Cervical myositis tablets. Myositis of the neck muscles. Purulent myositis of the neck

Cervical myositis is a common disorder in which inflammation begins to develop in the muscles located in the neck and shoulder girdle. The pathological process may involve either one or several segments. There are many reasons for the formation of the disease, and not all of them are associated with the course of infectious diseases. Most often this is facilitated by excessive physical activity and hypothermia of the human body.

Main clinical manifestation is a gradually increasing pain syndrome, spreading to nearby areas. Against the background of the main symptom, limitation of motor function, local edema, etc. may be observed.

The diagnosis can be made based on clinical presentation and objective examination data. However, diagnosis also includes several instrumental examinations patient.

Treatment is carried out only with the help conservative techniques, in particular physiotherapeutic procedures and techniques manual therapy. Often, all symptoms disappear within a week from the start of treatment.

In the international classification of diseases of the tenth revision, such pathology has several meanings. The ICD-10 code will be M60-M63.3.

Etiology

As stated above, cervical myositis spinal column is formed against the background of a large number of very different reasons, which is why they are usually divided into pathological and physiological, which have nothing to do with the course of other ailments.

However, inflammatory damage to the muscles of the cervical-shoulder girdle does not always act as a complication of the above diseases. Quite often it develops in completely healthy people - in such situations, the etiological factors can be:

• prolonged hypothermia of the human body;
• uncomfortable sleeping position;
• characteristics of work - drivers, pianists, violinists, as well as those who are forced to a large number of spend time in front of a computer monitor;
• prolonged influence of stressful situations and nervous overstrain;
• drug addiction and addiction to alcoholic beverages;
• inadequate use of medications - leads to short-term cervical myositis;
• professional sports.

Pathology affects people regardless of age category and gender.

Classification

Clinicians know several types of myositis of the cervical muscles, which differ in the reasons for their formation and the nature of their course. Thus, the inflammatory process in the neck muscles is divided into:

• purulent myositis - in addition to the symptoms characteristic of the disease, several days after the onset of progression, the presence of pus is noted during palpation;
• non-infectious non-purulent myositis - differs in that clinical picture is represented only by pain and the formation of painful compactions, which have small volumes and can change shape when physical impact on them;
• neuromyositis - in addition to the cervical muscles, the pathology affects peripheral nerve fibers;
• infectious myositis - distinctive feature there is a weak manifestation of symptoms;
• polyfibromyositis - has severe course, during which the replacement of healthy muscle tissue with fibrous or connective tissue is noted. The main symptom is considered to be a violation of motor activity;
• dermatomyositis - when occurring in the early stages, inflammation damages only the superficial muscles and skin, which is expressed in a change in its shade and the occurrence of rashes. Severe forms characterized by muscle weakness and pain, as well as problems with breathing and swallowing;
• - in the vast majority of situations, it is diagnosed in females, and is also considered one of the most severe types of inflammation. It is often complicated by disruption of the functioning of internal organs and the addition of a secondary purulent process;
• ossifying progressive myositis, which in medical field It is called Munchmeyer's disease - it is a rather severe, genetically determined disease, most often found in males in childhood or adolescence. The danger of the disease is that there is a slow but progressive ossification of the cervical muscles and tendons. In addition, the inflammatory process can spread to the muscles abdominal cavity and lower extremities.

Symptoms

The main symptom is pain, which appears within a few hours after the influence of one or another predisposing cause. First of all, local pain occurs, covering the back or posterolateral part of the neck. It is noteworthy that often its focus is located on one side. Turning or tilting the head can increase the intensity of pain.

The pain syndrome gradually irradiates to:

• area of ​​the back of the head and crown;
• upper back;
• shoulder area;
• chest;
• tongue and ears;
• area between the shoulder blades;
• one of the upper limbs.

The patient tries to avoid movements of the head and neck, so as not to cause a new attack of pain. Sometimes a person is forced to hold his head in an uncomfortable position.

Against the background of the main clinical sign in adults, the following symptoms are expressed:

• muscle tension in the neck and shoulder girdle;
• swelling and redness of the skin in the problem area;
• the appearance of rashes on the neck, shoulders and upper extremities;
• increase in local temperature;
• restriction of movements;
• increase in the volume of regional lymph nodes;
• severe headache;
• pulsation in the temples and back of the head;
• exacerbation of pain at night, which leads to sleep disturbance or its complete absence.

In cases where such a disease develops in a child, a more severe course is observed and bright manifestation the above symptoms. The clinic is often accompanied by an increase in temperature, even fever.

It is extremely rare that myositis localized in the cervical spine becomes chronic, which is characterized by a wave-like course with alternating phases of exacerbation and subsidence of symptoms. In such situations, the symptoms will be presented:

• recurrent severe pain that occurs even with minor physical activity, a short stay in an uncomfortable position, or after each cold;
• constant muscle strain;
• significant limitation of motor functions;
• progressive muscle weakness;
• atrophy of damaged muscles.

