ENTEROVIRAL INFECTION

Muscles are organs of the human body that are made up of muscle tissue. They allow a person to perform body movements and contract under the influence of nerve impulses. The term "myalgia" is used to describe a symptom that is expressed by muscle pain. It can be triggered by a variety of factors, which will be discussed in this article.

Myalgia occurs when moving or pressing on muscles. It can affect one or several muscles at once. Painful sensations may affect ligaments and tendons located nearby. If you want to know why the muscles in your body hurt and how to relieve muscle pain, contact the CELT Pain Clinic. Our doctors will conduct a diagnosis and find out the reason why you are experiencing discomfort. In accordance with it, treatment will be prescribed, which will definitely be effective.

At CELT you can get advice from a specialist algologist.

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Causes of muscle pain

The causes of muscle pain can be different. Below are the most common ones.

Muscle injuries

Muscle injuries usually occur as a result of physical activity. They cover specific muscle groups and include:

• sprains - occur due to sudden strong muscle stretching or contraction and are characterized by muscle stiffness and pain that lasts for several days;
• muscle overload, or soreness, occurs during intense training when moving to a new level of load, and is characterized by painful sensations in the muscles that arise due to their microtraumas.

Muscular-tonic syndrome

Muscular-tonic syndrome is a long-term persistent muscle tension, accompanied by the formation of painful compactions in it. This condition is characterized by muscle spasm, which appears reflexively, as a rule, with pathologies of the spine due to irritation of the nerve roots. The syndrome occurs when:

• spinal osteochondrosis;
• intense load on the back;
• long-term static loads.

It is customary to distinguish two types of syndrome:

• diffuse - a muscle area is involved;
• generalized - flexor and extensor muscles are involved.

The most common types of muscular-tonic syndrome are the syndromes of the following muscles:

• anterior wall of the sternum;
• pear-shaped;
• pectoralis minor;
• oblique muscle capitis;
• iliopsoas;
• gastrocnemius;
• backs.

Infectious muscle diseases

Myositis of a parasitic, bacterial and viral nature is an inflammation of the muscles that occurs, including as a result of complications of other diseases. With myositis, all muscles of the body can hurt: the upper and lower extremities and torso. When moving, the pain becomes more pronounced; dense nodules can be felt in the muscles.

With purulent myositis, the pain intensifies and is accompanied by:

• increased body temperature;
• tension of the affected muscle;
• swelling of the sore muscle and redness of the skin over it.

Fibromyalgia

Fibromyalgia is symmetrical pain in the muscles, ligaments and tendons of a chronic nature. It can be localized in the area:

• back of the head;
• chest;
• neck;
• lower back;
• thighs near the knee joint.

More about fibromyalgia

Most often, this pain syndrome occurs in women. In addition to symmetrical pain throughout the body, the following symptoms are present:

• sleep disorders;
• morning stiffness
• chronic fatigue syndrome;
• apnea.

Other causes of muscle pain

Other factors that can trigger muscle pain include:

• rheumatic disease (polymyalgia rheumatica);
• taking medications to lower blood pressure and statins
• systemic lupus erythematosus;
• muscle inflammation of autoimmune etiology;
• deficiency of calcium and potassium in the body.

Why does your body ache when you have a fever?

The cause of pain in muscles, joints and bones during fever often lies in intoxication, that is, poisoning of the body1. The “poisons” are bacterial toxins, products of inflammation and tissue breakdown in affected areas, substances that appear in the body due to metabolic disorders due to illness1. At the same time, the severity of intoxication symptoms primarily depends on the type of infectious agent and the body’s ability to resist it1.

Infectious diseases are most often caused by:

• viruses, for example, influenza viruses, parainfluenza, adenoviruses, hepatitis viruses, infectious mononucleosis, measles, chickenpox and others;
• bacteria: staphylococci, streptococci, salmonella, tubercle bacilli, etc.;
• protozoan microorganisms: amoebas and lamblia;
• mushrooms2.

The vast majority of all infections are acute respiratory viral diseases2,3. Their causative agents can be:

• influenza viruses - about 15% of cases;
• parainfluenza – up to 50%;
• adenoviruses – up to 5%,
• respiratory syncytial virus – about 4%;
• enteroviruses – 1%;
• viral associations – about 23%;
• other viruses4.

All these viruses are capable of infecting the mucous membrane of the upper respiratory tract. They penetrate the epithelial cells of the nasal cavity and pharynx, causing local inflammation and death of these cells3,4. Absorption of inflammation and decay products into the bloodstream leads to the development of intoxication syndrome, accompanied by body aches and fever, weakness, headache and other symptoms3,4.

