Morning stiffness of muscles and movements. Stiffness in the body causes

The main manifestations of the rigid person syndrome include: increasing muscle tension(rigidity) and muscle spasms. The process begins with the muscles of the trunk, after a few months it spreads to the muscles of the proximal limbs. The disease is based on an increase in the excitability of the alpha motor neurons of the anterior horns. spinal cord, but this state has not yet been established.

Treatment of muscle stiffness in rigid person syndrome is symptomatic. The patient is prescribed GAMergic agents: benzodiazepines ("Clonazepam", "Diazepam") and "Baclofen", which affects neuromuscular transmission. Drugs block increased activity spinal motor neurons and reduce the severity of reflex, spontaneous muscle spasms and rigidity.

How to take drugs for the treatment of rigid person syndrome

The most commonly used "Diazepam" ("Sibazon", "Relanium"). It enhances GABAergic transmission and simultaneously inhibits noradrenergic transmission. The drug is started with minimum dose(2.5 mg), it is taken 1-2 times a day. Then the daily amount is gradually increased until the desired effect is achieved, taking the medicine 3-4 times. Range therapeutic doses depends on the individual sensitivity of the patient and can vary from 10 to 200 mg per day.

Instead of "Diazepam" you can use "Clonazepam" in the amount of 2-10 mg / day. With the ineffectiveness of benzodiazepines, Baclofen (an agonist of type B GABA receptors) is prescribed. It is taken along with one of the benzodiazepines or used as monotherapy. The daily dose of the drug is increased gradually. Maximum amount is 100-120 mg per day (in 3 divided doses).

At simultaneous reception Baclofen and benzodiazepine healing effect achieved with a lower dose than with monotherapy. This reduces the risk of side effects. It is necessary to avoid abrupt discontinuation of drugs, as this is fraught with a deterioration in the condition and the development of pronounced vegetative changes.

In case of intolerance or ineffectiveness of these drugs, valproic acid preparations are prescribed: "Depakine" in daily dose 600-2000 mg, "Tiagabin" at a dose of 4-12 mg per day or "Vigabatrin" at a daily amount of 1500 mg. These drugs also enhance GABAergic transmission. The use of antiadrenergic drugs ("Clonidine", "Tizanidin") gives a less permanent therapeutic effect. AT severe cases Botulinum toxin A is injected into the paraspinal muscles.

Kozlovsky Vladimir Anatolievich 2016-11-17 2019-03-23

Stiffness in the morning when it is difficult to take the first steps after a night's sleep, this is a symptom of many diseases of the joints. The problem is and practical difficulties in everyday affairs, and a person’s mood deteriorates at the very beginning of the day.

It's hard to take the first step in the morning

Symptoms appear difficulty moving in the morning, after a long period of low mobility during sleep, people can explain in different ways. However, many patients describe their condition as "stiffness" of the legs and arms, feeling like stockings restrict movement on the legs.

It is worth moving a little, walking around, as this state disappears. medical science claims that the severity and duration of this symptom depends on the degree inflammatory process in the joints.

There are several options morning stiffness: in one joint, in several joints at the same time and sometimes such conditions begin to appear in the spine.

Causes of stiffness in the morning

If the patient complains that he it is difficult to take the first steps in the morning, first of all, it is worth suspecting the presence of arthritis (an ailment that is accompanied by inflammation of the articular membrane).

The synovial (surrounding the joint) membrane normally produces the fluid necessary for the proper functioning of the joint, this is the "lubricant" in which articular surfaces move easily.

