Trigger points (trigger zones) are small seals localized in muscle tissue. When you press on trigger points, an acute pain syndrome immediately occurs. In chronic pain, this pathology is called myofascial syndrome. Trigger points on the human body do not threaten his health, but they cause a lot of trouble and can cause a significant deterioration in the quality of life.
Trigger point treatment in Moscow is offered by the Yusupov Hospital, a leading multidisciplinary medical center equipped with the latest equipment and staffed by a staff of highly qualified doctors. If you are looking for where to perform trigger point massage in Moscow, the Yusupov Hospital Rehabilitation Center is the best clinic where trigger point massage is performed.
What is chronic muscle pain syndrome
Treatment and prevention of chronic muscle pain is an urgent and complex problem. Painful musculoskeletal syndromes often cause long-term disability, even in young people. Normally, during work, one muscle should contract, and at this time the other (antagonist muscle) should relax and recover.
Chronic muscle pain syndrome is a decrease in the function of muscle fibers that occurs as a result of prolonged static load of low intensity, accompanied by increased metabolic processes, increased contractility in these muscle fibers, leading to local muscle spasm with compression of neurovascular formations and impaired circulation.
Epidemiology
Pelvic pain affects 3.8–24% of women aged 15–75 years. Every year, this is the main indication for 10% of outpatient visits to a gynecologist, 40% of diagnostic laparoscopies, 12-17% of hysterectomies. The Women's Chronic Pelvic Pain Clinic reported that 14% to 23% of women with CPP have MPP. This problem may affect up to 78% of women with interstitial cystitis.
You can read more about chronic pelvic pain here.
Trigger mechanism of muscle pain syndrome.
The trigger for muscle pain syndrome is deformation of the working muscle, when the thicker and stronger part of it stretches the thinner and weaker part. At the same time, the thicker and stronger part of the muscle is in spasm, its metabolism and blood supply are disrupted, and the second part is overstretched, its blood supply is sufficient, but it is “tired.” A similar situation can occur not only in one muscle, but also in antagonist muscles.
When reserve capacity is depleted, tense bundles with increased irritability gradually form among the muscle fibers - myofascial trigger points (points, zones), which, when pressed, feel like a painful dense cord.
Clinically Relevant Anatomy
The pelvic floor or perineum is that part of the torso that is located below the pelvic diaphragm. The pelvic floor is limited:
- anal triangle (posterior), which contains the anal canal, ischiorectal fossae on each side and the external anal sphincter;
- the genitourinary triangle (anterior part), which contains the external genitalia and the terminal parts of the genitourinary ducts.
The posterior part is closed by the pelvic diaphragm, and the anterior part is closed by the urogenital diaphragm.
First of all, the pelvic floor muscles perform the following important functions:
- Provides support for the pelvic organs and their contents.
- Withstands increased intra-abdominal pressure.
- Helps stabilize the spine/pelvis.
- Maintains tone in the urethral and anal sphincters.
- Participates in sexual response and reproductive function.
Clinical signs of trigger points
Clinical signs of trigger points manifest themselves as unbearable pain when pressed; the ability to cause irradiation of pain to distant zones characteristic of a given muscle; vegetative disorders. Trigger points are located within tense, compacted bundles of skeletal muscles or in their fascia and can be in either an active or latent state. An active trigger point is an area of hyperirritability in a muscle or its fascia that manifests itself as pain.
In this case, pain is felt not so much in the area of the trigger point, but also in areas remote from it, characteristic of this point. Referred pain can be observed at rest and with movement. The active trigger is very sensitive, prevents the muscle from fully stretching and somewhat weakens its strength. When you try to actively stretch a muscle, the pain both in the muscle itself and in the area of reflected pain increases sharply. Trigger points may be in a latent (hidden) state. In these cases, pain is detected when palpating the location of the trigger, but no pain occurs in distant areas. Latent trigger points are much more common than active ones. Thus, in a study of 200 young people, latent triggers were found in 54% of girls and 45% of boys. However, active trigger points were identified only in 5% of cases. Latent trigger points, under the influence of adverse effects, such as prolonged muscle spasm, hypothermia, increased physical activity, can enter the active phase, that is, become active trigger points. If, in addition to muscle pain, pain appears in the cervical-collar region, chest, back, lower back, limbs, and there is also an increase in temperature, then you need to consult a doctor.
