Zur Therapie von Muskelkater, Myalgien, Krampi und Myotonie

Abstract

Muscle soreness and myalgia are very common neuromuscular entities. Muscle soreness is caused by sarcolemmal and sarcomeric micro-injury whereas myalgia is predominantly caused by ischaemia-associated local alterations in proton concentration or content, changes in tonus of the sympathic nervous system, or specific alterations of the muscle metabolism. Cramps frequently originate from either proximal motorneuron alterations or from modifications of the terminal intramuscular nerve branches. Nevertheless, often the precise source or even the origin of these neuromuscular entities remains hidden. In contrast, over the last 2 decades, all classic myotonic syndromes have been genetically proven to be specific ion channel disorders. For numerous gene mutations in, e. g., muscular chloride or sodium ion channels the particular mechanism of myotonic discharges has been discovered. Nevertheless, there is still a lack of clear-cut drug treatment options for these neuromuscular entities and disorders. Up to date studies of treatment options are lacking. Thus, based on clinical experience, non-steroidal anti-inflammatory drugs and inhibitors of ion channels are commonly used. An update of these drugs is given here. As a rule of thumb, aerobic exercise training using bulky muscle groups that keep constantly and are rhythmic and aerobic in nature, e. g., jogging, cycling or swimming, seem to be a prophylactic therapy for any type of muscle alterations. Therefore, every patient with a neuromuscular disorder should have access to an individual adapted aerobic endurance training.