Muscular hernia is a fracture of the fascia - the tissue covering the muscle. This phenomenon is most often caused by injuries and is quite rare. The most subject to him are sportsmen, especially runners.
Each of the bundles of muscle fibers is closed by connective tissue - fascia. When it breaks the fiber bulge into the resulting opening. Thus, a hernia of muscles is formed. Violation of the integrity of the fascia occurs when excessive load. It is accepted to divide a hernia into congenital and acquired. In congenital problems, the connective tissue that makes up the fascia is weak and thin.
For this reason, even a small load is enough to break it and form a protrusion. Acquired hernias are formed with injuries that may occur in different circumstances.
Causes of Acquired Muscular Hernia:
- Household injury,
- Excessive athletic load
- Surgical intervention that affects the condition of the fascia.
Most often, it is the traumatic effect that is the cause. With surgery, the problem rarely occurs. It is mainly caused by improper suturing, although damage to the connective tissue may also occur after purulent inflammation of a postoperative wound.
Only a doctor can diagnose a disease, as there is always a risk of confusing muscle hernia with another pathology. They confirm the diagnosis with an ultrasound and MRI, the doctor sees in the pictures a characteristic fascia tear and tissue swelling. It is worth noting that it is preferable to undergo an MRI scan in this case, since ultrasound is a less informative method of investigation.
In drawing up the history, the doctor takes into account such moments as injuries in recent times. The patient needs to remember whether there was pain during exercise and after it, and also to tell about all surgical interventions. On examination, the doctor finds a characteristic elastic tumor in the muscle, which is a hernia.
The treatment process depends on the patient's lifestyle, on the size of the hernia, and on what symptoms it is accompanied by. If, in addition to a person’s neoplasm, nothing is disturbing, neither pain nor movement disturbance, then no special treatment is given to the patient.
To reduce the size of the hernia, it is recommended to apply a tight retention bandage, and if the hernia appeared on the leg, then it is recommended to wear special therapeutic compression clothing. Stockings should be selected by a doctor taking into account the condition, since the compression of therapeutic models is different.
If the patient is worried about pain, then apart from a pressure bandage, pain relievers are prescribed. These can be non-steroidal anti-inflammatory drugs in the form of tablets, as well as ointments with analgesic and anti-inflammatory effects, such as Diclofenac, Ibuprofen, etc.
If there are signs of impaired blood circulation and sensitivity, ointment for vessels is prescribed, for example, Troxevasin and Lioton, as well as vitamins of group B. If muscle hernia is accompanied by hypertonic muscle, it is severely spasmized, then it may be necessary to take relaxing medications. Muscle relaxants are prescribed by the doctor individually.
In severe cases, when the hernia of the muscle becomes too large, causes a lot of inconvenience and does not respond to conservative treatment, surgical intervention is prescribed. The operation can also be shown to athletes who need to continue training.
The treatment consists in the restoration of the muscle with the help of vicrylpropylene nets, which self-absorb, and also release collagen to quickly restore muscle elasticity. This method allows muscle tissue to grow together correctly, without consequences.
There is another surgical method - the usual stitching of the edges of the muscle with each other. Such an operation in our time is extremely rare, since it is ineffective, especially among athletes. During physical exertion, a rough scar simply diverges and the hernia reappears.
Muscle hernia is a rather rare disease that occurs as a result of external influence (overwhelmingly from injury) and is characterized by a break in the fascia of a specific muscle. A fascia is a connecting tissue that covers the muscle, and that is why a muscular hernia occurs through a blow or a violation of the integrity of the muscle. This disease is most common in athletes and runners. In other cases, the hernia may manifest itself after surgery.
In the process of contraction, a hernia, when the fascia is broken, forms like a dome-shaped protrusion in the area of muscle damage. To the touch it is quite elastic and compacted during the contraction. Depending on the site of the hernia, the following areas of probable protrusion are distinguished:
- arm muscles (mainly in heavyweights),
- leg and calf area with recoil (observed in runners and track and field athletes),
- lower back (with excessive and constant physical exertion).
Unlike athletes, in which there are higher demands on the rehabilitation period, hernia in ordinary people does not cause difficult problems with vital activity and, quite often, does not require treatment as such.