Diagnostics

It seems possible to make a diagnosis of inflammation of the neck muscles already at the stage when the orthopedist carries out primary diagnostic measures, which include:

• familiarization with the medical history - to determine the underlying etiological factor with a pathological basis;
• analysis of the patient’s life history - this is necessary in situations where myositis develops in a healthy person;
• inspection and palpation of the affected area;
• a detailed survey of the patient - to establish the degree of intensity of symptom expression.

In some cases, it is necessary to carry out additional diagnostic measures, namely instrumental procedures, including:

• radiography;
• electromyography;
• biopsy.

In addition, you may need to consult the following specialists:

• rheumatologist;
• infectious disease specialist;
• surgeon

Laboratory studies of human biological fluids in this case are limited to general clinical and biochemical analysis blood, which may indicate the occurrence of some underlying illness.

Treatment

Regardless of the etiological factor, the methods of treating myositis will always be conservative. Drug therapy involves the use of:

Other methods of conservative treatment of myositis include:

• introduction of novocaine blockades with a high concentration of corticosteroids;
• physiotherapeutic procedures, namely heating and UHF;
• therapeutic massage course;
• manual therapy manipulations - indicated only in cases where the patient has no contraindications.

With the development of a purulent type of illness, treatment of cervical myositis in children and adults is aimed at opening the abscess. After this, the cavity is washed with antiseptic solutions and drained gauze pad. Patients should remember the need for dressings. As soon as the wound is cleared of pathological contents, apply bandages with medicinal ointments, promoting tissue regeneration.

In addition to the main methods of therapy, you can eliminate the symptoms of myositis at home by:

• bed rest;
• adherence to a gentle diet prepared by the attending physician;
• performing exercise therapy.

Prevention and prognosis

Preventive measures to prevent the development of myositis of the cervical spine are aimed at:

• complete renunciation of addictions;
• avoiding hypothermia;
• maintaining an active lifestyle;
• ensuring adequate sleep;
• taking medications in strict compliance with the clinician’s instructions;
• preventing the development of emotional stress;
• early detection and elimination of pathologies leading to the development inflammatory process in the neck muscles;
• regular full examination at a medical facility.

Timely and complex treatment Cervical myositis provides a favorable prognosis. However, in cases complete absence Therapy may cause inflammatory damage to other muscles, chronicity of the disease and the occurrence of atrophy, in which a person will not be able to hold his head up on his own. However, the formation of complications is extremely rare.

Clinical picture ( symptoms) and the prognosis depends on the type of myositis. So, depending on the cause, there are several types of this disease.

The main types of myositis include:

• idiopathic myositis;
• infectious myositis;
• focal myositis;
• giant cell myositis;
• eosinophilic myositis.

Idiopathic myositis

Characteristics of the main types of idiopathic myositis

Infectious myositis

For trichinosis ( a disease that also develops when meat is processed improperly) the nervous system is predominantly affected. Thus, Trichinella larvae ( source of the disease) with a current of lymph or blood penetrate into the central nervous system. The disease develops slowly and is characterized by symptoms such as headache, aches and muscle weakness.

Infectious myositis is also observed in Lyme disease, the most common disease transmitted by ticks. Bacteria enter the body through a tick bite and spread throughout the body through the bloodstream. Symptoms of the disease include fever, body aches, muscle weakness, and damage to the nervous system.

Focal myositis

Giant cell myositis

Eosinophilic myositis

Purulent myositis

The cause of purulent myositis is pyogenic flora, most often staphylococci and streptococci, less often gonococci and Ebert's bacillus. These pathogenic microorganisms enter the human body most often through open injuries. In this case, bacteria penetrate through the damaged layer of skin deep into the muscle tissue, where they trigger the process of inflammation.

Symptoms of purulent myositis are:

• local ( local) soreness;
• swelling and hardening of muscles;
• fever and chills;
• reflex contracture;
• headache.

Symptoms of myositis

• muscle weakness;
• tension and swelling;
• temperature.

Pain with myositis

Severe pain syndrome is observed with neuromyositis. Neuromyositis is a form of myositis that develops due to damage not to the muscle tissue itself, but to intramuscular nerve fibers. On the electromyogram ( records electrical activity muscles) foci of denervation are identified - places of muscle tissue devoid of nerve endings. Spontaneous pain in the areas of muscle attachment is observed with polyfibromyositis. This is a type of myositis, accompanied by a pronounced reaction from the connective tissue with the subsequent development of fibrosis in the affected muscle.

