Muscle fatigue
In our technological age, many people are gradually forming a new “bad habit”. Spending most of the day in front of a computer screen or holding mobile gadgets in our hands, we may not even notice that we are sitting in a completely uncomfortable and unnatural position. It especially affects the muscles of the shoulder girdle, neck, back and right arm, which is constantly on the computer mouse of office workers1. Staying in one position for a long time or using stereotyped movements can lead to overstrain of the muscles involved, which we feel as soreness1.
Carbon dioxide (carboxytherapy)
The effect of carboxytherapy is based on the property of carbon dioxide to cause oxygen starvation in tissues. Gas injections are given through a special device, and after the injection the body strives to enrich the joint with oxygen, increasing its blood supply. Metabolism accelerates sharply, and much more nutrients are supplied to damaged structures. In a matter of minutes, carbon dioxide leaves the joint cavity, and the effect remains for a long time.
Attention! The advantage of this unique technique is the absence of side effects, since CO2 is a natural element, a product of metabolic processes.
Carbon dioxide treatment was developed by Czech specialists from the city of Karlovy Vary, where the famous sanatorium is located. It has been successfully treating diseases of the musculoskeletal system for more than a century.
Exercise stress
“Body aches” after physical activity can occur both in untrained people and in professional athletes8. And the cause of discomfort is the accumulation of under-oxidized metabolic products in muscle cells; in particular, painful sensations are caused by an excessive amount of lactic acid (lactate)2. Less commonly, the cause is microtrauma, but this can only occur if the training rules are violated8.
Muscle soreness due to overwork does not occur immediately, but after a few hours or within 1-2 days after training or unusual physical activity and disappears within a week8.
Chondroprotectors
Such drugs are taken for degenerative-dystrophic diseases of the joints and spine to protect hyaline cartilage. The process of destruction of cartilage tissue during arthrosis and arthritis is progressive and irreversible. It can be slowed down with the help of chondroprotectors, which are especially effective when they “directly hit” the joint cavity. They improve local metabolism and nutrition of intra-articular tissues, and most importantly, stimulate the synthesis of their own collagen.
Collagen is the main component of cartilage, which performs a protective function. Thanks to the cartilage coating, the articular surfaces of the bones slide rather than rub, and movement does not cause pain. Most often, doctors prescribe Alflutop; the frequency and duration of the course is determined individually. The minimum number of injections is 5.
Injuries
Severe pain can occur when muscle fibers and tendons are torn. This usually happens if the load is excessive and the muscles are not prepared for it1. But they can also be damaged by sudden movements3. Unlike “ache” due to muscle overwork, pain due to injury occurs immediately, at the peak of the load3.
It should be remembered that even a small, but untreated injury can cause an even more severe sprain3. Therefore, if you experience pain during physical activity, be sure to consult a doctor to rule out a serious injury.
to come back to the beginning
Classification of drugs
Let's consider the main groups of local remedies for joint pain:
Non-steroidal anti-inflammatory drugs (NSAIDs) for topical use: Phenylbutazone, Etofenamate, Piroxicam, Ketoprofen, Ibuprofen, Diclofenac, Indomethacin, Meloxicam and Nimesulide.
Local agents with irritating effects:
a) Capsaicin and similar agents:
Capsaicin is fat-soluble, therefore, if necessary, products containing this drug can be removed from the skin or mucous membranes using petroleum jelly or vegetable oil.
- Capsicum fruit tincture;
- Capsicum fruit tincture + Camphor;
- Capsicum fruit extract;
- Capsaicin + Ethylnicotinate;
- Camphor;
- Carnation flowers oil + Camphor + Chinese cinnamon bark oil + Peppermint leaves oil + Eucalyptus leaves oil + Levomenthol;
- Camphor + Gum turpentine + Eucalyptus leaf oil + Levomenthol;
- Camphor + Salicylic acid + Gum turpentine + Viper venom;
- Camphor + Peppermint leaves oil / Levomenthol + Eucalyptus rodentum leaves oil;
- Camphor + Salicylic acid + Gum turpentine + Viper poison;
- Pepper patch.
b) Propyl nicotinate (salicylic acid derivatives in combinations):
- Methyl salicylate + Racementol;
- Methyl salicylate + Cobra venom;
- Methyl salicylate + Bee venom;
- Methyl salicylate + Levomenthol + Eucalyptus oil + Turpentine oil.