K.B. Petrov Department of Physical Therapy, Physiotherapy and Balneology, Novokuznetsk Institute of Advanced Medical Studies, Novokuznetsk, RussiaSummary
. The example of the most well-known theories shows the lack of a unified view on the pathogenesis of triggers. The close connection of trigger and acupuncture points with each other and with encapsulated receptors is proven. It is suggested that the transport-trophic function of the nerve plays a regulatory role on the excitability of the formations under discussion. The participation of trigger points in the physiology of reflex activity of spinal-trunk structures is considered. The basic principles of pathogenetic treatment and prevention of trigger pain are outlined.
Physiology of trigger points and pathogeny trigger to be sick: The report second (Generalization of the facts new views) KB Petrov Faculty of medical physical culture, physiotherapy and resort medicine Novokuznetsk institute after degree training of the doctors. Novokuznetsk, Russia
The resume
. On an example of the most known theories the absence of a uniform view on a pathogeny of triggers is exhibited. The close link trigger and acupuncture points among themselves and with Inside a sheath by receptors is proven. The supposition the supposition the supposition the supposition suppositions supposition supposition involvement of trigger points in physiology a reflector activity spinal cord - fulcrum of frames. The main principles of pathogenetic treatment are scheduled and prophylaxis trigger to be sick.
The history of studying painful manifestations caused by trigger points (TPs) covers more than eighty years [36, 39].
Although triggers can be identified in subcutaneous tissue, fascia, ligaments and periosteum [14, 40], this phenomenon has been studied in most detail in muscle tissue [12, 31 and many others. etc.]. Most modern theories associate the occurrence of TT in muscles either with injuries (microtraumas) due to professional, sports or other stress, or with viscero-somatic, in particular, with vertebrogenic influences [6, 12, 13, 31].
D. Simons et al. [31] believes that when the sarcoplasmic reticulum is damaged, an area of local increase in the concentration of calcium ions appears in the muscle fiber, which, using the energy of ATP, causes a contraction of individual sarcomeres, forming an area of stable contracture. A large number of platelets are released into the microtrauma zone - sources of serotonin and other biologically active substances (BAS), promoting vascular spasm and chemical sensitization of free nerve endings (nociceptors).
G.A. Ivanichev [15], putting forward his own concept of the pathogenesis of myogenic compactions around the TT, believes that due to temporary delays in the propagation of the motor impulse, muscle fibers located in the abdominal area, near the myoneural synapse, are activated earlier than others. As a result, with any contraction of the muscle there is a tendency to stretch its thinner and weaker sections adjacent to the tendon. As a biomechanical body, muscle is characterized by viscosity, therefore, after its relaxation, a change in the original configuration of the fibers may persist. If the proprioceptor, the muscle spindle, enters the area of the deformed area, then conditions are created for the self-maintenance of the segmental myotatic reflex. In this way, local muscle hypertonicity is formed. A certain role is played by the tonic reflex activity of the brain stem.
The above concepts not only demonstrate the lack of a unified view on the pathogenesis of myofascial pain, but also leave a whole list of questions unanswered. Here are just a few of them.
— If TT is a consequence of microtrauma, then why were no morphological changes identified in the area of their localization [16, 31]? Moreover, proprioceptors—spindles and Golgi tendon complexes—have never been detected in biopsy material from the TT [31].
— The microtrauma factor poorly explains the occurrence of TT in individuals with a complete absence of voluntary movements (immobilization with a splint, spinal spastic paralysis [26, 28]).
— Why are TTs detected in significantly smaller quantities or completely absent in patients with subcortical hyperkinesis, parkinsonism or ataxic-astatic syndromes [3, 23, 26]?
— How the most diverse therapeutic measures (acupressure, ischemic compression, puncture with a dry needle, incision with a scalpel, administration of various gases, saline or local anesthetic, cooling with chloroethyl, hot wet compresses, post-isometric relaxation) are effective in inactivating TT [16, 19 , 26, 31] ?
— What is the reason for the striking similarity (71%) between the localization of TT and the location of acupuncture points [38]?
— If triggers are a pathological phenomenon, then why are latent TTs found in large numbers in clinically healthy people, small children and even pets?
Let's try to understand this confusing problem. It is believed that the main clinical manifestation of TT is pain; in addition, vascular, secretory, pilomotor and other autonomic reactions have been described [31]. According to our observations [26], when stimulated by triggers, various motor responses can be evoked - from primitive defensive automatisms to very complex synergies of standing and walking. In the evolutionary aspect, most of the listed reflexes arose before the appearance of telereceptors, so the main external trigger stimulus for them remains irritation of the skin reflexogenic zones [1, 2, 4].