Intoxication is most severe with influenza4,5. Its appearance precedes symptoms of respiratory tract damage.

• Body temperature rises to 39-40 °C4, chills occur.
• The head begins to hurt in the forehead and temples.
• Sudden sounds and movements cause increased headaches.
• There is pain and pain in the eyes, which intensifies with movement of the eyeballs and pressure on them.
• The eyes become red and begin to water.
• Aches muscles and joints.
• The whole body is seized by severe weakness and lethargy5.

According to statistics, muscle pain accompanies the flu in 40% of cases. Muscle weakness occurs in 87% of patients4.

Additional manifestations of intoxication may be vomiting, which sometimes occurs in children, dizziness and fainting, which are more common in adolescents and elderly patients. Possible sleep disturbance in the form of insomnia5.

The manifestations of acute respiratory viral infections caused by other respiratory viruses (not the influenza virus) are similar to each other4. In terms of the severity of intoxication syndrome, these diseases are an order of magnitude inferior to influenza4.

Thus, rhinovirus infection , although it begins acutely, with sneezing and the appearance of profuse watery discharge from the nose, is almost never accompanied by body aches and fever - the temperature rarely rises to 38 ° C, and sometimes even remains normal4.

With parainfluenza , from the first day you are bothered by a sore throat, dry hacking cough, hoarseness of the voice, and manifestations of intoxication are limited to a rise in temperature to 37.5 ° C, mild weakness and headache4.

Adenoviral infection is characterized by high and prolonged fever, runny nose, conjunctivitis, sore throat associated with damage to the pharyngeal tonsils, and swollen lymph nodes. However, despite the impressive range of symptoms and high temperature, the muscles and joints do not hurt; some weakness and heaviness in the head are possible4.

Respiratory syncytial infection also occurs with moderate intoxication: weakness, lethargy, headache, discomfort in the muscles of the body, but the discomfort that arises is not comparable to what happens with the flu. Along with intoxication syndrome, a cough appears with difficulty breathing, wheezing and viscous sputum4.

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Diagnosis of muscle pain

Before prescribing treatment for muscle pain, it is necessary to conduct a diagnosis that will identify the root cause of their occurrence. Depending on the nature of your pain, the CELT Pain Clinic may refer you to one of the following specialists:

• traumatologist;
• rheumatologist;
• infectious disease specialist

As a rule, diagnosis is based on the history of the disease and its clinical manifestations. To confirm or differentiate the cause of myalgia, the following may be used:

• X-ray examinations;
• Magnetic resonance imaging;
• CT scan;
• ultrasonography;
• laboratory research methods;
• muscle biopsy.

Publications in the media

Almost any term in Latin with the ending “it” means inflammation: bronchitis is inflammation of the bronchi, tonsillitis is inflammation of the tonsils, etc. Myocarditis is inflammation of the muscle tissue of the heart. Similar to inflammation of any skeletal muscle after a sprain or hypothermia, which is manifested by pain, impaired muscle function, local swelling and redness, pain and decreased contractility also occur in the heart muscle. Due to inflammation, the current of impulses through the conduction system of the heart slows down - blockade and heart rhythm disturbances develop.

Myocarditis can occur with any acute or chronic indolent infectious disease. Most often, myocarditis develops due to viral infections. Non-infectious factors that cause myocarditis include some medications, including antibiotics, sulfonamides, etc., as well as vaccines and inoculations. In addition, myocarditis often accompanies systemic connective tissue diseases, for example, systemic lupus erythematosus, rheumatoid arthritis, and vasculitis. Among the causes of myocardial inflammation, a special place is given to rheumatism, in which myocarditis is one of the main and leading manifestations of the disease along with endocarditis and pericarditis - inflammation of the inner and outer lining of the heart, respectively.

There is also idiopathic (that is, without an obvious known cause) myocarditis, which is called Abramov-Fiedler. Moreover, in the classic course of the disease, examination and blood tests do not reveal the infection that provoked myocardial inflammation.

According to the course, acute, subacute and chronic myocarditis are distinguished. In a chronic course, depending on the frequency of relapses, cardiac function can significantly decrease and chronic heart failure develops.

Quite often, myocarditis is not accompanied by significant symptoms of the disease and is recognized only during an instrumental examination, sometimes performed for another reason. Complaints may be limited to general weakness, chest discomfort, palpitations, a slight increase in body temperature - nonspecific complaints, for which not everyone goes to the doctor, and almost no one comes to the cardiologist.

