Muscle aches

Definition

Muscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia, the soft tissues that connect muscles, bones, and organs together.

See also muscle cramps and joint pain.

Considerations

Muscle pain is most frequently related to tension, overuse, or muscle injury from exercise or physically-demanding work. In these situations, the pain tends to involve specific muscles and starts during or just after the activity. It is usually obvious which activity is causing the pain.

Muscle pain also can be a sign of conditions affecting your whole body, like some infections (including the flu) and disorders that affect connective tissues throughout the body (such as lupus).

One common cause of muscle aches and pain is fibromyalgia, a condition that includes tenderness in your muscles and surrounding soft tissue, sleep difficulties, fatigue, and headaches.

Common Causes

• Tension or stress
• Overuse: using a muscle too much, too soon, too often
• Injury or trauma including sprains and strains

Muscle pain may also be due to:

• Polymyositis
• Dermatomyositis
• Lupus
• Fibromyalgia
• Polymyalgia rheumatica
• Infections, including:
  • An abscess in the muscle
  • Trichinosis (roundworm)
  • Influenza (the flu)
  • Lyme disease  
  • Malaria  
  • Rocky Mountain spotted fever  
  • Polio
  • Many others
• Electrolyte imbalances like too little potassium or calcium
• Rhabdomyolysis
• Drugs, including:
  • Cocaine
  • Statins for lowering cholesterol (such as atorvastatin, simvastatin, and lovastatin)
  • ACE inhibitors for lowering blood pressure (such as enalapril and captopril)
  • Many others

Home Care

For muscle pain from overuse or injury, rest that body part and take acetaminophen or ibuprofen. Apply ice for the first 24 - 72 hours of an injury to reduce pain and inflammation. After that, heat often feels more soothing.

Muscle aches from overuse and fibromyalgia often respond well to massage. Gentle stretching exercises after a long rest period are also helpful.

Regular exercise can help restore proper muscle tone. Walking, cycling, and swimming are good aerobic activities to try. A physical therapist can teach you stretching, toning, and aerobic exercises to feel better and stay pain-free. Begin slowly and increase workouts gradually. Avoid high-impact aerobic activities and weight lifting when injured or while in pain.

Be sure to get plenty of sleep and try to reduce stress. Yoga and meditation are excellent ways to help you sleep and relax.

If home measures aren't working, call your doctor, who will consider prescription medication, physical therapy referral, or referral to a specialized pain clinic.

If your muscle aches are due to a specific disease, follow the instructions of your doctor to treat the primary illness.

Call your health care provider if

Call your doctor if:

• Your muscle pain persists beyond 3 days
• You have severe, unexplained pain
• You have any sign of infection, like swelling or redness around the tender muscle
• You have poor circulation in the area where you have muscles aches (for example, in your legs)
• You have a tick bite or a rash
• Your muscle pain has been associated with starting or changing doses of a medicine, such as a statin (atorvastatin, simvastatin, or lovastatin)

Call 911 if:

• You have sudden weight gain, water retention, or you are urinating less than usual
• You are short of breath or have difficulty swallowing
• You have muscle weakness or inability to move any part of your body
• You have vomiting, a very stiff neck, or high fever

What to expect at your health care provider's office

Your doctor will perform a physical examination and ask questions about your muscle pain, such as:

• When did it start? How long did it last?
• Where is it exactly? Is it all over or only in a specific area?
• Is it always in the same location?
• What makes it better or worse?
• Do other symptoms occur at the same time, like joint pain, fever, vomiting, weakness, malaise, or difficulty using the affected muscle?
• Is there a pattern to the occurrences?
• Have you taken any new medications lately?

Diagnostic tests that may be performed include:

• Blood tests to look at CBC, muscle enzymes (creatine kinase), and possibly a test for Lyme disease or a connective tissue disorder

Physical therapy may be helpful.

Prevention

• Warm up before exercising and cool down afterward.
• Stretch before and after exercising.
• Drink lots of fluids before, during, and after exercise.
• If you work in the same position most of the day (like sitting at a computer), stretch at least every hour.

References

Dannecker EA. Self-care behaviors for muscle pain. J Pain. 2004; 5(9): 521-527.

Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004 Nov 17;292(19):2388-95.

Illustrations

Muscle pain

Muscular atrophy

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