Muscle weakness with myositis

Temperature with myositis

Neuralgia and myositis

Occupational myositis

Professions with a high risk of occupational myositis include:

• machinists;
• rollers;
• riveters;
• stenographers.

Acute myositis

The disease begins acutely, with sudden sharp pain in the muscles of the arms, legs, lower back, and sometimes in the muscles of the chest. The pain sharply intensifies when pressing on the muscles, when breathing ( during chest movement). The pain is not constant, but paroxysmal in nature, that is, it develops like attacks. These attacks of pain can last from several hours to several days. A painful attack is accompanied by increased sweating, vomiting, and dry mouth. Since the fish toxin affects not only the muscles, but also the kidneys, disorders of the urinary system are also observed. Thus, the urine becomes dark red in color and contains red blood cells, white blood cells and myoglobin ( protein normally found in muscles). The volume of daily urine decreases sharply - this phenomenon is called oliguria. The mortality rate for this disease is very high and amounts to 2–3 percent.
The causes of acute nutritional myositis have not yet been studied. It is believed that the toxin accumulates in those fish that previously fed on toxic plankton.

Chronic myositis

Manifestations of chronic myositis are:

• formation of painful ridges in the muscles ( myogelosis);
• infiltrates in the subcutaneous tissue;
• local pain in the form of “nerve points” of Cornelius - manifests itself when pressing on the affected muscle;
• development of painful contractures.

The types of myositis by localization include:

• neck myositis;
• myositis of the chest;
• back myositis;
• shoulder myositis.

Myositis of the neck

Causes of neck myositis include:

• Cooling, most often drafts. One of the most common causes of neck myositis. Against the background of local cooling, the neck muscles begin to spasm ( strain), as a result of which pain occurs.
• Neck injuries. Traumatic damage to the neck muscles occurs no less often than drafts. In this case, myositis of the neck can be a consequence of both open injuries, and closed.
• Viruses. Inflammation in the neck muscles can occur against a background of general inflammation or common cold.
• Osteochondrosis of the cervical vertebrae. Myositis may be a consequence of damage to the cervical vertebrae. Thus, the muscles of the back are mainly attached to the processes of the cervical vertebrae. When inflammation develops in them, the muscles reflexively begin to tense. The more pronounced the inflammation, the stronger the spasm in a particular muscle. IN in this case myositis can be unilateral and predominate on the side where inflammation is more developed.

Externally, the muscle swells, which is why it looks enlarged and tense. Tension is easily felt when palpating the neck. Neck myositis can be either acute or chronic. The chronic form of the disease is characterized by increased pain at night.

Myositis of the chest and back

With myositis of the chest, the pain syndrome is most pronounced. The pain wears stupid character and it intensifies when changing body position. Increased pain is also observed when deep breath or exhale. This is explained by the fact that during chest excursion ( movements while breathing) muscles stretch and change their position. Nerve endings react to this by increasing pain. It is important to differentiate chest myositis from pathology of cardio-vascular system. So, sometimes the pain can radiate to the left side and imitate a heart attack.

Myositis of the back is the most common. However, as a rule, not all muscles become inflamed, but separate groups. Myositis of the lumbar muscles is most often observed. The reason for this is constant pressure on them, because the lumbar region takes on the main load. If an inflammatory component is also added ( "stretches out his back"), then the pain can radiate to the lower extremities.

The main symptoms of back myositis are:

• nagging pain, worse in the evenings;
• limited mobility of the lumbar region;
• spread of pain in the leg.

Shoulder myositis

Symptoms of shoulder myositis are:

• muscle tension;
• shoulder swelling;
• sharp pain in the shoulder muscles, which intensifies with arm movements;
• aching sensations throughout the shoulder girdle.

Myositis of the gastrocnemius muscles

Certain types of myositis include dermatomyositis and myositis ossificans.

Dermatomyositis

The causes of polymyositis have not been sufficiently studied to date. Dermatomyositis is believed to be predominantly an autoimmune disease. According to this theory, the body produces antibodies to own tissues, in this case to the muscles. Subsequently, the antibodies settle on the muscles, thereby damaging them. In addition to the autoimmune theory, other causative factors are identified in the development of dermatomyositis.

TO causal factors Dermatomyositis includes:

• injuries;
• effect of drugs;
• prolonged exposure to the sun.

Sometimes calcium can be deposited in the muscles, leading to the development of so-called calcifications. The main difference between dermatomyositis and other types of myositis is that it occurs with the involvement of the skin in the pathological process. So, rashes appear on various parts of the body. They can take the form of bubbles, stars, or large red spots. Foci of increased pigmentation or, conversely, depigmentation are also noted ( the skin loses its characteristic color). The rash is usually accompanied by unbearable itching. Dermatomyositis is characterized by swelling around the eyes with purple erythema. This characteristic erythema around the eyes is called spectacle dermatomyositis.

