Myositis of the back

According to statistics, almost everyone experiences back pain of varying intensity, and frequently recurring pain is observed in almost 20% of adults. However, there are not many patients diagnosed with myositis of the back.

Inflammatory processes that occur in human skeletal muscles and manifest as muscle pain (myalgia) of various localizations are combined into one large group of diseases – myositis (from the Greek myos – muscle). In myositis of the back, inflammation and associated pain are concentrated in the tissues of the striated muscles of the back.

Without going into the differences between the currently existing classifications of myositis, it should be noted that in domestic clinical medicine, myositis is divided into types, subtypes and mixed types based on etiology and clinical signs: infectious, purulent, parasitic, toxic, traumatic, professional. Moreover, they are trying to add myopathies (from the Greek myos - muscle and pathos - disease) - neuromuscular diseases with atrophic processes in the skeletal muscles...

In general, all myositis, and, first of all, myositis of the back, are still poorly understood diseases.

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Causes of myositis of the back

The list of causes of myositis of the back is extremely extensive. This disease can be a consequence of hypothermia or the result of an injury. Although, as experts say, myositis of the back muscles of traumatic origin is not so common, and the most common cause of myositis of the back is considered to be muscle strain from prolonged stay of the body in an uncomfortable position or prolonged tension of the spinal muscles during forced standing, sitting or repeated movements. This is well known to professional drivers, seamstresses, workers on conveyors and control panel operators in various manufacturing areas, etc. And this is professional myositis of the back, the etiology of which is not inflammation, but a violation of microcirculation in muscle tissue. At first, it gives a feeling of heaviness in the muscles, then - pain, and ultimately atrophic changes and functional disorders of both superficial and deep muscles of the back are quite possible.

The causes of myositis of the back include metabolic pathologies, as well as some systemic and infectious diseases. For example, myositis of the muscles on the back - in the lumbar region - can occur with chronic forms of brucellosis - a zoonotic infection that is transmitted to humans from sick animals.

There is a version according to which inflammatory processes in muscles occur as a result of autoimmune reactions of the body or as a result of autoimmune processes in the skeletal muscles themselves.

One way or another, it is necessary to distinguish between pain in the back muscles caused by various reasons and inflammation of the skeletal muscles accompanied by pain – myositis of the back.

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Symptoms of myositis of the back

The key symptoms by which doctors recognize myositis of the back muscles include:

• aching pain in the back (most often in the lumbar muscles),
• increased pain when moving and pressing on muscles,
• constant nature of pain, which may persist at rest,
• muscle tension and limited mobility,
• the presence of painful nodes and seals in the thickness of the muscle (with diffuse lesions of muscle tissue).

There may be significant swelling, hyperemia of the skin in the area of inflammation and an increase in temperature, which indicates purulent myositis. Patients may also complain of a general deterioration in well-being and fatigue - due to the reflex contraction of the inflamed muscle and its tension, especially in the morning. Specialists explain this manifestation of myositis of the back by the fact that at night, in a state of rest, the inflamed muscle tissue swells, its blood supply worsens, which leads to spasms.

Acute myositis, if left untreated, becomes chronic, when the pain becomes more severe, especially when exposed to cold and when staying in the same position for a long time. Inflammation can spread to other muscle groups.

Diagnosis of myositis of the back

It is not as easy to detect myositis of the back as it may seem. Firstly, the symptoms of this disease develop slowly and are clearly manifested only during exacerbations. Secondly, patients often mistake back pain for muscle pain, while the pain syndrome can be caused, for example, by an exacerbation of sluggish inflammation of one of the intervertebral discs. In addition, pain and spasm in the back muscles can be reflected and associated with many other pathologies of both the musculoskeletal system and internal organs.

So, the diagnosis of myositis of the back is carried out not only on the basis of the anamnesis and clinical picture of the disease, but also on the data of such studies as:

• clinical blood test;
• blood tests for autoantibodies and muscle enzymes (eg, creatine kinase);
• magnetic resonance imaging (MRI determines the exact location of muscle inflammation);
• electromyography (EMG, measures the bioelectric potential in skeletal muscles);
• muscle tissue biopsy (the most accurate diagnostic method that determines the degree of damage to muscle fibers).

Some cases of myositis of the back go undiagnosed for many years and are mistaken for other conditions that cause pain and muscle weakness.

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Treatment of myositis of the back

In case of acute non-purulent myositis of the back, doctors recommend disturbing the muscles as little as possible and staying in bed. And to relieve pain, painkillers are used - external and oral.

