Теоретически боль в грушевидной мышце не является причиной тяжелого заболевания, однако светлые будни этот недуг ухудшает заметно и при отсутствии соответствующего лечения вполне может вызвать осложнения. А именно нарушить функциональность мышц и спровоцировать деградацию суставов.
Попробуем разобраться, что представляет собой грушевидная мышца, где находится, каковы причины синдрома и как его лечить.
Этиология и суть синдрома
Проявление данного синдрома связано с передавливанием седалищного нерва и сосудов, которые находятся в подгрушевидном отверстии таза, однако главным фактором компрессии является пораженная грушевидная мышца, расположенная около этого отверстия ближе к седалищному нерву.
Отверстие под ней относится к части седалищного тазового отверстия щелевидной формы, которое ограничено нижним краем поврежденной мышцы, крестцово-бугристой связкой и верхней близнецовой мышцей.
В анатомии из полости таза в ягодичную часть через такое отверстие выходят нервы: седалищный и задний, относящийся к бедру, а также к сосудисто-нервным пучкам ягодиц, которые не в силах противостоять внешней компрессии даже несмотря на то, что наделены фасциальными футлярами.
При сокращении мышцы утолщается ее брюшко, провоцирует сужение отверстия, прижимание сосудов и всех нервов к расположенной рядом кости и крестцово-остистой связке. Эти факторы являются основной причиной возникновения симптомов.
Однако большее давление приходится на седалищный нерв, соответственно, главная проблема недуга — невропатия.
Синдром грушевидной мышцы может быть двух видов: первичным — возникает единожды и не повторяется, и вторичным, который проявляется в случае мышечно-тонического синдрома, возникающего в патологиях иного характера.
На долю нарушений второго вида приходится около 85% клинических случаев.
Причины как в первом, так и во втором случае могут быть следующие:
- Симптомы и признаки
У большинства пациентов болевой синдром начинает свое развитие в поясничном отделе, что относится к люмбалгии. Однако на протяжении пятнадцати дней недуга его можно отнести к люмбоишиалгии, так как за это время болезнь принимает тяжелый характер из-за того, что мышечные волокна, находящиеся под напряжением, еще больше сдавливают седалищный нерв.
Симптомы могут быть трех видов:
- Нейропатические — проявляются защемлением нерва, который захватывает зону от ягодицы до пальцев на ногах.
- Локальные — подтверждаются спазмами в мышце.
- Сосудистые — связаны с ухудшением кровоснабжение тканей, проявлением неблагоприятных симптомов из-за непоступления в организм кислорода и питательных веществ.
Международная группа ученых, исследуя мышечно-тонический синдром, выявила его основные признаки:
- Боль внутри мышцы.
- Боль в ягодичной части и в пораженной мышце.
- Постоянный мышечный спазм, вызывающий тягостную и ноющую боль в пояснице и крестце, усиливающийся при физических нагрузках, смене погоды и стрессах.
- Онемение конечностей, одеревенение ног, а также чувство жжения и ползания «мурашек», и холод на стопах и пальцах.
Большинство симптомов проявляется группами. Когда боли смежные, выявить синдром становится сложнее, поэтому проводится диагностика.
Чтобы предупредить рецидив необходимо придерживаться рационального лечения и корректировать сформировавшиеся двигательные стереотипы с помощью медикаментозного лечения, физиотерапевтических процедур и ЛФК. Довольно популярны и эффективны методы Бубновского и упражнения на МКБ.
Так как данный синдром не является самостоятельным заболеванием, медикаментозное воздействие поможет снять боль только на некоторое время, но при этом не излечит воспаление полностью. Снять отек и расслабить мышцы можно при помощи противовоспалительных медикаментов, спазмолитиков и анальгетиков.
Средства противовоспалительного действия гасят боль и спазм, блокируют очаг, воздействующий на мышцу, предотвращают воспаления смежных тканей, устраняя при этом воспаление пораженных. Медики рекомендуют внутримышечное введение лекарств, так как такой способ воздействует на защемление нерва быстрее, а препарат проникает в волокна глубже. В данном случае популярны следующие лекарственные средства: Кеторолак, Мелоксикам, Диклофенак и другие известные препараты. Если боль очень сильная, к данным лекарствам добавляют анальгетики.
Для того чтобы снять напряженность мышц. назначаются спазмолитики. В основном предпочтение отдается лекарствам на основе дротаверина. Если спазмолитики не в состоянии помочь больному, назначается курс миорелаксантов (Мидокалм — самый распространенный) и обкалывание пораженной мышцы растворами с содержанием новокаина или лидокаина.
Для устранения боли и мышечного спазма проводятся следующие физиотерапевтические мероприятия: прогревание УВЧ; электрофорез с Гидрокортизоном, ультразвук и парафиновые аппликации.
