Leg muscle tone in adults - treatment at home. Muscle tone

The main drugs used to reduce muscle tone are muscle relaxants. According to the mechanism of action, muscle relaxants are distinguished between central action (affect the synaptic transmission of excitation in the central nervous system) and peripheral action (inhibit direct excitability of striated muscles). When using muscle relaxants, quite significant side effects, which must be carefully evaluated when choosing a drug.

When choosing antispastic drugs, they mainly take into account their ability to inhibit polysynaptic reflexes (reducing spasticity), while having the least effect on monosynaptic reflexes (muscle strength). An antispastic drug should reduce muscle spasticity with a minimal decrease in muscle strength.

Drug therapy is based on the use of tablet and injection forms. Antispastic agents used internally, reducing muscle tone, can improve motor functions, facilitate care for an immobilized patient, relieve painful muscle spasms, enhance the effect of physical therapy, and prevent the development of contractures. At mild degree spasticity, the use of muscle relaxants can lead to a significant positive effect, however, with severe spasticity, large doses of muscle relaxants may be required, the use of which often causes unwanted side effects. Treatment with muscle relaxants begins with a minimum dose, then it is slowly increased to achieve effect.

The centrally acting muscle relaxants most often used in Russia for the treatment of spastic muscle hypertonicity include baclofen, tizanidine, tolperisone, and diazepam.

Baclofen (Baklosan, Lioresal) has an antispastic effect mainly at the spinal level. The drug is an analogue of gamma-aminobutyric acid (GABA), which binds to presynaptic GABA receptors, leading to a decrease in the release of excitatory amino acids (glutamate, aspartate) and suppression of mono- and polysynaptic activity at the spinal level, which causes a decrease in spasticity. The drug also exhibits a moderate central analgesic effect. Baclofen is used for spinal and cerebral spastic muscle hypertonicity of various origins. The initial dose is 5-15 mg/day (in one or three doses), then the dose is increased by 5 mg every day until the desired effect is obtained. The drug is taken with food. The maximum dose of baclofen for adults is 60-75 mg/day. Side effects often include sedation, drowsiness, decreased concentration, dizziness, and often subside during treatment. Nausea, constipation and diarrhea may occur, arterial hypertension, increased ataxia, the appearance of paresthesia. Caution is required when treating elderly patients, patients who have had a stroke, patients with peptic ulcer stomach and duodenum. Baclofen is contraindicated in case of epilepsy or a history of seizures.

For severe spasticity, when the usual oral use of antispastic drugs is not effective, intrathecal administration of baclofen is indicated, which was first proposed in 1984 by R. Penn. To achieve the required concentration of the drug in the cerebrospinal fluid, it is necessary to take quite significant doses of baclofen, which can lead to disturbances of consciousness, drowsiness, and weakness. Therefore, systems have been developed that deliver baclofen directly into the intrathecal space of the spinal cord using the intrathecal baclofen pump system. In this case, the clinical effect is achieved with much smaller doses of baclofen than when using tablet forms.

This system consists of a reservoir containing baclofen or a similar drug, a pump (pump), with the help of which the drug is dosed into the intrathecal space of the spinal cord through a lumbar catheter and a power supply. From the reservoir, baclofen enters directly into the cerebrospinal fluid, and its dosage is controlled by a special radiotelemetry device. The amount of drug entering the cerebrospinal fluid can be changed depending on the clinical picture. Baclofen is added to the reservoir after 2-3 months using percutaneous puncture.

The use of a baclofen pump improves the speed and quality of walking of patients with unfixed reflex contractures caused by high spasticity of synergistic muscles and imbalance of antagonist muscles. The existing 15-year clinical experience of using baclofen intrathecally in patients who have suffered a stroke indicates the high effectiveness of this method in reducing not only the degree of spasticity, but also pain syndromes and dystonic disorders. Noted positive influence baclofen pump on the quality of life of stroke patients.

Tizanidine (Sirdalud) is a centrally acting muscle relaxant, an alpha-2 adrenergic receptor agonist. The drug reduces spasticity due to suppression of polysynaptic reflexes at the level of the spinal cord, which can be caused by inhibition of the release of excitatory amino acids L-glutamate and L-aspartate and activation of glycine, which reduces the excitability of spinal cord interneurons. Tizanidine also has a moderate central analgesic effect. The drug is effective for cerebral and spinal spasticity, as well as for painful muscle spasms. The initial dose of the drug is 2-6 mg/day in one or three doses; with individual selection, the dose is increased on days 3-4 by 2 mg. When taken orally, the effect of the drug appears within 30-45 minutes, the maximum effect occurs within 1-2 hours. The average therapeutic dose is 12-24 mg/day, the maximum dose is 36 mg/day. Side effects may include drowsiness, dry mouth, dizziness and decreased blood pressure, which limits the use of the drug for post-stroke spasticity. The antispastic effect of tizanidine is comparable to the effect of baclofen, however, with adequate dosage selection, tizanidine is better tolerated, since it does not cause general muscle weakness and does not increase muscle weakness in the paralyzed limb.

