Myositis is a combination of the terms “myo” which refers to muscles and “itis” which refers to inflammation. Chronic inflammation of the muscles is known as Myositis. Swelling comes and goes gradually as a result of muscular inflammation. It is a condition where the immune system attacks the muscles, making them weak, fatigued and painful.
Myositis is a type of myopathy, which is a broad term for a condition that affects the muscles connected to your bones. If left untreated, it worsens over time. Myositis commonly affects the muscles required for movement, such as the shoulders, arms, hips, abdomen and legs. Muscle weakness in the eyes, mouth, and oesophagus may occur in some individuals.
Myositis can affect adults as well as children of all ages. Women are at a greater risk of affecting by this condition than men. Medication and exercise may help in certain situations, but finding the proper treatment requires time.
What causes Myositis?
Myositis may be caused by several factors, although the specific cause of myositis is unknown.
Here are a few factors which might cause the development of Myositis:
- Injury
- Infection
- Drug toxicity
- Inflammation
- Autoimmune response
- Inflammatory autoimmune disorders
Injury:
Muscle injuries from accidents or sports-related situations produce muscle pain and swelling, which can lead to inflammation and muscle damage.
Infection:
Environmental factors such as viral or bacterial infections have been linked to the development of myositis. Viruses such as the common cold, HIV and flu viruses are examples of what might cause Myositis.
Drug toxicity:
Certain drugs like alcohol, cocaine, alpha-interferon and statins may cause short-term muscle weakness, but this can happen in drug interactions in rare instances.
Inflammation:
Inflammation is a common symptom of Myositis. The early inflammation in muscle may be caused by the immune system’s reaction to an infection or various other factors.
Autoimmune response:
Myositis is an autoimmune disease in which the immune system mistakenly attacks the muscles in response to an infection in the body, resulting in muscle weakening, swelling, inflammation, and damage.
Inflammatory autoimmune disorders:
Myositis has been linked to various inflammatory disorders such as lupus, rheumatoid arthritis and scleroderma. These are usually the most significant causes and required a longer period for treatment.
Inflammatory disorders that can lead to serious Myositis may include:
- Polymyositis
- Dermatomyositis
- Inclusion-body myositis
How is Myositis diagnosed?
Myositis is a rare disease that is difficult to identify since the most prevalent sign of myositis is muscle weakness or soreness, which can occur in many other conditions.
Myositis diagnosis can be challenging and requires careful consideration and evaluation from healthcare professionals.
The healthcare professional examines you based on your symptoms. The diagnosis of Myositis requires a variety of methods, which may include:
- Medical history
- Physical examination
- Blood tests
- Muscle biopsy
- Electromyography
- Genetic testing
- Myositis-specific antibody tests
- MRI (magnetic resonance imaging)
When you have pain or weakness, it is essential to seek the appropriate advice. Effective management and therapy depend on early diagnosis.
Symptoms of Myositis:
Myositis symptoms vary depending on the type or severity of the disease. Muscle weakness is the most common sign of myositis.
Symptoms of myositis include:
- Rash
- Fever
- Fatigue
- Swelling
- Weight loss
- Inflammation
- Skin changes
- Night sweats
- Muscle weakness
- Joint or muscle pain
- Difficulty climbing stairs
- Difficulty walking and standing
- Trouble breathing or swallowing
- Difficulty sitting or lying positions
Different forms of Myositis might have different signs and symptoms that vary from person to person. If you suspect 50% of these signs or symptoms, you need to seek medical attention from a healthcare professional to ensure proper diagnosis, management and treatment.
Risk factors of Myositis:
Various factors raise the probability of developing this disease.
The following are some of the risk factors:
- Age
- Gender
- History
- Autoimmune diseases
- Environmental factors
Age:
Myositis can affect persons of various ages and different kinds of myositis affect different age groups. Polymyositis and dermatomyositis primarily affect persons aged 30 to 60 while inclusion-body myositis affects older adults aged 50 to 60.
Gender:
Myositis can affect both genders, however, women have been scientifically shown to be twice as likely as males to develop the condition in dermatomyositis.
History:
Myositis is not genetically inherited but family records of autoimmune conditions including myositis, may raise the likelihood of developing the disease.
Autoimmune diseases:
People who suffer from autoimmune disorders such as lupus, rheumatoid arthritis, or other medical conditions are more likely to develop Myositis.
Environmental factors:
Certain factors that induce the condition may include infections, drugs, or some incidents that increase the likelihood of developing Myositis.
The risk factors may increase the likelihood of having Myositis, however, the exact cause is unknown. It is essential to seek medical advice from a healthcare professional about your health and condition.
Complications of Myositis:
Myositis, if left untreated or poorly managed, can lead to complications, and the underlying cause must be addressed.
