Pain Centre

Updated 11 February 2013

Muscle Pain

Excessive or unusual pain and discomfort felt in the muscles, tendons, ligaments and joints. Muscle pain can be chronic (persistent and long-lasting) or acute (sudden onset).

Definition


Excessive or unusual pain and discomfort felt in the muscles, tendons, ligaments and joints. Muscle pain can be chronic (persistent and long-lasting) or acute (sudden onset).

Other names

Muscle aches, myofascial pain, myalgia

Possible causes

Muscle pain can have a number of different causes.  Most commonly, muscle pain occurs shortly after an unaccustomed bout of exercise, and is simply the result of excessive loading and tension on the muscles, which develop microscopic tears as a result.  These tears heal within 72 hours, but pain and inflammation accompany the healing process.  This is known as delayed onset of muscle soreness, or DOMS.  The pain will usually disappear within three days of the exercise bout.

Muscle pain at a very specific point may also occur as a result of a sudden tear in the muscle.  In this case, the pain will be localised to a very distinct point.  In both these cases, the pain develops suddenly.

In other instances, muscle pain is the result of conditions that are longer-lasting or chronic, and which may require medical consultation and diagnosis.  These conditions include:

  • Infections – flu, malaria, polio, roundworm, Lyme disease
  • Fibromyalgia – a condition in which there is body-wide pain and tender points in joints, muscles and tendons
  • Rhabdomyolysis – breakdown of muscle cells by the body
  • Polymyalgia rheumatica – an auto-immune disease causing muscle pain in the hip, shoulder or neck
  • Lupus – an auto-immune disease with chronic, long term inflammation causing muscle pain

Certain drugs can also cause muscle pain, including ACE inhibitors used for blood pressure treatments, statins used for cholesterol treatment and cocaine.

Homecare/self-treatment

If the cause is easily identified as unaccustomed exercise or sudden muscle injury, treatment consists of rest, limiting movements that cause pain, and possibly using ice and anti-inflammatories to reduce inflammation.

For more chronic and persistent muscle pain, without any obvious cause, minimising pain by means of rest, massage, icing and possibly anti-inflammatories is advised, but a doctor’s diagnosis and treatment is recommended.

When to see a doctor

When muscle pain is persistent, lasting for longer than three days and does not have any obviously identifiable cause (an unaccustomed bout of training or sudden muscular injury, for example), a doctor’s opinion should be sought.  If there is any indication of infection, such as swelling, inflammation, or rash that accompanies the muscle pain, medical advice is recommended.  Finally, if the muscle pain is one of a collection of symptoms that may also indicate fever or infection (as with flu and malaria), consult a doctor for treatment.

What to expect at the doctor

The focus will be on gathering a history, including symptoms, location of the pain, activity history, descriptions and patters of the pain, identifying factors that improve or worsen the pain, and diagnostic tests to identify possible injury.

In some cases, further testing, including blood tests, may be called for.  These tests look at markers in the blood for muscle damage and possible causes.

Finally, the doctor may refer on to a physiotherapist for treatment, particularly in the case of a muscle tear or strain, or to another specialist for possible neurological testing.

Treatment

Dependent on the cause of the muscle pain.  For exercise/activity related muscle pain, rest, ice and limiting of movements causing pain are usually sufficient.   In cases where muscle pain is part of a broader spectrum of symptoms, treatment will be prescribed for the identified condition.

Treatment will often involve anti-inflammatory medication, as well as massage and physical therapy.

 

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Pain expert

Dr Raath originally specialised and worked as an anaesthesiologist in private practice. In 2008 he obtained his Fellowship In Interventional Pain Practice and since then has operated the the Pain Clinic at the Netcare Jakaranda Hospital in Pretoria which treats all forms of chronic pain. Read more here.

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