In typical, clinically pronounced cases, there are complaints of prolonged pain in the heart area not associated with physical activity, weakness, increased fatigue, shortness of breath and palpitations even at rest, and interruptions in cardiac function. Body temperature is often subfibrile: 37-37.90C.

Myocarditis begins against the background of an acute infectious disease or shortly after it. The malaise intensifies and the above complaints appear. Sometimes the pain in the heart is persistent and long-lasting. Body temperature is normal or slightly elevated. The severity of symptoms is determined by the prevalence of the inflammatory process in the myocardium - how much of the heart muscle is involved in inflammation and begins to work worse - to contract. Due to a decrease in myocardial tone, the size of the heart increases, the normal functioning of the valves is disrupted, and cardiac output decreases. Myocarditis can be complicated by the development of acute heart failure - a reason for emergency hospitalization and intensive care.

Myocarditis can occur in two clinical forms: infectious-toxic (heart lesions appear during a period of severe intoxication against the background of infection) and infectious-allergic (the infectious agent triggers an excessive immune response of the body and the body’s own immune cells begin to fight and destroy their own cells in different organs , including hearts, which in a number of ways are a little similar to bacteria and viruses. Therefore, the immune system cannot distinguish body cells from harmful microbes. That is why infectious-allergic myocarditis can occur and continue after the end of the infectious process that caused it.

Idiopathic myocarditis

Idiopathic myocarditis, in which there is no clearly established cause for the development of inflammation in the myocardium, is characterized by a more severe, sometimes fulminant course with the rapid development of a large “flabby” heart and heart failure. Without timely help, most often, such myocarditis is fatal or requires an urgent heart transplant, which in our country, unfortunately, is not always possible. In a large heart, blood flow slows down significantly, valve function is disrupted, and cardiac output decreases. The walls of the heart are stretched so much that even after successful treatment, changes in the myocardium can be irreversible. In idiopathic myocarditis, both rhythm disturbances and the formation of blood clots inside the heart due to its expansion and turbulent blood flow, which can enter the brain and lungs, leading to fatal thromboembolic complications - pulmonary infarctions, strokes, etc., are deadly in idiopathic myocarditis.

Myocarditis in children

Myocarditis in a child, as well as in an adult, occurs as a result of an infectious factor. In children, due to the failure of the immune response to a number of bacteria and viruses that adults are more “familiar” with, even a mild infection can lead to generalization - complications in other organs, most often the heart and kidneys. Children are characterized by the presence of two types of myocarditis:

1. Congenital - in this case, from the day of birth, the child exhibits lethargy, pallor, shortness of breath, changes in the ECG, low blood pressure, weak sucking reflex, etc. The child does not gain weight. Jaundice prolongs due to insufficient blood supply to the liver. The situation requires immediate treatment. Most often, this condition is associated with an intrapartum infection - then antibiotics are quite effective and the process is reversible. If congenital myocarditis is associated with impaired immunity and occurs as part of an autoimmune process, treatment is more complex, the prognosis is worse, and death is possible.

2. Purchased. This type of myocarditis, as in adults, is divided into acute, subacute and chronic, and is most often a consequence of ARVI. The child's appetite decreases, anxiety occurs during the day and sleep disturbances at night, episodes of cyanosis (blue face) and shortness of breath, increased body temperature. In this case, examination and observation by a cardiologist is mandatory.

Instrumental examination methods

In a blood test, the level of inflammation indicators increases - leukocytes, ESR, C-reactive protein, etc., but, unlike a banal infection, with myocarditis the level of enzymes in the blood increases - MB-CPK and troponin. These enzymes are normally found inside the muscle cells of the heart. During inflammation, which leads, among other things, to disruption of the integrity of cell membranes, enzymes enter the blood and their level is proportional to the number of damaged cells. This happens when the myocardium becomes inflamed or damaged during a heart attack.

The ECG records certain changes that are characteristic specifically of myocarditis, although often difficult to distinguish from ischemic ones. Almost always, with myocarditis, ECG reveals disturbances in heart rhythm and conduction.

Ultrasound of the heart - decreased myocardial contractility, expansion of the cavities of the heart, accumulation of fluid around the heart and other specific changes.

Forecast

With Abramov-Fiedler myocarditis, myocarditis against the background of sepsis (severe generalized infection and damage to almost all organs), the prognosis for life is unfavorable - mortality up to 50-60%.