Myositis complications may include:
- Muscle weakness
- Dysphagia (difficulty swallowing)
- Muscle atrophy (loss of muscle mass)
- Functional impairment
- Dermatomyositis
- Respiratory complications
- Depression
Muscle weakness:
Prolonged muscle weakness can cause challenges with daily tasks, reduced movement and a decline in overall health quality.
Dysphagia:
Dysphagia is a difficulty in swallowing that can be severe when untreated and can make eating and drinking problematic.
Muscle atrophy:
In severe situations, muscular inflammation causes muscle damage and atrophy, resulting in chronic weakness and trouble moving.
Functional impairment:
Chronic muscle weakness can cause functional impairment, making it difficult to do muscle-strengthening tasks like climbing stairs, moving objects and rising from a seated or lying position.
Dermatomyositis:
Dermatomyositis is a condition in which the skin undergoes changes and produces purple-red rashes, which if left untreated, can progress to severe skin complications.
Respiratory complications:
In serious situations of muscle weakness, difficulty breathing may occur, leading to respiratory problems, which can be a life-threatening symptom.
Depression:
Prolonged myositis can have emotional and psychological effects, such as anxiety, depression, and stress.
It is essential to seek assistance from a healthcare professional if you notice the symptoms, as treating severe cases can be challenging. Early identification and treatment of the condition might reduce symptoms and risk for complications.
Types of Myositis:
The following are five types of myositis:
- Polymyositis
- Dermatomyositis
- Toxic myositis
- Juveline myositis
- Inclusion-body myositis
They all are classified as inflammatory myopathies because they develop muscular inflammation and damage.
Polymyositis:
Polymyositis is an autoimmune condition which causes muscular weakening, inflammation and pain. It begins near the trunk muscles (proximal muscles), such as the shoulders and hips and expands gradually over time.
The symptoms of Polymyositis patients may include:
- Fever
- Fatigue
- Weight loss
- Muscle pain
- Hoarse voice
- Muscle weakness
- Chronic dry cough
- Difficulty breathing
- Difficulty swallowing
- Trouble in lifting objects
- Difficulty climbing stairs
- Difficulty standing from a seated position
Dermatomyositis:
Dermatomyositis is an autoimmune condition like polymyositis, that affects the skin as well as the muscles. It causes skin changes and people frequently experience skin rashes around their eyelids, knuckles, knees, cheeks, chest, neck, or other parts of the body. It is the simplest form to identify because of purple-red rashes on the skin in the shape of a flower.
The symptoms of Dermatomyositis patients may include:
- Fatigue
- Skin rash
- Weight loss
- Skin bumps
- Muscle pain
- Hoarse voice
- Joint inflammation
- Difficulty breathing
- Irregular heartbeat
- Difficulty swallowing
- Gastrointestinal ulcers
- Scaly, dry and rough skin
- Lumps of calcium under the skin
- Difficulty standing from a seated position
- Muscle weakness (shoulders, neck, back, hip)
Toxic Myositis:
Toxic myositis develops as a result of the toxicity of certain prescribed medications. This condition can be linked to medications such as statins, omeprazole, cocaine, and toluene. However, it is very rare and persons with toxic myositis may improve after discontinuing those medicines.
The symptoms of toxic myositis are the same as other types of myositis that may include:
- Fever
- Fatigue
- Skin rash
- Joint pain
- Muscle pain
- Muscle swelling
- Muscle weakness
- Muscle tenderness
- Trouble in lifting objects
- Elevated muscle enzymes
- Difficulty standing from a seated position
Juvenile Myositis:
Juvenile myositis affects youngsters under the age of 18. Girls are more prone than young boys to develop juvenile myositis.
The symptoms of this condition are similar to those of other types and may include:
- Fever
- Fatigue
- Irritability
- Skin rash
- Joint pain
- Muscle pain
- Skin bumps
- Mood swings
- Hoarse voice
- Stomachaches
- Muscle weakness
- Difficulty swallowing
- Trouble climbing stairs
- Lumps of calcium under the skin
- Trouble lifting or reaching the head
- Difficulty standing from a seated position
- Redness and swelling of the skin around nails
Inclusion-body Myositis:
Inclusion-body myositis is the only kind of myositis that affects men more than women and people over the age of 50. This condition is believed to be inherited and begins with the wrist, fingers and thigh muscles, making it difficult to do hand activities.
Inclusion-body myositis patients may experience the following symptoms:
- Muscle pain
- Frequent falls
- Loss of balance
- Muscle weakness
- Difficulty walking
- Difficulty swallowing
- Weakened hand grip
- Difficulty standing from a seated position
It’s essential to remember that each form of myositis has a specific underlying reason that requires a distinctive approach to its diagnosis, management and therapy.