Tolperisone (Mydocalm) is a centrally acting antispastic drug that inhibits the caudal part of the reticular formation and has N-cholinolytic properties. Tolperisone reduces the activity of spinal neurons involved in spasticity by limiting the flow of sodium across the membrane nerve cells. The most commonly used dose is 300-450 mg/day in two or three doses. A decrease in muscle tone when tolperisone is prescribed is sometimes accompanied by a vasodilator effect, which should be taken into account when prescribing to patients with a tendency to arterial hypotension. The drug may also cause or worsen urinary incontinence in patients.

The main side effect of baclofen, tizanidine and tolperisone is the rapid onset of muscle weakness, and in each case the doctor must find a balance between decreased tone and increased weakness. The balance curve between a decrease in spastic tone and an increase in muscle weakness in patients with an increase in the dose of Mydocalm, Sirdalud or Baclofen shows that the most rapid increase in weakness occurs when taking Baclofen, and the mildest drug that allows you to effectively select an individual dosage is Mydocalm. In all cases, given the presence of a narrow therapeutic window, the course of treatment begins with a small dose of the drug, gradually increasing it until a clear antispastic effect is achieved, but not until weakness appears.

Diazepam (Realanium, Relium, Sibazon) is a muscle relaxant because it has the ability to stimulate reduced presynaptic inhibition at the spinal level. It does not have direct GABAergic properties, increases the concentration of acetylcholine in the brain and inhibits the reuptake of norepinephrine and dopamine at synapses. This leads to increased presynaptic inhibition and is manifested by a decrease in stretch resistance and an increase in range of motion. Diazepam also has the ability to reduce pain caused by muscle spasms. Along with a decrease in muscle tone, lethargy, dizziness, impaired attention and coordination develop due to the toxic effect on the central nervous system. This significantly limits the use of diazepam as a muscle relaxant. It is used mainly for the treatment of spasticity of spinal origin when a short-term decrease in muscle tone is necessary. For the treatment of spasticity, a dose of 5 mg once or 2 mg 2 times a day is prescribed. The maximum daily dose can be 60 mg. At high doses, disturbances of consciousness, transient liver dysfunction and blood changes may occur. The duration of treatment is limited due to possible development drug addiction.

Clonazepam is a benzodiazepine derivative. Clonazepam has a sedative, central muscle relaxant, and anxiolytic effect. The muscle relaxant effect is achieved by enhancing the inhibitory effect of GABA on the transmission of nerve impulses, stimulating benzodiazepine receptors located in the allosteric center of the postsynaptic GABA receptors of the ascending activating reticular formation of the brain stem and interneurons of the lateral horns of the spinal cord, as well as reducing the excitability of the subcortical structures of the brain and inhibition of polysynaptic spinal reflexes.

The rapid onset of drowsiness, dizziness and addiction limits the use of this drug. To reduce the occurrence of possible adverse reactions, it is necessary to achieve a therapeutic dose by slow titration over two weeks. For oral administration to adults, an initial dose of no more than 1 mg/day is recommended. Maintenance dose - 4-8 mg/day. It is possible to prescribe small doses in combination with other muscle relaxants. Clonazepam is effective for paroxysmal increases in muscle tone. Contraindicated in acute diseases of the liver, kidneys, myasthenia gravis.

Dipotassium clorazepate (Tranxen) is a benzodiazepine analogue, transforms into the main metabolite of diazepam, has greater activity and duration of antispastic action than diazepam. It has been noted to have a good effect in treatment in the form of a decrease in phasic stretch reflexes and has a slight sedative effect. The initial dose is 5 mg 4 times a day, then reduced to 5 mg 2 times a day.

Dantrolene is an imidazoline derivative that acts outside the central nervous system, mainly at the level of muscle fibers. The mechanism of action of dantrolene is to block the release of calcium from the sarcoplasmic reticulum, which leads to a decrease in the degree of contractility skeletal muscles, reduction of muscle tone and phasic reflexes, increasing the range of passive movements. An important advantage of dantrolene in relation to other muscle relaxants is its proven effectiveness against spasticity not only of spinal, but also of cerebral origin. The initial dose is 25 mg/day; if tolerated, the dose is increased over 4 weeks to 400 mg/day. Side effects are drowsiness, dizziness, nausea, diarrhea, decreased glomerular filtration rate. A serious danger, especially in elderly patients at a dose of more than 200 mg/day, is the hepatotoxic effect, so liver function should be regularly monitored during treatment. Elimination of dantrolene is 50% due to hepatic metabolism, and therefore it is contraindicated in liver diseases. Caution should also be exercised in case of severe cardiac or pulmonary diseases.

