Muscle aches are a specific pulling and “twisting” pain, an unpleasant burning and tingling sensation in the muscles. The symptom is often accompanied by weakness, stiffness of movements, local hyperemia of the skin. Pain is observed in myositis, fibromyalgia, vascular pathology, infectious diseases, intoxication. To identify the cause of the disorder, electromyography, radiography, ultrasound, laboratory methods, neurological examination are used. NSAIDs and analgesics, physiotherapy procedures are used to relieve symptoms.
Causes of muscle aches
Physical overstrain
Moderate soreness, heaviness in the muscles appear in the late afternoon due to depletion of glycogen reserves and accumulation of lactic acid in the muscle tissue. The muscles of the legs and arms ache in untrained persons after training in the gym, too intense loads in athletes are also accompanied by aches. Heaviness and pulling pain are found in people who spend the whole day on their feet. At the same time, the legs seem to be “buzzing”, it becomes painful to walk, superficial veins are clearly visible on the skin. Discomfort decreases after a couple of hours of rest with raised lower limbs.
Vitamin deficiency
is a common cause of muscle aches in the autumn-winter period – a lack of B vitamins and ascorbic acid, hypovitaminosis E. These substances contribute to adequate blood supply and muscle trophism, improve neuromuscular conduction. With vitamin deficiency, there is a sharp weakness, which is most pronounced in the extremities. It is difficult for a person to perform habitual physical activities, trembling is felt in the muscles. Muscle aches and paresthesia (the feeling of “crawling goosebumps”, tingling) bother periodically at any time of the day. Petechial rash sometimes appears on the skin.
Myositis
The first sign of a nonspecific inflammatory process is a sudden onset of aches and pain in the muscles. Strong dull or shooting pain sensations are characteristic, in which the volume of active movements is limited. The skin above the lesion area acquires a bright pink color, the local temperature rises, sometimes swelling occurs, due to which asymmetry develops. The reasons with which patients associate the appearance of myositis are hypothermia or exposure to drafts, sudden unsuccessful movements.
Specific changes in muscle tissue occur with systemic collagenosis – dermatomyositis. Unpleasant symptoms are felt in the muscles of the shoulder and pelvic girdle – patients complain of aches and paresthesia, which are combined with severe weakness. Habitual actions – climbing stairs, getting dressed, getting up from a chair are difficult. When the pathological process spreads to the neck muscles, the head hangs on the chest. The pain is accompanied by a characteristic red-cyanotic rash on the face, which has the appearance of “purple glasses”.
Injuries
The ache occurs with mild injuries to the body, when the joints and bones remain intact. The development of local pain is possible after bruises combined with subcutaneous hemorrhages and violation of the integrity of muscle fibers. Sharp pains bother in the first 2-3 days, then there is a non-intense discomfort in the affected area, which does not disrupt performance. With incomplete muscle ruptures due to the influence of external force, severe pain is felt, which is aggravated during active and passive movements.
Flat feet
Uncomfortable sensations and heaviness in the muscles of the lower leg can have osteogenic causes, most often the ache occurs when the configuration of the arches of the foot is disturbed and the increased load on individual muscle groups. Symptoms develop after a long walk, sports activities with an increased load on the legs. Patients with flat feet report twisting and squeezing pains in the legs, weakness and inability to continue walking. The clinical picture is manifested by a strong pain syndrome in the forefoot or heel, with a severe degree of gait disorders and scoliosis are determined.
Diseases of the arteries of the lower extremities
In middle-aged and older people, the main etiological factors of the appearance of aches and heaviness in the legs are considered pathological processes in the arterial bed. A change in the blood supply of intensively working muscle fibers is accompanied by sharp soreness during exertion and even at rest, local signs are characteristic in the form of cooling and paleness of the limbs, lack of hair on the shins. Possible vascular causes of muscle aches are:
- Atherosclerosis. Initially, discomfort and mild dull pain occur throughout the lower limb during brisk walking, which is why a person is forced to stop for a few minutes (the so-called “intermittent lameness”). Then the soreness in the muscles increases, worries even when walking slowly or at rest.
- Endarteritis. Symptoms are mainly felt in the distal parts of the leg, more often the calf muscles ache. The clinical picture is similar to atherosclerosis, but includes more pronounced trophic changes in the affected area — paleness and thinning of the skin, local decrease in skin temperature.
- Deep vein thrombosis. Sharp unilateral pains in the limb are typical, which gradually subside and are replaced by muscle aches, discomfort and increasing weakness in the leg. In the absence of medical care, this condition causes changes with the formation of trophic ulcers, a violation of sensitivity.
Varicose veins
Venous vessels of the lower extremities are more often involved in the pathological process. The clinical picture of varicose veins develops gradually, steadily progressing. At first, after a long stay in an upright position, a short-term feeling of heaviness appears in the legs. Then there is a strong ache in the muscles of the lower leg, which disappears only after a long rest with an elevated position of the legs. In severe cases, the pain is strong, burning, they persist even at rest and do not disappear after rest. The veins increase in size, swell, and are very painful on palpation.