In addition to free nerve endings, peripheral sensory devices are also represented by more complex encapsulated sensors. The latter lie mainly in the subcutaneous tissue, muscles, joints and capsules of internal organs [30]. Pacinian corpuscles, for example, are quite comparable in size to TT (0.5 - 0.7 mm in diameter and 1 mm in length). The intracapsular fluid of the receptor, as well as the trigger tissue, is characterized by an increased concentration of some enzymes and biologically active substances - cholinesterase, ATP, histamine, serotonin [30, 31].
When comparing TT with an encapsulated nerve ending, our data [26], showing that the tensile strength of the trigger is higher than that of indifferent muscle tissue, is well explained. Obviously, to destroy the membrane formed by the pereneural epithelium [24], greater gas pressure is required during pneumodestruction than in a randomly selected zone. The similarity of TT to encapsulated mechanoreceptors is also indicated by the fact that when irritating the skin areas above the trigger and nearby indifferent areas with pulsed current in patients with spinal spastic paraplegia, we did not see any differences in motor responses (protective shortening reflex [26]). When stimulated by pressure, the difference was obvious. Other authors also point to the role of extero- and interoreceptors in the genesis of TT [14, 31].
Acupuncture points (AP), as is known, are also located in places where encapsulated receptors and free nerve endings accumulate. In the AT area, many mast cells and biologically active substances were found in a bound state with heparin [5, 7, 10, 22]. The close relationship between TT and AT is evidenced by our studies of interstitial pressure [26]. The fluid pressure in the TT is close to that in the AT and lower than in the surrounding tissues. The presence of a sharp pressure drop in local areas corresponding to these formations is difficult to imagine if there are no semi-permeable membrane shells around them that have a certain rigidity. Only such a structural model of TT and AT can explain the therapeutic effect of piercing them with a needle [31], incising with a scalpel [14], or tearing them from the inside with liquid or gas [26, 31].
If an empty syringe is connected to the needle inserted into the TT and its piston is pulled “toward”, then due to the suction effect, the pressure in the trigger increases and the pain intensifies [26]. This fact, firstly, indicates partial permeability of the membrane membranes of TT and AT, and secondly, demonstrates the role of edema in the genesis of trigger pain.
However, the magnitude of intrathecal pressure is unlikely to play a decisive influence on the excitability of the receptor systems under consideration. In any case, no correlations were found between TT pain according to tensoalgisimetry and intra-trigger pressure (R = 0.0047) [26]. In addition, it is known that AT, unlike TT, is completely painless.
Rice. 1. Improved needle for puncturing trigger and acupuncture points 1. Encapsulated receptor (Pacinian corpuscles). 2. Hollow injection needle. 3. Drainage holes in the wall of the needle. The “+” sign indicates an area of increased interstitial pressure, and the “-” sign indicates an area of low pressure.
It has long been established that when afferent nerves are irritated, local acidosis, hypercalcemia occurs, and “pain factors” accumulate—histamine-like substances, kinins, acetylcholine and serotonin [29,31]. It is possible that the described reactions are directly or indirectly related to phenomena similar to axonal transport in motor neurons [8, 34]. Apparently, central control of these connections in the intrathecal space of the TT is possible, regulating the excitability of nerve endings. In this case, any penetration of the trigger causes a flow of tissue fluid in one direction or another, changing the concentration of the sensitizing factor. Indeed, after inserting a needle into the formations in question, following an abrupt drop or, more rarely, an increase in pressure, a gradual leveling off in relation to the surrounding tissues was often noted [26].
The above considerations allow us to draw one important practical conclusion: if we improve the injection needle, as shown in Fig. 1, by turning it into a drainage tube, the effectiveness of acupuncture and puncture treatment of TT should increase.
When a peripheral nerve is reinnervated, the function of nerve impulse conduction and its trophic capacity, carried out by axonal transport, are restored at the same time [8]. Obviously, in the absence of the latter factor, TTs do not form in the zone of autonomous innervation of the nerve [26].
The development of the central nervous system (CNS) of vertebrates goes through a number of successive stages. Each new stage of phylogenesis is marked by the formation of another sensorimotor superstructure, which is a set of morphological and functional adaptations, designated by N.A. Bernstein [2] as the level of movement construction. There are six levels of motor coordination.
