Cervical myositis is an inflammation in the neck and shoulder girdle muscles. The process can involve both one and several muscles. The cause is usually local hypothermia, unusual physical activity, prolonged stay in an uncomfortable position and infectious diseases. The main symptom is pain, which usually spreads only on one side of the neck, can give to the head, shoulder, back and arm. Movements are limited, sometimes minor edema and local hyperthermia are detected. In young children, a rise in temperature is possible. The diagnosis is made on the basis of clinical symptoms. Conservative treatment: blockades, physiotherapy, manual therapy.
ICD 10
M60 Myositis
General information
Cervical myositis is more common than all other types of myositis. It can affect people of any gender and age, including children. It is usually provoked by a draft, unusual load, overstrain or stress. Throughout life, almost every person suffers acute myositis at least once, caused by one of the listed reasons. Cervical myositis, developed as a result of autoimmune and parasitic diseases, are much less often detected. Unlike other forms of myositis, such muscle inflammation lasts for a long time, has a more pronounced tendency to chronicity and is difficult to treat.
Causes
The most common cause of cervical myositis is a draft. Slightly less widespread are myositis that have arisen after injury, prolonged stay in an uncomfortable position or after overstrain of the neck muscles as a result of unusual physical activity, excessive professional physical activity or overtraining in athletes. Sometimes cervical myositis becomes a complication of acute infectious diseases (ARI, influenza, sore throat).
Rare forms of cervical myositis are myositis with systemic connective tissue lesions (SLE, rheumatism, rheumatoid arthritis) and parasitic diseases. In the first case, the cause of the disease is the production of immune cells attacking the body’s own muscle tissue, in the second – a toxic-allergic reaction. In both cases, inflammation usually affects not only the neck muscles, but also other muscle groups. Another rare type of cervical myositis is purulent myositis. The disease develops when an infection spreads from open wounds or ulcers in the neck.
Risk factors
The risk group includes people who, when performing professional duties, have to stay in the same position for a long time: violinists, drivers, typists, pianists, office workers, etc. Students and schoolchildren may develop myositis due to overwork or an uncomfortable position during exam preparation. As an additional risk factor, many experts consider stress, in which the muscles of the neck and upper arms are in a state of constant tension.
Symptoms
The first symptoms of acute muscle inflammation appear a few hours after the adverse effect. Initially, there is a local pain on the posterior or posterolateral surface of the neck (usually on one side, either on the right or on the left), which increases with turns and tilts of the head. Gradually, the intensity of pain increases, there may be irradiation to the occipital and parietal regions, the upper back, the interscapular region, the area of the upper arm and the arm from the diseased side. The patient tries to avoid neck movements so as not to cause a new attack of pain, sometimes his head is in a forced position.
During examination, slight swelling may be detected in the area of the affected muscle group. Sometimes there is mild local hyperthermia and hyperemia. Inflamed muscles are tense and compacted, their palpation is painful. The general condition in adults does not suffer. In young children, there may be a significant increase in temperature (up to 38-39 degrees), weakness, lethargy, lack of appetite. The disease is acute, all symptoms disappear completely within a few days, less often – several weeks.
In some cases, acute myositis turns into a chronic form. The pains become recurrent, they begin to bother even after a slight overload, a short stay in an uncomfortable position and with every cold. The protective tension of the muscles becomes constant, the movements of the head are limited. Over time, muscle weakness occurs, and in some cases, atrophy of the affected muscles develops.
A special form of the disease is parasitic myositis, which, along with the neck muscles, affects a number of other muscle groups (limb muscles, chewing muscles) and is accompanied by an increase in temperature. Another rather rare form of myositis – purulent myositis – is acute. Intense twitching or bursting pains appear. There is a noticeable swelling in the neck area, the skin over the affected area turns red, its temperature rises. The development of the purulent process is accompanied by general hyperthermia, weakness, weakness, loss of appetite, headache and other signs of general intoxication. The feeling is sharply painful, fluctuation may be determined during the formation of an abscess.
Diagnostics
The diagnosis is made by a traumatologist or neurologist on the basis of characteristic clinical manifestations. In acute myositis, provoked by an uncomfortable posture, overload, draft and other similar causes, additional studies are not required. In the presence of uncharacteristic symptoms and a prolonged course of cervical myositis, an examination is prescribed, which may include an examination by a rheumatologist and an infectious disease specialist, identification of parasites, determination of rheumatoid factor, etc. Patients with suspected purulent myositis are referred for consultation to a surgeon.
Treatment
Conservative treatment
Treatment of traumatic cervical myositis and muscle inflammation developed as a result of overload or being in an uncomfortable position is carried out on an outpatient basis by specialists in the field of traumatology and orthopedics. The patient is recommended to limit physical activity, rub the affected area with warming and anti–inflammatory ointments, apply dry heat, and take analgesics in severe pain. They write out a referral to UHF. Usually all symptoms disappear within a few days, a maximum of 1-2 weeks.
If therapy is ineffective, the doctor conducts novocaine blockades with the addition of a small amount of corticosteroids. In the absence of contraindications, it is possible to use manual therapy techniques (postisometric relaxation).
Patients with other forms of cervical myositis are referred to appropriate specialists. Treatment of myositis caused by rheumatic disease is carried out by a rheumatologist, therapy of infectious myositis by an infectious disease specialist, treatment of parasitic myositis by a parasitologist. Patients with rheumatic process are prescribed glucocorticoids and immunosuppressants, patients with infectious myositis are treated with antibacterial therapy. With parasitic myositis, anthelmintic agents are prescribed.
Surgical treatment
In the presence of suppuration, treatment with a purulent surgeon is recommended. Antibiotics (penicillin, tetracycline and other drugs), painkillers and UHF are used. The appearance of a softening area is an indication for the opening of an abscess. The cavity is washed and drained with a gauze cloth. Bandages are carried out. After cleansing the wound, bandages are applied with Vishnevsky ointment and other drugs that help accelerate regeneration. The wound heals by secondary tension.