Treatment of Myositis:
Treatment for Myositis depends on the disease’s characteristics, symptoms, forms, and severity. There is no particular treatment for the disorder but some medications, lifestyle changes, continuing management and therapy may help to reduce inflammation, prevent complications and alleviate severe symptoms. These therapies and treatments may improve muscle strength and functions.
The following are the steps involved in treating myositis:
- Medications
- Physiotherapy
- Lifestyle modifications
- Speech and language therapy
- Monitoring and follow-ups
1: Medications
There are no specific medications to treat Myositis, although there are some that may help with symptoms.
Medications may include:
- Pain relievers
- Corticosteroids
- Biological therapies
- Immunosuppressants
- Intravenous immunoglobulin
- Pain relievers:
Myositis patients who experience serious pain and discomfort are frequently administered painkillers to help enhance their quality of life.
- Corticosteroids:
Corticosteroids, such as prednisone, are the primary treatment for myositis. These are anti-inflammatory medications, that reduce muscular inflammation and swelling while also preventing your immune system from attacking your body.
- Biological therapies:
Biological therapies are used in critical situations that target specific immune cells or proteins associated with the autoimmune response.
- Immunosuppressants:
In certain cases, immunosuppressants such as azathioprine (azasan) and methotrexate (trexall) are administered to help reduce inflammation and the immune system’s response when corticosteroids are insufficient or high doses are not advised due to side effects.
- Intravenous immunoglobulin:
Intravenous immunoglobulin is a treatment containing healthy antibodies derived from the donor blood that can be used in specific cases to control the immune response and lessen muscular inflammation.
2: Physiotherapy
Physical therapy or a planned workout program can be very beneficial in restoring muscle strength. Physiotherapy may also help to keep you active while alleviating muscle pain and stiffness. Consult with the top physiotherapists to develop a personalized exercise programme.
3: Lifestyle modifications:
Modifying your lifestyle can help you manage some of your symptoms. It is essential to maintain a healthy lifestyle and that involves avoiding smoking and alcohol use, eating a healthy balanced diet, exercising regularly and managing stress.
4: Speech and language therapy:
Speech and language therapy is recommended for myositis individuals who have trouble swallowing or talking.
5: Monitoring and follow-ups:
Regular visits with healthcare professionals are essential for monitoring the condition, adjusting medications and addressing emergent risks.
It is essential to maintain contact with your healthcare professional for ongoing monitoring and medication adjustments, as well as for regular checkups to determine the progression of the condition. This is because individuals dealing with Myositis may benefit from early diagnosis and management, which can improve their clinical outcomes and quality of life.
The dietary guidelines for Myositis:
There is no particular diet suitable for myositis, however, a well-balanced diet may be beneficial for inflammation, overall health and immune system support.
Dietary suggestions for myositis may include:
- Well-balanced diet
- Anti-inflammatory foods
- Avoid processed foods
- Limit sugary foods
- Limit saturated and trans fat
- Hydration status
- Moderate alcohol consumption
- Maintain a healthy weight
Well-balanced diet:
Adopt a balanced diet that includes nutrient-dense foods from all food groups, such as fruits, vegetables, whole grains, lean proteins, and healthy fats, to strengthen the immune system and promote overall health.
Anti-inflammatory diet:
Anti-inflammatory foods, such as fatty fish, whole grains, nuts, seeds, vegetables and fruits, can be beneficial to myositis and might help to reduce inflammation.
Avoid processed foods:
Processed foods such as canned, packaged and frozen should be avoided because they might induce inflammation and lack vital nutrients.
Limit sugary foods:
Excess sugar consumption leads to inflammation and can harm your health. Reduce your intake of sweets including desserts, cakes, pastries, doughnuts, and other sweets.
Limit saturated and trans fats:
Limit your consumption of unhealthy fats from fried, fatty and packaged foods and replace them with healthier fats such as nuts, avocados, seeds, and fatty fish.
Hydration status:
Drink enough water throughout the day to promote overall health and keep your muscles functioning properly.
Moderate alcohol consumption:
Excessive alcohol consumption may contribute to inflammation and interfere with the functions of the immune system.
Maintain a healthy weight:
Maintaining a healthy weight can be beneficial to boost the metabolism and general health and lower the risk of developing other diseases.
It is essential to discuss with your healthcare professional your dietary concerns while maintaining a healthy weight. They can guide you based on your body’s needs and health status.
When should I consult a healthcare professional?
See your healthcare professional if you have fatigue, muscle pain, or other symptoms and it should be taken seriously and treated, particularly if the symptoms don’t improve within a few days. If you are having difficulty breathing, swallowing, or moving any part of your body, you should go to the emergency department right away.
The bottom line:
Myositis can be a life-threatening condition, therefore do not delay to seek medical attention if the situation worsens. It is essential to identify the signs and symptoms and get treatment as soon as possible.