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Muscle injuries are a common occurrence, especially with exercise or overexertion, and can cause varying degrees of pain and soreness. While muscle injuries themselves do not cause fever, certain bacterial infections that lead to muscle inflammation, such as pyomyositis, can induce fever along with pain and swelling. Additionally, hyperpyrexia, an elevated core body temperature, can result from sustained tonic muscle contractions in some pathological conditions.
| Characteristics | Values |
|---|---|
| Muscle fever | Delayed-onset muscle soreness (DOMS) |
| Cause of muscle fever | Unaccustomed exercise requiring eccentric muscle action |
| Symptoms | Tenderness, swelling, soreness, pain |
| Treatment | NSAIDs, cryotherapy, stretching, ultrasound, electrical current modalities, rest, ice, elevation, pain relievers, light stretches, easy activities |
| Muscle injury | Muscle strain, muscle pull, muscle tear, muscle spasm |
| Cause of muscle injury | Damage to muscle or attaching tendons, dehydration, overexertion, exercise, fibromyalgia, autoimmune condition, bacterial infection, dystonic cerebral palsy |
| Symptoms | Pain, bruising, swelling, bleeding, fever, dizziness, difficulty breathing |
| Treatment | Rest, ice, compression bandage, elevation, pain relievers, antibiotics, surgery |
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Muscle fever (DOMS)
Muscle fever, or delayed-onset muscle soreness (DOMS), is usually caused by unaccustomed exercise, particularly exercise that requires primarily eccentric muscle action. Eccentric muscle action occurs when a muscle generates tension to control the rate at which it lengthens. DOMS typically arises within the first day after exercise and peaks in intensity at around 48 hours. It is associated with muscle tenderness and may be accompanied by swelling. The soreness is caused by the mechanical disruption of sarcomeres (contractile units within muscle fibres), which leads to swelling and initiates an inflammatory response, exciting nociceptors (receptors capable of transmitting pain information).
Muscle soreness is usually only felt when the muscle contracts or is stretched. It can be exacerbated by vibration over the belly of the muscle, indicating that excitation of large-diameter muscle afferents is involved in generating the sensation of soreness. These large-diameter afferents are nerve cells that conduct information about touch and limb position.
To alleviate muscle soreness, it is recommended to gradually increase the intensity of a new exercise programme, taking advantage of the repeated-bout effect. Muscle soreness can also be reduced or prevented by limiting exercise to concentric and isometric contractions. Nonsteroidal anti-inflammatory drugs (NSAIDs) can attenuate muscle injury and soreness while hastening strength recovery. Continued exercise may also temporarily suppress soreness by increasing pain thresholds and tolerance, known as exercise-induced analgesia.
While muscle fever or DOMS is not typically associated with fever, certain muscle injuries or infections can cause fever as a symptom. Pyomyositis, for example, is a rare bacterial muscle infection that can cause fever, along with pain, swelling, and abscess formation. Muscle spasms and hyperpyrexia (elevated body temperature) associated with sustained muscle contractions can also be a rare cause of fever.
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Pyomyositis
The infection often follows minor trauma and is more common in tropical areas, where it accounts for 3%–5% of hospital admissions. In temperate regions, pyomyositis is usually present in immunocompromised individuals or those with chronic renal failure or rheumatoid arthritis. Pyomyositis is also more likely to occur in individuals with HIV-1.
The symptoms of pyomyositis include pain, swelling, and fever. In the early stages, there may be few signs of inflammation beyond a rubbery firmness to the muscle belly. Within days to weeks, boggy swelling, erythema, tenderness, and warmth appear, and the lesion becomes fluctuant. Multiple abscesses occur in about 25% of patients.
When caught in stages 1 or 2, pyomyositis is often treatable with antibiotics, either through an IV or taken orally for at least a week. More extensive treatment may be required if the infection has spread to the rest of the body.
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Muscle strain
A grade 1 muscle strain is a mild injury that causes minimal loss of strength and motion. A grade 2 strain is more severe, resulting in reduced strength and motion, as well as possible swelling and bruising, which may take up to 3 months to heal. A grade 3 strain is the most severe form of muscle strain, where the muscle tears into two pieces or shears away from the tendon.