Catapresan - used mainly for spinal injuries, acts on alpha-2 agonists of the brain, has presynaptic inhibition. Side effects include decreased blood pressure and depression. The initial dose is 0.05 mg 2 times a day, the maximum is 0.1 mg 4 times a day.

Temazepam - interacts with benzodiazepine receptors of the allosteric center of postsynaptic GABA receptors located in the limbic system, ascending activating reticular formation, hippocampus, interneurons of the lateral horns of the spinal cord. As a result, channels are opened for incoming currents of chloride ions and thus the action of the endogenous inhibitory transmitter, GABA, is potentiated. The recommended dose is 10 mg 3 times a day. Its combination with baclofen is effective.

The main drugs used to treat spastic muscle hypertonicity are presented in Table.

Thus, the choice of drug is determined by the underlying disease, the severity of muscle spasticity, as well as side effects and the characteristics of the action of a particular drug.

For example, tizanidine and baclofen have a greater effect on the tone of the extensor muscles, therefore, in cases of significant hypertonicity of the flexor muscles of the arm, mild spasticity of the leg muscles, their use is not indicated, since a slight increase in the tone of the extensor muscles of the leg compensates for muscle weakness in the leg and stabilizes the patient's gait. In this case, the means of choice are methods of physical impact on the muscles of the upper limb.

In the treatment of cerebral spasticity, Sirdalud is most often used, and for spinal spasticity, Sirdalud and Baclofen are used. Mydocalm has an important advantage over other muscle relaxants, which does not have a sedative effect and has a favorable tolerability spectrum, therefore it is the drug of choice for treatment on an outpatient basis and for the treatment of elderly patients.

A combination of several drugs is acceptable, which allows you to effectively reduce tone at lower doses of each drug. Combining drugs with different points of application, from centers in the brain to muscles, can lead to a cumulative therapeutic effect.

The effectiveness of oral antispastic drugs decreases with their long-term use, and there is often a need for increasing dosages to maintain the initial clinical effect, which is accompanied by an increase in the frequency and severity of adverse reactions.

In a situation where spasticity is local in nature and the systemic effect of oral muscle relaxants is undesirable, local methods of exposure are preferred, one of which is local administration of botulinum toxin.

Literature

Skoromets A. A., Amelin A. V., Pchelintsev M. V. and others. Prescription reference book for a neurologist. SPb: Polytechnic. 2000. 342 p.
Shtok V.N. Pharmacotherapy in neurology: Practical guide. 4th ed., revised. and additional M.: Medical Information Agency LLC, 2006. 480 p.
Methodical recommendations on the organization of neurological care for patients with strokes in St. Petersburg / Ed. V. A. Sorokoumova. SPb: St. Petersburg, 2009. 88 p.
Lehmann-Horn F., Ludolf A. Treatment of diseases of the nervous system. M.: MEDpress-inform. 2005. 528 p.
O'Dwyer N., Ada L., Neilson P. Spasticity and muscle contractur in stroke // Brain. 2006. Vol. 119. P. 1737-1749.
Damulin I. V.
Zavalishin I. A., Barkhatova V. P., Shitikova I. E. Spastic paresis // In the book. Multiple sclerosis. Selected issues of theory and practice. Ed. I. A. Zavalishina, V. I. Golovkina. Elf IPR LLC. 2000. pp. 436-455.
Levin O. S. Basic drugs used in neurology: Directory. M.: MEDpress-inform, 2007. 336 p.
Boyko A. N., Lashch N. Yu., Batysheva T. T. Increased muscle tone: etiology, pathogenesis, correction // Handbook of a polyclinic doctor. 2004. T. 4. No. 1. P. 28-30.
Damulin I. V. Spasticity syndrome and the main directions of its treatment // Journal of Neurology and Psychiatry named after. S. S. Korsakova. 2003. No. 12. P. 4-9.
Selected lectures on neurology: ed. V. L. Golubeva. M.: EidosMedia, 2006. 624 p.
Parziale J., Akelman E., Herz D. Spasticity: pathophysiology and management // Orthopedics. 2003. Vol. 16. P. 801-811.
Katz R., Rymer Z. Spastic hypertension: mechanisms and measurement // Arch. Phys. Med. Rehab. 2009. Vol. 70. P. 144-155.
Barnes M. An overview of the clinical management of spasticity // In: Upper motor neuron syndrome and spasticity. Cambridge University Press. 2001. P. 5-11.
Parfenov V. A. Pathogenesis and treatment of spasticity // Russian Medical Journal. 2011. T. 9. No. 25. P. 16-18.
Kadykov A. S., Shakhparanova N. V. Drug rehabilitation of patients with spastic paresis. In the book: Upper motor neuron syndrome. Ed. I. A. Zavalishina, A. I. Osadchikh, Y. V. Vlasova. Samara: Samara department. Literary Fund, 2005. pp. 304-315.
Rehabilitation of patients with central post-stroke pain syndrome // Rehabilitation. Collection scientific works(annual publication), No. 1. M.: Publishing house RGMU, 2003. P. 357-359.
Sashina M. B., Kadykov A. S., Chernikova L. A. Post-stroke pain syndromes // Atmosphere. Nervous diseases. 2004. No. 3. P. 25-27.
Kamchatnov P. R. Spasticity - modern approaches to therapy // Russian Medical Journal. 2004. T. 12. No. 14. P. 849-854.
Gusev E. I., Skvortsova V. I., Platinova I. A. Therapy of ischemic stroke // Consilium medicum. 2003, special release. pp. 18-25.
Kadykov A. S., Chernikova L. A., Sashina M. B. Post-stroke pain syndromes // Neurological Journal. 2003. No. 3. P. 34-37.
Musaeva L. S., Zavalishin I. A. Treatment of spasticity in multiple sclerosis // Proceedings of the 9th symposium “Multiple sclerosis: treatment and recovery”. SPb: Faces of Russia. 2000. pp. 59-60.
Stroke. Principles of diagnosis, treatment and prevention / Ed. N.V. Vereshchagina, M.A. Piradova, Z.A. Suslina. M.: Intermedica, 2002. 208 p.
Sommerfeld D. K., Eek E. U.-B., Svensson A.-K. et al. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations // Stroke. 2004. Vol. 35. P. 134-140.
Bakheit A., Zakine B., Maisonobe P. The profile of patients and current practice of treatment of upper limb muscle spasticity with botulinum toxin type A // Int. J. Rehabil. Res. 2010. Vol. 33. P. 199-204.
Malakhov V. A. Muscle spasticity in organic diseases of the nervous system and its correction // International Neurological Journal. 2010. No. 5. P. 67-70.
Davis T., Brodsky M., Carter V. Consensus statement on the use of botulinum neurotoxin to treat spasticity in adults // Pharmacy and Therapeutics. 2006. Vol. 31. P. 666-682.
Childers M., Brashear A., Jozefczyk P. Dose-dependent response to intra-muscular botulinum toxin type A for upper limb spasticity after stroke // Arch. Phys. Med. Rehab. 2004. Vol. 85. P. 1063-1069.
Kadykov A. S. Muscle relaxants in the rehabilitation of patients with post-stroke motor disorders // Journal of Neurology and Psychiatry named after. S. S. Korsakova. 1997. No. 9. P. 53-55.