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This disease is rare and very specific, therefore, in order to specifically identify the causes of the formation of these protrusions, it is necessary to consider the factors that may affect it. Depending on the type and location, the causes of occurrence can be divided into two subgroups - acquired and congenital. To the acquired can be attributed the following:
- breaks that can be caused by overload during exercise or training,
- surgical intervention that affects the integrity of the connective tissue sheath. The main criterion may be improper stitching,
- injuries resulting from hard shots.
In turn, congenital factors include the genetic properties of each patient and are characterized by weakening and thinning of the fascia of the muscle. Therefore, even easier damage can lead to the formation of muscle protrusion.
Most often the disease is observed in the thigh, at least - in the legs. In most cases, the symptoms for people who are not involved in active sports, does not manifest itself. But there are common symptoms that will always be present during the formation of a hernia:
- pain syndrome in which muscle pain is localized not only at the point of rupture, but also around it. The pointed form manifests itself during exercise,
- hernia swelling,
- reduction of limb mobility through acute pain and contraction of damaged muscle,
- numbness and tingling in the affected area through the indentation of the hernia of the nerve plexus.
Muscle hernia treatment
A mild form of hernia is treated by conservative treatment with drugs that relieve muscle pain (ointments and anti-inflammatory) and limit physical exertion on the affected area. Sometimes prescribe compression stockings. If the injury is sporty in nature and is not amenable to conservative treatment, then surgical intervention is prescribed by stapling the muscle fascia. In recent years, this method is practically not used because of possible complications in the form of bad seams and relapses.
Modern methods include the use of vicryl propylene grids, which are strong enough and exclude the possibility of infection. The net consists of 50% vicryl, which has the ability to gradually dissolve, the rest is propylene. Due to this, the affected area is securely fastened with a homogeneous body (propylene). After the operation, you should regularly visit the doctor's consultations and follow his recommendations for prevention and the possibility of re-illness.
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In simple words, you buy the usual anesthetic, and the disease continues to develop into a more difficult stage.
A common hernia can be a symptom of more serious diseases:
- Muscular dystrophy of the buttocks, thigh and lower leg,
- Pinch of the sciatic nerve,
- Seps - blood poisoning,
- Violation of the tone of the muscular wall of the blood vessels of the lower extremities,
- Horsetail syndrome, often resulting in paralysis of the lower limbs.
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Hernias usually result from a violation of the cycle of destruction and the restoration of muscle tissue. Another reason may be increased pressure or tension in a weakened area of the plot. Despite a fairly simple explanation, the illness occurs under the influence of a number of phenomena occurring in the body.
The appearance of a hernia on the muscle may be due to injury or structural features. The disease may occur due to a fracture or under repeated physical exposure to the surrounding tissue.
Muscle hernias are usually asymptomatic, although some foci can cause frequent spasms, cramps and pain in the process of performing any physical activity. When probing the site, you can notice a small neoplasm, which may be an indicator of neoplasia. Swelling may be invisible when the patient is in a relaxed state. This feature is important for a specialist and can help in the differential diagnosis of the disease. Ultrasound and MRI can be used to study the disease in more detail, although the first method is preferable because of its low cost and relative ease of use.
Treatment and risks
There is no single way to treat muscle hernia. Pockets that exhibit minimal symptoms can be treated by a conservative method by limiting muscle mobility through elastic fixatives. Reducing physical activity is one of the additional methods. Surgical intervention is used for injuries that cause serious discomfort. Direct removal of the defect is the only available technique in the implementation of the operation. It should be noted that the use of instrumental methods of excision of the hernia is not always possible, and the probability of re-formation of the disease is quite high.
The risk of disease is significantly higher in all men and women over 35. People with birth defects often suffer from the disease. There are studies that associate the likelihood of damage with frequent smoking, since this addiction can disrupt the appearance of important enzymes that can positively influence cell creation and growth. However, muscle hernia is a rare occurrence, and therefore making such a diagnosis is unlikely for almost any patient.
Causes of muscle hernia, its signs and methods of treatment
Muscle hernia is a rather rare clinical condition. In most patients with this disease, it is not even diagnosed. Muscular hernia on the leg acquires special importance only in professional athletes, since it leads to limitation of physical exertion.
What is this disease? Normally, the muscles are covered with a dense connective tissue fascia. The weakening or rupture of this membrane leads to a protrusion of muscle fibers and the formation of a hernia.
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- Injuries directly to the muscle itself. They can be obtained during sports, with a fall, a strong blow.
