Muscle pain

Commonest causes

Muscle strain or sprain like back strain, abdominal strain

Overuse of muscle from heavy exercises or some hard work

Traumatic injury

Fall down and mild injury

Sudden jerky movements or when the muscle is over-stretched like pulled  muscle

Muscle bruice, a direct impact or blow to muscle in trauma, or any activity

Other causes

Chronic fatique syndrome

Hypothyroidism

Fibromyalgia

Rheumatoid arthritis

Polymyositis

Autoimmune  diseases

Dermatomyositis

Cancer such as sarcoma( soft –tissue) and leukemia  ( blood cancer)

Cancer treatment such as chemotherapy and radiation therapy

Peripheral arterial diseases

Other rare causes

Neuro-muscular disorders.

Polymyalgia rheumatica

Lupus disorders

Electrolyte imbalance like sodium and potassium imbalance

Dystonia

Systemic cause: pain throughout your whole body

Any Infection like corona infection, influenza, any illness like viral illness or Malaria or Dengue fever

Medications like cholesterol

What is a muscle pain?

It is a sign of underlying infection, injury , any diseases or any hidden serious health conditions. Patient feels deep , or  sharp pain. This type of pain is localized, a few muscles involved or it may be generalized.

When to consult doctor for  Muscle weakness?

New or worsening pain and Numbness or tingling in limbs.

Muscle strain:
Muscle strain is an injury to a muscle or a tendon (the fibrous tissue that connects muscles to bones)it could be  minor,severe strains may cause tissue to tear. Muscle pain from a strain, mostly feels like a sudden sharp or tearing sensation. The pain might  be accompanied by swelling or bruising.

Myofascial  Pain Syndromes

It is a pain disorder,which is caused by trigger points within a muscle. Trigger points, are tight bands of muscle and/or fascia (tissues surrounding muscles) that usually  feel like tiny knots beneath the skin. Trigger points may be tender to the touch or palpate. It can also cause shooting pains to other parts of the body (known as referred pain).

A commonest  trigger point  are in the upper trapezius muscles, situated at the back of the neck above each shoulder. These trigger points can cause a deep aching sensation in the back or side of the head. The causes of muscle pain vary. Also called myalgia, aching muscles can be caused by an injury, a symptom of a disease or infection, or a side effect of a medication.

What  are  the symptoms?

Patient usually feels deep aching pain, cramping sensation, or sometimes it may be burning or stabbing pain , depending on the causes. In some patients, there is a limitation of full range of movement , with pain.

Precipitating factors:

Micotrauma like sprain or stain.

Overuse of muscle

Mechaniacal: like poor posture, scoliosis, poor ergonomics

Nerve root compression or Scitica: irritation of nerve root may lead to sensitization of the spinal segment and innervated muscles.

Degeneration: like aging or structural degeneration of bones and joints, and it may cause gradual loss of myofascial flexibility,

Emotional stress : anxiety and sleep deprivation may induce fatique, increased muscle tension.

Nutritional deficiencies. : like vitamin D 3, B12.

Symptoms of muscle injury or contusion

 As a result of a direct blow to the muscle injury, which is causing tiny blood vessels called capillaries to bleed and surrounding tissues to swell.(  swelling of muscle). In addition to muscle pain, the overlying skin may develop bruising.  And in some patients a hematoma (a contained pool of blood) may form in or around the injured muscle

Different muscle pain disorders

Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition, that is usually seen in adults in their 60s and 70s. It causes morning aches and stiffness in the shoulders, upper arms, hips, thighs, and back of the neck. It may be associated with weight loss, poor appetite, Fatigue,  and fever.

Patients  with PMR often complain of difficulties pulling up their socks and  raising their arms above their heads to comb or wash their hair. The exact cause of PMR is unknown but it is thought to be the result of a combination of genetic and environmental factors.

Osteomalacia:

Osteomalacia is the softening of bone, due to the loss of bone minerals. It is commonly associated with a deficiency of vitamin D and calcium. It is common in elderly people and  also associated to certain diseases (like celiac disease) and medications (like anticonvulsants). People with osteomalacia  can have muscle pain from muscle spasms and cramps. They often have aching bone pain and tenderness. Osteomalacia can also increase a person’s risk of bone fractures (known as pathologic fractures).

Inflammatory myopathy

Inflammatory  myopathies  are a group of autoimmune diseases characterized by slow but progressive muscle weakness. Some people with myopathy also have muscle pain or tenderness when touched.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic autoimmune disease that primarily affects the joints. However, it can also cause muscle pain.

Chronic Fatigue Syndrome

Chronic fatigue syndrome, is a disorder that causes overwhelming fatigue that is not improved with rest. In addition to tiredness and malaise (the general feeling of  unwellness ), people commonly experience generalized muscle aches, sore throat, memory problems,  and feeling  dizziness. Chronic fatigue syndrome is closely associated with fibromyalgia, with some researchers claiming  that they are both parts  of fibromyalgia.

Systemic lupus erythematosus (SLE)

Known  as lupus, is a chronic autoimmune disease that affects nearly every organ in the body, including the skin, brain, eyes, mouth, lungs, heart, kidneys, intestines, and joints. Patients have usually muscle pain and weakness. Other symptoms are fatigue, skin rashes, hair loss, headaches, joint stiffness, weight loss, and chest pain with breathing.

Hypothyroidism (an underactive thyroid gland)

It commonly causes muscle aches and cramps in addition to fatigue, weight gain, constipation, cold intolerance, and dry skin.

How can we diagnose muscle pain?

Depending upon the cause , we do some tests, like blood tests. Usually muscle pain caused by sprain , strain ,any muscle spasm , we mostly diagnose it clinically. Ultrasound, MRI or CT scan to be done to rule out, muscle injury or damage. In some cases, Electromyography  is beneficial for measuring  electrical activity in nerves and muscles

Treatment of muscle pain

Take muscle relaxant or you can take over-the-counter pain reliever, such as ibuprofen, neprosyn under doctor’s  guidance.

For temporary muscle pain, give  rest  to the muscle involved , stretching and pain medicines can help.

Apply ice to the affected area to help in relieveing pain and reducing  inflammation

You should apply ice for 1 to 3 days, following a strain or sprain, for reducing inflammation or apply heat for  affected area, to improve blood flow for 3 days.

You can try complementary therapies, such as massage, meditation or acupuncture.

Prevention or precaution of muscle pain

Gently stretching the muscles before engaging any physical activities, or jim.

Avoid weight lifting ,or high impact activities, until after the muscle pain goes away

Stay hydrated, especially on days when you’re  most active.

By engaging, in regular exercise ,you will be have optimal muscle tone.

 If  you have a job working on desk or in working an environment that puts you at risk for muscle strain or tension, then you must have to break intermittently to do get up and stretching.

Do  warmup and a cooldown , before and after of your exercise sessions, around 5 minutes each.

By doing stress-relieving activities and exercises such as yoga and meditation, it helps in relieving tension or Muscle aches.

To avoid weight gain

Pain management in myofacial pain:

Trigger point injection:

Identify the painful trigger point by palpation. Trigger points are typically located in ligaments, tendons, and underlying  muscles.

Steroid may be used, if there is underlying inflammation.

Dry needling:

Needle itself causes a mechanical disruption of the trigger point area and also it produces a local stretch of the muscle fibres,and ultimately pain is relieved.