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Causes and symptoms of myositis

Myositis is the inflammation of one or more skeletal muscles. The disease is different in etiology, symptomatology, disease course and localization. Inflammation, progression, can spread to the heart, joints, intestines, skin and lungs.

The disease is quite rare, so out of 1 million people from myositis will suffer only one. But this statistic relates to those cases where myositis is manifested as a systemic disease, that is in the process of inflammation involves all skeletal muscles. The most common form of myositis is cervical myositis, it accounts for 60% of all cases of inflammation, in second place on the frequency of occurrence is lumbar myositis. It is believed that with such varieties of the disease at least once in life faced by every person.

Myositis can affect both adults and children, but in children is more often diagnosed dermatomyositis. Dermatomyositis in most cases affects the age group ranging from 1 to 15 years, although it may be discovered in adulthood. As for sex differences, dermatomyositis and polymyositis to a greater extent in women than men. After the age of 50 years people have often diagnosed fibromiozity.

Currently, myositis called the "office disease", there is a risk of its development increases in sedentary work. Some scoliosis can be the consequence of the profession, such as inflammation of certain muscle groups in pianists and violinists.

Myositis can occur as an independent disease or result from other diseases that can occur in the form of light and to take on their own after a few weeks, and can have severe and trouble the person throughout life.

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Causes of myositis

Causes of myositis may be due to the influence of exogenous and endogenous factors, among which are:

  • Infectious diseases. Infections viral are the most common causes of myositis, and rarely inflammation of the muscles is triggered by bacterial agents. The infection from the base of the hearth (e.g. tonsils) is distributed around the bloodstream on the muscle tissue. For influenza, SARS and other respiratory diseases, as well as forsyphilis, tuberculosis, typhoid, characteristic purulent myositis. Purulent myositis develops because of generalized purulent infection, often provoked by staphylococci and streptococci, osteomyelitis or fungal microorganisms. In this case, the myositis is characterized severe and require surgical treatment. It is also possible to lose muscle by microorganisms directly, when the inflammation develops because of the action of the toxins as waste products of pathogenic agents.

  • Autoimmune diseases. Most systemic diseases, especially connective tissue, accompanied by myositis. The body is starting to produce antibodies against its own tissues, causes muscle inflammation. This myositis is either subacute or chronic course and is accompanied by severe pain. Myositis is an almost constant companion of scleredema, lupus, rheumatoid arthritis.

  • Parasitic infestation. Infection with parasites can cause myositis. So, inflammation of the muscles observed in toxoplasmosis, cysticercosis, trichinosis, at least – with echinococcosis. With the introduction of the parasite in muscle tissue, is the start of the inflammatory process, toxic-allergic nature.

  • The negative impact of toxic substances. Most of the myositis affects people who abuse alcohol, taking drugs, undergoing insect bites. The mechanism of development of inflammation is a direct effect of the poison, alcohol, drug components on the muscles. Substances that increase the risk of myositis are: colchicine, statins, alpha-interferon, corticosteroids, isoniazid, anti-malaria products (plaquenil, delagil, quinacrine, etc.), cocaine, alcohol.

  • The trauma. In the place where there is a rupture of muscle fibers, and then increases inflammatory edema, associated with weakness and pain. As you heal, swelling subsides, and normal muscle tissue is replaced by scar causing the muscle becomes shorter. Typically, the myositis after minor trauma, hypothermia, muscle cramps or just intense physical activity occur quite easily. Very rarely develop the condition as rhabdomys, characterized by necrosis of muscle tissue. The reason randomise can be dermatomyositis and polymyositis.
  • The professional costs. Myositis often occurs in pianists, violinists, operators PC, the drivers. The reason be a long loadcertain groups of muscles or awkward body position. As a result, suffers of muscle power, disrupted the normal circulation of the blood, manifest degenerative processes.

The symptoms of myositis

The symptoms of myositis are diverse, but the major manifestation is considered a muscular syndrome, which is expressed in muscle weakness. It can disturb the person constantly and be quite severe, and can appear only after the person of certain tests. The loss of muscle strength occurs gradually, this process takes from several weeks to several months. In the inflammatory process involved the major muscles of the hips, neck, shoulders, back. For myositis of the muscles characterized by bilateral, symmetrical inflammation. This person is not able to lift weights, climb stairs, and sometimes just to raise my arm and to dress themselves.

The hardest people suffer myositis of the shoulder and pelvic muscles. These patients often suffer from gait disorders, have difficulty lifting from the floor or from a chair, can fall during movement.

