as a kind of “provoking factor”. Activation of the purulent-necrotic process is associated with the formation of heat. There is a transformation of the energy of the UHF field (UHF therapy), electromagnetic radiation in the microwave range (UHF and UHF therapy), and the optical range of the infrared spectrum into heat. The temperature of the tissues at the site of inflammation increases by 0.5-1 °C. As a result, during the alterative-exudative phase of inflammation, the activity of microorganisms is stimulated with the subsequent formation of vasoactive polypeptides.

When a purulent focus forms after the procedures, it is surgically opened. Prescribed to the source of inflammation with a power of up to 60 W or more, depending on the size of the capacitor plates, for 10-12 minutes, daily; course of treatment of inflammation of soft tissues 3 - 5 procedures.

Microwave therapy. This is exposure to electromagnetic radiation in the san-ti (2375 MHz) and decimeter-wave (460 MHz) ranges using a contact or distance method in thermal dosages (the level of output power depends on the device and the type of emitter used), for 15-20 minutes, daily; the course of treatment for soft tissue inflammation is 3 - 5 procedures (until the effect is achieved).

Advantages and contraindications of physiotherapy in the treatment of tissue inflammation

The above methods of treating inflammation of soft tissues are aimed at resolving the infiltrate and causing increased linear blood flow, venous outflow and lymphatic drainage with an anti-edematous effect, enhance the functions of fibroblasts, lymphocytes, helping to cleanse the source of inflammation and the formation of ordered structures of collagen fibers.

In more late dates from the onset of the disease to enhance reparative tissue regeneration, it is possible to prescribe thermotherapy (paraffin and ozokerite applications), peloid therapy, balneotherapy - mainly when the process is localized on the extremities (for example, phlegmon), using the method of local baths (hydrogen sulfide waters, as well as radon waters, but the possibilities of their use are limited for obvious reasons). If pain persists during these phases of development of inflammation, when it can be caused by compression of blood vessels and nerves, infiltration, analgesic methods are used.

Contraindications: pronounced signs intoxication syndrome with increased body temperature (above 38 °C). If there is a purulent encysted lesion, local physiotherapy is not performed before opening it.

Physioprophylaxis is aimed at increasing the body's reactivity by correcting immunodeficiency states (immunostimulating methods) in persons predisposed to such diseases (diabetes mellitus, hypovitaminosis, a number of enzymopathies, pyoderma, etc.).

Pain in soft tissues can bother a patient for many reasons. First of all, it is worth excluding injuries that resulted in the formation of subcutaneous hematomas. When they form, compression of the surrounding tissues occurs and pain develops. As the blood accumulated in them dissolves, an autogenic process of inflammation begins, which is also accompanied by extremely unpleasant sensations.

Very often, pain in soft tissues accompanies very serious pathological changes in large and small joints and the spine. Thus, pain in the soft tissues of the back is almost always associated with neuralgia due to compression of the radicular nerve in the spinal column. If you don't carry out timely treatment, then serious complications are possible, including paresis and permanent paralysis.

We offer you to find out all the necessary information about diseases that cause soft tissue pain and how to properly treat them.

The soft tissues of the neck hurt

If the soft tissues of the neck hurt, then two diseases are excluded first of all: myositis and osteochondrosis. In the first case, there are signs of an inflammatory reaction (redness of the skin, local increase in temperature, etc.), with osteochondrosis the symptoms are completely different.

Severe pain in the soft tissues of the thigh is also often associated with damage to the hip joint or lumbosacral spine. A correct diagnosis and timely treatment eliminate the risk of progression of cartilage tissue destruction. When the sciatic nerve is pinched, pain may be accompanied by a decrease in skin sensitivity. Pain in this pathology spreads in a stripe pattern inside or outside the thigh.

Severe pain in the soft tissues of the knee can be triggered by the development of post-traumatic inflammatory processes, such as bursitis, tenosynovitis, sprains and ruptures of the ligamentous apparatus. If injuries are excluded, then it is necessary to carry out diagnostics organic lesions cartilage and bone tissue. By using manual therapy Almost all types of gonarthrosis (arthrosis of the knee joint) can be successfully treated. But this needs to be done in a timely manner. At the 3rd stage of the disease, only surgery for joint replacement.

