Myalgia - treatment, causes and symptoms

Author

: Grachev Ilya Illarionovich
Editor
: Efremov Mikhail Mikhailovich

Date of publication: 05.13.2014 Date of update: 12.11.2020

Muscle pain, which can either intensify during movements or touches, or torment a person constantly, even at rest, is a reason to think about your health. Myalgia is the name of this common disease, and both older people and children suffer from it.

A large number of people around the world suffer from this disease, which negatively affects the quality of life, disrupting their usual routine. Myalgia is a disease that requires accuracy in diagnosis and correct, individual treatment. It has many manifestations and a variety of factors can trigger its development.

Myalgia does not go away on its own and has serious complications, so you should not delay treatment.
See how easily the disease can be cured in 10-12 sessions.

Causes of myalgia

It is very difficult to list all the causes of myalgia: the very lifestyle of a modern person is a negative factor that increases the chances of contracting this disease. The most common reasons include:

Stress, prolonged emotional tension.
Excessive physical activity overstrains the muscles, as a result of which myalgia develops, and a complete lack of exercise can also cause the disease.
Infectious diseases such as influenza virus and ARVI. Spinal diseases, arthritis, radiculitis.

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.

Symptoms of myalgia

Basically, the symptoms of myalgia manifest themselves in the form of pain, and the pain can be of a different nature and concentrated in different areas. But not only the presence of pain indicates an illness. This disease is characterized by a number of other symptoms:

Pain in muscles, joints, ligaments.
Heaviness in the limbs.
Hypertension, headaches.
Dizziness, weakness, nausea and even vomiting.

What is POSSIBLE for diseases of the spine

What NOT to do for spinal diseases

Chronic fatigue syndrome and myalgia

This pathology is characterized by diffuse symmetrical muscle pain combined with asthenia, increased fatigue, which does not go away even after rest, which significantly reduces a person’s performance. In this case, increased fatigue must last for at least 6 months and cannot be explained by the manifestation of a somatic or mental illness. In other words, it is not possible to identify pathology on the part of the organs, there is no psychiatric history, there are no episodes of drug addiction, at least during the previous 2 years, that could give such a symptom. Chronic fatigue syndrome is characterized by a distorted perception of ordinary non-painful sensations (touch, sensation of heat or cold) as painful manifestations.

At the moment, there is no need to talk about the specific cause of the development of chronic fatigue syndrome. There are various theories of the origin of this syndrome: infectious, in particular associated with the herpes virus, supported by descriptions of epidemic outbreaks of this symptom complex; neuroendocrine; stress theory, which has received the greatest development at present. It is known that among females this pathology occurs several times more often, which is associated with greater susceptibility to stress due to psychological characteristics.

Treatment methods for myalgia

In our clinic, myalgia is treated using techniques that have stood the test of time for centuries. The wisdom of oriental healers and the achievements of modern medicine - this symbiosis allows you to comprehensively and effectively influence the existing problem, completely solving it. We offer the following treatment methods:

Acupuncture. Using special needles, the impact on specific areas of the body allows you to quickly relieve muscle spasms and quickly relieve pain.
Massage. Honey, acupressure or general massage allows you to quickly relax tense muscles and have a general relaxing effect on the entire body, due to which myalgia recedes. Pinched nerves are released, and metabolic processes improve.
Hirudotherapy. The essence of the procedure is to stimulate bioactive points of the body through the bite of a medicinal leech. This method allows you to achieve an incredible reflex effect, since leeches not only mechanically affect the body, but also biologically.
Stone therapy. The method is based on the healing power of heat; this heat not only relaxes overstrained muscles, but also has a positive effect on the blood circulation process, improving tissue nutrition and promoting their recovery.
PRP therapy is the newest way to stimulate recovery processes. It is used to restore the functions of various organs after diseases and injuries, including to restore the function of the musculoskeletal system in case of myalgia.

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating Myalgia

Treatment of myalgia at the Paramita clinic

The main advantage of our clinic is accurate diagnosis. The examination is carried out to identify muscle tension. Attention is paid to the patient's symptoms and history. Thanks to a careful examination, effective treatment for myalgia is prescribed. After the first sessions, patients note that the pain gradually recedes and how much their overall health improves.

An individual approach, gentle but effective methods of influencing the problem and professionalism - these are the conditions due to which a quick and long-term result is achieved: myalgia recedes, and health problems cease to remind of themselves for a very long time!

Classification

The classification is based on various criteria, according to which the following are distinguished:

According to pathological changes in the muscular-ligamentous apparatus: fibromyalgia (primary/secondary), myositis (polymyositis), epidemic myalgia .
According to the nature of the course: acute, chronic.
According to the location of pain: localized, diffuse.
According to the level of the CPK enzyme (creatine phosphokinase) in the blood: with an increase in CPK activity and without a change in the level of CPK.

