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Myositis - Types, Symptoms, Causes, Treatment, and Prognosis

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The term "myositis" refers to a set of uncommon diseases. To know more about myositis, read the full article below.

Medically reviewed by

Dr. Nagaraj

Published At September 29, 2022
Reviewed AtAugust 10, 2023

What Is Myositis?

The term "myositis" refers to a set of uncommon diseases. Muscle weakness, soreness, and discomfort are the most common symptoms. This normally deteriorates over time. Myositis is caused by immune system malfunction, which causes it to target healthy tissue by mistake.

What Are the Types of Myositis?

Many acquired disorders are characterized by muscle inflammation and muscular weakening of myositis. They are as follows:

Polymyositis + Dermatomyositis = Inflammatory myopathies(IMs)

What Are Inflammatory Myopathies?

Polymyositis and dermatomyositis are predominantly described under the generic inflammatory myopathy. It affects various organs. Interstitial lung disease and dysphagia are the more fatal complications of inflammatory myopathies. This disease occurs most commonly in men over fifty years of age.

What Are the Symptoms of Polymyositis?

Polymyositis affects a wide range of muscles; however, it is most common in the shoulders, neck, hip, back, and thighs. The symptoms include weak and painful muscles, difficulty sitting and standing, dysphagia, tiredness, and depression. If not treated, the muscle weakness and pain worsen every week.

What Are the Symptoms of Dermatomyositis and Myositis?

Patients with dermatomyositis suffer from distinct rashes and weak and painful muscles in polymyositis. The rashes usually start as red or purple and then become dark. Most commonly occurs in the face and neck region. The rashes will be associated with itch and pain. A lump might also develop beneath the skin.

The other common symptoms of myositis are weakness and tiredness of muscles that can make daily routine difficult, muscle pain, pain on touch in the affected muscles, swollen muscles, feeling sick, weight loss, and sweating at night. The neck, hips, shoulders, and thigh muscles are most commonly affected.

What Are the Other Medical Conditions That Can Mimic Myositis?

Side effects of using steroids and statins, prolonged duration of alcohol consumption, hyper and hypothyroidism, vitamin D deficiency, varied calcium and magnesium levels, and clothes muscle-related abnormalities can mimic myositis clinically.

What Are the Tests to Diagnose Myositis?

  • Blood Tests:

    • Antinuclear Antibodies (ANA): To check for antibodies

    • Extractable Nuclear Antigens (ENA): To check for autoantibodies (treatment response)

  • Electromyography (EMG): Myositis is characterized by an atypical electrical activity pattern in a variety of muscles. This test is painless and a little uncomfortable.

  • Muscle Biopsy: Usually done in large muscles to check for inflammation. This can also be repeated if you do not respond to treatment as expected to check for proteins in the inclusion of body myositis.

  • Magnetic Resonance Imaging (MRI): This imaging can pick up areas of inflammation and sometimes areas of muscle damage, where the affected part of the muscle is replaced with fat.

How to Treat Myositis?

Steroids are the drug of choice for myositis, with a higher dose initially. Steroids are available both in tablet and injectable form. They instantly reduce inflammation, relieve muscle pain, and alleviate the feeling of being sick. Because high doses of steroids might have side effects, it is advisable to gradually reduce the dose. Long-term use of steroids raises the chance of developing osteoporosis, a disorder that causes bones to weaken and collapse more easily.

You can take medications in addition to steroids to lower your risk of getting osteoporosis. Bisphosphonates, for example, can help decrease bone loss. When the steroid dose is reduced, the manifestations of myositis may flare up, and your doctor may recommend other drugs to help lessen the inflammation. Routine blood tests will be required to check for probable side effects when using disease-modifying antirheumatic medications (DMARDs).

Drugs available for the management of myositis are

  • DMARD: Cyclophosphamide.

  • Biological therapy: Rituximab.

  • Immunoglobulin.

Biological Treatments:

Function by inhibiting certain immune system targets that induce inflammation. Immunoglobulins are antibodies derived from healthy people's blood donations that can prevent your immune system from attacking your tissues. This medication is normally administered as an intravenous infusion. During the therapy, you may feel a little sick at times. Myositis normally responds to therapy, even in extreme symptoms, though many people require lifelong medication to keep their illness under control.

Exercise:

Whenever the myositis is very severe, it's probably best to relax, but regular exercise can substantially relieve your symptoms and general wellbeing once it has settled down. Aerobic exercise helps you to breathe easier and your heartbeat quicker. It is particularly beneficial for restoring muscle strength and increasing stamina. At the beginning level, this should be done under the guidance of a physiotherapist who will create a personalized program for you. Physically demanding or intensive exercises should be avoided.

Physiotherapy:

To minimize the chance of extremities, especially the legs, becoming permanently bent, individuals suffering juvenile dermatomyositis will require more intense physiotherapy. Many features of the condition will be considerably improved if you exercise regularly and as regularly as possible.

What Are the Complications of Myositis?

Drug therapies may not always be effective, and muscles may remain weak. Lung inflammations can lead to scarring, altering how the lungs function. Long-term breathlessness can be caused by lung and cardiac diseases. If patients have a risk of developing these diseases, they should be referred to either a cardiologist or a pulmonologist. Calcium deposits in the injured muscles of children with dermatomyositis can be uncomfortable. These deposits can cause contractures and permanently inflexible joints when combined with a loss of movement. Myositis has been linked to cancer on rare occasions. The majority of myositis patients do not get cancer.

How Does Myositis Affect Prognosis?

Myositis patients can make a full recovery. On the other hand, some persons with severe symptoms might not fully recover. Even for those who fully recover, it can take months to see results because treatments require time to help the body restore muscles. People may become quite weary as a result of this.

