3. Muscular System Pathologies Flashcards
Muscle fatigue
Muscle fibres can fatigue if overused.
Common in sports, occupational overuse and poor posture.
Associated with a depletion of metabolic reserve. Cell respiration becomes anaerobic and by-products that can cause pain (lactic acid) are produced
It is essential to prevent poor posture and provide muscles with the time needed to rest. Meditation, relaxation exercises, yoga, pilates, essential oils, manual therapy, acupuncture, nutrition e.g. magnesium, herbs and homeopathy can support this.
Muscle shortening
If a muscle is continuously contracted, the actin-myosin filaments remain attached.
Chronic muscle contracture causes muscle fatigue but also places a strain on the skeletal muscle attachments.
e.g. a ‘stressed’ individual commonly sustains prolonged contraction of the upper trapezius muscle fibres. As this muscle attaches to the cervical vertebrae, this may cause a strain of these joints and possibly produce a headache.
Muscles require magnesium to break the actin-myosin bond.
Muscle strain
Over-stretching of muscle fibrils or the tendon, occurring when a joint is forced beyond its normal range (pulled muscle).
The muscle remains whole and blood supply intact to permit healing
Leg and back strains are common
Muscle tear
Where the muscle tears and is no longer whole. More likely to produce bruising.
Preventing natural complete healing. Can lead to fibrosis.
A tear is suggested if movement is not possible.
Muscle strain and tear treatments
RICE - Would you always rice?
Herbal medicine (inflammation, pain, connection tissue repair), Acupuncture, homeopathy (arnica), nutritional support (anti-inflammatory and tissue repair).
If torn: avoid heat, rest initially, exercise, massage.
Impingement syndrome
Impingement syndrome describes a shoulder condition in which movements of the shoulder can be painful and limited.
The rotator cuff tendons and/or bursa can become inflamed / damaged. Most noticeable when compressing the space that they are both found within (sub-acromial space - the area between the humeral head and acromion).
The rotator cuff tendons connect the humerus and scapula. Normally, when moving the shoulder, the rotator cuff has to manoeuvre intricately in order to prevent impingement.
Causes of impingement syndrome
- Overuse and working with the arms raised overhead
- More common with increasing age as blood supply is poor and the tendons degenerate
- Positional fault - when the head of the humerus does not sit well in the socket
- Bone spurs - can reduce the space available for the bursa and tendons to move under the acromion
- Oddly-sized acromion resulting in reduced space
Signs and symptoms of impingement syndrome
- Shoulder ache in early stages
- Pain when abducting the shoulder or rotating (i.e. reaching into back pocket)
- Painful arc of movement
- A catching sensation is felt on lowering the arm
- Weakness and inability to raise the arm may indicate rotator cuff tear
Impingement syndrome tretment
Allopathic treatment:
Cortisone injection, NSAIDs, surgery
Natural treatment:
Herbal medicine, acupuncture, homeopathy (arnica), nutritional support (anti-inflammatory), osteopathy, chiropractic, exercise, essential oils (peppermint, frankincense)
Fibromyalgia
Fibromyalgia is a chronic pain disorder, heavily associated with widespread musculoskeletal pain and fatigue
Often accompanied by multiple, unexplained symptoms of anxiety, depression and functional impairment of daily activities
Women are 10X more commonly affected than men - mostly occurring age 30-50
Has a neurophysiologic basis, characterised by abnormalities in pain processing by the central nervous system (CNS)
A form of ‘central sensitisation’ - pain perception to sensory stimuli that would not normally be painful
Fibromyalgia: Pain Processing
Fibromyalgia is associated with central sensitisation - a central disturbance in pain processing
Normally, sensory input such as light touch and temperature is sent as nerve signals to the brain / spinal cord where it synapses with nerves
In fibromyalgia, alterations occur in pain processing in the spinal cord and brain (centrally)
High levels of substance P are found in synapses - this makes nerves more sensitised to pain
Excess post-synaptic nitric oxide production also causes the synapses to amplify pain signals.
Fibromyalgia: causes and triggers
- poor mitochondrial functioning damaged by free radicals
- altered stress response (i.e. excess cortisol, adrenal fatigue)
- post-viral and chronic toxic load e.g. heavy meals, chemicals
- poor gut health - dysbiosis, leaky gut syndrome
- serotonin and noradrenaline deficiencies play a role in pain tolerance
- sleep dysregulation (fatigue, ↑pain, ↓activity).
Fibromyalgia: signs and symptoms
- widespread (diffuse) musculoskeletal pain
- pain that results from gentle pressure
- feeling of swollen joints, often with no actual swelling
- debilitating fatigue and severely-disturbed sleep
- headaches (muscular or migraines)
- IBS symptoms, numbness, tingling and weakness
- anxiety and depression
Fibromyalgia: diagnosis
Criteria for diagnosis: Excess pain on palpation in at least 11 of 18 predefined anatomical points.
The patient experiences pain at tender points at a decreased threshold. However:
• Normal biopsy.
• Normal electrical muscle tests. • Drug studies show no benefit
of NSAIDs but benefits of
antidepressants.
• It is also an ‘exclusion diagnosis’.
Fibromyalgia: treatment
ALLOPATHIC TREATMENT:
•Medications, e.g. pain relief. Pain clinics.
NATURAL TREATMENT:
•Gut — checking for dysbiosis, parasites etc. Digestive support.
• Detox — supporting the liver, removing heavy metals and
chemical exposures, limiting EMF exposure, castor oil (liver).
• Mitochondrial support — CoQ10, antioxidants,
magnesium malate, B vitamins, essential fats.
• Reducing stress — nervine herbs (e.g.
passionflower and valerian); breathing exercises.
• Acupuncture, homeopathy.
