What are causes, symptoms, and treatments of muscle pain?

Causes of muscle pain fall into a few general groups, as follows: injury or overuse; stress; autoimmune disease; neurological and muscle disorders; infection; obstructed blood flow, or drug side effects.

Injury

Symptoms of muscle injury include pain, weakness, bruising, swelling, and cramping (involuntary muscle spasms and contractions).

Injury can result from:

  • Blunt force trauma caused by a strong impact to the body.
  • Muscle strains, soreness, pulls or tears are anything from a simple overstretching of a muscle all the way to a complete tear. Accidents, falls, sudden twisting motions, and athletic activities are frequent causes.
  • Repetitive motion injury as seen in occupations or activities that use the same movements day after day. Occupational examples could include data entry typists all the way to heavy manual laborers. Following the same exercise routine or focusing exclusively on one sport might also be a cause.
  • Overuse injury, often seen in athletes competing in sports such as hockey, football, boxing, wrestling, soccer, and track and field. The muscle fibers can be predisposed and are prone to injury when the same activity is performed, over and over, without any variation. Muscle are dynamic and need to move in many directions to remain functional. Exercises should be performed as such, to avoid exposing the muscle fibers to the same repetitive force.
  • Improper warm up and cool down is one of the most common causes of muscle strains in an athletic individual. The fibers in muscles are able to do their job based on their ability to lengthen and contract; the better their motion, the less chance of injury. Spending 5 minutes before and after exercise to focus on stretching muscles and performing low intensity activities (like a very light jog, or 25% of the weight you were just lifting) can help to prevent muscle strains from occurring.
  • Myofascial pain syndrome (MPS) is a chronic (long-term) condition characterized by inflammation and pain in the body’s fascia, the connective tissue that covers the muscles. MPS can affect one muscle or an entire group. Causes include injury or excessive strain on a particular muscle group, ligament or tendon; injured vertebrae; repetitive motion, or lack of activity (such as when a limb is placed in a cast). Treatments include physical therapy, massage, and injections of pain relievers and steroids.
  • Poor posture can cause muscle pain and tension, as unnatural body positions place strain on muscles and soft tissues. Poor posture includes slouching in a chair; extreme curvature in the lower back caused by wearing high heels or by excess weight around the midsection; leaning on one leg; hunching the back; thrusting out the chin; rounding the shoulders, and cradling a telephone between the neck and shoulder. Besides being aware to keep the body in line, specific exercises are available to assist in correcting poor posture habits.
  • Poor form while exercising can predispose to significant muscle injury, especially when a large force, such as weight lifting, explosive activities, or prolonged endurance of an activity is placed on top of poor form.
  • Compartment syndrome: Compartments are groups of muscles, nerves, and blood vessels in the arms and legs, covered by a tough fascia. Compartment syndrome occurs when an injury causes swelling and bleeding within a compartment, increasing pressure on surrounding blood vessels, nerves and muscle to the point of choking off adequate nourishment and oxygen. The front part of the lower leg is most frequently affected but the arms, hands, feet, and buttocks may be as well.
    • Acute: Occurs after a severe accident or broken bone and should be treated as a medical emergency. Surgery is often needed to relieve the pressure within the compartment.
    • Chronic (exertional): Exercise, particularly repetitive motion activity such as running, biking, or swimming, leads to pain or cramping. Discontinuation of the activity and cross-training will usually bring relief.

Stress and tension

Psychological or physical stress can lead to muscle tension, the body’s automatic reflex to guard against injury and pain.

Sudden stress may cause muscles to tense up but once the stress passes, the tension is released. In chronic (long-lasting) stress, muscles may remain in a near constant state of tension, leading to pain and headaches if tension is felt in the shoulders and neck. If a person reacts to stress by reducing physical activity, muscles may begin to shrink (atrophy) due to lack of exercise, thereby making it even more difficult to escape the cycle of pain.

Learning psychological coping mechanisms and taking part in adequate physical exercise can improve how one deals with stress or chronic pain, and in turn reduce the negative effects of stress on the muscular system.