A. Rubrospinal (level of the proprioceptive ring or paleokinetic regulation).
B. Talamo-pallidar (level of synergies according to N.A. Bernstein).
C. Pyramidal-striatal (breaks down into two sublevels: C1 - striatal, belonging to the extrapyramidal system, and C2 - pyramidal, already belonging to the cortical levels).
D. Parietal-premotor (level of objective actions).
E. A group of higher cortical levels responsible for writing, speech, etc.
In lower animals (amphibians), starting from level B, and in higher animals (birds, mammals) - from level C, telereceptors (vision, hearing) are widely used to build highly coordinated movements. Thus, only the activity of the rubrospinal level is completely dependent on sensory information from extero-, proprio- and interoreceptors.
In addition to its supreme motor center - the red nucleus, the anatomical substrates of this system are the ancient parts of the cerebellum (vermis and floculus), the dentate nucleus, the vestibular nucleus of Deiters,
tegmental nuclei of the midbrain, ascending sensory tracts (spinotalamicus, spinocerebellaris) and descending motor tracts (rubrospinalis, tectospinalis, vestibulospinalis). This also includes numerous nuclei of the reticular formation of the brainstem and midbrain, which are an important link in the central part of the autonomic nervous system [33].
The rubrospinal level in humans is not capable of any voluntary actions, however, it is here that the coordination centers of static and statokinetic reflexes are located [1, 2, 20], ensuring a stable vertical position of the body; control is carried out
spinal automaticity of walking [32], respiratory, vasomotor and other autonomic functions are regulated [33].
We believe that TTs represent a phylogenetic modification of peripheral receptor systems, required to provide prolonged chain and ring reflexes at the spinal and brainstem levels. Being practically inexhaustible, the latter are an important component of muscle tone [11].
The physiological nature of trigger points is easily proven by their identification in clinically healthy people and animals. The ability of TT to influence muscle tone and support propriospinal reflexes is well demonstrated in individuals with partially or completely isolated spinal cord [26, 28]. In visceral pathology, they also often arise in accordance with the law of segmental reflection [9] or along myovisterofascial connections based on polysegmental chain myotatic synkinesis [27].
Studying for a number of years nonspecific reflex-muscular syndromes in pathologies of the musculoskeletal system [24, 25], we were surprised to note the presence in individuals with complete organic preservation of the central nervous system of extremely uniform muscle-tonic reactions, manifested mainly in the form of pathological fixation of reflexes standing and walking stem level. Inactivation of TT in most cases relieved not only pain, but also a characteristic increase in tone. G.A. Ivanichev [13], studying the evoked polysynaptic reflexes when stimulating the median nerve in patients with TT in the shoulder girdle, also found persistent irradiation of excitation within the spinal-trunk ring. All of the above coincides with the opinion of K. Lewit [37], who believes that the pathology of the musculoskeletal system is based on disorders of a few basic functions: standing, walking, as well as grasping and holding an object with the upper limb. Obviously, motor acts related to higher coordination levels do not require external triggering through the TT. That is why, in syndromes of irritation of the cortex and subcortical structures, triggers are almost not detected, and muscle soreness on palpation is mild [3, 23, 26].
The stated point of view can be illustrated with a simple and clear example. If you first palpate your own masticatory muscles, and then the facial muscles, you can easily make sure that the first ones are more painful than the second ones and TTs are almost certainly detected in them. It is known that facial expressions appeared at the later stages of phylogenesis (even in birds they are absent) and are characteristic at least starting from level C2. The function of chewing is much older; it is controlled by the rubrospinal level. Of course, TTs can also be detected in facial muscles, for example, in cases of reflected viscerogenic syndromes [21], trigeminal neuralgia, or during the recovery stages of facial nerve paresis [13, 15], however, in all these cases there is a return to the rubrospinal level of regulation.
Thus, a certain amount of TT is inherent in a healthy body to participate in maintaining muscle tone and autonomic activity (of course, they are not absolutely necessary). Any pathological process lying within the extero- or interoceptive reflexogenic zones increases the excitation of the nerve centers of the spinal-trunk ring, which leads to additional formation of TT. Under these conditions, they are often perceived by consciousness in the form of pain [35]. Similar phenomena can be caused by activation of the reticular formation through the limbic system, for example, during exogenous psychogenies.
The main cause of the so-called “functional” pathology of the musculoskeletal system is often considered to be a “suboptimal” motor stereotype [18]. We believe that this phenomenon, on the contrary, is associated with the improvement of household and industrial motor skills, namely, with the increasing degree of their automation.