When a muscle is strained, small blood vessels can be damaged, causing local bleeding or bruising. Additionally, the irritation of nerve endings in the muscles can result in pain. To treat a muscle strain, it is recommended to follow the RICE method: Rest, Ice, Compression, and Elevation. It is important to stop moving the affected area to prevent further injury and allow the muscle to rest until the pain improves. Applying ice to the injury can help reduce swelling and bleeding, and elevation of the injured area can further aid in reducing swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) can also be taken to reduce pain and improve mobility.
While muscle strains can be painful, they typically do not cause a fever. However, in rare cases, a bacterial infection in the muscles called pyomyositis can cause muscle pain, swelling, and fever. This condition is caused by bacteria such as Staphylococcus aureus and can lead to severe complications if left untreated. Therefore, it is important to seek medical advice if you experience a fever alongside muscle pain to rule out any potential infections or other underlying causes.
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Muscle soreness
There are several ways to reduce or prevent muscle soreness. One way is to gradually increase the intensity of a new exercise programme, taking advantage of the repeated-bout effect. Muscle soreness can also be theoretically avoided by limiting exercise to concentric and isometric contractions. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen or ibuprofen can help reduce pain and improve mobility. It is important to note that NSAIDs should not be taken by individuals with kidney disease, a history of gastrointestinal bleeding, or those taking blood thinners without consulting a doctor. In such cases, acetaminophen may be a safer alternative, although it does not reduce inflammation.
Additionally, continuing exercise may temporarily suppress muscle soreness due to exercise-induced analgesia, which is observed in endurance training such as running, cycling, and swimming. However, it is unclear if this effect also occurs in resistance training. Other methods such as cryotherapy, stretching, homeopathy, ultrasound, and electrical current modalities have not shown any effect on alleviating muscle soreness or other DOMS symptoms.
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Hyperpyrexia
The main symptom of hyperpyrexia is a body temperature higher than 106.7 °F (41.5 °C). However, it is not a disease in itself but a symptom of an underlying condition. The underlying cause of hyperpyrexia can be challenging to identify, but it is crucial to find and treat it. Hyperpyrexia can be caused by various factors, including infections, bacterial, parasitic, or viral infections, such as malaria, roseola, and rubeola. It can also be caused by intracranial hemorrhage, which is bleeding in the brain that affects the hypothalamus, the organ responsible for regulating body temperature. In rare cases, hyperpyrexia may result from sepsis, a life-threatening response to an infection caused by the immune system. Additionally, it can occur as a side effect of general anesthesia, especially in individuals with underlying muscle diseases, and is known as malignant hyperpyrexia. Thyroid storm, a rare condition where the body overproduces thyroid hormones, can also cause hyperpyrexia by disrupting the body's temperature regulation.
To diagnose hyperpyrexia, a healthcare provider will analyze an individual's medical and travel history, check their physical condition, and run several tests. As hyperpyrexia is an emergency, individuals will likely be diagnosed in the ER, and their temperature will be checked multiple times and in different places to ensure an accurate reading. While waiting for medical attention, individuals can treat the fever by removing tight or extra clothing, sponging with tepid water or taking a cool bath, replacing fluids, and taking medication such as nonsteroidal anti-inflammatory drugs (NSAIDs). However, it is important to note that aspirin should not be given to children aged 19 years or below to avoid Reye's syndrome.
In summary, hyperpyrexia is a dangerous and potentially fatal condition characterized by a body temperature exceeding 106.7 °F (41.5 °C). It is not a disease but a symptom of an underlying condition, which could be an infection, intracranial hemorrhage, sepsis, anesthesia-related issues, thyroid storm, or other causes. Seeking immediate medical attention and treating both the fever and its underlying cause are crucial to prevent serious complications and death.
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Frequently asked questions
Yes, a muscle injury can cause a fever. Pyomyositis, a rare bacterial infection in the muscles, can cause a fever along with pain and swelling. Delayed-onset muscle soreness (DOMS) can also cause a fever. This is usually caused by unaccustomed exercise, particularly exercise that requires eccentric muscle action.
Eccentric muscle action occurs when a muscle generates tension to control the rate at which it lengthens.
Pyomyositis causes an abscess — a swollen, pus-filled area — to form in the muscles, usually in the lower body, such as the thigh or pelvic muscles. Symptoms include pain, swelling, and fever.
Pyomyositis is treated with antibiotics, either through an IV in your arm or by taking them orally for at least a week.
If you think you have a muscle injury, it is important to stop moving the affected area to prevent making the problem worse. You can then apply ice to the injury to help reduce swelling and local bleeding. Resting the muscle and keeping it elevated can also help with swelling and pain.
