The tense, painful state of muscles induced by excessive accumulation of INTERSTITIAL fluid following unusual exercise. This condition is more liable to occur in the muscles at the front of the shin, because they lie within a tight fascial membrane: here the syndrome is known as ANTERIOR TIBIAL SYNDROME. Prevention consists of keeping fit and in training adequately for the amount of exercise to be undertaken. Equally important is what is known as ‘warming down’: i.e., at the end of training or a game, exercise should be gradually tailed off. Treatment consists of elevation of the affected limb, use of compression bandages, with ample exercise of the limb within the bandage, and massage. In more severe cases DIURETICS may be given. Occasionally surgical decompression may be necessary.
Painful spasm of a muscle usually caused by excessive and prolonged contraction of the muscle fibres. Cramps are common, especially among sportsmen and women, normally lasting a short time. The condition usually occurs during, or immediately following, exercise as a result of a build-up of LACTIC ACID and other chemical by-products in the muscles.
Repetitive movements such as writing (writer's cramp) or operating a keyboard can cause cramp. Resting muscles may suffer cramp if a person sits or lies in an awkward position which has restricted blood supply. Profuse sweating as a result of fever or hot weather can also cause cramp in resting muscle; because the victim has lost sodium salts in the sweat, this disturbs the biochemical balance in muscle tissue.
Treatment is to massage and stretch the affected muscle – for example, cramp in the calf muscle may be relieved by pulling the toes on the affected leg towards the knee. Persistent night cramps sometimes respond to treatment with a drug containing CALCIUM or QUININE. If cramp persists for an hour or more, the person should seek medical advice, as there may be a serious cause such as a blood clot impeding the blood supply to the area affected.
See myopathy, below.
of various types may occur. As the result of injury, an ABSCESS may develop, although wounds affecting muscle generally heal well. A growth due to SYPHILIS, known as a gumma, sometimes forms a hard, almost painless swelling in a muscle. Rheumatism is a vague term traditionally used to define intermittent and often migratory discomfort, stiffness or pain in muscles and joints with no obvious cause. The most common form of myositis is the result of immunological damage caused by autoimmune disease. Because it affects many muscles it is called POLYMYOSITIS.
(see MYASTHENIA GRAVIS) is muscle weakness due to a defect of neuromuscular conduction.
is a term applied to an acquired or developmental defect in certain muscles. It is not a neurological disease, and should be distinguished from neuropathic conditions (see NEUROPATHY) such as MOTOR NEURONE DISEASE, which tend to affect the distal limb muscles. The main subdivisions are genetically determined, congenital, metabolic, drug-induced, and myopathy (often inflammatory) secondary to a distant carcinoma. Progressive muscular dystrophy is characterised by symmetrical wasting and weakness, the muscle fibres being largely replaced by fatty and fibrous tissue, with no sensory loss. The inherited disease may take several forms, thus affecting the sex and age of sufferers. The commonest type is DUCHENNE MUSCULAR DYSTROPHY, which is inherited as a sex-linked disorder. It nearly always occurs in boys.
There are three chief types of myopathy. The commonest, known as pseudo-hypertrophic muscular dystrophy, affects particularly the upper part of the lower limbs of children. The muscles of the buttocks, thighs and calves seem excessively well developed, but nevertheless the child is clumsy, weak on his legs, and has difficulty in picking himself up when he falls. In another form of the disease, which begins a little later at about the age of 14, the muscles of the upper arm are first affected, and those of the spine and lower limbs become weak later on. In a third type, which begins at about this age, the muscles of the face, along with certain of the shoulder and upper arm muscles, show the first signs of wasting. All the forms have this in common: that the affected muscles grow weaker until their power to contract is lost. In the first form, the patients seldom reach the age of 20, falling victims to some disease which, to ordinary people, would not be serious. In the other forms the wasting, after progressing to a certain extent, often remains stationary for the rest of life. Myopathy may also be acquired when it is the result of disease such as thyrotoxicosis (see under THYROID GLAND, DISEASES OF), osteomalacia (see under BONE, DISORDERS OF) and CUSHING'S DISEASE, and the myopathy resolves when the primary disease is treated.
Some myopathies may be the result of inflammation or arise from an endocrine or metabolic abnormality. Treatment of these is the treatment of the cause, with supportive physiotherapy and any necessary physical aids while the patient is recovering. Treatment for the hereditary myopathies is supportive since, at present, there is no cure – although developments in gene research raise the possibility of future treatment. Physiotherapy, physical aids, counselling and support groups may all be helpful in caring for these patients.
or deposition of bone in muscles, may be congenital or acquired. The congenital form, which is rare, first manifests itself as painful swellings in the muscles. These gradually harden and extend until the child is encased in a rigid sheet. There is no effective treatment and the outcome is fatal.
The acquired form is a result of a direct blow on muscle, most commonly on the front of the thigh. The condition should be suspected whenever there is severe pain and swelling following such an injury. The diagnosis is confirmed by hardening of the swelling. Treatment consists of short-wave DIATHERMY with gentle active movements. Recovery is usually complete.
,quite apart from any inflammation or injury, may be experienced on exertion. This type of pain, known as MYALGIA, tends to occur in unfit individuals, and is relieved by rest and physiotherapy.
sometimes lodge in the muscles, the most common being Trichinella spiralis, producing the disease known as TRICHINOSIS (trichiniasis).
of a muscle may occur, without any external wound, as the result of a spasmodic effort. It may completely tear the muscle – as sometimes happens to the feeble plantaris muscle in running and leaping – or part of the muscle may be driven through its fibrous envelope, forming a HERNIA of the muscle. The severe pain experienced in many cases of LUMBAGO is due to tearing of one of the muscles in the back. These conditions are usually relieved by rest and massage. Partial muscle tears, such as occur in sport, require more energetic treatment: in the early stages this consists of the application of an ice or cold-water pack, firm compression, elevation of the affected limb, rest for a day or so and then gradual mobilisation (see SPORTS MEDICINE).
occur occasionally, the most common being fibroid, fatty, and sarcomatous growths.
of muscles sometimes occurs as a symptom of disease in other organs: for example, damage to the nervous system, as in poliomyelitis or in the disease known as progressive muscular atrophy. (See PARALYSIS.)