Stages of the disease

Sometimes the disease is preceded by a feeling of malaise and weakness.
The pain may gradually increase or, conversely, suddenly manifest itself.
A “myopathic syndrome” appears when climbing (from a sitting position, up stairs) and the pain intensifies.
There is a feeling of stiffness and limited body mobility.
There is a feeling of constant tension.
If the cause of the disease is serious enough, the next stage may be pain in the joints and bones.
Possible fever and chills.

List of sources

Shostak N. A., Pravdyuk N. G., Novikov I. V., . Trofimov E. S. Myalgia in therapeutic practice – approaches to differential diagnosis, treatment // Attending physician. No. 3 p. 21-24.
Ivanichev G.A. Pathogenetic aspects of the formation and manifestation of classical muscle pain syndromes. Manual therapy. 2009; 3 (35): 3–12.
Busheneva S.N., Kadykov A.S., Piradov M.A. Myofascial syndrome: from theory to practice. Russian medical journal. 2005; 22. p. 57-62.
Godzenko A.A., Badokin V.V. Local therapy of myofascial pain syndrome. RMJ. Rheumatology. 2007; 26: 1998–2003.
Osipova N. A., Abuzarova G. R., Petrova V. V. Principles of using analgesics for acute and chronic pain. Clinical recommendations. M.: FSBI “MNIOI im. P. A. Herzen” Ministry of Health and Social Development of Russia, 2010. 67 p.

Diagnosis of myalgia

Many people do not attach importance to muscle pain, considering it a consequence of fatigue. But it should be understood that all processes in the human body are closely connected; damage to one of the systems can unpredictably affect the other. Therefore, it is better to use modern diagnostic methods:

collecting the patient's medical history;
Ultrasound of superficial muscles;
MRI for muscle groups located deep in the body;
taking samples for infections;
Needle electroneuromyography is performed to assess muscle activity.

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.

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.

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

Enteroviral diseases. Symptoms, prevention and treatment

01/12/2018 Enteroviral diseases are acute infectious diseases caused by intestinal viruses from the Coxsackie and ECHO group. Clinical manifestations are varied, often associated with damage to the central nervous system, muscles, myocardium and skin.

Etiology. The causative agents of enteroviral diseases are non-polio viruses. Enteric viruses belong to the picornaviruses (family Picornavindae, genus Enterovirus). There are 23 serotypes of Coxsackie A virus, 6 serotypes of Coxsackie B virus, 32 serotypes

ECHO viruses and 5 more human enteroviruses (enterovirus types 68-72). Enterovirus 70 is the causative agent of acute hemorrhagic conjunctivitis. Enterovirus 72 corresponds to the hepatitis A virus (see viral hepatitis). General properties of enteroviruses: a) small size (15-35 nm), b) contain RNA, c) resistant to ether, 70% alcohol, 5% Lysol, and freezing.

Epidemiology. The source of infection is only humans. The infection is transmitted by airborne droplets (from patients) and fecal-oral routes (from virus carriers). The disease is widespread. In temperate countries, seasonality is characteristic with an increase in incidence in late summer and early autumn. Mostly children and young people get sick. Diseases are observed in the form of sporadic cases, local outbreaks (usually in children's groups) and in the form of large epidemics affecting a number of countries.

Pathogenesis. Intestinal viruses enter the body through the mucous membrane of the upper respiratory and digestive tracts. In some cases, at the site of the infection, changes occur in the form of damage to the mucous membranes (acute respiratory disease syndrome, pharyngitis, herpangina). After accumulation of the virus at the site of primary reproduction, the pathogen enters the blood (viremia) and spreads throughout the body. Enteroviruses have a tropism for nervous tissue, muscles and epithelial cells, which is manifested in the clinical picture of the disease, as well as in morphological changes in tissues. The lymphogenous spread of viruses is of some importance. In pregnant women, intrauterine damage to the fetus is possible. A previous enteroviral disease (or an inapparent infection) leaves behind immunity to the type of virus that caused the infection. There are cross-immunological reactions to some enteroviruses.

Symptoms and course. The incubation period lasts from 2 to 10 days (usually 3-4 days). Enteroviral diseases are characterized by a variety of clinical manifestations. Some of the clinical forms (herpangina, epidemic myalgia, pericarditis) are associated with a specific group of enteroviruses. Diseases begin acutely. Below is a brief description of individual clinical forms. Combined symptoms of various clinical forms are often observed.