Dermatomyositis also affects internal organs. The heart is most often affected ( namely the myocardium), lungs , gastrointestinal tract. The cardiovascular system is especially often affected. This is explained by the fact that the bulk of the heart is formed by muscle tissue ( the myocardium is the thickest layer), which becomes a target for dermatomyositis. Inflammation in the myocardium in this disease is accompanied by myocardial dystrophy. In this case, the function of the heart is significantly impaired. The main symptoms are rapid heartbeat, low blood pressure, and uneven pulse.

There are acute, subacute and chronic forms of dermatomyositis. In the first case, the disease develops at lightning speed, muscle weakness progresses until complete immobility. The subacute form is characterized by periodic exacerbations and remissions, with the gradual development of contractures. Chronic dermatomyositis also occurs cyclically, but there are remissions ( periods of subsidence of symptoms) are the longest.

Treatment of all forms of dermatomyositis involves the use of corticosteroids. Maximum doses of prednisolone and dexamethasone are prescribed.

Myositis ossificans

Symptoms of myositis ossificans
The disease develops in childhood, boys are predominantly affected. Extremely specific symptom, observed in children with this pathology, is a pathology of the big toe. In this case, the phalanx of the finger is turned inward, and sometimes there is no joint on the finger at all. This anomaly in 90 percent of cases indicates a disease.

Since childhood, the disease occurs in the form of exacerbations. So, at about the age of 10 years, seals of various shapes appear under the child’s skin. Initially, they are localized in the neck, back, and forearms.

To localization locations primary focus ossifications in myositis ossificans include:

• paravertebral zone;
• shoulders and arms;
• head and face;
• pelvis and legs.

Death occurs due to ossification of the intercostal and abdominal muscles, which are responsible for breathing. Average age Life expectancy in this case is 10–20 years. If the respiratory muscles are not affected, then disability occurs later - by 30–40 years. There is currently no treatment.

Diagnosis of myositis

Which doctor should I consult for myositis?
If you have muscle pain, you should first consult your family doctor. He will direct you to the necessary laboratory and instrumental studies. If the cause of myositis is infectious or traumatic, then the myositis is treated by a therapist.
If tests indicate a rheumatic or autoimmune nature, then you need to contact a rheumatologist. A rheumatologist deals with the diagnosis and treatment of dermatomyositis, myositis in the context of rheumatic and autoimmune diseases.

Myositis code according to ICD

Types of myositis according to ICD

Tests and studies for myositis

Mandatory tests for diagnosing myositis

TO instrumental methods diagnostics include:

• Electromyography. A method for assessing muscle weakness is based on recording the electrical activity of muscles. May indicate replacement of muscle tissue with connective tissue.
• Fluorography. Used to diagnose tuberculous myositis.
• X-ray. Uninformative in the diagnosis of myositis. May indicate the presence of calcifications or cold spots in the muscles.

Treatment of myositis

Treatment of myositis that developed against the background of a common cold or against the background of drafts includes general and local treatment. General treatment involves prescribing painkillers and anti-inflammatory drugs, as well as vitamins. Local treatment consists of warming ointments, massage, and compresses.

Drugs for the treatment of myositis

Medicines used to treat myositis

Antibiotics for myositis

Ointments for myositis

Ointments used for myositis

Treatment of myositis at home

It should be noted here that only those types of disease that are not complicated by infection can be treated at home ( accompanied by elevated temperature, sharp deterioration general condition ). Treatment for such forms of myositis is prescribed only by a doctor. You should also consult a doctor if muscle inflammation is accompanied by severe pain or if there is no relief 3 to 4 days after treatment at home.

There are the following basic provisions for treating myositis at home:

• the use of patches and other therapeutic agents;
• compliance with a gentle regime of physical activity;
• correction of diet taking into account the disease;
• performing special exercises.

Plasters, compresses and other remedies for myositis

The following remedies are used to treat myositis at home:

• plasters;
• compresses;
• other means.

The following types of patches can be used in the treatment of myositis:

• Pepper. It is the most popular patch due to its low cost. The patch has a pronounced warming effect, which is why it should be used intermittently so as not to cause a skin burn. In addition, this product should not be used if there are rashes, cuts, or sores on the skin on which it will be attached.
• Reflecting. The principle of this patch is that it reflects the heat that the body produces. The product is attached not to the skin, but to inner side clothes.
• Anti-inflammatory. Such patches contain medications that achieve an anti-inflammatory effect. They use non-steroidal anti-inflammatory drugs as the main component. The most common types of anti-inflammatory patches are Voltaren ( based on the drug diclofenac) and ketotop ( based on the drug ketoprofen).
• Anesthetic. These patches are recommended for use for severe muscle pain. They contain drugs that block nerve receptors on the surface of the skin, thereby achieving an analgesic effect. The most common means of this type is the Versatis patch based on the anesthetic lidocaine. The product should not be used for more than 5 days.
• Magnetic. The design of the patch includes a magnetic plate, thanks to which a pain-relieving effect is achieved. The patch should be attached to the skin in the area of ​​pain and left for 2 to 3 days. It is not recommended to use a magnetic patch during pregnancy and breastfeeding.