If there is pain in the soft tissues of the foot, you should avoid physical activity, apply a tight bandage and consult a specialist as soon as possible. Ankle sprains and hallux valgus are very common nowadays. But it is necessary to carry out differential diagnosis with tendovaginitis, heel spurs and a number of other pathologies.

Why do the soft tissues of the hand hurt?

It is impossible to answer in absentia the question of why the soft tissues of the hand hurt, since such a symptom can accompany many diseases. At a young age, carpal tunnel and carpal tunnel syndrome are currently common among representatives of office professions. With these pathologies, the nerve fiber is affected, which is accompanied by severe pain that spreads along the forearm and shoulder.

In addition, the patient may be diagnosed with tendovaginitis, epicondylitis, arthrosis and arthritis. It is impossible to diagnose a particular disease without the help of a doctor, since in most cases the symptoms will be the same. However, there are specific signs, diagnostic tests that allow you to establish a correct preliminary diagnosis.

So don't do it self-diagnosis. Contact our manual therapy clinic for a free initial consultation, and you will know exactly what kind of ailment is causing discomfort in soft tissues upper limbs.

Why is pain in the soft tissues of the hand dangerous?

Do not think that the use of pain-relieving ointments has therapeutic effect. Yes, they will help eliminate pain in the soft tissues of the hand. But this is a temporary effect. Meanwhile, the disease will continue to develop. The gradual destruction of cartilage and then bone tissue will continue for a long time. Unfortunately, this will lead to the fact that it will no longer be possible to cure pathologies without surgery.

The first danger of pain in the soft tissues of the hand is the destruction of the nerve fiber. Subsequently, innervation may not be restored. Paralysis and paresis of the upper limbs are common complications. Don't delay treatment. Contact your doctor promptly.

Inflammation is a pathological process that develops when cells and tissues are damaged. Inflammatory processes are accompanied by changes in blood composition. It threatens to damage individual organs and causes damage to the body.

Inflammation of joints and tendons becomes common. Similar processes can be observed in various diseases, for example, tendonitis, arthritis (inflammation of the joints), fasciitis. To facilitate recognition of the names of diseases accompanied by inflammation, the ending “itis” is added to the Latin name of the organ. You can tell that inflammation accompanies a disease by its name; there are exceptions to the general rule.

Symptoms of inflammation of the soft tissues of the foot

Any inflammation is accompanied by general symptoms: increased body temperature, swelling, redness and pain in the area of the inflammatory process, disruption of the normal functioning of the damaged organ or tissue. Inflammation of the soft tissues of the foot shows clear symptoms; it is often easily confused with other pathological processes.

The reason for redness is that when the mucous membrane or soft tissues are irritated, a reflex expansion of the blood vessels occurs, blood flows to the site of the foot with a pathological process. A local increase in body temperature is explained by the fact that blood flow increases the rate of metabolic processes in the damaged tissue.

Damaged foot tissues feel much warmer to the touch than healthy tissues near inflamed tissues. Walls blood capillaries The liquid component of the blood begins to pass through, and blood cells penetrate into them. Due to such an invasion, exudate appears, which determines swelling. The cause of inflammation of the foot is capable of irritating local nerve endings, leading to pain. The pain is caused by the pressure exerted by the influx of large amounts of fluid.

The stage of pathology is alteration or damage, which is destructive to the cells of the body. Damaged cells and cellular structures are not capable of normal functioning, and disturbances in the normal functioning of organs or tissues are observed.

Stages and types of inflammation

Doctors around the world usually distinguish three main stages of inflammation of soft areas of the body: the alteration stage (damage), the exudation stage (reaction) and the proliferation stage (recovery). The stages are divided into stages:

Alteration: primary and secondary;
Exudation and emigration;
Proliferation and repair: proliferation and the end of inflammation.

The stages of inflammation occur unequally in time, do not have clear boundaries, smoothly flowing into one another. Symptoms also differ at different stages. Treatment at each stage is multidirectional. At the first stages it is to eliminate the root cause of the disease, at the last it comes down to the restoration of destroyed cells and tissues.

Prevention of inflammation of the soft tissues of the foot

To preventive measures to prevent the occurrence and development inflammatory reactions soft areas include simple techniques that are easy to perform. This includes eliminating excessive monotonous loads on the musculoskeletal system. Lack of physical activity, which causes blood to stagnate and circulation to be disrupted, causes inflammation.

