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Vibration disease


The vibration disease is caused long (not less than 3 — 5 years) by impact of vibration in conditions of production. Vibrations divide on local (from hand tools) and the general (from machines, the equipment, moving cars). Impact of vibration meets in many professions.

Reasons of a vibration disease:

The major etiological factors are production vibration, accompanying professional to harm: noise, cooling, a static stress of muscles of a shoulder, a shoulder girdle, the forced rejected position of a body, etc.

Symptoms of a vibration disease:

The clinical picture is characterized by a combination of vegeto-vascular, sensitive and trophic frustration. The most characteristic clinical syndromes: angiodystonic, angiospastic (Reynaud's syndrome), vegetosensorny polyneuropathy. The disease develops slowly, in 5 — 15 years from the beginning of the work connected with vibration, at further work the disease accrues, after the termination incomplete recovery is noted slow (3 — 10 years), sometimes. Conditionally allocate 3 degrees of a disease: the initial manifestations (the I degree) which are moderately expressed (the II degree) and expressed (the III degree) of manifestation. Characteristic complaints: pains, paresthesias, a chill of extremities, attacks of albication or cyanosis of fingers of hands when cooling, decrease in force in hands. At increase of a disease the headache, fatigue, a sleep disorder join. At impact of the general vibration complaints to pain and paresthesias in legs, a waist, a headache, dizzinesses prevail.

Objective symptoms of a disease: the hypothermia, a hyperhidrosis and puffiness of brushes, cyanosis or pallor of fingers, the attacks of "white" fingers arising when cooling is more rare in operating time. Vascular disorders are shown in a hypothermia of brushes and feet, a spasm or an atony of capillaries of a nail bed, decrease in arterial inflow of blood to a brush. There can be cardialgias. Increase in thresholds vibration, painful, temperature is obligatory, is more rare than tactile sensitivity. Disturbance of sensitivity has polyneuritic character. In process of increase of a disease the segmented hypalgesia, a gipapgeziya standing comes to light. Morbidity of muscles of extremities, consolidation or flabbiness of certain sites is noted.

On roentgenograms of brushes clustery enlightenments, small islands of consolidation or osteoporosis often come to light. At long (15 — 25 years) impact of the general vibration degenerative and dystrophic changes of lumbar Department of a backbone, the complicated forms of lumbar osteochondrosis often come to light.

Characteristic of the main syndromes of a vibration disease. Peripheral angiodystonic syndrome (I degree); complaints to pain and paresthesia in hands, a chill of fingers. Unsharply expressed hypothermia, cyanosis and a hyperhidrosis of brushes, spasms and an atony of capillaries of a nail bed, moderate increase in thresholds of vibration and painful sensitivity, decrease in skin temperature of brushes, the slowed-down its recovery after cold test. Force, endurance of muscles are not changed.

The peripheral angiospastic syndrome (Reynaud's syndrome) (I, II degree) is pathognomonic for impact of vibration. Attacks of albication of fingers, paresthesias disturb. In process of increase of a disease command extends to fingers of both hands. The clinical picture out of attacks of albication of fingers is close to a kangiodistonichesky syndrome. Preobladayetkapillyarospazm.

The syndrome of a vegetosensorny polyneuropathy (the II degree) is characterized by diffusion pains and paresthesias in hands, is more rare legs, decrease in painful sensitivity on polyneuritic type. Vibration, temperature, tactile sensitivity is reduced. Force and endurance of muscles is reduced. In process of increase of a disease vegeto-vascular and sensitive frustration come to light and standing. Attacks of albication of fingers become frequent and extended on time. Dystrophic disturbances in muscles of hands, a shoulder girdle develop (миопатоз). The structure of EMG changes, the speed of carrying out excitement on motive fibers of an elbow nerve is slowed down. Quite often the adynamy, a vasculomotor headache come to light. The vibration disease of the III degree meets seldom, at the same time the syndrome of a sensomotor polyneuropathy is leading. Usually it is combined by sgeneralizovanny vegeto-vascular and trophic disturbances, the expressed psychasthenia.

The vibration disease should be differentiated from Reynaud's syndrome of other etiology, a myelosyringosis, polyneuropathies (alcoholic, diabetic, medicinal, etc.), vertebrogenny pathology of a nervous system.

Treatment of a vibration disease:

Temporary or constant termination of contact with vibration. The combination of drug, physiotherapeutic and reflex treatment is effective. Ganglioblokator — Halidorum, Bupatolum, vasodilators — the niacin drugs, sympatholytics, drugs improving a trophicity and system of microcirculation are shown: ATP, фосфаден, компламин, trental, curantyl, injections of vitamins of group B, injection gu-mizolya. Chamber galvanic bathtubs with an emulsion of the Naftalan oil, an electrophoresis of novocaine, papain or heparin on a brush, a diathermy, UVCh or Ural federal district on area of cervical sympathetic nodes, diadynamic currents, ultrasound a hydrocortisone, massage, LFK are effective. Hyperbaric oxygenation is shown: Widely use resort factors: mineral waters (radonic, hydrosulphuric, iodine-bromine, nitric thermal), therapeutic muds.

Working ability of patients with a vibration disease of the I degree it is long remains safe; preventive treatment once a year with temporary transfer (for 1 — 2 month) for work without impact of vibration is recommended. And in particular the III degree needs to transfer patients with a vibration disease of II to work without vibration, cooling and an overstrain of hands; by it appoint repeated courses of treatment. At the II degree patients remain able-bodied in a wide range of professions. At the III degree professional and general working ability of patients is with firmness reduced.

Prevention consists in use of so-called vibrosafe tools, observance of the optimum modes of work. During replaceable breaks self-massage and heating of hands (sukhovozdushny thermal bathtubs) is recommended. Courses of preventive treatment are shown (1 — 2 time a year).

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