- Another cause of muscle fascia damage is surgery. In such cases, the connective tissue sheath weakens due to the failure of the surgical suture.
- Damage to the fascia due to excessive muscle tension. For example, with excessive physical effort. Sometimes it can be a sharp jerk movement, for example, the start of the runners.
Constitutional causes include genetically determined weakening and thinning of the muscle fascia. In this case, any, even not too strong injury, can lead to the formation of a hernia.
What are the manifestations of the disease?
Most often, muscle hernias are located on the thigh, less often in the lower leg region (tibial, and sometimes gastrocnemius muscles). The disease often has non-specific symptoms. Therefore, most people who are not professionally connected with an increased load on the muscles do not even suspect that they have a muscular hernia. The main symptoms include:
- The presence of pain. As a rule, pain is localized in the area of damaged muscle and increases with physical exertion. Acute muscle pain can also cause miglosis. In rare cases, there are painless forms, they impede timely diagnosis.
- The presence of a local tumor formation in the damaged muscle. Hernial protrusion is small, elastic to the touch. With muscle contraction, it becomes more dense.
- Edema. There may be a slight swelling in the hernia area.
- Impaired limb function. When the defect is located near the site of attachment of the muscle, limitation of movement of the limb may be observed due to pain, and subsequently due to the development of contractures.
- The presence of paresthesias (tingling) or numbness in the affected limb. Such symptoms may occur due to compression of hernia located near the nerve trunks or plexuses.
Muscular hernia should be distinguished from such pathology as miglosis. Migeloza (they are also called myogeloza) are small nodules located in the muscle tissue. They are painful on palpation and can cause pain in the entire muscle. Usually they are combined with her defense (tension) and soreness.
Myogeloses are localized in the areas of primary load on certain muscle groups. For example, in basketball, they are located more often in the muscles of the shoulder girdle and back, in runners and football players - in the area of the thigh, lower leg.
What is the diagnosis of muscle hernia?
As already noted, quite often muscle hernias are not diagnosed at all. You can suspect the presence of this pathology already during the initial examination. At the same time, painful elastic "tumor-like" formation in the muscle area can be identified.
The main method for diagnosing the disease is MRI. At its carrying out thinning of a connective tissue muscular fascia and protrusion of a muscle site is defined. The photo below shows an example of an MRI picture of a hernia of the leg muscle, the arrows indicate a muscle defect.
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On the photo - the image of muscle hernia
Ultrasound is also used for diagnosis. It is more accessible than MRI, but is not always able to detect thinning of the muscle fascia. In order to diagnose miogelozy, an MRI or ultrasound is not required. In such cases, most often it is enough just a primary examination by a doctor.
What are the methods of treatment of this pathology?
If the hernia is asymptomatic, then no treatment is required. In milder forms of the disease, limitation of physical exertion and wearing compression stockings is recommended. Pain medications may also be prescribed (Diclofenac, Movalis).
The hernia treatment is described in detail in the video:
With the ineffectiveness of conservative therapy, as well as in cases where the muscular load is associated with professional activity, surgical treatment is carried out. The simplest method is stitching the muscle fascia. Such an operation can be carried out with a small defect in the muscle membrane and the possibility of its connection "edge to edge". In recent years, this method has practically not been practiced because of frequent complications such as inconsistency of the sutures and hernia recurrence.
Therefore, plastic hernial defect is most often performed using vicrylpropylene nets. These nets are strong enough, consist of 50% of vicryl, the rest is propylene. Vicryl gradually resolves, only the propylene part remains. The result is a fixation of the fascia without excessive tension. The complications of such treatment include cases of infection or allergic reactions, since after the operation a foreign body remains in the body (the propylene part of the mesh).
Miglosis is treated as a rule, conservatively. The treatment consists of a special massage, in which painful myogeloses warm up. A good effect is also given by physiotherapeutic methods of treatment. Additionally, analgesics and warming ointments may be prescribed.
Prevention of muscle hernia and migloses
Prevention in athletes is the correct distribution of loads on muscle groups. Before training, a mandatory set of exercises is recommended, aimed at "warming up" the muscles. This helps prevent miglosis and muscle hernia. After excessive loads, a preventive massage is recommended.
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Causes of the disease
The disease is rare, its occurrence depends on the effects of various factors. There are congenital and acquired protrusions.