The following components are used to prepare compresses:

• heated cabbage leaves, which need to be chopped in a blender or beaten until soft;
• burdock leaves, scalded with boiling water and laid in several layers;
• warm boiled potatoes mashed with a fork ( no added salt, spices);
• a mixture of natural honey and grated horseradish ( can be replaced with black radish);
• alcohol tincture of lilac flowers ( Pour 300 grams of fresh or dried flowers with a glass of alcohol and leave for a week);
• pepper tincture ( prepared from 2 red pepper pods and 200 milliliters of alcohol).

When using mustard plasters, the following rules should be observed:

• a contraindication for the use of this product is a body temperature above 37.5 degrees;
• before use, mustard plasters must be immersed in a container of warm water for 30 seconds;
• Mustard plasters are applied directly to the painful area, except for the heart area;
• to enhance the effect, mustard plasters should be covered with polyethylene or a blanket;
• Mustard plasters should be kept on the skin until pronounced redness appears ( this usually takes 5 to 10 minutes);
• After the mustard plasters are removed, the skin should be washed with warm water ( not hot) water.

Exercise regimen for myositis

Patient's diet for myositis

Along with food, a patient with myositis should receive the following elements:

• Vitamins A, C, E. These vitamins neutralize toxic substances that are formed as a result of the inflammatory process. They are present in large quantities in tomatoes, sweet peppers, citrus fruits, apples, and unrefined vegetable oil.
• Protein. Protein is building material for muscles, so with myositis the need for it increases. A lot of easily digestible protein is found in lean meat ( chicken, turkey, veal
  The type of exercise depends on which muscle group is affected. So, with neck myositis, it is recommended to perform circular movements and tilt your head. If the disease has affected the lower back, you need to tilt your body left and right, back and forth. For myositis of the arms, rotational movements with the hands and arms bent at the elbows will be useful. In addition to local load on specific muscles, for myositis they will be useful general loads- walking or running, long walks in the fresh air, sport games or dancing.

  Folk remedies for myositis

  In folk medicine there are recipes, the use of which can alleviate the condition of a person with myositis. The use of such drugs should be supplemented with pharmacological drugs, since as the main treatment ethnoscience has a weak effect. All types of folk remedies, depending on the composition and the effect they provide, are divided into 3 categories.

  For myositis, the following types of folk remedies are used:

  • ointments;
  • tinctures;
  • decoctions for oral administration.
  Ointments for myositis
  Ointments for the treatment of myositis are made from a fat base and an additional component ( one or more). Therapeutic effect ointments lies in their analgesic and anti-inflammatory effects. Butter, pork ( unsalted) or badger fat. The fat base is supplemented by dry ( Necessarily) plant components.

  The following plants can be used to make an ointment for myositis:

  • chamomile flowers;
  • lilac flowers;
  • horsetail;
  • willow buds;
  • Bay leaf.
  Vegetable raw materials should be crushed into powder, combined with a fat base and kept in a steam bath for several hours, avoiding boiling. After this, the mass is poured into a glass container and kept in a dark place for at least 10 days. It is recommended to use the finished product daily, 2 – 3 times a day. The ointment is applied to the painful area and covered with polyethylene and a warm cloth.
  ).

  Decoctions for oral administration
  Drinking decoctions is indicated to compensate for the deficiency of vitamins and other valuable substances, which provokes an inflammatory process. Also, drinking such drinks allows you to maintain the recommended fluid volume. For this disease, you need to drink at least 2 liters per day, not counting the water used for cooking.

  You can prepare decoctions from various fruits and berries that have increased content vitamins It can be rose hips, hawthorn, cranberries, apples ( dried or fresh), prunes. Decoctions from medicinal plants such as chamomile and linden are also useful for myositis.

  Before use, you should consult a specialist.

- an inflammatory process in the neck and shoulder girdle, which may involve one or more muscles. This is a very common disease that affects people of all ages and genders. Throughout life, almost every person experiences an acute form of myositis at least once.

The disease occurs during uncomfortable conditions, as a result of which muscle tissue begins to swell and reflexively contract. The spasm irritates the nerve endings, causing them to become inflamed. Severe pain appears.

Reasons for development

Acute myositis, which occurs for the last two reasons, most often becomes chronic. It takes a long time and is difficult to treat.