Но при мышечно-тоническом синдроме, проявляющемся в тканях мышцы, обезболивающих способов недостаточно. В этом случае важно комплексное лечение: сочетание миорелаксантов с массажем пораженной области, а также физиопроцедуры с лечебной гимнастикой.
Самый действенный способ лечения воспаления грушевидной мышцы — это регулярные упражнения специального назначения. Лечебная гимнастика поможет расслабить спазмированную мускулатуру, растянуть и активизировать сокращенные мышцы, расположенные как вокруг поражаемой части, так и мышцы, с ней связанные.
Чтобы достичь результата, необходимо выполнять заданные упражнения строго по порядку:
Лечение в домашних условиях
Одними медикаментами и физиотерапевтическими методиками не победить воспаления. Поэтому к этим способам лечения и ЛФК можно добавить массаж, который также действенно снимает спазмы и стабилизирует кровоток не хуже препаратов с насильственным, но, к сожалению, кратковременным действием. При этом для этого необязательно посещать профессионального массажиста, можно попросить родственников помочь. Вместе с усилиями врача это способно вернуть безболезненные будни и легкость в ходьбе.
Способы альтернативной медицины направлены скорее на снятие болей, требуют много времени и часто не приносят желаемого результата, так как лечение в большей степени зависит от самого больного и его отношения к здоровью.
Чтобы мышца перестала болеть, многие прибегают к народным методам, используя различные настои.
Рецепты для лечения:
- 250 мл одеколона смешать с аптечной настойкой боярышника (половиной бутылочки), таким же количеством валериановой настойки, 10 таблетками анальгина и дозой перцовой настойки из красного перца. Настоять сутки, затем втирать в пораженную мышцу три раза в течение дня.
- Смешать 500 мл спирта и 60 граммов цветков конского каштана (продается в аптеках), сутки настоять, сделать компресс, пропитав марлю в настое, и прикладывать на ночь в течение десяти дней.
- В равном количестве соединить цветки чабреца, календулы и калины. Две ложки цветков залить кипятком, настоять в течение часа и пить по трети стакана до еды.
Все действия, связанные с народными способами лечения, необходимо скорректировать с доктором. И в случае запрета их использования придется воздержаться от них.
Также стоит знать, что нельзя использовать одни и те же методы дольше одного месяца, так как организм к рецептам быстро привыкает и перестает на них реагировать.
Чтобы избежать неприятных симптомов, достаточно бытовой осторожности. Если с органами таза и позвоночником никаких проблем нет, значит, синдром грушевидной мышцы вам не грозит. Однако это не исключает возможности получить его, если не избегать непосильных нагрузок и переохлаждений. Не рекомендуется также долгое время находиться в одной позе. А для гарантии своей безопасности не лениться при малейших намеках на радикулит обращаться к врачу, ведь если своевременно не уточнить причину развития синдрома, можно пропустить возникновение более серьезных заболеваний.
Болевые ощущения в области ягодиц, постепенно распространяющиеся на ноги, иногда возникают после неудачного укола или вследствие развития патологий тазовых органов. Одной из таких болезней является синдром грушевидной мышцы (СДМ). Встречается он достаточно часто, и главная проблема этого заболевания заключается в сложности диагностирования. Ведь в основном боль имеет непостоянный характер и проявляется лишь в определенном положении ноги. Несмотря на такую непростую задачу, выявить спазм грушевидной мышцы следует при появлении первых симптомов, чтобы снять компрессию с седалищного нерва. В таком случае нервные пути быстро восстановятся, а дискомфорт вскоре пройдет.
Сложно понять особенности этого синдрома, не зная, где находится грушевидная мышца. Увидеть ее локализацию можно на этом изображении: Признаки компрессии
Синдром грушевидной мышцы имеет симптомы свойственные такому виду воспаления и по ним можно понять, как снять спазм. Однако признаки этой патологии часто отличаются, ведь компрессия может произойти не только с нервом, но и артерией, которая его питает. Основные проявления воспаления грушевидной мышцы выглядят следующим образом:
- Признак Бонне-Бобровниковой. Для этого симптома свойственна боль, которая проявляется в определенном положении ноги. Обычно для выявления наличия этого признака пациента кладут на кушетку и сгибают его нижнюю конечность в области таза и в колене;
- Болевые ощущения ноющего характера. Они проявляются если человек долго стоит или ходит. В этот момент возникает неприятное тянущие ощущение в ноге, которое уменьшается в лежачем или сидячем положении;
- Дискомфорт в районе седалищной кости. Врач может найти этот признак с помощью пальпации. Его выполняют рядом с седалищным нервом;
- Болезнь тазового дна. Если снимать спазм грушевидной мышцы не удается долгое время, то это может свидетельствовать о повреждении других мышечных тканей в этом районе;
- Признак Виленкина. Он проявляется в виде болевых ощущений вследствие постукивания по задней половине нижней конечности. Читайте также: Мазь против отеков после перелома
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