Tense muscle syndrome (muscle pain). Shock wave therapy at the Awatage medical center
Tense muscle syndrome (muscle pain).
Shock wave therapy at the Awatage medical center
Tense muscle syndrome (myofascial pain syndrome) is a condition characterized by the presence of extremely painful seals in the muscle (the so-called trigger points), as well as general muscle spasm with increased tone. This pathology is very common among young people of working age. According to epidemiological data, pain in the muscles of the back and limbs is found in 64% of the population. An important role in its occurrence is played by long-term work in non-physiological postures (sitting at a computer, reading, writing, driving a car, etc.), accompanied by hypodynamia (a small number of movements).
Weak untrained muscles are unable to withstand prolonged static overload. That is why myofascial pain syndromes are so common among knowledge workers. Irrational, ill-conceived sports activities, when physical activity is performed without preliminary warming up the muscles, also cause the activation of old trigger points and the appearance of new ones. Any pathology of internal organs can lead to a local "protective" muscle spasm. For example, ischemic heart disease is characterized by the presence of muscle pain syndromes in the chest area.
In addition to the above reasons, one should not forget about the factors that many of us do not pay attention to. These are skeletal deformations: flat feet, scoliosis and many others, which lead to an uneven redistribution of the load on different muscle groups. Also, a significant role is played by hypothermia ("blown out", "through"), prolonged immobility of the limb (with sound sleep or wearing a plaster splint due to injuries), direct muscle compression for a long period (wearing shoulder bags, backpacks, jeans, belts), compression muscle fibers hematoma (intramuscular hemorrhage) with muscle contusion.
Chronic emotional stress, depressive and anxious states are always accompanied by the tension of various muscle groups (especially the neck, head, shoulder girdle, face). The so-called "muscle tension headache", which occurs when the muscles of the head and neck are strained, affects up to 80% of the adult population. Trigger points themselves are active and passive. The active trigger point is the site of muscle fiber spasm, which is almost always involuntary. They usually appear at the entry of the motor nerve into the muscle. When palpating (feeling) this place, the pain is felt not only and not so much in it, but in distant areas. This phenomenon is called reflected pain. She is in motion and at rest.
The active trigger point is extremely sensitive. When activated, there is a slight decrease in muscle strength, since pain interferes with full stretching of the affected muscle. When the affected muscle is stretched by the doctor, the pain increases sharply and covers both the muscle itself and the zones of reflected pain. Trigger points may coincide with acupuncture points, which explains some of the effectiveness of reflexology in myofascial pain syndromes.
Latent trigger points are less painful than active ones, have a smaller area and never give reflected pain. However, they are much more common than active ones, and they are more difficult to identify. Under the influence of the above adverse factors, latent trigger points can become active. Conversely, under the influence of therapeutic influences (rest, warmth, physiotherapy procedures, including shock wave therapy, massage), the active trigger point can become latent.
Q: does myofascial pain need treatment? After eliminating its cause, thereby we release the muscle from overload, the spasm will pass, and with it trigger points will disappear. However, this view is dangerous and erroneous. With prolonged spasm in the muscle, oxygen starvation occurs, changes in biochemical processes, which eventually lead to structural changes.
In conditions of impaired metabolism, connective tissue develops around the affected muscle fibers. The trigger point becomes a formation that lives by its own laws separately from the rest of the muscle. This leads to long-term spasm and pain, which occur independently of the functioning of the nervous system. Continued exposure to pain receptors leads to sensitization (overexcitation). Impulses from them, reaching the spinal cord, are switched to the fibers of the motor nerve, which in turn makes the muscle contract even more. Thus, one of the classic pathological circles is formed: "pain-spasm-pain", which cannot be broken without treatment. Pain and limited movement spread to other muscle groups and become persistent.
Medication for muscle pain
Pharmacological treatment of myofascial pain includes the use of muscle relaxants, antidepressants, tranquilizers, vascular and other agents. These drugs have a number of side effects and do not always bring the expected effect. They often have to be alternated and combined, which increases the cost of treatment for the patient. Traditional analgesics (paracetamol, ibuprofen, etc.) are often ineffective. The use of local treatment is promising - massage, therapeutic exercises, acupuncture, post-isometric relaxation, physiotherapy procedures.
Shockwave therapy for muscle pain
One of the most effective modern physiotherapeutic methods in the treatment of muscle pain is shock wave therapy (SWT). Recent studies carried out in European countries indicate that shock wave therapy is highly effective with no side effects.
The points of impact of shock waves in myofascial pain are manifold, leading to a rapid breakdown of the vicious circle of pain and spasm. The depth of penetration of shock waves into the tissue ranges from 1 to 12.5 cm, which allows you to act on trigger points at a greater depth than during massage. SWT improves local blood circulation and lymph drainage at the level of small vessels, which helps to remove accumulated algogenic substances (causing pain) and inflammatory mediators. Local metabolism also improves, which leads to a decrease in the degree of oxygen deprivation in the muscle.
Shock wave therapy has an excellent antispasmodic effect, which is achieved both through mechanical stimulation of the muscle and reflex action through the peripheral nervous system through the effect of pressure and vibration on the mechanoreceptors, which brings shock wave therapy closer to reflexotherapy methods.
SWT sessions do not require any preliminary preparation, are non-invasive (no injections or other violations of the integrity of the skin are required) and are well tolerated by patients.
The clinical effect occurs quickly enough, often already during the procedure itself!
This will allow the patient to reduce the frequency of taking analgesics or to completely abandon them. Shock wave therapy is combined with all therapeutic methods, including physiotherapy exercises and classes at Evminov's dispensary. Moreover, the combined effect of these methods exceeds the effect of using each of them separately. The course of treatment includes 2-4 SWT procedures with an interval of 5-7 days. The use of shock wave therapy allows you to quickly stop pain syndrome and eliminate muscle spasm, thereby giving the patient the opportunity to get rid of excruciating pain, stiffness of movements and significantly improve the quality of life.