In the presence of an inflammatory process, the amount of fluid decreases, its viscosity and composition change. Movement becomes more and more difficult.

morning stiffness occurs with such ailments:

• osteoarthritis and osteoarthritis (destruction of the cartilage of the joints, most often the hip and knee); difficulty moving in the morning lasts usually 20-30 minutes;
• rheumatoid arthritis - autoimmune disease, affects the knee, shoulder, but more often - small joints; stiffness lasts an hour or more; joints are deformed;
• reactive arthritis (after past infection); most often it is Reiter's syndrome after urinary infection, it is characterized by damage to the joints of the legs, and asymmetrical; stiffness is short-term, may be completely absent;
  This group also includes rheumatoid arthritis after acute tonsillitis or pharyngitis or chronic tonsillitis; stiffness in the morning no more than 1/2 hour, heart lesions are often detected;
• as a symptom of another disease (psoriasis, rheumatism - with rheumatism morning stiffness lasts no more than half an hour, other organs are affected);
• ankylosing spondylitis, here stiffness is long, up to several hours, sometimes requires special gymnastics.

Treating Stiffness in the Morning

Osteoarthritis is treated comprehensively, with the use of analgesics, NSAIDs, glucocorticoids, chondroprotectors.

A large role in the treatment of joints is assigned. The range of physiotherapeutic procedures is wide: these are electromagnetic fields of microwave and high frequency, and short-wave diathermy, and ultrasound (including drugs), and microwave therapy, and electrophoresis of drugs that relieve inflammation, and laser therapy.

Applications of heat carriers, balneo- and hydrotherapy are very beneficial.

It is necessary to reduce the load on the diseased joint; for these purposes, orthoses and bandages are used. Shown sanatorium treatment.

Treatment rheumatoid arthritis is a laborious and lengthy process.

The funds can be:

• antirheumatic (basic) means;
• glucocorticoids;
• non-steroidal anti-inflammatory drugs;
• medicines that are used to treat concomitant diseases (heart, lungs).

From not medicinal methods diet, exercise therapy and physiotherapy have proven themselves well.

AT acute stage diseases prescribe ultraviolet light on diseased joints and electrophoresis of glucocorticoids. Further, after some time, you can do laser helium-neon irradiation of the joints, UHF therapy, low-intensity magnetotherapy, use light therapy. Later, you can connect other rehabilitation techniques to combat stiffness in the morning.

Ankylosing spondylitis also involves the use of drugs. Usually these are non-steroidal anti-inflammatory drugs in maximum doses.

However, it is impossible to rely only on drugs for such a disease. Diet combined with physiotherapy will bring if not complete healing, which will greatly alleviate the patient's condition. Massages are also required. special exercises(LFK).

Complications in the presence of stiffness in the morning

How the morning stiffness of the joints will end can be said only by establishing exact reason given symptom. With active and thorough treatment of arthritis and arthrosis, people live for many years without experiencing much pain.

If you do not pay attention to the difficult movements in the joints and do not go to the doctor, the disease will develop, the prognosis may be unfavorable.

This is especially true of such ailments as Bechterew's disease.

Risk factors for developing difficulty moving in the morning

Risk factors include: hypothermia, untimely treatment infectious diseases, hereditary predisposition. Lifestyle and nutrition play a big role. Physical inactivity and an abundance of salty, spicy and fried foods adversely affect the functioning of the joints.

In the end, irritability, internal dissatisfaction with oneself and all those vegetative-vascular manifestations that were mentioned above appear.

At first, they do not always occur, but only after some noticeable psycho-emotional experiences. The hypersthenic phase of the disease is characterized by increased excitability of patients, irascibility. A previously calm, balanced person becomes impatient, irritable, emotionally unrestrained. Understanding and appreciating the changes, the patient controls his behavior in society all the time, which leads to unnatural tension. stiffness in mental sphere transmitted to muscular system. Hence - a feeling of weakness, the appearance of pain in the muscles of the whole body. “It was as if they were carrying water on me,” patients often notice.