The main causes of muscle hernia are:
- mechanical injuries and injuries during training or sports,
- muscle injuries from shock or fall,
- excessive weight lifting or bodybuilding,
- genetic predisposition
- structural features of the body and body,
- complications after surgery, interference with the integrity of connective tissues.
A combination of several factors at once is especially dangerous. With genetic predisposition, even a small bruise will trigger the development of pathology.
Most often, the disease is formed in such parts of the body:
- upper and lower extremities (hernia of biceps and knee joint),
- shoulder and forearm area
- lower back and lower back (protrusion of the spinal disc),
- in the intercostal space and sides (when lateral physical activity prevails).
The affected area depends on the type of sport a person is engaged in and which group of muscles is subjected to the greatest physical exertion. Bodybuilders can have bulges in any part of the body, even under the arm.
Symptoms of pathology
It is rather difficult to reveal a muscular hernia, the symptoms are mild and not pronounced. To detect it, you need to constantly monitor the state of health and the presence of deviations. The following clinical manifestations exist:
- The formation of a soft protrusion in the affected area. Education may disappear if the muscles are in a relaxed state and become more dense and elastic in the presence of physical activity.
- The presence of swelling on the affected area.
- Pain syndrome. Localized in the area of damage, increases with movement and physical exertion. Pain can be felt in the left side and in the right side, depending on the location of the hernia.
- The presence of a small swelling of the tissues around the hernia.
- Impaired motor functions due to the presence of painful symptoms during contractions of damaged muscles.
- The appearance of numbness, the formation of paresthesias caused by the compression of the nerve trunks of the hernia. Occur with severe injuries, sudden increases in gravity.
- Formation of hematomas if blood vessels are injured.
- There is itching and burning in the affected area.
From such manifestations, it is possible to determine that a hernia is developing. To prevent the formation of complications and serious consequences, it is necessary to begin its treatment in the early stages. For professional athletes, this is especially important, as they may lose their shape and will not be able to do their sporting activities anymore. Therefore, you should know how pathological deviation looks and how it manifests itself.
Variety of types and species
Usually the names of hernias correspond to the place where they occur. Most often, surgeons encounter inguinal and umbilical hernias. These statistics are very contradictory, but most experts believe: this problem in the structure of all surgical diseases takes one of the first places.
According to European researchers, hernia occurs in about 2% of the population. Of all this amount of hernia, inguinal make up about 90%. A strong half of humanity is most susceptible to them, in women an inguinal hernia occurs 2 times less frequently.
Speaking figuratively, a hernia is a hole through which internal organs can fall out under the skin: for example, the omentum or the intestinal loop. These "holes" come in different sizes - from very small to large and even giant, "with the head of a prominent scientist." They arise where there are weak spots in the muscular aponeurotic layer (an aponeurosis is a wide tendinous plate formed from dense collagen and elastic fibers that serves to attach muscles). Hernias are congenital and acquired, there are still postoperative - they are formed as a result of discrepancies between previously applied sutures.
Unfortunately, the prevention of hernia is impossible. The main cause of their occurrence is weakness of the connective tissue, a person cannot know whether he will be at risk or not.
At the initial stage, this disease may not manifest itself as pains - the person just feels discomfort, notices a slight swelling in the groin or navel. But if intestinal loops get into the hole (the so-called hernial ring) and are infringed, there is a sharp pain. Then the clock goes to the clock: deprived of blood supply, this part of the intestine can die off and lead to death. So the presence of a hernia is a serious threat to human health and life!
Treat means to operate
The treatment of any hernia is exclusively surgical. Contrary to popular belief, it can not "cut" - just sew. Otherwise, it behaves in the same way as a non-stitched hole in clothes — it increases over time, stretches. Unfortunately, it is not necessary to rely on the fact that “it will resolve itself”: neither independently nor under the influence of gymnastics, drugs or a bandage, the hernia will not disappear. Long conservative therapy only leads to an increase in its size and complicates the operation.
Therefore, doctors warn all patients - operate as early as possible until it hurts. It is much simpler and better for health to do a planned operation with all the necessary preparation and analysis than in an emergency situation, when the infringement has already occurred. And it is much more difficult for doctors to operate a large hernia: it is not just a disease that has to be dealt with, but often its complications, because when the intestine goes into the hernia sac, inflammation and adhesions may occur.