Other symptoms of myositis may be:

  • The appearance of the rash.
  • The increase in General fatigue.
  • Thickening and compaction of the skin.
  • Aching pain that increases with movement and palpation of muscles.
  • Sometimes there is flushing of the skin and swelling in the affected area.

  • May increase the body temperature, fevers, headaches.

  • Pains appear in the joints during periods of exacerbation of myositis, but the skin over the joints becomes swollen or hot, as in arthritis or arthrosis.

Myositis can have an acute onset, and can have a chronic course. The acute phase is able to become chronic. Often this occurs when there is insufficient treatment or no therapy at all. Acute myositis occur after injuries, after a pronounced lean surge or after exposure.

Chronic disease is characterized by a fluctuating course with increased pain during weather changes in muscle tension. Sometimes there is a slight restriction of mobility in the adjacent joints.


Types of myositis

To distinguish between the following types of myositis characterized by different manifestations:

  1. Myositis of the neck. Pain in myositis of the neck arise latera few hours after exposure to a provoking factor. Painful sensations tend to gain while the man attempts to turn his neck or tilt your head. Possible irradiation of pain in the head, the shoulders, the back and shoulder. Pain not become weaker after a period of rest, do not leave a man when he is without movement. Possible redness of the skin over areas of inflammation. When exposed to cold, the patient's condition is getting worse.

  2. Myositis of the back. Pain have a tendency to increase in the morning, after a long time without movement. At night increasing the swelling of the tissue, reflex muscle spasms. Usually back pain after a few days after exposure to a provoking factor and stored for a long time after its elimination. Any physical activity – bending, turning and other movements, accompanied by stretching of muscles leads to increased pain.

  3. Myositis of the feet and hands. This type of myositis is rare without involvement in the process other skeletal muscles located in other parts of the body. Most often the muscles of the lower and upper extremities become inflamed when polymyositis. The patient becomes difficult to move, to raise his hands up.

  4. Myositis of the thoracic. Myositis of the thoracic is quite widespread. Pain syndrome is constantly chasing a man, so as to limit the movement of the chest caused by breathing, the patient is not able to.

    If the myositis of the thoracic runs hard in the pathological process involved muscles of the larynx and pharynx. This contributes to difficulties with swallowing, associated with coughing and shortness of breath. The person becomes difficult to perform a deep breath. In extreme cases, possible involvement in the pathological process the respiratory muscles with subsequent fibrosis of the lung tissue.

  5. Myositis eye muscles. Myositis can affect the muscles in one or both eyes. The pain is worse when trying to look sideways or up. Swollen eyelids, to open them completely is not possible. Probably the ulterior development of exophthalmos. If the disease becomes chronic there is a likelihood of restrictive myopathy.

  6. Polymyositis. Polymyositis is most often diagnosed in people with a predisposition to systemic diseases. Scientists assume that shock mechanism for the development of inflammation can be a viral infection, and cancerdisease. Against them producing specific antibodies, the immune system directs them to fight against their own tissues. Starts the process called rhabdomyolysis, characterized by damage to muscle fibers. Rhabdomyolysis is accompanied by an inflammatory process that tends to spread to the surrounding tissues. In this regard, polymyositis so often accompanied by joint pain, dermatitis and arthritis.

    Polymyositis with symptoms of dermatitis is called dermatomyositis. Starts the process acute, can affect both adults and children. In addition to the main symptoms of myositis, dermatomyositis is characterized by the appearance of lesions. The rash is purple or lilac color, a few towers over the skin. Are rashes on the neck, torso and face. Internal organs if polymyositis affects rarely, however, do not exclude the involvement in the pathological process of the lungs, heart, digestive tract, endocrine system.

    When juveniles dermatomyositis, the child begins to show complaints of pain in the lower extremities, appearing when walking. Particularly painful parts of the leg near the Shin. Often the development of the acute form of juvenile dermatomyositis preceded by sore throats or colds.

    Dermatomyositis twice as often diagnosed in women than in men, and treats systemic diseases of connective tissue.

  7. Neyromiozit. Neyromiozit is a subtype of polymyositis, but the process involved muscles and the nerves that are in the area of inflammation. With the progression of the disease is the spread of inflammation in the distal nerve fibers.