Open and closed injuries to the lower extremities that cause inflammation of the soft tissues of the foot should be avoided.

Myositis

One of the causes of pain in the soft tissues of the thigh is myositis arising due to hypothermia, injury, infectious or autoimmune processes when the body begins to perceive tissue cells as foreign and attack them. The patient feels pain of moderate intensity due to weakening of the thigh muscles.

Diagnosed disease based on a survey, examination, and a blood test that detects eosinophilic leukocytosis. A soft tissue biopsy is also performed.

Treatment of myositis is complex:

ensuring rest (bed rest);
diet correction (strengthening the diet with vitamins and mineral complexes).

Depending on the cause of the disease, treatment is carried out with antibiotics (for infection), immunosuppressants and glucocorticosteroids (for autoimmune cause), non-steroidal anti-inflammatory drugs, therapeutic physiotherapy and massage (if the doctor allows).

Trochanteritis is an inflammation of the tendons that connect the lesser and greater trochanters to the femur. Most often, the pathological process occurs due to injuries, due to hypothermia or overload. Pain– aching, pressing, aggravated by exertion (walking, climbing stairs), hypothermia. Localization unpleasant sensations – in the outer side part (“breeches”).

Diagnosed disease also through examination and questioning, blood tests, x-rays or MRIs of the hip.

Treatment- conservative, consists in the use of non-steroidal drugs. In more complex cases, injections of glucocorticosteroids into the tendon area are prescribed, which are done once every 2 weeks. Physical therapy is also prescribed, less often - laser therapy, massage with rubbing of anti-inflammatory ointments.

Inflammatory bone lesion

The bones and joints of the hip are also susceptible to negative factors leading to pathological processes that cause pain.

Coxarthrosis

The main symptom of coxarthrosis is pain in the groin, radiating to the outer frontal and lateral part of the thigh, less often to the buttock and knee. Both joints or just one can hurt. It becomes difficult for the patient to move the limb, especially to the side. A crunching sound is heard in the joint, and the leg may look slightly shorter than the other.

Coxarthrosis is diagnosed using radiography (the image shows an increase in the neck-shaft angle, dysplasia or changes in the proximal part of the femur).

Treatment of the disease:

conservative, at an early stage - with the help of anti-inflammatory drugs, chondroprotectors, warming ointments,
surgical - if the hip joint is severely damaged, endoprosthetics (replacement) is performed.

very similar in symptoms to coxarthrosis, but characterized by high pain intensity, which becomes unbearable with the development of the pathological process. The disease begins due to the cessation of blood supply to this part of the joint; the process itself proceeds quickly and is accompanied by severe night pain. Characteristic for this disease is the age of the patients: most often it affects men from 20 to 45 years old, while women are 5-6 times less likely to suffer from it.

Diagnostics Diseases of the hip joints are performed using modern research methods - X-ray and MRI. Experienced doctor can make a diagnosis based on symptoms and examination of the limb, but in the end everything is decided by an X-ray examination of the joint and bone.

Therapy consists of restoring nutrition to the femoral head. Non-steroidal and steroidal agents, chondroprotectors and calcium preparations are also used to accelerate the restoration of damaged bone tissue.

Sometimes pain with outside can be caused by cancer, pathologies of arteries and veins. In case of diseases of the spine, unpleasant sensations on the outside of the thighs may be reflected, but we will not dwell on these reasons in detail, because already discussed them in the article

When should you contact a specialist?

Depending on the type and intensity of pain, as well as other signs, the patient can cope with the problem on his own or seek help. Since the hip is an important part of the body, responsible for the ability to walk, pain in it should not be ignored. Location large arteries and veins is another reason why it is necessary to monitor the condition extremely carefully.

Warning signs that require you to see a doctor as soon as possible:

sharp and acute pain making leg movement impossible;
crunching and clicking in the joints and the bone itself when moving;
extensive hematoma accompanied by edema;
uncharacteristic position of the leg relative to the axis of the body.

These symptoms indicate a serious hip injury or dysfunction that requires medical attention.