At home, in the family circle, tension subsides somewhat, control over emotions decreases, irascibility and incontinence are more pronounced. Relatives of the patient begin to experience inconvenience from communicating with him, express displeasure. Hotbeds of tension in the family are created, which further exacerbates the situation. The smallest irritants become excessive, significant, cause outbursts of anger. Against this background, absent-mindedness often appears, difficulty concentrating on important facts. Hence the frequent complaints of patients about memory loss, the inability to learn anything. However, here we are dealing with the pathology of attention rather than memory. The patient focuses on some very significant problem for him, which has not yet been resolved despite a lot of efforts. He is absorbed by it, cannot be distracted from it, and life goes on around him. You need to participate in it, make contacts, resolve a number of issues, give and carry out orders, read, write, eat, sleep, and raise children. Thoughts are tied to only one question, occupied with only one idea. For the rest, there is neither time, nor strength, nor desire. Any new stimuli only increase the feeling of dissatisfaction, as if being attracted by a magnet to the focus of stagnant excitation in the brain.

Sleep disorders are very painful for a neurasthenic. Insomnia is one of the cardinal symptoms of neurasthenia. She “... kills the joy of life, undermines strength, like a vampire, sucks blood from the heart and brain. At night, it forces a person to remember what he seeks to forget in a fertile sleep, and during the day it makes him forget what he wants to remember. First, the memory dies, then the waves wash away friendship, love, a sense of duty and even compassion. Only despair clings to the doomed ship, only to smash it against the rocks. Voltaire was right in putting sleep next to hope,” Axel Munte wrote so figuratively about insomnia, although he exaggerated considerably.

Patients with neurasthenia hardly fall asleep, several times a night they wake up in a cold sweat from nightmares. Often, going to bed, a neurasthenic long and persistently analyzes the events of the day, criticizes his actions, and makes plans for the next day. A kaleidoscope of thoughts captures the patient, but sooner or later they all converge on that main problem, which has not been resolved. Even falling asleep, the patient sees events in a dream that are somehow connected with her. She, like a nail in a shoe, all the time reminds of herself, all the time she torments the patient. After such a heavy sleep, which does not bring a feeling of relief, rest, the patient gets up broken, with a heavy head, as if from a hangover. The pains resemble the feeling of a helmet or hoop squeezing the head. Sometimes there is a feeling of something shimmering in the head, a feeling of confusion and chaos. Such is the heavy morning of the neurasthenic! He waits for morning and night as punishment, as something unpleasant and inevitable. Already in the morning, the neurasthenic is tired. His fatigue is different from the usual fatigue, which, as you know, comes at the end of the working day. Only by the middle of the day the condition improves somewhat, vivacity appears, a feeling of freshness, but by the evening, along with thoughts about the upcoming hard night, it is replaced by poor health, headache. Its occurrence is associated with a change in the tone of the vessels of the brain and with a constant tension in the muscles of the back of the head and neck.

Where does the tension of these muscles come from, and not others?

Neurasthenics are usually reluctant to blame anyone but themselves for their failures. The patient may experience this feeling all the time. Imagine a person who is being reprimanded for something, and he knows that he is really guilty. Such a person usually bows his head and shoulders low, as if drawing it in, he is ashamed to look into the eyes of other people, a heavy burden makes him take a guilty pose. To keep the head and shoulders in a normal state, in order to see others, the patient must strain the muscles of the neck, shoulder girdle and back all the time. From here almost constant feeling heaviness in the head, neck, back; feeling of stiffness and weakness. It is not in vain that we talk in everyday life about the "gravity of guilt", about the "gravity of worries" that do not fall somewhere, but on the shoulders, it is our head that cracks from worries, from unresolved problems.

Irritability, excitability in a neurasthenic are combined with rapid exhaustion, leading to fatigue, fatigue. Hence, in fact, the name of the disease. Neurasthenia means "weakness of the nerves" (from the Greek "asthenos" - weak). Fatigue is almost constant. It seems that the patient is constantly doing overwork. He gets tired easily even during a conversation with a doctor. Most often, patients with neurasthenia call fatigue the cause of poor health, although this is a symptom of the disease, and not its cause. To confirm, the volume of work, difficulties, lack of sleep are listed.