A. A. Korolev,Candidate of Medical Sciences

FSBI " All-Russian Center emergency and radiation medicine named after. A. M. Nikiforova" EMERCOM of Russia, Saint Petersburg

Normal muscle contractility ensures harmonious physical and mental development child. Muscle tone in a baby can be physiological and pathological. Physiological conditions include increased muscle tone in the first weeks after birth. Next, the tone should return to normal. If a child still has increased muscle tone two weeks after birth, this phenomenon is called hypertonicity and belongs to the category of pathological conditions.

Hypertonicity of the muscles of a newborn is an understandable phenomenon. Inside the womb, the child was in a constrained state. His limbs were tightly pressed to his body, there was no room for movement.

After birth, the baby's body gradually gets used to the new conditions. During the first two weeks, the muscles gradually relax, and the limbs return to a new state. However, if the baby has central nervous system lesions of varying severity, the brain will not be able to fully control muscle activity. In this case, the condition of the muscles will deviate from normal.

The persistence of hypertonicity during the first month of life should be a reason to examine the child by a neurologist.

Age norms

The following development of the situation is considered normal.

Pathology can be suspected from birth. Problems with the central nervous system are often expressed in muscle hypertonicity syndrome. In such children, all movements are constrained, lower limbs– no more than 45 o. The arms and legs are firmly pressed to the body, and the fingers cannot be unclenched.

What should you be wary of?

Hypertonicity syndrome prevents further development child, the formation of joints and ligaments is disrupted. Persistence of the condition can lead to impairment of motor skills, motor activity, and the formation of the spine and posture.

If after the first month of life the baby’s muscle hypertonicity persists, in the future he will have the following signs.

The child behaves restlessly, sleeps poorly, wakes up in less than an hour and cries often.
The baby spits up profusely after every meal.
During sleep, the child arches his back and throws his head back. This is characteristic feature for hypertension. At the same time, his arms and legs are bent and pressed to the body.
During a tantrum, the child is tense and bends. In a nervous state, trembling of the chin is noted.
The baby is able to hold his head upright from birth.
When you spread your legs to the sides, you feel strong muscle tension. When you try again, the tension increases. The child resists and protests with a cry.
In an upright position, the baby does not rest his entire foot on the surface, but stands on his toes.

Existing signs of hypertonicity should prompt parents to seek advice from a neurologist.