First aid at home

In case of serious hip injuries, especially fractures, it is important to provide timely assistance to the victim even before the doctor arrives. The limb must be immobilized by placing a splint on it. It is important to provide rest to the injured leg. If the pain is severe, ice or other cold objects may be applied, but a heating pad or other heat sources should not be used. In case of severe unbearable pain, the victim can be given an analgesic, and then constantly monitor his condition, not leaving him alone until the ambulance arrives.

Conclusion

Injuries to the bones and soft tissues of the hip, as well as pathological processes in the bones, tendons and joints are the main factors in the occurrence of pain. Even if it does not prevent a person from going about his business, there is no need to let the situation take its course and self-medicate. This can lead to worsening of the inflammatory process, after which longer and more complex treatment will be required. For fractures and bruises professional help A doctor is simply necessary, otherwise it is fraught with lifelong limitation of limb function as a result of improper fusion or a chronic inflammatory process.

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Diseases (inflammations) of soft tissues do not affect the bones and joints themselves, but the periarticular tissues: muscles, tendons, ligaments, joint capsules, fatty tissues.

Muscle diseases (myositis, myalgia) are characterized by prolonged and persistent pain in the affected areas, most often in the cervical-dorsal, paravertebral and lumbar muscles. At the same time, the muscles become excessively tense, become hard, and pain is felt when pressing on them. Sometimes painful lumps can be felt in them. People suffering from muscle damage often complain that after a day of work they feel very tired and have muscle pain and are forced to lie down. After a short, sometimes only 15-minute rest in a supine position, they feel much better.

A number of factors contribute to the occurrence of myalgia. The main ones are microtraumas associated with muscle overload. In the muscles, if they are not properly trained, pain is felt during prolonged efforts, especially static ones. They are a consequence of oxygen starvation of the muscles and the biochemical changes occurring in them. Pain impulses are transmitted by nerve fibers to the spinal cord. From there, reflexively through peripheral nerve fibers, signals go back to the muscle, causing it to contract. Arises vicious circle resulting in persistent muscle pain.

Myalgia often appears in people with poor posture. Some muscle groups in their body are constantly overworked and overworked, while others become flaccid and weaker.

Each person has his own characteristic posture and gait. We can talk about correct posture when the foot has normal structure, with good longitudinal and transverse arches when the knees and hips are straight. Spinal column has the correct bends, which determines the equally high position of the shoulders, good form chest and correct head position. If we were to tie a weight to a string and apply its free end to the ear, then with correct posture this string will pass through the middle of the shoulder, hip, knee and ankle. Of course, there may be various small deviations in posture, which give characteristic features to the figure of each person.

Cold and changes in ambient temperature may have some influence on the occurrence of myalgia. These factors can cause spasm, as well as expansion and contraction of the blood vessels that supply the muscles with blood, which leads to a lack of oxygen in them and the appearance of symptoms of myalgia. Examples of severe muscle pain are well known. lumbar region after lying on damp ground for a long time. Previously, it was believed that the most important factors in soft tissue damage were cold and dampness. Currently, this reason is not rejected, but there is an opinion that overload and microtrauma of tendons and muscles are more important.

In addition to the already mentioned objective factors (microtraumas, overloads, cold and dampness) that cause diseases of soft tissues, it is necessary to indicate psychological and emotional factors. The psychological state affects the perception and degree of pain. For example, during air raids and bombings, people did not feel pain caused even by extensive wounds. Only when the danger disappeared did the ability to feel pain return.

The influence of emotional stress on the state of the musculoskeletal system is well known. An example is trembling in the muscles and throughout the body during a moment of intense fear.

Some people overreact even to minor painful stimuli, exaggerating their ailments. They cause fear in them, which, in turn, leads to an increase in muscle tension and the onset of myalgia.

In addition, severe local and general painful processes can occur in the muscles, the manifestation of which is pain. Only a doctor can determine the disease and properly treat it. Therefore, in any case, if muscle pain occurs, you should consult a doctor who will explain the reason and advise what to do next.

Soft tissue damage affects not only muscles, but also other elements of the musculoskeletal system, including tendons and ligaments. We have already said that one of the most common reasons When pain occurs in soft tissues, microtrauma occurs. So, both tendons and ligaments are susceptible to injury. At the point of attachment of the tendon to the bone, all the components of the forces acting when performing both static and dynamic work converge in a small space. Therefore, these places are especially often affected.