According to N.A. Bernstein [2], in the process of mastering any motor act, the highest “leading” level for a given class of movements is initially involved. As a rule, he finds in the lower levels ready-made motor preparations suitable for use as “background”. Only the content of the leading level falls into the field of consciousness (this does not mean that all levels are equal in the degree of awareness). As soon as a group of movements moves from the leading level to the background level, it ceases to be conscious, and the movements themselves become automated. Apparently, with many relatively simple motor acts in the process of automation, the rubrospinal level is reached, the activity of which is associated with the formation of TP.
Obviously, one of the ways to prevent and treat such dysfunctions may be to “de-automatize” existing motor stereotypes, for example, through dance training (level C1), the use of unnaturally elaborate body movements characteristic of Wu-Shu gymnastics, highly rhythmic aerobics or Shaping. Such gymnastic systems as the M. Alexander method or the M. Feldenkrais method are based on awareness of the intermediate stages of movement [17].
conclusions
.
- In their structure, trigger and acupuncture points are close (or identical) to encapsulated mechano- or chemoreceptors.
- The transport-trophic function of the peripheral nerve plays a certain role in the regulation of TT excitability.
- In the evolutionary aspect, triggers are physiological structural and functional formations necessary for long-term maintenance of chain and ring reflexes of the rubrospinal level of movement construction.
- In humans, TTs take part in the regulation of muscle tone and motor pre-tuning.
- Any factors that increase the excitability of the nerve centers of the spinal cord and trunk, as well as a high degree of automation of motor acts, lead to excessive formation of TP and the appearance of trigger pain.
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Published by: Petrov K.B. Physiology of trigger points and pathogenesis of trigger pain: Second message. // Manual medicine. - No. 9. - Novokuznetsk, 1995. - P. 15 - 19.
<< message 1
Causes of muscle pain
Pain in the muscles “speaks” of overstrain in them. They occur against the background of stress, injuries, prolonged muscle immobilization, and certain diseases (osteochondrosis of the spine, developmental anomalies: body asymmetry with different leg lengths, flat feet). Reasons also include a sedentary lifestyle; muscle tension associated with sedentary work or incorrect posture when writing and reading, working at a computer, driving a car; due to the inability to relax the muscles and give them the necessary rest. The tension can reach such an extent that pain occurs.
The risk group for myoskeletal syndrome includes: persons maintaining a forced, uncomfortable posture during working hours, performing the same type of movements (for example, working on a conveyor belt), patients suffering from any postural disorders, resulting in prolonged compression of the muscles. Maintaining one position for long periods of time during deep sleep can also activate trigger points. It is in these cases that nagging, deep, poorly localized, diffuse pain in the back appears after getting out of bed in the morning.
Prolonged limb immobility due to fractures
Of particular importance is prolonged limb immobility due to fractures. You should approach the selection of crutches very responsibly, since crutches that are incorrectly selected for height can cause various damage to muscle, bone tissue and nerves (inflammation of the shoulder joint, traumatic plexitis, etc.). Low crutches lead to excessive stooping; using one crutch leads to lateral curvature of the spine.
After removing the cast, the muscles are always painfully tense, require gradual stretching, and the joints need to be “developed.” After removing the plaster, pain can appear in almost all parts of the back, since immobilization of both the upper and lower extremities after fractures leads to a gross violation of the stereotype of movements of the whole body and the appearance of pronounced asymmetries of the body.
Compression of muscles by bag or backpack straps, narrow, tight or heavy (such as a winter coat) pieces of clothing, bandages or corsets can activate trigger points in the corresponding muscles.
Massage
The effect of smoothing trigger points during the massage process is explained by the fact that first metabolic products and blood are squeezed out of the sore spot, and then, after relaxation, a new portion of fresh blood washes the point, which leads to its warming up and gradual deactivation.
After palpating and gradually squeezing the seal by the massage therapist, the patient feels a slight pain (at the trigger point and the irradiation zone), which gradually subsides and completely disappears. Then the trigger point is compressed again, more intensely, and held from the moment the pain appears until it disappears. The procedure consists of three to four such sessions, after which a warm compress is applied to the trigger points. Only a qualified massage therapist with special skills knows how to knead such seals. Therefore, self-massage is not recommended, since in this case the massage may be ineffective. Comments from patients on how to treat trigger points once again confirm that self-medication does not bring the desired result.