During the examination, the doctor identifies the presence or absence of certain reflexes in the child and their compliance with the age norm.

Walking reflex. In an upright position, the baby tends to take steps. Normally, this ability disappears after 2 months of age.
Symmetry of reflexes. When lying on the back, the baby's chin is pressed to the chest. At the same time, the behavior of the limbs is observed - bending of the arms and straightening of the legs should occur. When the head is tilted to the right, there is straightening of the limbs on the right side and tension on the left. When you turn your head in the other direction, everything happens exactly the opposite. This reflex should disappear after 3 months.
Ability to tone. While lying on his stomach, the baby should tuck his limbs. Lying on your back relaxes your arms and legs. After three months the ability disappears.
When examining a newborn, the doctor places the baby in his arm, face down. In this position, the baby should experience contraction of the arms and relaxation of the legs. Under normal conditions, the head and back should extend into one line.

Parents can detect symptoms on their own. If a violation is suspected, they should consult a doctor.. A neurologist will be able to determine the presence or absence of a diagnosis and establish its type.

Nature of violations

Muscle tone can be either increased or decreased. Sometimes there is an imbalance - a combination of the first and second. In other words, increased muscle tone in the arms and decreased tone in the lower extremities may be present at the same time, or vice versa. This symptom is called dystonia.

With asymmetry, muscle hypertonicity occurs only on one side. This condition is also called torticollis. The child is placed in a prone position and examined from the back. With asymmetry, the head is turned towards that half of the body where hypertonicity appears. On the same side, there is a bend in the back and tension in the arms.

Hypotension is also considered a disorder. This phenomenon has the opposite symptoms of hypertonicity and manifests itself in lethargy and impaired motor activity.

Muscle hypertonicity and hypotonicity may not appear systemically, but in individual parts of the body. In this case, there is a decrease or increase in muscle tone only in the arms, legs or back.

Violation of muscle tone is not an independent disease, but indicates other, more serious pathologies of the nervous system. That is why the symptoms of hypertension should not be ignored. If the syndrome is detected, the child must be thoroughly examined. In this case, an ultrasound of the brain is performed, and in rare cases, a tomogram.

Possible reasons

The causes of damage to the central nervous system can lie both in problems associated with pregnancy and in complications during childbirth.

Scroll possible reasons lesions of the central nervous system in a child that cause a violation of muscle tone:

infectious diseases of the mother during pregnancy;
improper lifestyle of a pregnant woman;
taking medications by the mother during pregnancy;
Rhesus conflict expectant mother and fetus;
injuries received by the child during childbirth;
genetic incompatibility of parents;
unfavorable environmental situation.

The presence of these factors can only indirectly confirm the presence of a symptom of hypertonicity in a child.

Treatment should be aimed not only at correcting muscular dystonia, but also at identifying and eliminating the underlying cause that caused the condition.

Treatment options

When treating muscle tone disorders, non-drug methods are primarily used:

massage techniques;
water procedures (bathing in herbal infusions of valerian, motherwort, sage, excluding diving);
gymnastic exercises, with the exception of dynamic gymnastics;
physiotherapy;
osteopathic techniques.

Upon appointment medicines those that can improve cerebral circulation, improve metabolic processes and reduce muscle tension are selected.

Minor violations may hide serious reasons. Harmonious development the child should extend in all planes. A deviation in one area may lead to a violation in another area. Alarming symptoms of changes in muscle tone should not be ignored. During the examination, the doctor will be able to determine in which direction to move next, what examination and treatment the child may need.

Muscles are one of the important components of the ODA, which is responsible for motor activity the body along with the ligamentous apparatus and nervous system. If its functioning is disrupted, this is fraught with various uncomfortable sensations. Therefore, we will next consider how to relieve hypertonicity of the back muscles or another area of the body.

- a pathological condition in which there is a persistent and reversible increase in muscle tone.

The trigger for the development of the condition lies either in muscle damage or in a disruption in the transmission of nerve impulses.

Reference. The phenomenon is considered a symptom of many diseases, and most often occurs against the background of ailments of the nervous system.

The state of muscle tissue in normal condition and during spasm

In neurology, there are several main types of this disorder:

spastic;
plastic;
mixed.

Spastic appearance develops when elements of the pyramidal system are damaged (neurons that transmit nerve impulses from the center of the brain to the skeletal muscles).

It spreads unevenly, that is, some muscle group may be affected. A good example This type is observed during a stroke with damage to the motor centers of the brain.

Plastic look occurs when there is dysfunction of the extrapyramidal system, represented by brain structures that are involved in controlling movements, maintaining muscle tone, and body position in space.

It is characterized by a constant nature, which is why spasm of all muscle groups is observed. A striking example this type can be observed during the course of Parkinson's disease.

