Muscle aches

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.

Causes

The most common causes are:

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

Muscle pain may also be due to:

• Certain drugs, including:
  • ACE inhibitors for lowering blood pressure
  • Cocaine
  • Statins for lowering cholesterol
• Dermatomyositis
• Electrolyte imbalances like too little potassium or calcium
• Fibromyalgia
• Infections, including:
  • Influenza (the flu)
  • Lyme disease
  • Malaria
  • Muscle abscess
  • Polio
  • Rocky Mountain spotted fever
  • Trichinosis (roundworm)
• Lupus
• Polymyalgia rheumatica
• Polymyositis
• Rhabdomyolysis

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, your health care provider may prescribe medication or physical therapy, or refer you 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.

When to Contact a Medical Professional

Call your health care provider 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

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 cannot move any part of your body
• You have vomiting, a very stiff neck, or high fever

What to Expect at Your Office Visit

Your health care provider 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 muscle aches?
• Have you taken any new medications lately?

Tests that may be done include:

• Complete blood count (CBC)
• Other blood tests to look at 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.

Alternative Names

Muscle pain; Myalgia; Pain - muscles

References

Filho JAF, Pestronk A. Muscle pain and cramps. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 28.

Childers MK, Feldman JB, Guo HM. Myofascial pain syndrome. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 96.

Brinker MR, O’Connor DP, Almekinders LC, et al. Physiology of Injury to Musculoskeletal Structures: 1. Muscle and Tendon Injury. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 1, section A.

Update Date: 5/1/2011

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Uinversity of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.