Preparations containing dimethyl sulfoxide:
- Sodium heparin + Dexpanthenol + Dimethyl sulfoxide;
- Dimethyl sulfoxide + Camphor + Turpentine oil + Benzyl nicotinate + Nonivamide.
Other drugs
- Nicoboxil + Nonivamide;
- Benzocaine + Procaine + Racementol;
- Glucosamine + Chondroitin sulfate;
- Formic alcohol;
- Titanium glycerosolvate aquacomplex;
- Menthol + Novocaine + Anestezin.
Anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) suppress inflammation and reduce pain and swelling. Drugs in this group are generally well tolerated, but are not recommended in cases of hypersensitivity to NSAIDs (including bronchial asthma), erosive lesions of the gastrointestinal tract, as well as during pregnancy and breastfeeding (a number of drugs can penetrate the placental barrier) . In addition, the use of NSAIDs is associated with the risk of local and systemic allergic reactions, the possible development of increased sensitivity to light (photosensitivity), especially when used together with cosmetics containing octocrylene sunscreen. Therefore, topical use of NSAIDs on areas with damaged skin, as well as use without protection from direct sunlight, is not recommended. If necessary, these products can be removed from the skin with plenty of water.
Salicylic acid derivatives (for example, methyl salicylate), which are included in various combinations of medicinal substances, have similar effects.
Irritants
A fundamentally different group of drugs from non-steroidal ones are painkillers with a local irritant effect, often used for joint pain. Products based on capsicum extract containing capsaicin are widely used. This alkaloid irritates and warms the skin and increases local blood flow in the area of application. In addition, it affects pain receptors, which leads to a local analgesic effect. Products containing capsaicin should also not be used for damaged skin. The question of use in pregnant and lactating women should be decided by a doctor. We should not forget about the possibility of developing allergic reactions.
Other substances of plant origin act in a similar way, for example, mustard oil and its derivatives (allyl isothiocyanate), camphor, menthol (which also has a “cooling” effect), extracts of cloves, eucalyptus, peppermint, and gum turpentine. The use of these products may also cause allergic reactions.
Keep away from children!
It is important to avoid accidental ingestion of any topical medications, which is especially important for families with young children.
If this does happen, then in the case of NSAIDs you should rinse the stomach. If locally irritating drugs are ingested, vomiting should not be caused due to the risk of inhalation. For example, inhalation of camphor followed by laryngospasm can lead to death. Instead, you need to take enveloping antacids and/or sorbents, and consult a doctor. There is a synthetic analogue of capsaicin with an identical mechanism of action - nonivamide. Nonivamide is usually used in combination with nicoboxil, a substance with vasodilating activity ( expands the lumen of blood vessels - Ed.).
). The application of these drugs to areas of skin with increased permeability, to the neck, lower abdomen and inner thighs is contraindicated.
Another representative of this group, propyl nicotinate, also has an irritating effect. When applied, propyl nicotinate is broken down to form nicotinic acid, which increases local blood flow and blocks nerve endings, which leads to the development of local anesthesia and hyperthermia. This painkiller can be used for joint pain only if it is non-inflammatory in origin, for example due to injury. Using a large amount of the drug over a large area can lead to a decrease in blood pressure and bradycardia, and the entry of propyl nicotinate into the oral cavity is fraught with respiratory failure, increased blood pressure, and the development of cardiovascular failure.
It is also not recommended to use propyl nicotinate simultaneously with other locally irritating agents (local medications, warming physiotherapy) due to the risk of skin irritation and lowering blood pressure. Benzyl nicotinate works similarly.
Poisons
Often, topical products contain venoms of hymenoptera and reptiles. Bee venom has an analgesic and anti-inflammatory effect, and may also have an antibacterial effect. The venoms of snakes - vipers, vipers, cobras - act similarly. If such products are used, allergic reactions may develop.