Characteristics of types of muscle hypertonicity

Mixed variety develops when both systems (pyramidal and extrapyramidal) are affected. Has symptoms of the two previous forms of the pathological phenomenon. May occur against the background of brain tumors.

Reasons

Promotion muscle tone may develop under the influence of various negative factors and diseases.

Reference. Conventionally, all causes of a pathological phenomenon can be divided into 2 groups: physiological and pathological.

Physiological factors that may contribute to the development of this disorder include:

Staying in an uncomfortable position for a long time.
Bruises, various types of injuries.
Frequent stressful situations.
Poor posture.
Overwork.

The phenomenon can act as a protective reaction to pain, for example, tension in the back muscles due to damage to the vertebrae or bruise.

Pathological causes include various diseases that are accompanied by an increase in muscle tone:

Stroke is one of the causes of muscle hypertonicity

Stroke.
brain and spinal cord.
Bruxism is teeth grinding, which is manifested by various symptoms, including: hypertonicity of facial muscles, or rather chewable ones.
Vascular pathologies.
Dystonic syndrome.
Spastic form (hypertonicity of the sternocleidomastoid muscle).
Infectious diseases of the central nervous system.
Epilepsy.
Parkinson's disease.
Myopathy.
Multiple sclerosis.
Head injuries.
Tetanus.

Since this condition can be a symptom of a serious pathology, therapy requires a thorough diagnosis and an individual approach to the choice of treatment methods.

In adults, hypertonicity of the neck muscles or muscles in another area of the body is manifested by the following characteristic symptoms:

increased tendon reflexes;
feeling of stiffness;
muscle spasms;
slow relaxation of spasmodic muscles;
uncontrolled motor activity;
discomfort when moving;
tension, limited mobility.

Hypertonicity has a characteristic clinical picture

When moving, muscle tone increases, which leads to pain and temporary cramps.

Prolonged muscle tension can cause disruption of the blood circulation and the formation of painful seals.

When going to the hospital, the patient undergoes a thorough examination, which allows us to identify the reasons that provoked the increase in muscle tone, the condition of the muscle tissue and the nature of the spasms.

Reference. During the examination, laboratory and hardware diagnostic techniques are used.

After a conversation and examination of the patient, the specialist selects the necessary diagnostic methods, which include:

General and biochemical blood test— many indicators are studied, the main one being the level of electrolytes.
MRI, CT for examination of the brain and cerebrospinal fluid.
EMG(electromyography) - determining the speed of nerve impulses.

EMG is one of the main diagnostic methods

Also in some cases, a muscle biopsy or consultation with specialists in another field of medicine may be necessary(endocrinologist, psychiatrist, etc.).

Choice of treatment options increased tone muscles depends on the factor of its appearance, the severity of the lesion and the patient’s well-being. Postural exercises - aimed at preventing contractures and pathological body position.

Psychotherapy- necessary during the rehabilitation period.

Therapeutic massage- prescribed to relax muscle tissue, improve metabolic processes and blood circulation.

Acupressure- impact on biological active points, which helps reduce muscle tension, pain, and improve metabolism.

Conservative treatment methods

In such cases, they resort to implementation quite rarely.

Conclusion

To prevent the development of muscle hypertonicity, you should regularly visit a specialist to monitor the condition of the body and the course of the existing disease, moderately load the body, and periodically undergo massage courses.

Muscle tone is resistance that must be present in muscle tissue. It appears when passive movement occurs in the joint.

Tone depends on many factors, including the condition of muscles, nerve fibers and impulses; can be low or high.

High resistance is called hypertonicity of the back muscles. What is characteristic of this condition? Why is it developing?

Classification

Hypertonicity of the back muscles in adults is of two types: pyramidal and extrapyramidal. Their main difference is the damage different parts nervous system.

In the first case, resistance appears only at the beginning of the movement. Afterwards the muscle moves freely. In the second, there is constant resistance. Sometimes a mixed type of disease develops - most often it appears with brain tumors.

Causes of increased tone

The manifestation of the disease is not always associated with disturbances in the functioning of the body. Sometimes it develops for physiological reasons.

Excessive stress on the back muscles. When they have to work for quite a long period of time, they exhaust their energy reserves. The fibers contract and freeze in this position. It will be difficult to restore their mobility, since this is a very energy-consuming action.
Uncomfortable position. It most often occurs in those who work at the computer for a long time. In this case, the neck suffers. Another example is gardeners who have to deal with back hypertonicity.
The body's response to pain. Muscle spasm is the body’s protective reaction to sudden pain. For example, the back muscles spasm if the cervical, thoracic or lumbar spine is injured.
Bruises and frequent stress.

Among the diseases that lead to the appearance of back hypertonicity, the following can be distinguished:

stroke,
brain tumor
Parkinson's disease,
epilepsy,
tetanus,
multiple sclerosis,
myotonia.

This list can be continued indefinitely.

How to improve the condition?