Conclusion:

Many people with myositis respond to various steroids and immunosuppressive therapies. Steroids are often needed in low doses, but most cases can be easily managed with antibiotics.

Frequently Asked Questions

1.

What Are the Initial Symptoms of Myositis?

The first signs of myositis can vary depending on the specific type of myositis, but common early symptoms may include muscle weakness, fatigue, muscle pain or tenderness, difficulty swallowing, muscle stiffness, and trouble getting up from a seated or lying position. Additionally, some individuals may experience joint pain. 

2.

Is Myositis Curable?

No, myositis is a chronic condition, and while it may not be curable, it can often be effectively managed and controlled. Treatment approaches for myositis typically involve a combination of medications, physical therapy, exercise, and lifestyle modifications. The goal is to reduce inflammation, manage symptoms, improve the individual’s quality of life, and prevent complications associated with the disease condition.

3.

Is Myositis Considered a Serious Condition?

Yes, myositis is generally considered a serious medical condition. The severity and impact of myositis can vary depending on the specific type of myositis and the individual. In some cases, myositis can affect vital muscles involved in breathing and swallowing, leading to respiratory and swallowing difficulties that can be life-threatening. 

4.

What Is the Most Effective Treatment for Myositis?

The primary treatment for myositis often involves the use of steroids, which are typically administered at higher doses initially. Steroids can be administered orally as tablets or through injections. Their purpose is to rapidly reduce inflammation, alleviate muscle pain, and improve overall well-being. Physical therapy, exercise, stress management, and a balanced diet are important components of myositis treatment. 

5.

Is It Possible to Live a Full Life With Myositis?

Yes, it is possible to have a fulfilling life while living with myositis. While myositis is a chronic condition that requires ongoing management, with appropriate treatment and support, individuals with myositis can manage their symptoms, maintain a good quality of life, and the impact on daily functioning can be minimized.

6.

What Diagnostic Tests Are Used to Confirm Myositis?

Tests used to confirm myositis include blood tests such as antinuclear antibodies (ANA) and extractable nuclear antigens (ENA) are used to check for antibodies and autoantibodies associated with myositis, respectively. Additionally, electromyography (EMG) to assess muscle activity, muscle biopsy to examine tissue for inflammation, and magnetic resonance imaging (MRI) to detect inflammation and muscle damage may also be done.

7.

Is It Common to Have Myositis?

No, myositis is not considered a normal condition. It is an uncommon medical condition characterized by inflammation in the muscles when the body's immune system mistakenly attacks its own muscle tissue. While myositis is not normal, it does exist and can significantly impact a person's health and quality of life. It requires appropriate treatment to manage symptoms and prevent complications.

8.

Is Myositis Detectable Through Blood Tests?

Yes, myositis can be detected through blood tests. Specific autoantibodies related to myositis, such as antinuclear antibodies (ANA) and myositis-specific antibodies (MSAs), can be detected through blood tests. Elevated levels of muscle enzymes, such as creatine kinase (CK), aldolase, and lactate dehydrogenase (LDH), also indicate muscle inflammation and damage. 

9.

Does Myositis Have a Cancerous Nature?

No, myositis does not have a cancerous nature. However, certain types of myositis, such as dermatomyositis, are slightly more prone to developing certain cancers. Individuals with myositis must receive appropriate medical treatment and have regular follow-ups to monitor for any potential cancer-related risks.

10.

What Is the Primary Cause of Myositis?

The cause of myositis is generally considered to be a condition where the muscle tissues are attacked by the immune system itself (autoimmune disease). The exact cause responsible for the development of myositis is still unknown. However, factors such as injury, infection, autoimmune diseases like rheumatoid arthritis and lupus, viral infections, and drug toxicity may play a role in some cases of myositis. 

11.

Can Myositis Be Cured on Its Own?

In some cases, myositis can go into remission or resolve on its own. However, the course of myositis varies for each individual, and some individuals may require ongoing treatment to control the associated symptoms and prevent further complications. It is important to work closely with healthcare professionals to determine the most appropriate treatment approach for managing myositis.

12.

What Is the Typical Duration of Myositis?

The duration of myositis varies widely depending on the individual and the specific type of myositis. Some cases may be short-lived, while others may become chronic or recurrent. With appropriate treatment and management, many individuals are able to control symptoms associated with myositis and live life to the best of one’s ability.

13.

What Are the Natural Ways to Treat Myositis?

While there is no cure for myositis, there are some natural ways that can help manage symptoms and support overall health. These may include regular exercise, physical therapy, stress reduction techniques, a balanced diet, and adequate rest. However, consulting a doctor for a comprehensive treatment plan is important, as natural remedies alone may not effectively control the inflammation and progression of myositis.

14.

Wat Is the Duration of the Treatment of Myositis?

The duration of treatment for myositis varies depending on the individual and the response to treatment. In most cases, treatment is long-term and aimed at managing symptoms, controlling inflammation, and preventing complications. The treatment duration may extend for months or years, and regular follow-up with the doctor is necessary to assess treatment effectiveness and make any necessary adjustments.

15.

Does Myositis Eventually Cause Paralysis?

In severe cases, myositis can cause muscle weakness to the extent that it affects mobility and daily functioning. However, complete paralysis is rare in myositis. The majority of individuals with myositis experience varying degrees of muscle weakness, which can be managed and improved with appropriate treatment and rehabilitation.

16.

Is There a Risk Of COVID-19 for Individuals Associated With Myositis?

Individuals with myositis may have a higher risk of complications if they contract COVID-19 due to their underlying autoimmune condition and potential immune system dysfunction. It is important for individuals with myositis to follow recommended COVID-19 precautions, such as vaccination, wearing masks, practicing good hand hygiene, and maintaining physical distancing.
Dr. Nagaraj
Dr. Nagaraj

Diabetology

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