The place where the tendon is attached to the bone has a characteristic structure. There is no periosteum, and bundles of tendon fibers in a small space gradually enter cartilaginous and then bone tissue. With each movement, the muscle pulls on the tendon ligaments. Therefore, all excessive loads can lead to the occurrence of inflammatory and degenerative processes. In some cases, tendon rupture may occur. Sometimes the strain on the ligaments causes thin layers of cartilage and bone to tear away. In these places, an inflammatory process occurs, and then the deposition of calcium salts.

These processes can develop in the area of the knees, hips, elbows - where it is attached to the bone a large number of tendons.

Sometimes the cause of pain is inflammatory or degenerative processes within the boundaries of tendons and fascia. Pain is often felt in the area of the thumb, palm, or where the tendons of the foot muscles pass. These pains intensify when pressed. As the tendon works, a crackling and sometimes crunching sound is heard. Swelling and redness may be noticeable over the diseased tendon.

Sometimes, as a result of minor injuries and chronic inflammation, tubercles form on the tendons (especially the muscles of the hand), which prevent the fingers from moving. In this case, flexion of the fingers occurs freely, but extension is difficult. When the finger is extended, a cracking sound is clearly heard, caused by the movement of the tubercle in the narrow fascia of the tendon.

Sometimes thickenings appear on the palm, and then persistent bending of the fingers (most often the fourth and fifth) is noted. Fingers cannot be straightened completely. The reason lies in the formation of scar connective tissue in the area of the palmar erector tendon.

Under the influence of frequent minor injuries, sometimes inflammation of the joint capsules. Capsules filled with a thick gelatinous mass are located in places most susceptible to pressure or injury, for example on the front of the knee, shoulder, and heel. The inflammatory process in them is accompanied by pain, movements are difficult.

Inflammation of the patellar capsule (located at the front of the knee) in people who kneel for long periods of time, as well as inflammation of the capsule near the Achilles tendon (on the back of the heel) in people who wear tight shoes, is quite common.

Quite often, painful processes selectively affect not only muscles, tendons or joint capsules, but all of these elements at once. In this case, we are dealing with extra-articular inflammation. The most common non-articular inflammation of the shoulder, elbow, hip and knee.

Extra-articular inflammation of the shoulder is usually caused by macro- or microtrauma. Sometimes these injuries are remembered, but usually special attention they are not paid attention to.

Extra-articular inflammation of the shoulder can occur in acute or chronic form. In acute cases, there is very severe pain in the shoulder, which is at times accompanied by mild swelling. Start chronic form is usually hidden. Gradually, the mobility of the shoulder becomes limited, which is accompanied by pain. Raising the arm to the side or making circular movements of the shoulder is difficult and causes pain. Putting on a jacket or coat, fastening the buttons on the back, raising your hand to straighten your hair can be painful and sometimes very difficult. If treatment is neglected, significant deterioration in the function of the shoulder joint may occur. In this case, the patient usually holds his arm along the body and avoids any movements, which leads to even greater limitation of mobility. Quite often, layers of calcium are deposited in the shoulder area, in the place where inflammation has occurred, which provoke reactive inflammation and increase pain (these deposits can be seen on an x-ray). Overweight people suffer quite often extra-articular inflammation of the hip. It makes itself felt by the appearance of severe pain in the lower part of the buttock, in the outer part of the thigh or in the groin. Pain also occurs when flexing the hip and especially when rotating the hip inward or outward. Sometimes layers of calcium are deposited in the soft parts near the hip joint, visible on x-rays, just as in the shoulder joint.

Extra-articular inflammation may also affect knee-joint. In this case, aching pain occurs, most often in the central part of the knee. If you try to remember well the onset of the disease, it usually turns out that some time ago (maybe even a long time ago) the knee was injured, and perhaps even a tendon ruptured. Chronic inflammation occurs in this area, and in many cases calcium is deposited. These processes are sometimes accompanied by slight swelling of the knee.

Quite often noted extra-articular inflammation of the lob cha. It occurs primarily as a result of overwork of the tendons of the elbow joint. Attempts to straighten the arm at the elbow joint or perform a twisting movement are usually accompanied by pain. When pressed, pain is felt in the lateral or central part of the elbow. It is transmitted to the arm, less often to the shoulder. This type of ailment is quite common among people who play tennis; they are even called “tennis elbow.”