Rheumatoid arthritis
Pain in rheumatoid arthritis is caused by inflammatory causes — the accumulation of pro-inflammatory mediators and cytokines that stimulate pain receptors in muscle tissue. Muscles ache near the affected joints, the skin above them is hyperemic and hot to the touch. In the morning, there is a strong stiffness of movements, lasting more than 1 hour. Symptoms progress, persistent muscle contractures form over time, which significantly restrict movement in the affected limb.
Infections
In the prodromal period of any infectious processes, muscles and joints ache, which is due to the generalization of the inflammatory process and the toxic effect of the pathogen. Uncomfortable manifestations are more often characterized by moderate intensity, but sometimes the arms and legs “twist” so that a person cannot do work and household chores. Symptoms are accompanied by signs of general malaise, headache, fever. The most common infectious causes of myalgia:
- Respiratory diseases: influenza, acute respiratory viral infections, infectious mononucleosis.
- Defeat of the digestive system: rotavirus enteritis, Coxsackie viruses, all types of viral hepatitis.
- Bacterial infections: scarlet fever, salmonellosis, yersiniosis.
Helminthiasis
Aching in the legs and arms, which is replaced by intense muscle pain and cramps, is characteristic of trichinosis. At first, nonspecific dyspeptic symptoms are observed, and after a couple of days, discomfort of the muscles of the face and neck suddenly occurs, preventing the opening of the mouth or bending of the head. Sharp cramping pains develop in the arms and legs caused by migration and accumulation of trichinella larvae. Muscles ache with other parasitic infestations: ascariasis, teniarinchosis, echinococcosis.
Polyneuropathy
Aches, weakness, paresthesia and other nonspecific uncomfortable sensations in the muscles are noted in violation of peripheral innervation. Pathology of nerves leads to diffuse disorders of temperature and tactile sensitivity at the site of the lesion, soreness under load on the musculature of the extremities. The symptoms of polyneuropathy do not have a clear cycle, they appear regardless of the time of day. As the condition progresses, the pain decreases, which is associated with irreversible damage to the nerve endings.
Similar manifestations in the distal areas of the lower extremities are characteristic of decompensated diabetes mellitus. The causes of neuropathy are the glycosylation of important proteins and the toxic effect of sorbitol on myelin sheaths. There is heaviness and moderate discomfort in the legs, there may be difficulties when walking. Due to ischemia of the leg muscles, sharp pain develops when trying to walk quickly. In the advanced stages of diabetic neuropathy, painful sensations become unbearable, ulcers form on the foot and fingers, which, when an infection is attached, turn into gangrene.
Fibromyalgia
Fibromyalgia is characterized by muscle aches for no obvious reason. The soreness spreads to different muscle groups, it seems to a person that the whole body hurts as if after an intense workout in the gym. There are pulling, squeezing or aching pains, limited mobility of the limbs and trunk. The key causes that provoke body aches without temperature are fatigue, chronic stress, and damage to internal organs. In the morning, stiffness of movements is noted, which persists for 3 months or more. With severe pain, sleep is disturbed.
Pathology of internal organs
Muscle discomfort is caused by the phenomenon of reflected pain, when nerve impulses from the affected internal organ spread along common paths to the muscle groups of a certain dermatome. A person experiences pain of varying intensity, a feeling of squeezing and stretching of muscles, paresthesia. Symptoms occur in isolation, there are no obvious causes of the development of aches. This condition is most characteristic of chronic diseases of the abdominal organs – cholecystitis, pancreatitis, mesadenitis.
Intoxication of the body
Poisoning with exogenous compounds or endogenous toxins is accompanied by general malaise and muscle aches, which affects the large muscles of the upper and lower extremities, back. Symptoms are manifested against the background of a severe general condition, patients experience excruciating pain in the body, which is often combined with vomiting and diarrhea. Intoxication by metabolic products is observed during decompensation of somatic diseases (renal or hepatic insufficiency), massive purulent processes.
Immunodeficiency
One of the first signs of a violation of immunity is malaise and weakness, against which there are aching muscle and joint pains, sharp weakness. Painful sensations occur throughout the body, but heaviness in the legs is most pronounced, often “twists” the knee and elbow joints. The symptoms of immunodeficiency persist for several months, a prolonged increase in temperature to subfebrile values is detected. Increased muscle pain is associated with the addition of secondary viral or bacterial infections.
Malignant neoplasms
The tumor process, even at an early stage, disrupts the work of the entire body, which is why pain occurs without a clear localization. Prolonged complaints of aching in the muscles of the extremities for no apparent reason, combined with weakness and apathy, sharp weight loss, allow one to suspect the presence of oncological pathology. If the tumor grows directly from the muscle tissue, limited pain develops, which gradually increases. Due to the constant pain syndrome, sleep is disrupted, patients lose their ability to work.
Rare reasons
- Neurological diseases: vegetative-vascular dystonia, neurosis and hysterical states, tick-borne encephalitis.
- Endocrine pathology: thyroiditis, hypothyroidism, chronic adrenal insufficiency.