How to relieve hypertonicity of the back muscles? There are two ways:

eliminate the root cause of its appearance;
relieve symptoms and unpleasant consequences.

Unfortunately, it is not always possible to remove the cause. However, there is an opportunity to improve at least a little general condition patient.

Physical therapy, psychotherapy, reflexology and other similar treatment methods have a good effect on hypertonicity.

Another treatment option is the use of medications. They will reduce tone, relieve pain, normalize blood circulation and the process of nutrition of affected tissues. The most popular are muscle relaxants, antipsychotics and.

It is worth remembering that you should consult your doctor before using any of these medications. Self-medication can be dangerous.

Problems in children

Sometimes hypertonicity of the muscles of the back and neck occurs even in infants. And that's quite normal. Throughout pregnancy, the baby remains in the uterus in the fetal position. Even after birth, his limbs are pressed to his body.

This will continue for about another 1-3 months. After this period, the tone should normalize. If this does not happen, we can judge the development of pathological hypertonicity in the infant. It is characterized by some symptoms:

The baby begins to hold his head up ahead of schedule.
By three months of age, the child still has not learned to open his palm in order to take, for example, a toy.
The head is always tilted in the same direction.
My chin is shaking. The child may arch and throw his head back.
With hypertonicity in the back, a newborn often regurgitates.

What can cause this condition in young children?

encephalopathy,
increased intracranial pressure,
brain tumor,
myopathy or myotonia,
torticollis,
infections.

These diseases, as the cause of hypertension, are the most common. In fact, there are many more reasons. If measures are not taken in time, serious complications may arise:

lack of coordination of movements;
delayed motor development;
problems with gait and posture;
pain syndrome;
disorders in speech development.

How to remove muscle hypertonicity in children? As in the situation with adults, it is necessary to determine the cause of its appearance and get rid of it.

After this, you can take measures to eliminate symptoms and unpleasant consequences. These include massage and exercise therapy. A child’s massage is performed exclusively by a specialist.

Complex therapy to eliminate hypertension in infants includes other procedures:

Taking baths with herbal supplements. You can use pine needles, valerian, etc.
Paraffin wraps.
Electrophoresis.
Classes in the pool.
Taking special medications. They should be prescribed exclusively by a neurologist.
Performing a set of exercises on a fitball.

Hypertonicity of the muscles of the back and neck can develop in both adults and children, even the smallest. This may be due to physiological factors, for example, excessive load on your back or uncomfortable position.

Another reason is serious disruptions in the functioning of the body. These could be infections, cerebral palsy, myotonia, myopathy, etc. If complex treatment is started in time, the patient’s condition can significantly improve.

Disclaimer

The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, therapist). Please consult your doctor first to know the exact cause of your health problem.

I will be very grateful if you click on one of the buttons
and share this material with your friends :)

Muscle hypertonicity is a pathological condition in which there is increased muscle resistance when performing any passive movements. Thus, during periods of relaxation and rest, muscle fibers remain tense. Increased muscle tone also creates an obstacle to performing voluntary actions.

In neurology, this pathological condition is diagnosed quite often. It occurs in both adults and children. This disorder has an extremely negative impact on a person’s ability to lead a full life, as it causes physical discomfort.

Causes of pathology

Hypertonicity of muscle tissue in most cases is a symptom of other pathological conditions and disorders. Muscle tone largely depends on the elasticity of muscle tissue and the correct functioning of motor neurons located in the spinal cord. In addition, the motor center of the brain is responsible for regulating muscle tone.

Thus, the appearance of hypertonicity may be the result of damage to both muscle tissue and the nerves of the central and peripheral nervous system that regulate tension and relaxation of the body’s muscles. Reasons for the development of hypertension in patients different ages vary. In adults, the causes of this disorder can be divided into physiological and pathological. Physiological reasons for this problem include:

overstrain of muscle fibers;
being in an uncomfortable position for a long time;
defensive reaction to pain;
stressful situations and bruises.

With severe overstrain of the muscles, the energy accumulated in them is exhausted. This leads to the fact that the muscles freeze in a tense position until the necessary energy for relaxation is accumulated. Spasms often occur due to overexertion. calf muscles shins after running or intense exercise.

When staying in an uncomfortable position, overload occurs separate groups s muscles, which leads to an increase in their tone. Often such a violation occurs when working at a computer for a long time. Hypertonicity of the lumbar and cervical spine is often diagnosed.

With such prolonged tension, the back muscles do not relax completely even when the posture changes. With hypertonicity of the muscles of the neck and lower back, there is a high probability of lumbago. The spinal cord and the nerve endings that extend from it may be subject to compression.

Often, the appearance of spasticity in certain muscle groups can be a reaction to severe pain. This is often observed with vasospasm of the lower extremities. Less commonly, a similar problem occurs when the nerve roots of the spinal cord are damaged as a result of the progression of osteochondrosis. In this case, hypertonicity of the lumbar and cervical muscles is often observed.