    This patient is experiencing the following symptoms:

    • The deterioration of sensitivity (paresthesia), or an increase in sensitivity (hyperesthesia).
    • Severe pain.
    • The feeling of tension of the muscles.
    • The decrease in muscle strength, decrease muscle tone.
    • Pain in the joints.

    Painful when neyromiozit tend to gain, as the progression of the disease. Eventually, the pain ceased to retreat, even when the person is at rest.

  8. Polybrominated. Polybromide is another subtype of polymyositis, which is manifested in the fact that muscle tissue is replaced by connective. This happens due to the fact that the muscles are for a long period of time in the fevered state begins to deteriorate. In their placeformed scar tissue in the form of nodules that can be felt. If scars are formed in the area of the tendons, it is not excluded the appearance of contractures and deterioration of mobility of the muscles.

    Signs of polybrominated may be:

    • Seal muscles, located in the area of inflammation.
    • The appearance of nodules.
    • Abnormal muscle contraction.
    • The reduction in the amplitude of movements.
    • More than 20% of patients complain of difficult swallowing of food.
    • The soreness of the muscles, particularly on deep palpation.

    For polybrominated characterized by the fact that the nodules can appear and disappear on their own, without any treatment. If you start the process of formation of contractures, the deformation of the muscles, accompanied by severe pain. Most often, this type of disease affects people in old age.

  9. Myositis ossificans. Myositis ossificans is one of the most rare kinds of polymyositis which occurs as a result of the injury: dislocation, injury, stretching or tearing of a muscle, or after fracture. So, myositis ossificans thigh often observed in riders, and miotic thorax swordsmen. In addition, this type of disease may be of an innate nature.

    Myositis ossificans is the result of untreated polybrominated. Appeared for his cause scar tissue transformirovalsya in mass with heterogeneous content, which is impregnated with minerals and other substances (salts of phosphate acid, calcium, potassium). When minerals become too much, you start to kostaniani. If the muscles are closed areas are in close proximity to the skeletal bones, the deformation of the latter.

    Indicate myositis ossificans following symptoms:

    • Deformity of hands and feet.
    • The presence of portions of muscle with uncharacteristic seals.
    • Violation of mobility.
    • The appearance of pronounced pain tend to increase during movement.

    During palpation detected rigid parts of the muscles, which is similar in density with the bones. As the progression of the disease may be complete loss of motor activity of the limbs.

    If myositis ossificans resulting from the injury has a favorable, a genetic variant of the disease begins spontaneously and is characterized by the unpredictability of the forecast. The death of a patient often occurs by ossification of the thoracic and muscles of swallowing.

  10. Lumbar myositis. Lumbar myositis is widespread. This disease often patients are confused with lumbago, but the pain in myositis are less acute. It is aching in nature and does not stop even when the person is at rest. Increased pain occurs with pressure on the lumbar area, as well as during the Commission of movements: tilts, turns, body, etc.

    Lumbar myositis must be differentiated not only from disease, from kidney disease, but also from hernia of the lumbar spine. The doctor particular attention should be paid to the symptoms of the disease, carried out x-ray, MRI or CT scan.

    This type of myositis is most often diagnosed in the elderly and office workers.

The classification of myositis

The classification of myositis may vary. So, depending on the nature of the disease there are chronic, acute and subacute myositis, and depending on prevalence: limited and generalized.

In addition, scientists have noted these particular forms of myositis, such as:

  • Infectious purulent with severe pain and General malaise. This form develops in viral infections.
  • Acute purulent with the formation of purulent foci in the muscles, with their swelling and severe pain. This form of myositis is often a complication of existing septic processes, or acts as a symptom of septicopyemia.
  • The parasitic form of the disease is the result of toxic and allergic reactions.
  • Myositis ossificans, can be congenital or acquired as a result of the trauma.
  • Polymyositis is expressed in the multiple lesions of muscular tissue.
  • Dermatomyositis, called Wagner's disease is a disease of a systemic nature.

What is the risk of myositis?

The risk of myositis is not just that the disease disrupts the patient's quality of life, restricting freedom of movement, but also threatens the development of more serious consequences.

Complications of myositis are:

  • the Spread of the disease to neighboring muscles with involvement in the pathological process of the vital organs.
  • Atrophy of muscle tissue. If the disease progresses and is not treated, possible total loss of functionality with the advent of the need to systematically care.
  • Ossification of muscle fibers that may eventually even lead to the death of the patient.
  • Disorders of breathing and swallowing if the inflammation involves the muscles of the larynx, esophagus, and pharynx.
  • Complications of cervical myositis there may be extensive destruction of the ENT-organs with subsequent shortness of breath and strain on the cardiovascular system.
  • Purulent myositis often leads to abscesses, phlegmon, which is a threat to human life.

