Myopathy

Muscle diseases and disorders

Strains and Tears

• Strains – injuries caused by overstretching the tendons or the muscles

• Range from slight (pulled muscle) to complete muscle tear or tendon rupture

• Symptoms of muscle/tendon injury vary with severity

Types of Strains • Mild strain –No tearing of tendons or muscle fibers–Results in mild pain or stiffness

• Moderate strain– Some tearing of muscle or tendon fibers– Cause more severe pain, bruising, and

weakness

• Severe strain– A complete muscle / tendon tear results in

severe pain– Swelling, extensive bruising, and complete

loss of movement (often, not always)

Diagnosis of Strains / Myopathy

• Physical examinations are necessary – MRI, X-ray, Ultrasound, and Med History

• Moderate and severe strains should be treated by physician– Early stages of injury need RICE or sometimes

PRICE– Protection (Rest, Ice, Compression, and Elevation)

• Acetaminophen can be used for pain or NSAID’s (non-steroidal anti-inflammatory drugs) like ibuprofen or advil can be used.

• After first 72 hours of injury, gradual rehab is required (PT and heat)

• After a few weeks if therapy is not working, then surgery may be required

Chronic tendon injuries

• Tendonitis – incorrect name because there is rarely inflammation (-itis)

• Tendinosis – degenerative disease leading ot breakdown and scarring of tendons – Caused by failure of tendons to repair themselves

after injury– Those most vulnerable: rotator cuff, patellar,

achilles, and tibialis posterior tendons

Fibromyalgia Syndrome

• Myalgia – pain or tenderness in muscle– Symptom of many disorders (acute injury and viral

infection) • FMS - chronic pain syndrome charac by pain of

at least three months duration, bilateral tenderness, fatigue, sleep disorders, depression, anxiety, and exercise intolerance. – Found in 2% of population in US and Canada– Majority of patients are women

– Common in patients with rheumatological disorders

– Primary – FMS only– Secondary – with pain related to another disorder– Caused by hyperactive stress response or by

neurological problems that leads to increased sensitivity to pain (mult. Scler)

– Diagnosed by recognizing pain in 11-18 tender points

– No definitive treatment other than pain management

Duchenne’s muscular dystrophy

• DMD – genetic, incurable myopathy• Most common childhood form of MD• Carried on X chromosome, so it is mostly

found in boys (why?) • 1 in 3500 live male births • Mistake in gene coding for a protein called

dystrophin • Dystrophin holds muscle fibers together

• Without dystrophin, fibers degenerate • All muscle types affected (skel, card, smth)• Symptoms – Muscle weakness– Scarring– Fatty deposits replace muscle fibers– Very progressive, leading to paralysis

• First diagnosed at age 4 in boys

• Wheelchair bound by age 10, average life span is 17 years

• Death usually due to cardiac/respiratory failure

• Diagnostic symptoms – Abnormal gait in toddlers– Progressive myopathy– Overdeveloped calves– Electromyogram – stim group of muscles to gage

contraction strength

• PT should NOT be used, since it increases breakdown of muscle fibers

• Gene therapy and stem cell research are the only options for good prognosis

Myasthenia Gravis

• Grave muscle weakness• Autoimmune disorder in which immune

system attacks and destroys a large number of acetylcholine receptors.

• So muscles cannot respond to motor neuron• Eye muscles are usually first affected• Progressive• Rare disorder, found in women, hard to treat

Tetanus

• Aka lockjaw• Muscle disorder caused by untreated bacterial

infection• Bacteria Clostridium tetani release toxins that

keeps a muscle contracted constantly• Less than 1 mg of toxin required to cause

disease • Diagnosed by physician and lab test

• Symptoms of tetanus– Muscle spasm, rigid paralysis and stiffness, pain– Spasms caused with loud noises or lights– Fever– Progressive and can eventually paralyze the

diaphragm, causing respiratory failure• Treatment is easy if caught soon, most

patients end up in ICU• Vaccinations available to prevent it

Myasthenia gravis

DMD

lockjaw *tetanus*