With infectious myocarditis, with timely and adequate treatment, in most cases, myocarditis is asymptomatic and ends with complete recovery. Occasionally, changes in ECG or cardiac ultrasound data will persist for a long time. Most often, there are no signs of previous myocarditis 2-3 months after the end of the disease. Other forms of myocarditis with an acute and subacute course in at least 1/3 of cases result in complete recovery, and mortality in Russia reaches 5-10%.

Prevention

Prevention is the prevention and timely effective treatment of infectious diseases. If signs of infection appear, you should consult your doctor. Of course, a runny nose can be treated at home, but without a doctor and a basic examination you will not be able to distinguish between a “lingering” runny nose and the onset of an inflammatory process in the heart. It is also important to treat infectious diseases. Do not stop therapy prematurely, including antibiotics, even if nothing bothers you anymore.

If you have had myocarditis, you need to be examined and treated with greater care and attention for any, even “harmless” infection. If you are planning to undergo any surgical intervention, including tooth extraction, warts or skin papillomas, etc., be sure to undergo antibiotic prophylaxis under the supervision of a doctor.

Indications for hospitalization

In this matter everything is extremely simple. Suspicion of acute myocarditis or exacerbation of chronic myocarditis is an undeniable indication for hospitalization. Myocarditis is not treated at home, no matter how severe it is. Severe arrhythmias and acute heart failure can develop suddenly, and you will miss the moment to begin adequate treatment.

Treatment of myocarditis is carried out exclusively in a hospital under the dynamic supervision of a doctor. Antibiotics and anti-inflammatory drugs, including hormonal ones, are prescribed, the pulse rate is reduced and, if necessary, drugs are prescribed against disturbances in heart rhythm and conduction.

Cardiologist, Ph.D. Zaikina Alexandra

Treatment for muscle pain

The CELT Pain Clinic uses modern methods for treating muscle pain, which allows you to effectively cope with the existing problem. First of all, it is aimed at eliminating its original source. Systemic therapy allows you to minimize (or even completely eliminate) pain. It involves the use of painkillers, non-steroidal anti-inflammatory drugs and opiates. Systemic therapy is combined with other treatment methods:

• exercise therapy;
• massage;
• electromyostimulation;
• physiological and manual therapy.

CELT specialists recommend the prevention of muscle pain, which consists of maintaining a healthy and active lifestyle, ergonomics of the workplace and eliminating bad habits.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

How to alleviate the condition if the temperature and body aches

In the treatment of ARVI, symptomatic drugs1 are mainly used, the action of which is aimed at alleviating the manifestations of the disease. Among these drugs, a special place is occupied by antipyretic drugs that help fight fever, including paracetamol preparations.

According to WHO recommendations, paracetamol is included in the list of vital drugs used in the treatment of adults and children, and is considered one of the safest means for reducing fever. Paracetamol blocks the synthesis of prostaglandins (inflammatory mediators) in the central nervous system, due to which it provides a good antipyretic effect and has a mild analgesic effect. The maximum daily dose of paracetamol for adults is 4 g, for children - up to 60 mg per kilogram of body weight per day1.

Based on paracetamol, many combination drugs have been created that can simultaneously affect almost the entire complex of symptoms of acute respiratory diseases, which can significantly alleviate the patient’s condition during treatment and recovery1. In addition to the main active ingredient, these drugs include:

An example of combination drugs intended for the symptomatic treatment of “colds” - ARVI, including influenza - is RINZA®. The drug is available in the form of tablets and powders for making drinks.

The composition of the drug RINZA® in tablets for children over 15 years of age and adults includes phenylephrine, chlorphenamine and caffeine7, which simultaneously help fight fever, headache, nasal congestion and runny nose, weakness and lethargy.

RINZASIP® with vitamin C for adults and children over 15 years of age is available in powder form for the preparation of hot drinks with lemon, orange and blackcurrant flavors. Due to the inclusion of ascorbic acid, it can help strengthen the immune system and increase resistance to infection7.

RINZASIP® for children over 6 years of age is available in the form of a powder for preparing a drink with raspberry flavor9. In addition to paracetamol in children's dosage and vitamin C, it contains pheniramine maleate, which acts similarly to phenylephrine in the preparation for adults7.

Important! RINZA® does not treat the disease itself, it only helps alleviate its symptoms. Any disease or condition that is accompanied by fever and body aches requires consultation with a doctor and examination.

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