Risk group

People whose professional activities involve prolonged stay in one position are at risk of developing cervical myositis. These are pianists, typists, office workers, violinists, drivers, etc. During preparation for exams, cervical myositis can occur in schoolchildren and students.

Symptoms

Signs of acute myositis

Begins to appear a few hours after adverse effects. These include:

1. Pain in the back of the head, spreading to the shoulder (usually on one side). The sensations intensify when tilting the head and turning. Gradually, the intensity of the pain increases, and it begins to radiate to the parietal, occipital, interscapular region, shoulder girdle, upper back and arm on the injured side.
2. Impaired motor functions. The patient holds his head in forced situation, trying to avoid moving your neck so as not to cause a new attack of pain.
3. Slight swelling in the area of ​​the affected muscles.
4. Sometimes there is a local increase in temperature and redness skin.
5. The muscles are tight and tense, painful on palpation.
6. A feeling of tingling and numbness in the inflamed muscles, resulting from a violation of the patency of nerve impulses.

Symptoms of myositis in children

• Temperature rises to 38-39 degrees.
• Lack of appetite, lethargy and weakness.
• Possible damage to nearby muscles: the esophagus, respiratory tract, larynx, which makes it difficult to eat and contributes to shortness of breath.

Symptoms of chronic myositis

• Minor pain, worse in the morning. It does not completely disappear, but only decreases. Exacerbation occurs even after light exertion, with every cold and after a short stay in an uncomfortable position.
• Muscle tension is minimal.
• The numbness is constant, more pronounced in the mornings and at night.
• Head movements can be full, but cause numbness and pain.
• Muscle weakness gradually develops. Sometimes muscle atrophy (reduction) occurs, which makes it difficult for a person to lift his head.

Specific signs of varieties of cervical myositis

The purulent form of the disease is characterized by the following symptoms:

• Intense bursting and tugging pain in the neck.
• Swelling and redness of the skin in the damaged area.
• Signs of body intoxication: elevated temperature, weakness, loss of appetite, headache, fatigue.
• Soreness and fluctuation (presence of fluid in tissues) upon palpation.

Autoimmune diseases cause a form of myositis characterized by red or purple rashes and swelling of the eyelids, accompanied by the accumulation of calcium salts in the muscles and severe pain (dermatomyositis). Dense lamellar formations that limit neck mobility (Münchmeyer disease) can also be felt.

In the infectious form of cervical myositis, compactions of a gelatinous consistency of an oblong or round shape are found, changing with pressure (symptom of Müllerian hypertonicity). Dense, painful formations the size of a millet grain (Cornelius points) may also occur.

For cervical myositis, in which the muscle fibers And end sections nerves (neuromyositis), characterized by symptoms of tension and severe pain. When the neck muscles are replaced with connective tissue (polyfibromyositis), motor activity is sharply limited, and the muscles lose the ability to relax even during sleep, under general or local anesthesia.

Diagnostics

Detection is sufficient to make a diagnosis clinical signs myositis. In case of a protracted course of the disease, additional studies are prescribed to determine the cause of its occurrence:

Myositis caused by muscle overexertion or hypothermia is treated on an outpatient basis and conservatively. For purulent forms of the disease, surgical intervention is indicated.

The intensity of the massage is increased gradually. Course – 5-8 procedures for 10-15 minutes every other day or daily, depending on the patient’s condition.

Treatment of purulent myositis

Antibiotics (Tetracycline, Penicillin, etc.), UHF and painkillers are prescribed. After the affected area has softened, opening the abscess is indicated. It is produced by a surgeon.

An incision is made into the tissue, the cavity is washed and drained with a gauze pad. Then the patient cleans the wound and applies a bandage with Vishnevsky ointment and other drugs that accelerate tissue regeneration. Dressings are done until the wound heals by secondary intention.

Prevention

To prevent myositis it is necessary: ​​rest during long work, maintenance correct posture, moderate physical activity, comfortable temperature (including the absence of drafts), healthy food. It is not recommended to go out into the cold after physical activity and suffer from a cold on your feet (to avoid complications). Hardening and periodic visits to a massage therapist will help, relieving excess tension from the muscles.

Forecast

• chronic overstrain of the neck muscles due to professional reasons;
• hypothermia;
• thermal effects;
• intoxications and other factors.

The forms of manifestation of myositis themselves are also varied:

• It can affect not only the muscles, but also the skin, occurring in the form of dermatomyositis.
• At the same time, damage to the nerves is possible (neuromyositis).
• The consequences of the disease are changes in the structure of fibrofibers (fibromyositis) and even their calcification and ossification (calcific and ossifying myositis).
• The nature of the course of the disease (acute, chronic, purulent) and the scale (single myositis and polymyositis) differ.