How to treat myositis?

Treatment primarily will depend on the severity of symptoms. It can be limited to antibacterial medications, antiviral agents, immunosuppressive agents, etc.

The scheme of treatment of the myositis should be chosen individually with consideration of all clinical manifestations of the disease.

To resolve inflammation, which provoked myositis, possible use of drugs-immunosuppressants, e.g., Methotrexate, Prednisolone, Azathioprine.

If myositis has a viral nature, the treatment should be aimed at maintaining the body's immune and fight infection as the etiologic treatment does not exist. If the cause of muscle inflammation was a bacterial infection, then appropriate antibiotics.

When myositis occurs on a background of reception of medicines, it is necessary to cancel. Muscle fibres usually return to normal after 14-21 days.

  • Taking corticosteroids. Hormonal drugs are aimed at reducing inflammation. This is usually done by doctors use the prednisone. Can also be applied such as: Methylprednisolone, Hydrocortisone, Triamcinolone, Betamethasone, Dexamethasone. Taking high doses of these drugs allows to reduce the activity of the immune system, which will reduce inflammation. However, in this case increased risk of infection in other diseases. The dose of corticosteroids is calculated in each case individually, on their own use of these drugs is prohibited.

    If a patient with myositis recommended hormonal means, it is necessary to an ophthalmologist at least once a year.The fact that these drugs increase the risk of cataract formation. A serious complication of corticosteroids is necrosis of the bone, so when the pain in the skeleton, you should immediately inform your doctor.

  • Azathioprine and Methotrexate. This two drug is an immunosuppressant, which are aimed at inhibition of the function responsible for the production of red blood cells and white blood cells. Their reception requires monthly blood monitoring. Side effects is also loss of hair, disorders of the liver, vomiting, nausea, secondary infection.
  • Plaquenil. The drug helps to relieve inflammation and exerts an immunosuppressive effect. Most often it is prescribed to receive elderly people who suffer from dermatomyositis.
  • Gamma-immunoglobulin. This drug for the past 15 years is used for the treatment of various diseases. In myositis, it allows to reduce the level of enzyme (CPK), which appears in the blood in large volumes due to the destruction of the muscles. This drug is useful for myositis triggered by viruses. This drug can cause many side effects (digestive disorders, meningitis aseptic nature, fevers, headaches), so it is used in cases when other drugs proved to be ineffective.
  • Cyclophosphamide. Potent immunosuppressant drug, which is used only in severe course of the disease. The risk of any side effects when taking Cyclophosphamide increases.

It is worth noting physiotherapeutic techniques for the treatment of patients with myositis. They are an essential condition for the recovery of the patient and therapeutic course of is complete. Physical therapy allows you to improve muscle tone and prevent their atrophy and to improve the health of the patient.

Physical activity needs to be daily. Worth a visit the pool, since swimming has a positive effect on all muscle groups.

Should follow these expert recommendations:

  • Before beginning any physical activity the muscles need to be warmed up. This will help to normalize the blood flow and accelerate the heart.
  • Need to take it easy, all the exercises should be done at a pace that is optimal for a person.
  • After exercise should be followed by rest.
  • The pace should increase gradually.
  • Should focus on the inflamed muscle, in that case, when the affected area tooperenapravljaetsja, you need to stop training and rest.
  • At a time when wellbeing is severely disturbed, you should exercise program a little easier.
  • Better if the classes will be held in tandem.

The specific schema classes in myositis exists, they are recommended to each patient individually. This takes into account the severity of the disease, the affected area, age of the patient.

Particular attention is paid to the aerobics. Regular classes allow to quickly restore activity to increase muscle tone.

As for drugs, in this area there are constant studies and in the near future there will be new drugs to better get rid of myositis.

As a rule, people with different types of polymyositis often either completely or partially restore the lost activity of muscles and tone. Therapy fibromiozity can not fully rid of the disease, but its progression is slowed down substantially in compliance with all recommendations of the doctor. So sick for a long time cannot do without the wheelchair or other mobility device. On the background of concomitant diseases, such as cancer and pneumonia, the prognosis is much worse.

Infectious myositis the more successful it will be cured, the sooner therapy is begun. Therefore, when the first symptoms of muscle inflammation, should immediately contact the doctor.