The term myositis refers to any condition that causes inflammation in the muscles. Muscles that are involved in movement, such as the arms, legs, and trunk, or other functions, such as the eyes, esophagus, and diaphragm, can be affected. There are various types of myositis, each with its own causes, symptoms, and treatments. Myositis can cause muscle weakness, pain, swelling, and difficulty performing daily activities. We will discuss the common forms of myositis in this blog post, how they are diagnosed, and how they can be managed.
Causes of Myositis
There are a variety of causes of myositis, including:
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Viruses, bacteria, fungi, or parasites can infect the muscles and cause inflammation. Examples include influenza, HIV, Lyme disease, and trichinosis.
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Muscle injury can be caused by trauma, overuse, or strenuous exercise. This is typically a temporary condition that heals with rest and anti-inflammatory medications.
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In autoimmune diseases, the immune system attacks the body's own tissues, including muscles. Examples include lupus, rheumatoid arthritis, scleroderma, and Sjogren's syndrome.
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Medications: Statins, colchicine, hydroxychloroquine, and cocaine can cause muscle inflammation as a side effect or an allergic reaction.
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Some genetic disorders can affect the structure or function of the muscles and cause inflammation. Examples include muscular dystrophy, McArdle's disease, and Pompe's disease.
Symptoms of Myositis
Symptoms of myositis vary depending on the type and severity of the condition, as well as the affected muscles.
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Myositis is characterized by muscle weakness. It usually affects the muscles close to the trunk, such as the shoulders, hips, thighs, and upper arms. Lifting, walking, climbing stairs, or performing other activities can be difficult. The weakness can also affect the face, neck, hands, feet, or respiratory system in some cases.
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It can range from mild to severe, and it can be constant or intermittent. It can worsen with movement or pressure. Muscle tenderness, stiffness, or spasms can also accompany muscle pain.
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This is a less common symptom of myositis. It may be caused by fluid accumulation or inflammation in the muscles. The muscles may appear larger or feel harder than normal. It may also limit joint movement.
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In dermatomyositis, which affects the skin and muscles at the same time, a skin rash is a specific symptom. Itchy, scaly, or flaky rash can occur on the eyelids, face, chest, back, knuckles, elbows, knees, or toes. It can also change the nails, hair, or mouth as well.
Diagnosis of Myositis
Because myositis is rare and has overlapping symptoms with other diseases, it can be difficult to diagnose. During a physical examination, the doctor asks about the patient's medical history and symptoms and orders some tests to verify muscle function and possible causes of inflammation. Some of these tests include:
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The presence of certain enzymes, antibodies, or proteins in the blood can indicate muscle damage or inflammation. Examples include creatine kinase, aldolase, lactate dehydrogenase, myoglobin, and antinuclear antibodies.
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A muscle biopsy involves taking a small sample of muscle tissue and examining it under a microscope to determine whether there is inflammation, infection, degeneration, or abnormality in the muscle fibers.
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A muscle electromyogram (EMG) measures electrical activity in the muscles at rest and during contraction and can detect nerve or muscle damage.
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The images of the muscles and surrounding tissues are created by using X-rays, ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT). In addition to showing muscle size, shape, and structure, they can also reveal inflammation, infection, and injury.
Treatment of Myositis
Myositis is treated based on its type, cause, and severity. Treatment aims to reduce inflammation, prevent or repair muscle damage, relieve symptoms, and improve quality of life.
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Myositis can be treated with a variety of medications, including:
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Prednisone, prednisolone, and methylprednisolone are examples of corticosteroids that suppress the immune system and reduce inflammation. Initially, they are given in high doses, then tapered down gradually. Weight gain, diabetes, osteoporosis, and infections can be serious side effects of these drugs.
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Drugs called immunosuppressants suppress the immune system differently than corticosteroids. They are used to treat myositis caused by an autoimmune process or to reduce corticosteroids' dose. For example, methotrexate, azathioprine, cyclosporine, and mycophenolate are examples. There are also serious side effects, including liver damage, kidney damage, and infection.
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Biologics: These drugs target specific molecules or cells involved in inflammation. Among the medications available are rituximab, infliximab, adalimumab, and tocilizumab, which can be used to treat myositis that is refractory or severe, or to reduce the dose of corticosteroids or immunosuppressants. As well as serious side effects, such as infusion reactions, allergic reactions, and infections, they can also cause serious side effects.
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Malaria can be treated with antimalarial drugs, but they can also have anti-inflammatory and immunomodulating effects. Aside from treating skin rashes and muscle pain caused by dermatomyositis, they also have mild side effects, including nausea, diarrhea, and headaches. Examples include hydroxychloroquine and chloroquine.
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Analgesics: These are drugs that relieve pain. They can be purchased over-the-counter or prescribed, depending on the intensity of the pain. Examples include acetaminophen, ibuprofen, naproxen, and tramadol. Side effects include stomach upset, bleeding, liver damage, and addiction.
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Exercise and activities are used to improve the strength, mobility, and function of muscles and joints in physical therapy. In addition to improving posture, balance, and coordination, it can also help prevent or reduce contractures, deformities, or atrophy of the muscles.
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Myositis patients may benefit from occupational therapy, which involves training and assistance for daily activities, such as dressing, eating, writing, and working.
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People with myositis benefit from speech therapy, which involves exercises and techniques for improving their speech, voice, and swallowing abilities. Dysphagia, dysarthria, or dysphonia, which are problems with swallowing, speaking, or vocalizing, can be prevented or treated with this treatment.
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As part of this procedure, damaged or inflamed muscle tissue is removed or repaired. It is usually reserved for severe or complicated cases of myositis, such as infection, abscess, or necrosis of muscles. A muscle or joint deformity or contracture can also be corrected with it.
Prevention of Myositis
Some measures may reduce the risk or severity of myositis, but there is no sure way to prevent it. These include:
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Vaccinating against infections that can cause myositis, such as influenza, hepatitis, and tetanus.
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Drugs, alcohol, tobacco, chemicals, and toxins can trigger or worsen myositis.
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Maintaining muscle health by eating a balanced and nutritious diet rich in protein, vitamins, minerals, and antioxidants.
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Maintaining or improving muscle strength, endurance, and flexibility by exercising regularly and moderately.
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Avoiding overexertion or muscle injury by resting adequately.
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It is important to seek medical attention as soon as possible if you experience any symptoms of myositis, such as muscle weakness, pain, or swelling.
