Myogelosis

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Classification according to ICD-10
M62.8 Other specified muscle diseases
ICD-10 online (WHO version 2019)

The term myogelosis (from ancient Greek μῦς mys , Gen. μυός myos , German 'muscle' and Latin gelu 'frost'; synonym muscle hardness ) denotes a circumscribed, palpable, mostly tender thickening of a muscle with contractile muscle bundles and the formation of knots or bulges. In contrast to the hard tension, they also exist under relaxation under anesthesia . Structural changes can be demonstrated histologically in the affected muscle sections. Myogelosis is a common finding in chronic pain conditions in many areas of medicine .

Definition of terms

The nomenclature in international literature has to be considered very differentiated in this area, as the terms used are sometimes not only related to the respective language, but also to the time period.

The German term “muscle hardness”, which was already familiar at the beginning of the last century, did not establish itself in Anglo-American literature. "Myogelosis" is used synonymously in the German-speaking area and "Myogelosis" in Anglo-American. The term “ trigger point ” can also be found as an analogue in the literature . From a pathophysiological point of view, myogelosis is probably the same phenomenon as the “trigger point”. The term myogelosis emphasizes the palpable hardening of the muscles, while the term trigger point emphasizes the pain and the appearance of the contracted muscle bundles.

The term “ fibrositis ” appeared at the beginning of the last century (1904) with a similar meaning in Anglo-American literature and was then adopted in German-language literature as “ fibrositis syndrome ”. However, due to the lack of a satisfactory histopathological explanation, the term did not gain acceptance in its original form and is now outdated. After its redefinition in 1977, it nowadays describes a completely different clinical picture as " fibromyalgia " than when it was introduced in 1904.

The term “(myofascial) trigger point” appears in Anglo-American literature in 1942 and is adopted with the same name in German-language literature.

The terms “maximum point” and “maximum pain point”, which are also used in the literature, are also used synonymously with myogelosis in a corresponding context.

The term "(muscle) hard instep" is used differently. Either as a synonym for myogelosis or as a broadly circumscribed, palpable, usually pressure-sensitive hardening of a muscle that disappears under anesthesia.

The muscles denotes a temporary painful irritation of the muscles to a corresponding load.

definition

Myogelosis is a circumscribed, palpable, usually pressure-sensitive hardening of a muscle that remains palpable even under anesthesia. It is a common finding in chronic pain conditions in many areas of medicine.

According to a source of complementary medicine, the focus of myogelosis is a clearly measurable oxygen deficiency, electromyographically there are no indications of muscle activity (no muscle action potential ) .

root cause

Local metabolic changes are the cause, and in some cases inflammation of the muscles . Because of the local accumulation of acidic muscle metabolism products or mechanical hindrance due to the increased space requirement of the muscle cells during activity ( muscle tone ) , this local reduced blood flow and consequently metabolic changes can trigger.

histology

There is a significant narrowing of the endomysium in the affected sections of the muscles . In addition, damage and signs of atrophy of muscle fibers could be detected. Since these changes appear long-term, they explain the observation that myogeloses remain palpable even under anesthesia.

therapy

An essential part of the "therapy", especially in sports medicine, is prevention by leaking and stretching after exercise. For treatment are local anesthesia , deep zirkelnde massage of the view - and complementary medicine - acupuncture suitable. In addition, other forms of physical treatment can also be used. The focus should be on therapy for the underlying disorder.

See also

literature

  • JP Shah, N. Thaker, J. Heimur, JV Aredo, S. Sikdar, L. Gerber: Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. In: PM & R: the journal of injury, function, and rehabilitation. Volume 7, number 7, July 2015, pp. 746-761, doi : 10.1016 / j.pmrj.2015.01.024 , PMID 25724849 , PMC 4508225 (free full text) (review).
  • John Quintner, Milton Cohen: Myofascial pain syndrome: a bogus construct , in: Michael Hutson, Adam Ward (Eds.): Oxford Textbook of Musculoskeletal Medicine , Oxford University Press, Second Edition 2015, ISBN 9780199674107 , pp. 134-142.

Individual evidence

  1. ↑ a b c d A. Lange: Physical medicine . Springer, 2002, ISBN 3-540-41306-5 , pp. 191ff., Books.google.de
  2. ↑ a b c d D. G. Simons: Trigger points and myogeloses . In: Manuelle Medizin , 1997, pp. 290-294, doi : 10.1007 / s003370050045
  3. ↑ J. Travell ea: Pain and disability of the shoulder and arm: Treatment by intramuscular infiltration with procaine hydrochloride . In: JAMA , 120, 1942, pp. 417-420.
  4. ↑ a b In: Pschyrembel . de Gruyter, ISBN 3-11-007018-9
  5. ↑ a b c d U. Wegner: Sports injuries . Schlütersche, 2003, ISBN 3-87706-632-1 , p. 36, books.google.de
  6. ↑ a b J. Grifka: Orthopedics and trauma surgery in questions and answers . Urban & Fischer, 2008, ISBN 3-437-41269-8 , p. 70, books.google.de
  7. ↑ a b c A. Windisch et al .: Morphology and histochemistry of myogelosis. In: Clin Anat. , 1999, 12 (4), pp. 266-271, PMID 10398386
  8. ↑ E. Bader et al .: Applied Physiology - Understanding and Integrating Complementary Therapies . Thieme Verlag, 2005, ISBN 3-13-131121-5 , p. 522, books.google.de
  9. ↑ Armin Lange: Physical medicine . Springer Verlag, 2003, ISBN 3-540-41306-5 , books.google.ch
  10. ↑ E. Bader et al .: Applied Physiology - Understanding and Integrating Complementary Therapies . Thieme Verlag, 2005, ISBN 3-13-131121-5 , p. 258, books.google.de