Excessive fatness goes hand in hand with joint damage. Excess weight overloads the musculoskeletal system and forces the body to continuously withstand additional weight for which it is not adapted. This leads to soft tissue disease, joint and spinal dystrophy. Therefore, one of the main commandments for preventing damage to the supporting apparatus is the fight against excess weight. Our faithful ally in this fight - in addition to the appropriate diet - sports and gymnastics. Correct body weight is determined taking into account gender, age and height. Approximately correct weight can be determined by subtracting the number “100” from height (in centimeters) this person. For example, a person 170 centimeters tall should weigh 70 kilograms. Men may weigh slightly more than women.

To avoid obesity, you should follow an appropriate diet. Diet with the goal of losing weight general outline consists of giving up sweets and limiting starchy foods. Pastries, cakes, soups, dumplings, thick sauces should be eliminated from the menu fat people. At the same time, you can eat lean meat, cottage cheese, boiled vegetables, and eggs. You need to drink more milk. It is also useful to eat only milk on one day of the week, giving up everything else.

However, one diet for... Losing weight is not enough. To maintain the correct weight and good figure, appropriately dosed movement is necessary.

From the above it follows that the cause of many diseases of bones and joints are microtraumas, to which the musculoskeletal system is especially susceptible in cases of improper muscle development. Well-trained muscles are like elastic and powerful springs that protect other elements of the musculoskeletal system from possible injuries. Flaccid and weak muscles do not perform their task properly. In this case, a number of loads are transferred to other elements of the musculoskeletal system, to tendons, ligaments, as well as to bone tissue, causing painful processes. Therefore, taking care of maintaining a developed muscular system and good posture is a significant problem. Well-developed muscles and correct posture are factors that prevent the occurrence of lesions of the musculoskeletal system.

Diseases (inflammations) of soft tissues do not affect the bones and joints themselves, but the periarticular tissues: muscles, tendons, ligaments, joint capsules, fatty tissues.

A number of factors contribute to the occurrence of myalgia. The main ones are microtraumas associated with muscle overload. In the muscles, if they are not properly trained, pain is felt during prolonged efforts, especially static ones. They are a consequence of oxygen starvation of the muscles and the biochemical changes occurring in them. Pain impulses are transmitted by nerve fibers to the spinal cord. From there, reflexively through peripheral nerve fibers, signals go back to the muscle, causing it to contract. A vicious circle arises, resulting in persistent muscle pain.

Myalgia often appears in people with poor posture. Some muscle groups in their body are constantly overworked and overworked, while others become flaccid and weaker.

Each person has his own characteristic posture and gait. We can talk about correct posture when the foot has a normal structure, with good longitudinal and transverse arches, when the knees and hips are straight. The spinal column has regular curves, which determines the equally high position of the shoulders, the good shape of the chest and the correct position of the head. If we were to tie a weight to a string and apply its free end to the ear, then with correct posture this string will pass through the middle of the shoulder, hip, knee and ankle. Of course, there may be various small deviations in posture, which give characteristic features to the figure of each person.

Cold and changes in ambient temperature may have some influence on the occurrence of myalgia. These factors can cause spasm, as well as expansion and contraction of the blood vessels that supply the muscles with blood, which leads to a lack of oxygen in them and the appearance of symptoms of myalgia. There are well-known examples of severe pain in the muscles of the lumbar region after lying on damp ground for a long time. Previously, it was believed that the most important factors in soft tissue damage were cold and dampness. Currently, this reason is not rejected, but there is an opinion that overload and microtrauma of tendons and muscles are more important.

The influence of emotional stress on the state of the musculoskeletal system is well known. An example is trembling in the muscles and throughout the body during a moment of intense fear.

Some people overreact even to minor painful stimuli, exaggerating their ailments. They cause fear in them, which, in turn, leads to an increase in muscle tension and the onset of myalgia.

Soft tissue damage affects not only muscles, but also other elements of the musculoskeletal system, including tendons and ligaments. We have already said that one of the most common causes of pain in soft tissues is microtrauma. So, both tendons and ligaments are susceptible to injury. At the point of attachment of the tendon to the bone, all the components of the forces acting when performing both static and dynamic work converge in a small space. Therefore, these places are especially often affected.