We have already talked about all this in detail in the article about. But it is worth mentioning in more detail another type of pathology, which is often common - neck myositis.

Neck myositis is one of the types of muscular myositis, an inflammatory disease of soft tissues, which has the code M60 - M61 in the international classification of diseases ICD 10 (code M61 denotes calcific or ossifying myositis).

Inflammation of the neck muscles (cervical myositis) can develop for all of the reasons listed above, but most often it is associated with:

• with hypothermia (especially with drafts);
• muscle fatigue due to prolonged static tension in the neck;
• cervical radiculopathy;
• traumatic injuries to the neck, both internal (fractures, bruises, dislocations, muscle strains) and external (wounds, burns);
• infectious processes of the nasopharynx (purulent tonsillitis, ARVI, tonsillitis, diphtheria).

Symptoms and treatment of neck myositis are closely related to its cause.

How to recognize neck myositis by the first signs

Myositis of the neck is similar to acute radiculitis, and the pain with it can be so severe that the patient involuntarily begins to exaggerate the danger of the disease. It may seem to him that a disc has collapsed, a nerve has been pinched, and paralysis will soon occur. A forced, often unnatural position of the cervical spine is adopted: for example, tilting the head to one side or another, stretching the neck forward, upward, etc. From the side external signs really reminds spastic paralysis, in which the muscles are tense and immobile, but in reality these are pain restrictions.

Typically, cervical myositis is a harmless disease that resolves within one to two weeks. The exception is severe injuries, deep wounds to the neck or dangerous infections such as diphtheria, which causes swelling of the throat and respiratory muscles.

How does acute cervical myositis manifest?

Symptoms of neck myositis can appear literally a few hours after a person has suffered a cold, a thermal burn, a cervical injury, an injury or an acute respiratory viral infection. When these factors are applied, acute myositis very often develops, which is characterized by immediate onset and obvious clinical signs:

• swelling of the neck;
• hyperemia of skin surfaces;
• a rise in temperature both in the area of ​​the inflamed muscle and in general body temperature;
• painful sensitivity of the neck to the slightest movement;
• spasms in the chewing and laryngeal muscles (the patient finds it difficult to chew and swallow food).

Infectious acute cervical cancer can occur against the background standard symptoms ARVI: sore throat, cough, runny nose, shortness of breath, etc.

Purulent myositis of the neck

For purulent form CMM is characterized by the manifestation of symptoms of inflammation throughout the body:

• changes in the content of leukocytes and ESR;
• headache;
• apathy, weakness, nausea;
• the addition of symptoms of dermatomyositis in the form of multiple uneven purple rash.

Chronic neck myositis

The inflammatory muscle process in the cervical region is triggered by chronic muscle spasms, reflex and pain:

• the first ones occur with classical radiculopathy based on (arthrosis, protrusion, IVD hernia);
• the second - due to chronic stress, prolonged static stress while sitting at a computer, sewing machine, piano and other professional objects. meanings.

Permanent muscle spasms themselves can provoke radiculopathy, generating a vicious circle of pain, therefore chronic cervical myositis is periodically combined with radiculoneuropathy: in the first phase of the disease, symptoms appear more symptoms radicular pain, and in later, neuropathic pain - symptoms of loss of sensitivity, muscle atrophy.

Symptoms of chronic cervical myositis are manifested:

• constant pain of a moderate, aching nature, alternating with attacks of exacerbation;
• gain pain occurs upon palpation of the diseased area;
• pain radiates to the upper shoulder girdle, scapular region, and upper limb;
• cords (areas of increased density) and hardening are felt in the muscles - symptoms of fibromyositis and muscle ossification;
• motor restrictions (stiffness) occur;
• signs of paresthesia, numbness of the cervical-collar area, and the area of ​​the shoulder blades are possible.

Diagnosis of myositis

Cervical myositis is established on the basis of:

• clinical examination and questioning of the patient;
• radiography (CT, MRI);
• laboratory blood tests to identify the source of infection;
• electroneuromyography - examination of impulses conducted by nerves and muscles.

Myositis of the neck muscles should be differentiated from cervical radiculopathy, although the diseases can occur simultaneously.

How to treat neck myositis

Symptomatic treatment

Symptomatic treatment of cervical myositis consists mainly of taking non-steroidal drugs and muscle relaxants.

Therapeutic anti-inflammatory drugs that have worked well in the treatment of cervical myositis:

• diclofenac, nise, movalis, arcoxia, next, dolaren.

The last two drugs have a combined effect: both contain paracetamol + another NSAID (Next - ibuprofen, Dolaren - diclofenac).

The most popular muscle relaxants are:

• mydocalm, sirdalud, tizanidine, baclofen.

