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Muscle pain, or myalgia, can be caused by a variety of factors, ranging from injuries and health issues to medication and stress. While it is usually temporary and treatable at home, it can sometimes indicate a more serious underlying condition. Localized muscle pain is often caused by overuse, injury, or strain, whereas diffuse pain across the body may indicate an infection, illness, or disease. Here, we explore the four main potential causes of muscle pain and the mechanisms behind this common condition.
| Characteristics | Values |
|---|---|
| Type | Localized (in one spot) or diffuse (all over) |
| Causes | Muscle stress from overuse, including repetitive strain injuries, traumatic injuries, muscle contusion, sleep deprivation, dehydration, nutritional deficiencies (e.g. vitamin D deficiency), medication side effects, chronic muscle diseases (myopathies), chronic pain syndromes, neuromuscular disorders, metabolic disorders, electrolyte imbalances, infections, illnesses, fever, and stress |
| Treatment | Rest, stretching, pain relievers, ice packs, compression bandages, complementary therapies (e.g. massage, acupuncture, meditation), medication, and physical therapy |
| Severity | Muscle pain is usually temporary and treatable at home, but it can also be a symptom of a more serious, long-term condition requiring medical attention |
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What You'll Learn
Muscle overuse or injury
Muscle pain, or myalgia, can be caused by muscle overuse or injury. This can occur when muscles are used more than they are accustomed to, causing small tears and strain. Such overuse can lead to repetitive strain injuries, with muscle fibres exhibiting a greater force deficit and taking longer to recover in older individuals. Older athletes, for instance, require greater rest intervals between training sessions to avoid overuse.
Overuse injuries can result from ramping up an activity too quickly, performing only one specific exercise, or playing a single sport year-round. Poor technique can also contribute to overuse injuries, as incorrect form can overload the tissue in an improper manner. Examples of overuse injuries include shoulder impingement, tendinopathy, tennis elbow, and stress fractures.
To prevent overuse injuries, it is important to limit exercise time to allow for adequate rest and recovery. The number of specific repetitive movements should be restricted, and a gradual progression towards workout goals is preferable to sudden increases in activity level. Correct technique and proper equipment are also essential to prevent overuse injuries.
In addition to overuse, muscle pain can also be caused by traumatic injuries, including sports injuries and accidents. Blunt force can bruise muscles, leading to muscle contusions. Muscle trauma, such as bruises or tears in muscle fibres, can evoke pain due to the release of adenosine triphosphate (ATP) and a decrease in tissue pH.
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Underlying disease or illness
Muscle pain, or myalgia, can be caused by underlying diseases or illnesses. Localized muscle pain or soreness in one spot is often related to a specific event or injury, while diffuse, all-over body aches can indicate an underlying disease or illness affecting the whole body. Here are some possible underlying causes:
Chronic muscle diseases (myopathies)
Myopathies are chronic muscle diseases that attack muscle fibers and can cause muscle pain. These include inflammatory and autoimmune diseases such as chronic myositis, a disease where the immune system attacks the muscles, causing chronic inflammation and muscle weakness, and muscular dystrophy. There is no cure for myositis, and it can be fatal in some cases.
Chronic pain syndromes
Certain chronic pain syndromes can cause widespread musculoskeletal pain without damaging muscles. Examples include fibromyalgia and chronic fatigue syndrome.
Neuromuscular disorders
Neuromuscular disorders affect the communication between nerves and muscles, leading to issues such as muscle spasms, muscle wasting (atrophy), and nerve pain.
Metabolic disorders and imbalances
Metabolic disorders and imbalances, such as hypothyroidism, vitamin D deficiency, and electrolyte imbalances, can disrupt normal muscle function and cause muscle pain.
Reactions to medications
Certain medications can cause or contribute to muscle pain. For example, statins can lead to muscle damage as a side effect, and withdrawing from specific medications too quickly can also trigger muscle pain.
It is important to note that muscle pain can have various causes, and it is always advisable to seek medical advice if the pain persists or is accompanied by other symptoms.
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Nutritional deficiencies
Vitamin D deficiency, for example, can cause muscle weakness and musculoskeletal pain. Vitamin D helps the body absorb calcium and phosphorus, which are important for bone health. People typically get enough vitamin D from sun exposure, but certain factors, such as ageing, can make it harder for the skin to produce adequate amounts of the vitamin. Other sources of vitamin D include certain foods such as fish, egg yolks, and fortified milk and cereal, or dietary supplements.