Herpangina is caused by Coxsackie A viruses (serotypes 2,3,4, 6,7 and 10) and Coxsackie B-3 viruses. The disease begins acutely, body temperature quickly rises to 39-40°C, but the general condition of the patients remains satisfactory. Fever lasts 2-5 days. Sore throat is moderate or absent. Changes in the pharynx are characteristic: against the background of a moderately hyperemic mucous membrane of the pharynx, single (from 1 to 20) clearly demarcated elements appear, which are sometimes presented in the form of small papules (1-2 mm in diameter), then they turn into vesicles (up to 5 mm), filled with clear liquid. The blisters quickly burst, and in their place superficial ulcerations appear, covered with a grayish coating and surrounded by a narrow rim of hyperemic mucous membrane. Individual ulcers can merge, forming more extensive defects (up to 7 mm). They are located on the anterior arches, less often on the palate, uvula, and palatine tonsils. By the 4-7th day of illness, the mucosal defect heals without any traces. In 1/3 of patients, other manifestations of enteroviral diseases are observed.

Epidemic myalgia (pleurodynia, Bornholm disease) is caused by Coxsackie B viruses (types 1-5), Coxsackie A-9 viruses and possibly some ECHO viruses (types 1,6,9). The disease begins suddenly. Chills, increased body temperature (up to 39-40°C) and almost simultaneously severe muscle pain appear, which are localized in the abdominal muscles (often in the umbilical region) and in the lower parts of the chest. The pain intensifies with movement and coughing. Myalgay attacks last 5-10 minutes and repeat after 30-60 minutes. Sometimes they last longer (from several hours to 1-2 days). Fever often lasts 2-3 days. Half of the patients experience a second wave of fever with a new attack of pain. In some patients, a picture of serous meningitis develops at this time (on the 5-7th day of illness). Other symptoms often include hyperemia of the mucous membrane of the pharynx, lymphadenopathy, and sometimes exanthema.

Serous meningitis is one of the common forms of enteroviral diseases, caused by all groups of enteroviruses (Coxsackie A (types 2,4,7,9), Coxsackie B (types 1-5), ECHO (types 4, 6,9,11,16, 30). Observed both in the form of sporadic cases and in the form of epidemic outbreaks. Begins acutely with an increase in body temperature (up to 39-40 ° C) and symptoms of general intoxication. By the end of the 1st or 2nd day, the illness appears clearly pronounced meningeal symptoms (severe headache, stiff neck, Kernig's, Brudzinski's symptoms, etc.). Sometimes other symptoms of enterovirus infection are observed (myalgia, exanthema, myocardial damage, hyperemia of the mucous membrane of the pharynx). Cerebrospinal fluid flows out under pressure, transparent, cytosis 200-300 in 1 μl, neutrophils up to 50%, sugar and chloride levels are normal.Some patients experience a second wave of fever.

Myelitis (with paralysis) can be caused by Coxsackie viruses A (types 4,7,10,14) and B (types 1-6), as well as ECHO viruses (types 2,4,6,7,9,11,16). Clinical symptoms and course resemble paralytic forms of poliomyelitis. It flows easier. Paresis and paralysis pass relatively quickly with the restoration of motor functions. Sometimes they are difficult. Deaths have been described.

Neonatal encephalomyocarditis is caused by Coxsackie B viruses (types 2-5). It is characterized by a severe course and high mortality (up to 60-80%). Small outbreaks have been described. Main signs: fever, eating disorder, increased drowsiness, convulsions, cyanosis, jaundice, tachycardia, expansion of the borders of the heart, collapse, hemorrhage, enlarged liver and spleen, diarrhea.

Encephalitis is caused by the Coxsackie and ECHO viruses. The severity of the disease varies widely. In mild cases, it manifests itself only in isolated, not pronounced symptoms and EEG changes. In severe cases, it occurs with impaired consciousness, choreo-like muscle twitching, convulsions, nystagmus, and facial nerve paralysis.

Pericarditis and myocarditis are caused by Coxsackie B viruses (types 2-5) and ECHO viruses (types 1,6,8,9,19). Moderate fever, general weakness, pain in the heart area, dullness of tones, pericardial friction noise appear, and effusion into the pericardial cavity is possible. ECG changes characteristic of myocarditis are revealed. The current is favorable.

Infectious exanthema (Boston exanthema, epidemic exanthema, measles-like and rubella-like exanthema) is most often caused by ECHO viruses (types 4,5,9,12,16,18), less often by Coxsackie viruses (A-9, A-16, B-3). The disease begins acutely. Body temperature rises to 38-39°C, symptoms of intoxication are noted (weakness, headache, muscle pain, sore throat). After 1-2 days, a rash appears, which in severe cases affects the torso, limbs, face, and feet. The nature of the exanthema is often rubella- or morbilliform, less often scarlet-like or petechial. After 3-4 days it disappears. Fever lasts 1-7 days. In some patients, other manifestations of the disease are observed (serous meningitis, epidemic myalgia).