The duration of treatment is from five days to two weeks. Beyond this period, use is not recommended due to serious contraindications for NSAIDs and muscle relaxants.

Etiotropic therapy

In addition to eliminating the symptoms of the disease, targeted etiotropic therapy is carried out:

• Infectious sharp forms CMM can be cured with a combination of antibiotics and antiviral agents.
• Purulent - by surgical removal abscesses, pumping out pus, drainage deep wounds and antibacterial treatment.
• Traumatic - by eliminating the consequences of injuries (skeletal traction, surgery, immobilization).
• Chronic myositis - treatment of degenerative diseases of the cervical spine.
• Professional cervical myositis, caused by prolonged static tension, is treated with special therapeutic exercises.

Exercise therapy, massage and physiotherapy for cervical myositis

• Myositis is often accompanied by spasms, tightening of the neck muscles, so stretching therapeutic exercises have a very positive effect on this disease. They need to be performed slowly, without exposing the muscles to pain. Such exercise therapy should be led by a competent specialist who will correctly determine which muscles are most spasmodic.
• Massaging the back of the neck and shoulder areas can also cause relaxation of tense muscles. Deep and superficial massage are used, various techniques(effleurage, stroking, pinching, kneading, vibration, etc.).
• Physiotherapy uses:
  • drug electrophoresis using NSAIDs;
  • ozokerite treatment (paraffin treatment);
  • acupuncture;
  • shock wave therapy;
  • hirudotherapy and other methods.

Surgical methods

Surgical methods are rarely used in the treatment of neck myositis. The exceptions are injuries, burns, wounds, purulent abscesses, fibrosing and ossifying myositis

The essence of the treatment is:

• in the removal of burn scars;
• wound sanitation;
• opening abscesses;
• removal of modified muscle fragments;
• plastic surgery of destructured muscles.

Compliance with treatment rules for cervical myositis

An important condition for the treatment of cervical myositis is the removal of physical stress from the neck. During an exacerbation of the disease, you should not exercise on strength training equipment, even if they are not intended for the shoulder girdle and cervical-collar area, since tension in the abdominal muscles, quadriceps and other muscles is inevitably transferred to the neck.

The only exercises that have a direct therapeutic effect for cervical myositis are post-isometric muscle relaxation ().

The second condition necessary for recovery from cervical muscle inflammation is the exclusion of spicy, sour foods and alcohol.

Treatment of neck myositis at home

At home you can supplement the treatment carried out in the clinic:

• Neck rubs:
  • local ointments with NSAIDs (diclofenac, voltaren, fastum-gel);
  • warming ointments (viprosal, finalgon, apizartron, etc.
• Self-massage of the cervical and collar areas.
• Therapeutic exercises for the neck.

Folk remedies for the treatment of cervical myositis

You can also use the following folk recipes for cervical myositis.

Myositis: what are the 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” various localizations The doctor immediately establishes it 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, treatment at home 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 diseases of skeletal muscles 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 various groups muscles 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 for the disease acute stage. Sometimes a person does not even feel the transition of pathology into a chronic form, considering himself completely healthy until next exacerbation. And the chronic form is precisely characterized by alternating exacerbations and periods of remission.

Infectious type of pathology

To produce effective scheme In the treatment of 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 damage is infection. The main pathogen infectious form Myositis is caused by enteroviruses as a consequence of influenza. 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. This is how internal (endogenous) toxins are produced during significant disturbances metabolic processes, in particular, for diseases of the cardiovascular system, liver and kidneys, as well as for pathologies of an endocrine nature ( diabetes, thyrotoxicosis). A bright representative 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. 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, thickening is observed muscle tendons with the development of abbreviations 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– weakening of muscle strength and decrease in 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.

Muscle myositis chest area occurs much less frequently and is often generated by human activities associated with long standing in an awkward 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 paravertebral 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 injections:

• 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 before use, a test for the susceptibility of the body should be performed.

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.

1. Warming ointment: egg yolk, apple cider vinegar (1 tbsp), turpentine (1 tsp) - rub in before bed, cover with a woolen scarf throughout the night.
2. Iodine mesh is applied cotton swab on the skin in the affected area.
3. Burdock: apply a leaf after the plant, which is fixed on the sore muscle before going to bed.
4. A compress from this mixture: add 10-15 drops of laurel, fir or sea ​​buckthorn oil, the water is preheated to 48-55 0 C.
5. A mixture of bodyaga and butter in equal proportions - rub the sore spot before going to bed.
6. Decoction: prepared from willow bark (2 tablespoons per 0.5 liters of water), heated in a water bath.
7. 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 peace and proper nutrition. It is necessary to exclude alcoholic drinks, 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 muscle diseases that can ruin a person’s life. Timely detection and effective treatment at home will help get rid of these problems.