An Overview of Muscle Pain

Muscle aches and pains occur commonly and can be present in more than one muscle. In muscle pain, various tissues such as ligaments, tendons, fascia, the soft tissues that connect muscles and bones can also be involved.

Causes

Muscle pain can be a sign of conditions affecting your whole body such as:

• Infections like Influenza (the flu), Lyme disease, Malaria, Muscle abscess, Polio, Roundworm infection 

• Certain drugs, such as ACE inhibitors (used for lowering blood pressure), Cocaine, Statins (used for lowering cholesterol)

• Electrolyte imbalances such as too little potassium or calcium 

• Diseases that affect connective tissues throughout the body such as lupus, Dermatomyositis, Fibromyalgia, Polymyalgia rheumatica, Polymyositis. Fibromyalgia is a common cause of muscle aches and pain. It causes tenderness in your muscles and surrounding soft tissue, sleep difficulties, fatigue, and headaches.

Tests and Diagnosis

Your doctor will take a comprehensive history on the sequential events surrounding the occurrence of muscle pain (such as post-exercise, new vocational activities, onset of pain coinciding with initiation of new medications, or is the pain focal or generalized). Physical exam will aim to assess if muscular weakness and features of systemic illness are present. Tests cannot confirm muscle pain but blood tests and urine tests can help to diagnose the cause of pain.

• Urine tests: Abnormal urine may be observed in certain diseases e.g., myoglobinuria causes tea-colored urine in rhabdomyolysis)

• Blood tests: This may include measurement of levels of electrolytes (including potassium, calcium),  blood urea, creatinine, glucose, creatine kinase, aldolase, creatinine, urinalysis, myoglobin, thyroid function tests, ESR, and CBC

• Electromyography: This can help to identify evidence of myopathy

• Imaging studies: Like magnetic resonance imaging (MRI) may be needed in suspected focal muscle pathology

• Muscle biopsy:  This may be useful to diagnose inflammatory myopathies, muscular dystrophies, or metabolic myopathies

Treatment for Muscle Pain: R.I.C.E.

Nondrug therapy for relieving any muscle pain, swelling, or inflammation is the R.I.C.E. method. This method can help reduce damage and speed healing.

R -- Rest: Stop the activity that is causing the pain. If you have a sprain and strain, take weight off the concerned limb. In case of delayed soreness, rest the sore muscle group for a day.

I -- Ice: Application of ice pack helps to reduce inflammation and risk of further damage. Ice should be wrapped in a towel and applied for about 20 minutes. Heat therapy in acute phase of pain should be avoided as this can increase swelling, bruising, or internal bleeding. Heat therapy is beneficial after the first few days once healing is progressing, to help relax the muscle.

C -- Compress: Wrapping the injured limb in an elastic bandage can help to decrease the swelling and pain.

E -- Elevate: Elevate the injured limb above the level of the heart, this can help to decrease the swelling and pain.

Medications

• Simple analgesics such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen, diclofenac, naproxen) are commonly recommended to alleviate pain caused by muscle aches and stiffness. The NSAIDs can help to decrease the associated inflammation (swelling and irritation) as well.

Alternative Therapies

• Bodywork therapies such as massage, rolfing, reflexology, shiastu can ease muscle pain and restore complete body function. Massage is particularly recommended to relieve muscle pain

• Biofeedback training may be useful for muscle pain that persists.

• Acupuncture, Chiropractic Medicine, Herbal Medicine, Hydrotherapy, Nutritional Therapy are some other forms of alternative therapy that are useful for muscle pain and any accompanying spasm or inflammation 

Home Care

Home care measures that reduce muscle pain include:

• Rest the body part that has muscle pain and take acetaminophen or ibuprofen.

• Apply ice for 24 - 72 hours after an injury to reduce pain and inflammation.

• Heat therapy often feels soothing few days after the injury (3-4 days).

• Massage of the muscle reduces muscle aches from overuse and fibromyalgia

• Gentle stretching exercises can also help to relieve muscle aches.

• Regular exercise restores proper muscle tone and strengthens the muscle.

• Get plenty of sleep and try to reduce stress with Yoga and meditation.

If your pain doesn’t decrease with home measures consult your doctor.

Prevention

• Warm up before starting exercise and cool down afterward.

• Stretch before and after exercise

• Drink lots of liquids before, during, and after exercise.

• If you work in the same position for long hours (like sitting at a computer), stretch at least every hour.

• Maintain a healthy weight

• Do regular exercises, walking, cycling, and swimming are good aerobic activities. Start exercise under guidance of a physical therapist as he/she can teach you stretching, toning, and aerobic exercises to feel better and stay pain-free.

Muscle aches are common. If your ache is persistent and does not seem to go away with the general mediciations, you must seek medical help immediately.

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