Ordinary fatigue (physical or mental), no matter how severe it may be, after rest, a night's sleep passes. How often do people who are physically or mental labor in the process of favorite work, creative inspiration, they work hard for many hours in a row. Often, tired of work, they fall asleep right there, at their workplace. having slept a short time, with new energy, plunge into work, getting pleasure from it. If the case is successful, no matter how much time, physical or mental strength is spent on it, there will be no neurosis. A sense of satisfaction from the work done, joy for success in such cases prevail over fatigue, give strength and energy in order to continue active creative work. Short break- a reward for success.

If physical and psychic powers spent in good faith, but in vain, if the results are not visible, such work will not bring satisfaction, but will only cause a feeling of annoyance, resentment. Recall that neurasthenics are hypersocial, honest, and tend to blame only themselves for failures. The patient is tired and sees his failures well. He would like to rest, but he cannot afford it, he believes that he does not deserve it. After all, rest is a reward! And what kind of reward can we talk about for unfulfilled work. That is why the fatigue of the neurasthenic seeks no rest. Patients with neurasthenia often report that they have not been on vacation for several years, that they are the first to come to work, and the last to leave, and this is true. Often they are considered iron men”, “two-core”, in which “instead of nerves - ropes”. Colleagues are often surprised that their colleague fell ill, broke down "on a nervous basis."

In the hyposthenic stage, fatigue intensifies even more, turning into almost complete apathy, indifference to the environment. Bad feeling becomes permanent, as does the painful feeling of inferiority. The range of interests narrows: “Everything is indifferent, nothing is nice”, “I don’t want to see anyone” - these are frequent statements of neurasthenics. Tiring not only work, but also rest. Movies, theatre, books, friends - everything is uninteresting. If we add to this picture the symptoms of vegetative-vascular instability, which, as a rule, accompany neurasthenia, the whole complex of painful sensations and experiences of the patient will become clear. The neurasthenic is one of the most honest people in the world. His only mistake: he does not really trust others, he wants to do everything himself, while overestimating his capabilities.

Stiffness Syndrome is a rare pathology that is referred to in the literature as the stiff man disease. It is not yet known exactly why the disease occurs, but its symptoms are described quite well, and they are based on an increase in general muscle stiffness, which is characterized by increased muscle tone and painful spasms.

The reasons

Why exactly this pathology occurs is not known, although several theories have been put forward. In stiffness syndrome, of which only 200 cases have been described worldwide, patients often have antibodies to the GABA-synthesizing enzyme glutamate decarboxylase (GAD65). However, this condition is also characteristic of other diseases, for example, diabetes, convulsions.

According to another study, people with this diagnosis were found to have a decrease in the cerebral cortex gamma-aminobutyric acid, which is one of critical components leading to inhibition of CNS neurotransmitters.

In 10% of all patients who were glorified in the diagnosis of muscle stiffness syndrome, this pathology developed against the background of another pathology - paraneoplastic syndrome, which occurs when there is malignant tumors and its metastases.

The course of the disease

The syndrome begins to manifest with a small, barely noticeable lesion. skeletal muscles heads and torsos. But, unfortunately, at the same time, the patient's complaints and the symptoms found by the doctor do not help to expose accurate diagnosis and start treatment on time.

Then the symptoms begin to increase. A person complains that his back is in an unnatural position all the time. upright position, and he also notes stiffness and discomfort in the back. These symptoms are aggravated when trying to tighten the muscles or when stressful situations. Sometimes there is sleep disturbance.

Some patients begin to develop seizures from the very beginning, the duration of which can range from a few minutes to many hours and even days. These conditions almost always go away on their own.

Because of these attacks, the diagnosis can be delayed, and often the wrong diagnosis is made - hysterical anxiety neurosis.

Further development

At further development pathology is noted in the muscles of the legs. Their tension is most often noted at the moment of fright, surprise, sadness. very painful and go away on their own, but very slowly. Due to the fact that exacerbation of the disease most often occurs with sudden movements, a person tries to move very slowly, and often completely refuses to move.

After a certain period of time, distant muscles begin to tighten. The patient is diagnosed with a pronounced one, in which there is a strong and rapid contraction of the muscles of the abdominal cavity.