A peculiar variant of enteroviral exanthema is a disease that occurs with damage to the hands, feet, and oral cavity (Hand-Fuss - Mund Krankheit, or abbreviated HFMK). In this form, against the background of moderate intoxication and a slight increase in body temperature, an exanthema appears on the fingers and toes in the form of small vesicles with a diameter of 1-3 mm, slightly protruding above the skin level and surrounded by a halo of hyperemia. At the same time, single small aphthous elements are found on the tongue and mucous membrane of the cheeks. The disease is caused by Coxsackie A viruses (serotypes 5,10,16).

Minor illness (three-day fever, summer flu, indeterminate fever, Coxsackie and ECHO fever) can be caused by all types of enteroviruses. It is characterized by a short duration and ease of course, as well as the absence of pronounced changes in individual organs and systems. Manifests itself in the form of moderate short-term fever (1-3 days), weakness, weakness, muscle pain. Sometimes blurred signs of other clinical forms are observed (mild epidemic myalgia, herpangina without typical changes in the pharynx, mild meningeal symptoms, etc.).

Acute catarrh of the upper respiratory tract is caused by many types of enteroviruses. In infection caused by the Coxsackie A-21 virus, this form is predominant. Unlike minor illness, in such cases short-term fever is combined with severe inflammation of the mucous membrane of the upper respiratory tract (rhinopharyngitis, laryngitis, croup syndrome may occur in children).

Enterovirus diarrhea can occur not only in children, but also in adults. Diarrhea can be combined with other manifestations of enteroviral diseases or be the main symptom of the disease. In some patients, the symptoms of enterocolitis are combined with a pronounced picture of acute mesadenitis, which often causes diagnostic difficulties.

Epidemic hemorrhagic conjunctivitis is caused by enterovirus 70. The disease begins acutely. Usually one eye is affected first, and after 1-3 days the process affects the second eye. Photophobia, lacrimation, and foreign body sensation are noted. The patient's general condition remains satisfactory. On examination, swelling of the eyelids, hyperemia and swelling of the conjunctiva, hemorrhages in the conjunctiva, most often of the upper eyelid, scanty discharge, mucopurulent or serous, are observed. The cornea is rarely affected. Normalization occurs after 10-14 days.

Diagnosis and differential diagnosis. For a number of clinical forms, the diagnosis can be established on the basis of characteristic clinical symptoms (herpangina, epidemic myalgia, serous meningitis with exanthema, epidemic conjunctivitis), especially during epidemic outbreaks. Diagnosis of sporadic enteroviral diseases is often difficult. For laboratory confirmation of the diagnosis, virus isolation (from mucus and throat washings, cerebrospinal fluid, feces) and serological tests are used. It should be taken into account that the isolation of viruses from feces can also be observed in healthy virus carriers. For serological studies, paired sera are taken (the first before the 4-5th day of illness, the second after the 14th day of illness). An increase in antibody titer of 4 times or more is considered diagnostic. They use a neutralization reaction with reference strains of enteroviruses (on tissue cultures or suckling mice), RSC, RTGA, and gel precipitation reaction.

Differential diagnosis is carried out depending on the clinical form (with serous meningitis, infectious conjunctivitis, rotavirus diarrhea, polio, etc.). Particular caution is necessary when diagnosing epidemic myalgia, which can be similar to acute surgical diseases (acute appendicitis, intestinal obstruction, etc.).

Treatment. There is no etiotropic treatment. There are indications of the effectiveness of immunoglobulin with a high titer of antibodies in the treatment of patients with severe forms of enteroviral encephalitis in individuals with antibody deficiency. General restorative and symptomatic medications are prescribed. The course of treatment is 5-7 days.

The prognosis in most cases is favorable, serious in myelitis and encephalitis, unfavorable in neonatal encephalomyocarditis. The timing of disability depends on the clinical form. For serous meningitis, inpatient treatment lasts 2-3 weeks, discharge is made after complete clinical recovery and sanitation of the cerebrospinal fluid.

Prevention and measures in the outbreak. The outbreak is carrying out a set of preventive and anti-epidemic measures aimed at preventing infections with airborne droplets and fecal-oral transmission. The administration of immune immunoglobulin does not provide a pronounced preventive effect. Specific prevention has not been developed. The isolation period is 14 days. For children who have been in contact with sick people, quarantine is established in children's institutions for 14 days after the cessation of contact and disinfection. Employees of maternity hospitals and children's institutions who were in contact with patients are transferred to another job for 14 days.

Take care of your health and the health of your loved ones!