Dimethyl sulfoxide
An important component of many compounds used for arthralgia is dimethyl sulfoxide. It improves the penetration of medicinal substances into tissues by increasing the permeability of cell membranes, and also has its own local anti-inflammatory and analgesic effect. Dimethyl sulfoxide, with long-term use, improves the absorption of ethanol from the gastrointestinal tract, can enhance the effect of insulin, and increases sensitivity to anesthesia drugs. The drug should not be used if you are hypersensitive to it, pregnant or lactating women, or children under 12 years of age. An additional limitation on its use may be a specific odor reminiscent of garlic.
Other
Metal compounds can also be used in the treatment of joint pain. Thus, there are preparations based on titanium compounds, for which anti-inflammatory and antimicrobial effects, anti-edematous and local analgesic effects are described.
Another option is the use of local anesthetics, for example, novocaine and anesthesin in combination with menthol, which provides both an analgesic effect and a cooling sensation in the sore joint.
Many of the listed drugs are included in various combination drugs and enhance each other’s effect.
Diseases of the spine and joints
Muscles react to disruption of the joints4 and vertebrae5 associated with them. Therefore, myalgia is one of the symptoms of diseases of the spine5,11 and joints of the limbs4. For example, with osteochondrosis or scoliosis (curvature of the spine), pain in the neck, chest or lower back is associated with overstrain of the paravertebral muscles5,11. And in advanced cases, when the vertebra compresses the nerve root emerging from the spinal cord, the pain can “radiate” to the arm or leg11.
Often myalgia with osteochondrosis is combined with a feeling of numbness or “crawling goosebumps”. At the moment of acute pain, a person freezes, taking a forced position11.
Other reasons
Almost any disease of the internal organs can lead to myalgia11. When an organ is affected, it creates pain impulses that are partially transmitted to the muscles located nearby11.
Myalgia can also be caused by:
- endocrine diseases, such as thyroid hormone deficiency16,7;
- vascular pathologies that disrupt the nutrition of the muscles of the limbs15,16;
- chronic fatigue syndrome7;
- imbalance of microelements in the body16;
- taking medications that lower blood cholesterol levels12.
to come back to the beginning
Features of myalgia
Pain emanating from the muscles is usually deep6. Acute myalgia is protective in nature because it causes reactions aimed at eliminating the damaging factor11. Such reactions include, for example, muscle spasms4. But despite its protective nature, there is almost always a risk that the pain will become chronic11. There are 2 main causes of chronicity:
- Increased sensitivity. In response to irritation, the muscle releases substances that support inflammation. They further irritate pain receptors in the muscles. In response to frequent signals, the central nervous system lowers the pain threshold, so we can feel soreness in the muscle even when it is not strongly irritated11.
- Spasm. If pain and spasm persist, a “vicious circle” is formed: pain causes spasm, and spasm maintains pain1,5, 11.
What they say about paracetamol
When treating gonarthrosis, EULAR recommends using paracetamol as the first choice drug. If this oral non-narcotic analgesic of central action gives the desired effect, it is used for long-term therapy. However, it is only suitable for treating mild to moderate pain. The recommended maximum dosage for an adult is 4 g/day. Research results have confirmed that this dose is no less effective for moderate pain than 2.6 g/day of ibuprofen for severe knee pain.
The above dosage of paracetamol does not pose a danger when taken for a long time - up to two years. Therefore, it is often prescribed in combination therapy for knee arthrosis. If the dosage exceeds 4 g/day, negative effects on the liver are possible. 2 g/day is safe, but not always effective for moderate pain.
Paracetamol – pain reliever for mild to moderate pain
Diagnosis of muscle pain
Determining why myalgia occurs is not always easy. Only a doctor can understand the causes and select treatment that helps get rid of disturbing symptoms or alleviate them. To find out the cause of myalgia, the doctor conducts a comprehensive examination, including a neurological one, prescribes laboratory tests, ultrasound, computed tomography and other research methods3.
Various specialists treat myalgia. Depending on its cause, a traumatologist, rheumatologist, neurologist or endocrinologist can help you.