Another accompanying symptom of this disease is depression. going on sharp deterioration standard of living, since a person can no longer drive a car, perform other actions that were habitual for him until that time.

Last stage

In the last stage, stiffness and spasms occur in all the muscles of the body. The pathology is characterized by the absence of spasms of the masticatory muscles, but there are spasms of the muscles of the face and pharynx. With very severe spasms, bone fractures, ruptures and damage to tendons and ligaments can occur. At the same time, a person practically does not move, cannot independently eat food and perform other actions.

Treatment

Not developed to date effective treatment, which could lead to recovery, because the cause of the disease is not known.

Most often, patients are prescribed baclofen or benzodiazepines. In some cases, tizanidine may be used. There is a description of clinical picture almost disappeared after the appointment of propofol.

There is information that medical procedure, like plasmapheresis, helps to get rid of symptoms for a while. However, after 2 weeks, the symptoms of the disease return again.

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> Muscle stiffness

This information cannot be used for self-treatment!
Be sure to consult with a specialist!

Muscle stiffness is called their increased tone hindering voluntary movements. medical name such a condition is muscle rigidity.

The causes of this syndrome are not fully understood. It is associated with a violation of the conduction of neuromuscular impulses due to various pathologies central or peripheral nervous system. Muscle stiffness is accompanied by some neurological diseases such as Parkinson's disease. The cause of muscle rigidity can be injuries of the spinal cord and brain, atherosclerosis of cerebral vessels. This syndrome can occur with various intoxications, for example, with poisoning carbon monoxide or manganese. Sometimes he is side effect in the treatment of some medications. One of the causes of muscle stiffness syndrome is pathology musculoskeletal system such as osteochondrosis. Provoke such a state of stress, prolonged exposure to an uncomfortable position, hypothermia.

Clinical signs of pathology

The disease begins most often with a slight lesion of the muscles of the trunk and head. Complaints about a feeling of discomfort and stiffness of the back muscles are characteristic. Symptoms worsen with nervous overload. Patients have sleep disturbances, manifested by frequent awakenings at night. Occasionally in initial stage severe attacks are observed, which can last several hours or even several days. Often, seizures occur against the background of a state of neurosis.

With the progression of muscle stiffness syndrome, the muscles of the limbs become tense, and their painful spasms can be observed. The exacerbation of the syndrome most often occurs at moments of emotional overload, for example, with fright, surprise, sadness, as well as with rapid movements. Patients begin to move as slowly as possible, they often have lumbar lordosis(curvature spinal column in lumbar forward).

AT final stages diseases of stiffness and spasms affect the vast majority of the muscles, including the muscles of the face and throat.

Consequences of the syndrome of stiff muscles

Stiffness syndrome can lead to depression in patients, they experience difficulty in the process of work, while eating, in communicating with others and driving a car. Severe spasms can be complicated by joint deformities, muscle ruptures, and fractures.

What examinations can the doctor prescribe?

With such complaints, you should contact a neurologist. A doctor diagnoses stiffness syndrome based on an examination of the patient and the results of a blood test that detects specific antibodies. Magnetic resonance spectroscopy is prescribed to detect biochemical changes in muscle tissues. If necessary, the doctor sends the patient for consultations with a psychiatrist, orthopedist, surgeon and other narrow specialists.

Treatment and prevention of muscle stiffness

For effective treatment, it is necessary to eliminate all provoking factors and treat the diseases that caused muscle stiffness syndrome. Specific sedatives, muscle relaxants (drugs that relax muscles), B vitamins, sometimes antiepileptic drugs. Plasmapheresis may be effective. Apply massage and manual therapy, reflexology, physiotherapy. Ointments and gels are locally prescribed. To unload the spine, a special Shants collar is sometimes used. After pain relief and improvement general condition exercise therapy is used.

To prevent muscle stiffness, it is not recommended to stay in the awkward position, supercool. It is necessary to avoid stress and monitor intake enough vitamins of group B. It is recommended to sleep on flat and low pillows. All medical prescriptions must be strictly followed.