If the hernia of the anterior abdominal wall is large, the likelihood of infringement is less, but another problem appears: a large number of intestinal loops fall under the skin, so that after ablation and stitching, the abdominal pressure rises sharply, therefore, respiratory function is disturbed. Such patients need to specifically prepare for the operation - wear bandages and even special suits.
Unfortunately, Russian patients, unlike their Western “comrades in misfortune”, often go to a doctor only when they cannot walk on their own. But the earlier the treatment is carried out, the higher the chance that it will be successful and less traumatic. And the smaller the hernia - the smaller the volume of the operation, the easier it is for the surgeon to operate and recover the patient.
The best way
The traditional method of surgical treatment of hernias of any localization, including the inguinal and umbilical, is the so-called tension technique, hernia repair with the strengthening of the wall of the hernial canal tightened and sewn together with each other's own tissues.
In the entire history of surgery, hundreds of variants of such an operation were invented. And despite this, the probability of hernia recurrence is about 10-15%. Moreover: repeated operation increases this probability up to 50%! Such a progressive increase is explained simply - dissected and stitched fabrics give a scar, and a scar - a weak tissue.
Since the beginning of the 90s of the last century, laparoscopic hernia repair with plastic mesh has been increasingly used in Russia. Returning to our comparison of a hernia with a hole on clothes, you can compare the traditional plastic with the way inexperienced housewives do: they fasten the edges of the hole and put a seam that quickly spreads back.
An experienced hostess puts a patch - a laparoscopic operation is based on this principle. From the inside, a mesh is inserted into the hernial orifice and is fixed in a special way. Then, like a skeleton, it grows through vessels, nerves, connective tissue and keeps very firmly. The percentage of relapses during laparoscopy is only 0.01%! And they arise only in cases where the patient in the first month violates the protective regime: for example, he will take his beloved woman in his arms ...
Previously used nets made of synthetic materials that are not rejected by the body - prolen or propylene. But no matter how good the implant is, the less foreign material the better. Now they began to make meshes combined: some of the fibers - the same prolen, and some - vicryl, suture material, which is absorbed after 90 days.
Laparoscopic surgery is also good because it is performed through three punctures, without an external incision, this eliminates the possibility of suppuration. Another plus is that on the first day after laparoscopy (as opposed to open intervention), anesthesia with narcotic analgesics is not required. And in general, the rehabilitation period is shorter and much easier: the patient can walk already on the day of the operation, and on the third day go home. After traditional plastics, a three-month limit on physical activity is recommended, and during laparoscopy, a protective regimen is prescribed for a month.
In any case, there is no need to be afraid of operations for suturing hernia - now their equipment has been worked out to the smallest detail. The main thing is to contact a competent specialist and do it without delay!
Excessive exercise, weight lifting, a sharp increase in intra-abdominal pressure (for example, with a strong cough) provoke the appearance of hernias. The risk factors can be otnosti and age - because over the years, people weaken physically, and the aponeurosis begins to exfoliate, like a decrepit fabric. But quite often a hernia occurs in physically strong young people, in athletes with relief muscles.
Where are formed
A hernial protrusion can form anywhere, but muscle hernia on the leg is most common. The legs are subjected to the greatest stress, so injuries often occur right here. However, athletes of different specialization may be at risk and other muscle groups. For example, skiers, athletes, or football players most often suffer from hip or lower leg, and from tennis players or paddlers of the shoulder muscle. Muscular hernia on the back is possible with constant high physical exertion.
Injuries that could cause a break in the fascia:
- Bad move
- Sharp jerk
- Heavy object drop
Postoperative hernia of the muscles threatens those who have undergone the surgery itself not very well or have complications with a suture. In general, such a hernial protrusion happens rather rarely, but abdominal surgery carries the greatest threat, therefore, after surgery, such a complication is possible.
The main manifestation of this problem is protrusion in the field of education, which can be permanent or appear only when a muscle is stressed. Other manifestations are associated with the processes occurring in the tissues in connection with pathology. Since there is damage, swelling is inevitable, which can compress the surrounding tissues or nerve pathways.
- Pain syndrome, which can be felt under load or constantly, can extend not only to the area of damage,
- Reduced limb mobility due to pain, swelling and tissue damage,
- Tingling and numbness in the area of the hernia due to pressure on the nerve endings
- Hematomas in the area of damage.
Hernia itself looks like a tumor-like protrusion or dome-shaped swelling. It is elastic, but with a contraction of the muscle it is compacted. All symptoms, especially pain, are aggravated by physical exertion. Severe limitation of mobility is usually observed with significant damage, as well as with improper or late treatment.
