Chronic pain felt deep within the muscles could be a sign of something serious. For example, it could be a symptom of myositis, a rare group of inflammatory myopathies that have the potential to become life-threatening. The key to treating these conditions is early diagnosis and intervention.
My goal for this post is to introduce you to myositis and its implications. Please bear in mind that, as a private rheumatologist, I specialise in chronic pain and inflammatory conditions. Do not hesitate to visit my office if you are suffering from chronic muscle pain. It’s best that we do a thorough examination to determine what’s going on.
Myopathies Are Muscle Conditions
Myositis is not a single disease. Rather, it is classified as a myopathy in as much as it targets muscles and muscle tissue. All myopathies share that characteristic. That being said, there are multiple types of myositis. The four that we deal with most frequently are:
- Inclusion body myositis (IBM)
- Juvenile dermatomyositis
The common thread here is an immune system that attacks muscle tissue. As you may know, the immune system normally protects the body against viruses, bacteria, and other pathogens. A strong immune system keeps a person healthy. For reasons we do not always fully understand, autoimmune diseases resulting in myositis cause a person’s immune system to attack healthy tissue.
Primary Symptoms of Myositis
Though a number of tests are needed to conclusively diagnose myositis, there are some tell-tale symptoms to point doctors in that direction. The first is the previously mentioned chronic pain deep within the muscles. It may be preceded by a noticeable rash on the face, back, or chest. Patients may also exhibit:
- general muscle weakness
- chronic tiredness
- difficulty sitting up or standing from a prone position
- difficulty swallowing or holding the head up
- general feelings of unhappiness or depression.
It is common for myositis patients to have difficulty doing things they used to take for granted. Climbing stairs, standing up from a chair, and lifting heavy objects may all be too hard. Some people have trouble doing things like picking up a cup or brushing their teeth.
Myositis Is Progressive
The most challenging thing about myositis is that it tends to be progressive. This is one of the reasons we say early diagnosis and treatment are so important. With the right treatment administered by an experienced physician, progression can often be slowed. It is possible to continue living a fairly normal and productive life if the illness is caught early enough.
Diagnosis is generally made through a combination of tests. If a doctor is concerned about myositis after a complete physical, a blood test is the first step toward confirming the diagnosis. The doctor may request a tissue biopsy, an MRI, and an EMG as well.
If myositis is confirmed, a treatment plan will be developed. Exercise and physiotherapy tend to be at the top of the list. In fact, exercise is a key component in treating all types of myositis. Regular exercise works to restore muscle mass, increase strength, reduce swelling, and restore energy levels.
Myositis is a rare condition that could be potentially life-threatening. However, early diagnosis and treatment makes it very manageable. I would be happy to see you in my London rheumatology clinic if you believe you are showing symptoms of myositis. Please do not delay in making an appointment. We want to get to the root of your chronic muscle pain as soon as we can.
What Is Orbital Myositis?
Orbital or Ocular Myositis (OM) is a very rare autoimmune condition that affects the extraocular muscles found in the eye. The extraocular muscles control your eye movement, so you may experience orbital pain and double vision when you first develop orbital myositis.
Orbital myositis has no known cause, but doctors believe there may be some association with non-infectious diseases such as Crohn’s disease and Lupus SLE. Some patients have developed orbital myositis after suffering sinus infections or upper respiratory tract infections.
There is also some anecdotal evidence that this condition may be triggered by infections and diseases such as Herpes Zoster, Lyme disease, and Cysticercosis.
Orbital myositis primarily develops in young to middle-aged women. Symptoms can vary from patient to patient, but some of the most common signs of orbital myositis include:
- Bulging eye
- Double vision
- Drooping eyelid
- The feeling of the eye being stuck
- Pain, especially with eye movement
- Restricted eye movement
- Swelling around the eye
What Is Juvenile Myositis?
Juvenile myositis is a condition that usually affects children under the age of 18. It is scarce and only affects two to four children per million. Although incredibly rare, the most common form of juvenile myositis is called juvenile dermatomyositis.
Juvenile dermatomyositis presents itself in children with a skin rash and very marked muscle weakness. There is no known cure for juvenile myositis, but there are effective treatments that can help to manage the symptoms.
These are the most common symptoms of juvenile myositis:
- Complaints of stomach pains
- Difficulty lifting arms into the air
- General tiredness
- Gradual muscle and joint weakness
- Hardened lumps developing under the skin
- Hoarse voice
- Moodiness and irritability
- Red or purple skin rash over the eyelids or joints
- Swelling and redness around the fingernails
- Trouble standing from a seated position or climbing stairs
- Trouble lifting and holding up the head
- Trouble swallowing
What Is Myositis Gravis?
Myositis Gravis is a condition that is characterised by rapid fatigue and weakness of any muscles under your voluntary control. The cause is a breakdown in neurological communications between the nerves and muscles in your body.
Myositis gravis is a rare condition. In about 1 in 5 people diagnosed with the condition, only the muscles of the eyes are affected. There are effective treatments that can help keep symptoms of the disease under control.
One of the most common symptoms is excessive daytime fatigue and sleepiness, which can affect your ability to concentrate and focus on your job. Myositis gravis can also affect your quality of sleep, contributing to brain fog and memory issues.
Symptoms can range from mild to severe, and it can be debilitating in the most severe of cases. The condition can cause problems with short term memory and reduced cognitive performance. This has led to some patients needing to switch to a less demanding job or even not being able to hold down a job at all.
Article by Dr. Naveen Bhadauria