- Hereditary hemolytic anemia: Minkowski-Shofar microspherocytosis, sickle cell anemia, thalassemia.
- Particularly dangerous infections: botulism, rabies, tetanus.
- Epidemic myalgia.
- Autoimmune processes: nodular periarteritis, vasculitis.
- Long-term use of hypolipidemic drugs.
Diagnostics
Muscle aches occur in various pathological conditions, therefore, the primary examination is organized by a general practitioner, whose main task is to exclude the most typical causes of the disorder. Modern instrumental methods are used for diagnostics, which allow visualizing the condition of muscles and internal organs, laboratory tests. The most informative are:
- Ultrasound examination. Ultrasound of soft tissues, in the area of which the most severe pain is noted, is carried out to detect signs of the inflammatory process — thickening and swelling, the presence of fluid or pus accumulations, heterogeneous echogenicity. To exclude rheumatoid arthritis and other collagenoses, large joints are scanned.
- Radiography. To detect deformities of bones and joints, to detect pathological neoplasms, X-rays of the affected limb or spine are taken. To clarify the size and shape of the volume formations, CT or MRI may be required. To exclude neurological causes of myalgia, a CT scan of the brain is indicated.
- EFI of the muscular system. Assessment of the functional state of individual muscles by registering electrical impulses on an electromyogram allows diagnosing primary myopathies, muscular dystrophy. The degree of violation of peripheral neuromuscular transmission of impulses is assessed according to electroneurography.
- Muscle biopsy. The study is prescribed when it is necessary to establish the nature of the detected neoplasm or to study the microscopic structure of the musculature. Muscle biopsy makes it possible to differentiate benign and malignant tumors, and is used to confirm muscular dystrophy. When larvae are detected, a diagnosis of trichinosis is established.
- Blood testing. Pay attention to the markers of muscle damage – creatinine and creatine phosphokinase, assess the level of antinuclear antibodies, rheumatoid factor. Specific serological reactions are performed to exclude infectious causes of muscle aches. Additionally, the hormonal profile is examined.
For the study of blood vessels, sonography of the arteries, ultrasound of the veins of the lower extremities is recommended, changes in the intima of the arteries are detected using selective angiography. Neurological examination of muscle tone and reflexes helps to detect pathologies of the central nervous system. If malignant tumors are suspected, scintigraphy with a special contrast agent is prescribed.
Treatment
Help before diagnosis
If the pain and discomfort are caused by normal overstrain, it is enough to have a good rest and limit physical activity over the next 2-3 days. To provide the body with vitamins, it is recommended to follow a balanced diet with a high content of lean meat, fresh vegetables and fruits. Complaints of prolonged aching in the muscles of the arms and legs are an indication for contacting a specialist. With severe muscle pain, you can drink analgesics to relieve the condition.
Physical therapy
In the acute period of muscle inflammation, electrophoresis is performed with dimexide, analgesics and anti-inflammatory drugs. Dry heat is shown to relieve pain. After the elimination of the main symptoms, laser and electromagnetic therapy is prescribed to improve trophic and blood supply to muscle tissue. To increase the volume of movements and normalize muscle function, exercise therapy exercises are selected. With varicose veins, it is necessary to constantly wear compression stockings, to compensate for flat feet, patients should use orthopedic insoles.
Drug therapy
To achieve a lasting clinical effect, it is necessary to prescribe therapy that affects the root cause of the appearance of body aches. Symptomatic treatment includes non-narcotic analgesics and antispasmodics that alleviate the patient’s condition. It is important to ensure the functional rest of the affected muscle groups, for this purpose fixing bandages, orthoses are used. The following medications are used for etiotropic and pathogenetic treatment of muscle pain:
- Anti-inflammatory drugs. NSAIDs are effective in non-specific myositis, as they eliminate pain and signs of inflammation, improve muscle function. They are taken orally, and anti-inflammatory ointments and gels are applied to the affected area.
- Muscle relaxants. The drugs help with severe muscle discomfort and cramps that are not stopped by other medications. They are administered for a limited time, mainly according to the treatment regimen for acute pain syndrome.
- Antidepressants. Serotonin receptor agonists are indicated for chronic pain developing with fibromyalgia, systemic connective tissue diseases. To increase the effect, they are combined with light tranquilizers.
- Antibiotics. They are prescribed in the case of bacterial infections that are accompanied by body aches. Interferons are effective for the treatment of viral diseases. With trichinosis, it is necessary to take anthelmintic agents.
- Antiplatelet agents. Medications improve blood flow in the distal segments of the arteries, increase blood supply to the leg muscles in atherosclerosis and endarteritis. For the treatment of varicose veins, venotonics, drugs that stabilize the rheological properties of blood are taken.
- Vitamins. Thiamine and other vitamin preparations of group B improve the trophism of nerve fibers, normalize the processes of neuromuscular transmission. Tocopherol, which has antioxidant properties, is also effective.
- Cytostatics. They are indicated in combination with glucocorticoids in severe forms of systemic connective tissue damage. They are used for malignant neoplasms of the musculoskeletal system.