Pathological causes of muscle hypertonicity in adults include disorders that occur in the following pathological conditions:

tumors of the spinal cord and brain;
traumatic brain injuries;
infectious lesion of the central nervous system;
spastic torticollis syndrome;
epilepsy;
vascular pathologies of the spinal cord and brain;
multiple sclerosis;
dystonic syndrome;
tetanus;
Parkinson's disease;
vasculitis;
lack of calcium;
hepatic encephalopathy;
hemorrhagic and ischemic stroke;
bruxism.

In children younger age symptoms of hypertonicity are often observed. The following disorders predispose to the appearance of such pathology in newborns:

hypoxia during fetal development;
intrauterine infection;
birth injuries;
intracranial hemorrhages;
congenital developmental anomalies;

There is an increased risk of developing this pathological condition in children born against the background of Rh conflict in the mother and fetus. Perinatal encephalopathy experienced by the child can contribute to the appearance of hypertonicity. The risk of developing pathology is higher in the presence of early and late toxicosis.

Localization of the disease

All muscles of the body can be affected by hypertonicity. Damage to the thigh and calf muscles of the legs is common. The subclavian, trapezius, deltoid and pectoral muscles may be affected.

In addition, a similar problem often affects the rhomboid muscles, as well as the elements involved in raising the scapula. When the spine is damaged, hypertonicity of the posterior cervical muscles is observed. Spasms of the quadratus lumborum muscle are often observed. The occipital muscle may also be affected.

Characteristic symptoms

The development of hypertonicity is accompanied by the appearance of characteristic symptoms. In adults, this pathological condition appears with the following symptoms:

feeling of tension;
increased muscle tissue density;
tightness;
impaired coordination of movements;
feeling tired;
deterioration of flexor function;
painful spasms;
tremor.

In children, in addition to these symptoms, additional signs appear. The presence of hypertonicity in a child may be indicated by impaired development of fine motor skills and movement coordination. Often, children at 3 months with hypertonicity continue to have a tendency to clench their hands into fists.

The baby begins to hold his head up too early. A trembling chin and frequent regurgitation may also indicate the presence of a similar problem in a child. In severe cases, children arch and throw their heads back. The emergence of a problem may be indicated by the support and automatic walking reflex. In this case, the child stands on one foot and at the same time tries to take a step with the other.

Diagnostic methods

If there are manifestations of hypertonicity, the patient requires consultation with a neurologist, since the presence of this pathology can be determined even by performing special neurological tests. Anamnesis is being collected. The patient may need to consult a psychiatrist and endocrinologist. After this, general and biochemical blood tests are performed.

The level of electrolytes and CPK in the blood must be determined. To determine the conduction speed of nerve impulses, an EMG is prescribed. To assess the patient's condition and identify the cause of the problem, CT and MRI may be prescribed.

A cerebrospinal fluid analysis is required. Often, to clarify the diagnosis, a biopsy of nerves and muscles is prescribed.

Treatment options

To remove hypertension, therapy is primarily aimed at eliminating the primary pathology that caused the problem. To relieve increased tone, various conservative treatment methods are used. Medications that have a sedative effect are often prescribed. These medications help suppress psycho-emotional stress.

In some cases, antispastic medications and muscle relaxants are prescribed to reduce hypertension. In addition, . can be introduced into the treatment regimen. In most cases only drug treatment is not enough to eliminate hypertension.

The course of therapy is introduced. At least 10 procedures are required to improve the condition. Electrophoresis procedures are introduced into the treatment regimen. Swimming and specially selected exercise can help relax muscle fibers. therapeutic exercises. The exercise therapy complex should be learned under the supervision of an instructor. In the future, you can do physical exercise at home.

To eliminate increased muscle tone, warm baths with herbal decoctions of thyme, chamomile, pine needles or valerian root may be recommended. Such decoctions can be made at home from herbs that are sold ready-made in pharmacies, because their recipe is extremely simple. To prepare a strong decoction for a bath, take approximately 50 g of the selected herbal component and pour 3 liters of boiling water. You need to put the mixture on the fire and boil for 5 minutes.

After this, remove the broth from the stove and leave for 3 hours. The composition must be filtered and added to the water collected in the bath. To reduce muscle tone, warm paraffin wraps and acupuncture are prescribed.

Folk remedies intended for oral administration are ineffective for hypertonicity. You should take such medications only on the recommendation of a doctor, because... in some pathological conditions that can provoke a problem, medicinal herbs may cause poor health.

Conclusion

Hypertonicity can be either a congenital or acquired pathological condition. Despite the fact that this disorder causes a lot of discomfort to the patient, with complex therapy it is possible to achieve a pronounced improvement. In mild and moderate cases, treatment can completely eliminate the problem.