Muscle hypothermia, mental factors
Muscle hypothermia - both general and local. I was sitting in a draft, my neck was “bloated”, my lower back was “blown out”, etc. Cooling is one of the most common triggers. Usually combined with muscle overload, when overworked, tense muscles are cooled.
Mental factors
Emotional stress is always accompanied by muscle tension, which ensures that the body is ready to fight or flee. After the stress stops, the muscles often remain tense. The role of chronic stressful situations is also important, when many muscles of the face, neck, and torso are in a contracted state and a person seems to “forget how” to control muscle tension and relax the muscles. In a state of chronic stress, gait and movement patterns change. Remember the expression - “he was bent by grief.” The state of the psyche is always reflected in movements; a person’s so-called psychomotor skills change. A change in posture leads to muscle spasms and overloads, pain appears, which in turn further disrupts gait and posture.
Diseases of visceral organs and joints
Almost any somatic pathology can be accompanied by myofascial pain syndromes. Painful impulses from the affected internal organ or joint lead to protective tension in the corresponding muscles to immobilize the joint or create a muscle “corset” around the diseased organ. Thus, coronary heart disease with attacks of angina or myocardial infarction, as a rule, is accompanied by the appearance of myofascial pain syndromes in the chest area on the left; exacerbation of chronic pancreatitis - in the lower thoracic and lumbar spine.
Overload of untrained muscles is more typical for people with mental work with a weak muscle corset. With unusual long-term work of weak and untrained muscles, painful muscle tension arises in them and trigger points are activated. Often muscle pain occurs at the beginning of the summer season during physical overload in the garden after winter inactivity, during sports, when a muscle is strained, or when turning unsuccessfully. Basketball throws, tennis serves, javelin throwing or shot put have a detrimental effect on unwarmed and unprepared muscles.
Direct muscle contusion can activate triggers that remain active after the hematoma has resolved.
How to get rid of muscle pain?
Improving blood circulation in damaged muscles and normalizing all types of metabolism help remove lactic acid, a breakdown product. Muscle pain deprives you of healthy, deep sleep. Without adequate sleep, the body produces less growth hormone, which is necessary for muscle recovery. Anti-stress techniques, proper rest, natural anti-inflammatory and decongestant agents, adequate physical activity in combination with thermal and physiotherapeutic procedures and against the background of therapeutic fasting accelerate the “healing” process.
When treating painful muscle syndrome, it is necessary to: eliminate the cause of pain, interrupt pain impulses from the spasmed muscle, prevent further development of the pathological process, reduce or relieve pain, prevent the occurrence of muscle spasms and maximize the sensitivity threshold of pain receptors, improve blood circulation, stimulate tissue metabolic processes, increase the functional abilities of muscles and the level of psycho-emotional comfort.
To treat myofascial syndrome, therapeutic blockades, physiotherapy, massage, and physical therapy are used. Very effective treatment methods are post-isometric relaxation (manual therapy method) and acupuncture. In some cases, it is necessary to take medications that relieve spasms of skeletal muscles. An important aspect of treatment is the identification and treatment of diseases that contribute to the development of myofascial pain syndrome (osteochondrosis of the spine, arthrosis, etc.)
Diagnostics
To determine the causes of such disorders, you should contact a neurologist. A doctor can accurately determine the presence of myofascial syndrome only on the basis of the existing clinical picture and examination results.
To definitively confirm the diagnosis, patients may be prescribed:
- X-ray;
- MRI;
- electroneuromyography;
- Ultrasound.
To determine the reasons that served as the impetus for the development of myofascial syndrome, patients are recommended to undergo a comprehensive examination with an assessment of the condition of the internal organs, as well as obtain consultations with specialized specialists.
Prevention
- compliance with the work and rest schedule
- correct body position while working
- availability of short breaks from work
- control of your psycho-emotional state
- performing gymnastic exercises to relax muscles
- maintaining an active lifestyle
Trained muscles are able to withstand greater loads than untrained muscles. You need to pay attention to your back not only when it has already started to hurt. Daily exercises aimed at developing the muscles of the whole body will take no more than 20 minutes a day, but will allow you to saturate all the cells with oxygen, launch many chemical and organic processes in the tissues and raise vitality to the proper level.
Pain in the back muscles, like most diseases, is much easier to prevent than to treat, so learn to treat your body wisely and it will not ignore it. Lyapko application therapy is a simple, safe means of preventing and treating muscle pain at home.