- Medical examination and anamnesis
Suspicions of a hernia of the muscles arise from a specialist if he is faced with pain and the presence of a dome-shaped protrusion that has arisen after an injury. Based on the patient's complaints and the clinical picture, the doctor makes a preliminary diagnosis.
An ultrasound or MRI scan is done to detect a muscular facies rupture. This allows not to confuse muscle hernia with myelosis, which has similar manifestations and is accompanied by the formation of nodes in the thickness of the muscles.
Mild damage does not require the help of a specialist, the body gradually cope with the problem itself. In the presence of pain and slight edema, it is necessary to limit movement and load. Anti-inflammatory and analgesic ointments will help reduce pain and recover faster. In some cases, compression stockings are shown for injuries in the lower leg or thigh region. They will help the muscle to take up its normal position and reduce the load on adjacent tissues.
If symptoms include the appearance of hematomas, then in addition to painkillers and anti-inflammatory drugs, drugs are prescribed to improve local blood circulation, such as Troxevasin or Liotone in the form of gels. They are easily absorbed into the skin, leaving no residue on clothing. When muscle spasms need muscle relaxants, and in the presence of numbness or other manifestations of compression of the nerve endings are shown vitamins of group B.
Surgical treatment is prescribed in cases where the damage cannot be repaired by conservative methods. This usually occurs with serious sports injuries.
Such treatment is carried out by stitching the muscle fascia or stitching vicrylpropylene nets into the place of the fascia rupture. In most cases, the second method is used. Vicrypropylene grids support damaged, weakened tissue for the first time. They gradually dissolve, but contribute to increased production of collagen. As a result, the shell reliably strengthens and maintains muscle fibers in a normal state.
A pinched nerve usually occurs with osteochondrosis as a complication. Osteochondrosis is a degenerative disorder in the spine, in which there is a violation of blood circulation, muscle spasm, as well as pinching of nerve endings.
Accompanied by this state of sharp pain, a violation of motor activity, there may also be weakness in the affected part of the body. Due to the disruption of the nerve, sensitivity is reduced, a person may feel numbness, unpleasant tingling, and muscle spasm often occurs.
Unlike a hernia, a pinch requires urgent and competent treatment, as it causes a person great pain and a lot of inconvenience. If you have severe pain in any part of the body, you need to follow the following recommendations:
- First of all, it is necessary to provide the patient with rest, try not to move the affected part of the body, especially sharply. Movement can cause deterioration and increased pain.
- The patient needs to sleep more, during sleep the muscle tone is reduced, the body is restored. After sleep, all patients talk about relief, pain decreases.
- To relieve swelling and pain, it is recommended to apply contrasting compresses, first cold and then warm.
- In the event that the patient cannot stay at home, and he needs to go to work, the condition can be alleviated by immobilization. For this it is recommended to use a tire or bandage.
- Very effective for pinching massage. It is best to visit a special massage room, where the procedure will hold a professional. At home, you can slightly alleviate the condition of the patient, if gently stroking and rubbing the sore spot, but the main thing is not to press, so as not to worsen the patient's condition.
- It is best to pinch the nerve immediately to a doctor who will recommend the tire, drugs to relieve symptoms and ointment, so that the sore spot recovers faster. Most often, when pinching nonsteroidal anti-inflammatory drugs are prescribed, they effectively relieve pain and eliminate inflammation in the tissues.
It is important to note that after pinching the muscles are weakened and there is always a risk of relapse. Therefore, you need to take time to prevent disease. To do this, you must first do medical gymnastics to strengthen muscle tissue and improve circulation.
The best exercise for this purpose is suitable for stretching, yoga, classes in the pool, the usual morning exercises. After pinching the nerve, you need to stop training in the gym for some time, since excessive loads can greatly worsen the condition and provoke a relapse.
An excellent preventive measure is the general massage, which is recommended for each person to undergo at least once or twice a year. Massage relaxes muscles, removes increased tone, fatigue and normalizes blood circulation, makes muscle tissue more elastic.
No less important is the role of the patient. During the recovery period and after it, food should be complete and healthy, it is recommended to eat more vegetables and fruits of protein foods, such as meat, cottage cheese, eggs. To exclude from the diet you need fatty, fried, canned, sweets and other harmful foods.