Infections

  • Respiratory and viral infections, such as colds and influenza (flu): Muscle pain is one of many symptoms of these infections, which also includes fever, chills, sore throat, headache, cough, stuffy or runny nose, and general fatigue.
  • Malaria: A potentially serious to fatal disease caused by the transmission of parasites from the bite of the Anopheles mosquito. Overall body aches and weakness are accompanied by fever, sweats, chills, headaches, nausea, abnormal blood metabolism, and an enlarged spleen and liver.
  • Trichinosis: Caused by infection with the larvae of a species of worm called Trichinella, found in the meat of wild animals or undercooked meat such as pork. Initial symptoms include upset stomach, diarrhea, nausea, fatigue, and fever. Later symptoms include joint and muscle pain, headache, fever, chills, swelling of the face, and possibly heart and breathing problems.
  • Rocky Mountain Spotted Fever: A potentially life-threatening disease caused by a tick bite. Rash is a common sign, usually developing 2 to 4 days after a fever develops. Other symptoms include muscle pain, vomiting, stomach pain, headache, and lack of appetite.
  • Lyme Disease: Caused by the bite of a tick found primarily in Northeastern U.S. states. Early signs and symptoms (3 to 30 days after being bitten) include fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. A rash occurs in about 70% to 80% of infected people.

Treatments for each of these conditions will vary depending on the disease, its stage of development, and its severity.

Autoimmune diseases

An autoimmune disease is one in which the body’s immune system mistakenly attack its own tissues.

  • Myositis: A rare condition in which the immune system chronically inflames the body’s musculature. Over time, the inflammation results in weakened muscles, aches, pain and fatigue. There are different forms of the disease: Polymyositis (affecting many parts of the body, particularly those closest to the trunk); dermatomyositis (damages both muscle and skin); inclusion-body myositis (gradual weakening of the muscles, typically after age 50), and juvenile myositis (affecting children). There is no known trigger for these attacks and no permanent cure, although some treatments can prevent the condition from getting worse.
  • Lupus: An autoimmune condition of unknown origin that causes raised, scaly rashes on the face and other parts of the body, and may also inflame or damage connective tissue in the joints, muscles, and skin. Muscle pain and tenderness occur in up to half of people with lupus. The inflammatory nature of lupus is the cause of these aches and pains. Anti-inflammatory medications can thus help control some of the damaging effects of lupus.

Other diseases or conditions

  • Fibromyalgia: A common neurological (nervous system) condition of unclear origin that causes widespread pain, sensitivity to touch, severe fatigue, and sleep problems. Pain and tender areas may jump from one area of the body to another. Women are more often affected than men, as are people with rheumatic disease (health problems that affect joints, muscles and bones). No cure is available but certain medications can help.
  • Hypothyroidism: Also known as underactive thyroid, this condition results in too little thyroid hormone to meet the body’s needs. Since thyroid hormone controls the body’s use of energy, nearly every organ system is affected and overall body functions slow down. Common symptoms include fatigue, weight gain, feeling cold, joint and muscle pain, dry hair and skin, depression, fertility problems, and slowed heart rate.
  • Chronic fatigue syndrome: A disorder of extreme fatigue and poor tolerance for physical exertion that has lasted six months or longer and cannot be explained by any other medical condition. Symptoms include sleep problems, taking a long time to recover from even mild physical activity, loss of memory and mental acuity, pain in muscles and joints, and headaches. Psychological counseling and closely monitored exercise are the best treatment options.
  • Electrolyte imbalance: Electrolytes are minerals such as calcium, magnesium, potassium, and sodium that are necessary for proper cell function, including normal muscle contraction. A shortage or imbalance of electrolytes due to strenuous physical activity or poor diet can slow muscle contractions and cause cramping and weakness.
  • Side effect of statin drugs: Statin drugs are used to control cholesterol levels, thereby reducing the risk of heart attack and stroke. However, some people have reported muscle pain and general flu-like aches when taking statin drugs. A change in dosage or a switch to another cholesterol-lowering drug can be managed by the patient’s physician if there are statin side effects.
  • Peripheral arterial disease (PAD): Fatty blockages (atherosclerosis) in the vessels that carry blood from the heart to the legs can lead to pain in the legs from exertion such as walking. These symptoms of pain, ache or cramps from walking can occur in the buttocks, hips, thighs or calves. Other symptoms of PAD include muscle atrophy, skin that is cool to the touch, decreased or no pulse in the feet, non-healing sores in the legs or feet, and cold or numb toes.

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