The place where the tendon is attached to the bone has a characteristic structure. There is no periosteum here, and bundles of tendon fibers gradually enter cartilaginous and then bone tissue in a small space. With each movement, the muscle pulls on the tendon ligaments. Therefore, all excessive loads can lead to the occurrence of inflammatory and degenerative processes. In some cases, tendon rupture may occur. Sometimes the strain on the ligaments causes thin layers of cartilage and bone to tear away. In these places, an inflammatory process occurs, and then the deposition of calcium salts.

These processes can develop in the area of the knees, hips, elbows - where a large number of tendons are attached to the bone.

Extra-articular inflammation of the shoulder usually caused by macro- or microtrauma. Sometimes these injuries are remembered, but usually not much attention is paid to them.

Extra-articular inflammation of the shoulder can occur in acute or chronic form. In acute cases, there is very severe pain in the shoulder, which is at times accompanied by mild swelling. The onset of the chronic form is usually hidden. Gradually, the mobility of the shoulder becomes limited, which is accompanied by pain. Raising the arm to the side or making circular movements of the shoulder is difficult and causes pain. Putting on a jacket or coat, fastening the buttons on the back, raising your hand to straighten your hair can be painful and sometimes very difficult. If treatment is neglected, significant deterioration in the function of the shoulder joint may occur. In this case, the patient usually holds his arm along the body and avoids any movements, which leads to even greater limitation of mobility. Quite often, layers of calcium are deposited in the shoulder area, in the place where inflammation has occurred, which provoke reactive inflammation and increase pain (these deposits can be seen on an x-ray). Overweight people suffer quite often extra-articular inflammation of the hip. It makes itself felt by the appearance of severe pain in the lower part of the buttock, in the outer part of the thigh or in the groin. Pain also occurs when flexing the hip and especially when rotating the hip inward or outward. Sometimes layers of calcium are deposited in the soft parts near the hip joint, visible on x-rays, just as in the shoulder joint.

Quite often noted extra-articular inflammation of the lob cha. It occurs mainly as a result of overwork of the tendons of the elbow joint. Attempts to straighten the arm at the elbow joint or perform a twisting movement are usually accompanied by pain. When pressed, pain is felt in the lateral or central part of the elbow. It is transmitted to the arm, less often to the shoulder. This type of ailment is quite common among people who play tennis; they are even called “tennis elbow.”

Excessive fatness goes hand in hand with joint damage. Excess weight overloads the musculoskeletal system and forces the body to continuously withstand additional weight for which it is not adapted. This leads to soft tissue disease, joint and spinal dystrophy. Therefore, one of the main commandments for preventing damage to the supporting apparatus is the fight against excess weight. Our faithful ally in this fight - in addition to the appropriate diet - is sport and gymnastics. Correct body weight is determined taking into account gender, age and height. An approximate correct weight can be determined by subtracting the number “100” from the person’s height (in centimeters). For example, a person 170 centimeters tall should weigh 70 kilograms. Men may weigh slightly more than women.

To avoid obesity, you should follow an appropriate diet. A diet aimed at losing weight, in general terms, consists of giving up sweets and limiting starchy foods. Pastries, cakes, soups, dumplings, thick sauces should be eliminated from the menu of overweight people. At the same time, you can eat lean meat, cottage cheese, boiled vegetables, and eggs. You need to drink more milk. It is also useful to eat only milk on one day of the week, giving up everything else.

However, one diet for... Losing weight is not enough. To maintain the correct weight and good figure, appropriately dosed movement is necessary.

From the above it follows that the cause of many diseases of bones and joints are microtraumas, to which the musculoskeletal system is especially susceptible in cases of improper muscle development. Well-trained muscles are like elastic and powerful springs that protect other elements of the musculoskeletal system from possible injuries. Flaccid and weak muscles do not perform their task properly. In this case, a number of loads are transferred to other elements of the musculoskeletal system, to tendons, ligaments, and also to bone tissue, causing painful processes. Therefore, taking care of maintaining a developed muscular system and good posture is a significant problem. Well-developed muscles and correct posture are factors that prevent the occurrence of lesions of the musculoskeletal system.