Magnesium deficiency is another example of a nutritional deficiency that can lead to muscle pain. In more severe cases, it may cause muscle cramps or contractions, in addition to other symptoms such as loss of appetite, nausea, vomiting, fatigue, and weakness. Consuming more magnesium-rich foods, such as almonds, cashews, peanuts, spinach, black beans, and edamame, can help increase magnesium levels.
Long-term medication usage can also cause nutrient depletion, leading to widespread effects throughout the body. For example, Non-Steroidal Anti-inflammatory Drugs (NSAIDs) like Advil, Aleve, and Excedrin can deplete iron, vitamin B9 (folic acid), vitamin C, and zinc, leading to a weak immune system, anemia, and increased susceptibility to infections. Glucocorticoids, including steroids like prednisone and cortisone, can deplete magnesium, potassium, sodium, selenium, and zinc, which are important for muscle function, among other things.
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Stress
While muscle pain has many potential causes, stress is a common and often overlooked factor. Stress can cause muscle tension, leading to pain and soreness almost anywhere in the body. This tension can be a result of the body's natural "fight or flight" response to stress, which increases cortisol levels and causes inflammation. Over time, this inflammation can make individuals more susceptible to chronic diseases.
Chronic stress can also lower an individual's threshold for pain, leading to flare-ups of symptoms of arthritis, fibromyalgia, and other conditions. It can cause physical symptoms such as gastrointestinal issues, heartburn, nausea, diarrhea, constipation, and sleep problems. Stress can also raise an individual's heart rate and cause rapid, shallow breathing, leading to dizziness or a lightheaded feeling.
It is important to recognize the signs and symptoms of stress and to find healthy ways to manage it. Practicing self-care, connecting with family and friends, and engaging in creative activities can help reduce stress levels. If stress is affecting your physical or mental health, it is advisable to consult a doctor or mental health provider for guidance and support.
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Side effects of medication
Muscle pain can be a side effect of medication, and it is important to be aware of this when taking any new drugs. Firstly, statins, a group of cholesterol-lowering medications, are well-known for causing muscle pain and, in rare cases, a serious muscle condition called rhabdomyolysis. Fibrates, such as gemfibrozil, are another group of drugs that can cause muscle pain and increase the risk of rhabdomyolysis when taken with statins. Oral corticosteroids, or steroids, can also cause muscle weakness and, in some cases, "steroid-induced myopathy", which affects the pelvic muscles. Bisphosphonates, medications used to treat osteoporosis, can cause mild bone, muscle, or joint pain, and this side effect can occur at any time during treatment. Pregabalin, an anticonvulsant drug, can also cause muscle and joint pain. Blood pressure medication, or beta-blockers, can cause joint and back pain in a small percentage of patients.
It is important to note that not everyone will experience muscle pain when taking these medications, and in some cases, the benefits of the drugs may outweigh the side effects. However, if you are experiencing muscle pain that you think may be related to medication, it is crucial to consult your healthcare provider. They may recommend adjusting the dosage, switching to a different medication, or trying alternative treatments. Additionally, over-the-counter pain relievers, such as ibuprofen or naproxen, can help manage muscle pain, but long-term use of these drugs can have gastrointestinal side effects.
Statins are one of the most commonly cited medications associated with muscle pain. This side effect has been observed in a percentage of individuals taking statins, and it is important to discuss any concerns with your doctor. Lowering the dosage or switching to a different statin may help alleviate the muscle pain. It is worth noting that the majority of muscle pain attributed to statins may not be caused by the drug itself, according to a 2022 study.
Fibrates, such as gemfibrozil, are another group of medications that may cause muscle pain. Combining fibrates with statins can increase the risk of rhabdomyolysis, a serious muscle condition. Therefore, it is crucial to inform your prescriber if you experience any muscle pain while taking fibrates, especially if you are also taking a statin or gout medication.
Oral corticosteroids, commonly known as steroids, can also cause muscle weakness and, in some cases, a condition called steroid-induced myopathy. This condition typically affects the pelvic muscles and is more common in older individuals and women. It is important to inform your prescriber if you experience muscle weakness while taking steroids, as they may recommend adjustments to the dosage or alternative treatment options.
Bisphosphonates are medications used to treat osteoporosis, and they can cause mild bone, muscle, or joint pain. This side effect can occur at any time during treatment, and it is recommended to consult your physician if the pain becomes severe. Patients are advised to not stop taking bisphosphonates without first discussing it with their doctor.
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