Миофасциальный болевой синдром: практическое развитие теоретических оснований
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Pain 2020 03 039
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- Myofascial pain syndrome: practical development of theoretical foundations © F.I. DEVLIKAMOVA, F.A. KHABIROV Kazan State Medical Academy, Kazan, Russian Federation ABSTRACT
- Material and methods .
| ИНФОРМАЦИЯ ОБ АВТОРАХ:
Девликамова Ф.И. — https://orcid.org/0000-0003-4411-7051; e-mail: fdevlikamova@mail.ru Хабиров Ф.А. — https://orcid.org/0000-0002-2572-6970 Автор, ответственный за переписку: Девликамова Ф.И. — fdevlikamova@mail.ru КАК ЦИТИРОВАТЬ: Девликамова Ф.И., Хабиров Ф.А. Миофасциальный болевой синдром: практическое развитие теоретических оснований. Российский журнал боли. 2020;18(3):39–47. https://doi.org/10.17116/pain20201803139 Myofascial pain syndrome: practical development of theoretical foundations © F.I. DEVLIKAMOVA, F.A. KHABIROV Kazan State Medical Academy, Kazan, Russian Federation ABSTRACT Objective. To analyze myofascial pain mechanisms in practical aspect and evaluate the effect of changes in muscle fibers archi- tectonics on formation of clinical symptom complex. Material and methods. The research was based on the own analysis of long-term outcomes in patients with myofascial pain. The di- agnosis was based on kinesthetic study of myofascial trigger zone according major and minor criteria. Clinical electromyogra- phy combined with ultrastructural analysis of muscle fibers and ultrasound examination of the muscles were selected as a meth- odological technique for this study. Results. It was concluded that formation of myofascial trigger zones is based on neuromuscular dysfunction of the end plates of ex- trafusal muscle fibers with local intramuscular hypoperfusion and subsequent hypoxia. Local injection therapy with tolperisone hy- drochloride ensured restoration of blood flow within the myofascial trigger zone. Structural abnormalities in the taut band of tra- pezius muscle including altered myofibrils, divergence of myofilaments and Z-lines with uneven distribution of mitochondria and appearance of autophagosomes in the muscle compression zone were observed in patients with myofascial pain. These disor- ders may be a result of inadequate depleting physical load on the muscle in spasmodic condition with local hypoxia or ische-mia. Conclusion. Analysis of myofascial pain mechanisms is important due to inextricable relationship between treatment and patho- genesis. Long-term static load contributes to muscle overload and overstrain and subsequent activation of pain receptors. These 40 Российский журнал боли 2020, т. 18, № 3 40 Оригинальные статьи Original articles data are valuable to develop therapeutic measures aimed at restoration of muscle function and nociceptive pain relief. Keywords: myofascial pain syndrome, myofascial trigger zone, muscle fiber, electromyography, ultramicroscopy, ultrasound ex- amination. жүктеу/скачать 444,62 Kb. Достарыңызбен бөлісу:
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