Non-steroidal anti-inflammatory drugs such as Ibuprofen and Febrofid are widely used in the treatment of myositis of the back. Ibuprofen (synonyms - Brufen, Ibuprom, Ibusan, Ibufen, Nurofen, etc.) has an analgesic, anti-inflammatory, antipyretic effect and is available in the form of tablets, capsules, syrup, suspension for oral administration, as well as for external use - in the form of gel and cream. Adults are recommended to take Ibuprofen in tablets and capsules in a daily dose of 400-1200 mg - in 3-4 doses. The course of treatment is no more than 7 days. Ibuprofen syrup or suspension is prescribed to children - 10-20 mg per kilogram of body weight per day. The cream or gel is applied to the skin in the area of the painful area (a strip 5-10 cm long) - 3-4 times a day and rubbed in until the drug is completely absorbed.

Contraindications for this drug include: bronchial asthma, gastric ulcer and duodenal ulcer, optic neuritis, thrombocytopenia, liver and kidney dysfunction, severe heart failure, pregnancy and lactation, childhood (syrup, suspension - for body weight up to 7 kg; tablets or capsules - up to 12 years).

The gel for external use Febrofid contains ketoprofen lysine salt and also refers to non-steroidal anti-inflammatory drugs, providing anti-inflammatory, anti-edematous and analgesic effects. The gel is applied to the skin of the painful area (3-5 cm strip) and lightly rubbed in - 2-3 times a day. When using this drug, allergic reactions and hyperemia of the skin are possible. Contraindications to its use are weeping dermatoses, eczema, infected abrasions, wounds, burns, pregnancy (third trimester) and lactation period, hypersensitivity to ketoprofen and other components of the gel.

It should be noted that very severe pain in the back muscles may require a novocaine blockade, in which a medicinal composition of novocaine and a corticosteroid drug is injected intramuscularly into the inflamed area.

In addition to medications, myositis of the back is treated with physiotherapy procedures (electrophoresis, UHF, phonophoresis, diadynamic currents), reflexology (acupuncture), therapeutic exercise (not during an exacerbation), as well as therapeutic massage and hirudotherapy. These therapeutic methods help to activate blood circulation, improve lymph drainage and stimulate metabolic processes in muscle tissue.

If myositis is purulent, then antibiotics are prescribed. At the same time, situations are not excluded when they resort to surgical treatment of purulent myositis of the back muscles. Such treatment involves opening the resulting suppuration and draining the wound with washing with antiseptic agents.

Treatment of myositis of the back with folk remedies

It is important to remember that during an exacerbation of inflammation of the back muscles, as with any other inflammatory process, warming up is unacceptable. But applying cold to the painful area during the first 2-3 days from the onset of pain helps. The duration of one procedure is no more than 20 minutes, the intervals between them are 1.5-2 hours. You can try hydrotherapy: alternating showers on the lumbar region: 2 minutes hot, 30 seconds cold. And heat can be applied only after 72 hours from the onset of exacerbation.

Treatment of myositis of the back with folk remedies is carried out by rubbing the painful area of the back with essential oils of fir, pine, chamomile or rosemary. To prepare a home rub, it is enough to add 10-15 drops of essential oil to a tablespoon of any vegetable oil and gently rub the skin with this mixture - 2-3 times a day.

A poultice with an infusion of black elder flowers and regular pharmacy chamomile helps relieve pain. You need to take two tablespoons of a mixture of these plants (1:1), pour a glass of boiling water, close tightly and leave for two hours. Put warm steamed flowers in gauze and apply to the sore spot for half an hour.

Traditional healers claim that ordinary white cabbage can also provide some help with inflammation of the back muscles. You need to wash a cabbage leaf, soap it on one side with laundry soap, sprinkle it with baking soda on top and apply it to the sore spot at night (wrapping your lower back with a towel or a warm shawl).

Prevention of myositis of the back

Myositis of the back muscles is a serious disease, and in its chronic form, back pain can occur in the most unpredictable situations. Therefore, it is necessary to treat acute myositis.

And the advice on preventing myositis of the back is as follows: do not sit or stand in the same position for a long time; if you have a sedentary job, get up and do some warm-up exercises at least once every one and a half to two hours (bend forward and backward and turn right and left). In the cold season, wear outerwear with a warm lining and try to stay away from drafts.

In addition, you need to include fresh vegetables and fruits containing vitamins A, E and C, as well as calcium-rich whole milk products in your daily diet. Don't forget to have "fish days" for yourself, because sea fish contains a lot of iodine, potassium, sodium, magnesium, vitamin D and B12, and omega-3 polyunsaturated fatty acids. All these substances are necessary for strengthening health, in particular, the musculoskeletal system.

Prognosis of myositis of the back

Myositis of the back generally has a positive prognosis - provided it is detected in a timely manner and treated well. However, it should be borne in mind that myositis can progress, involving new muscles in the inflammatory process.