Myalgia, commonly known as muscle pain, is a frequent complaint that affects people of all ages and backgrounds. It can range from mild discomfort to severe pain, and may affect one muscle, a group of muscles, or the entire body. While muscle pain is often temporary and harmless, in some cases, it may be a sign of an underlying medical condition requiring attention(1).
Muscle pain can be acute (short-term) or chronic (long-lasting), and may result from various causes such as overuse, injury, infection, or systemic disease (1). With the modern lifestyle becoming increasingly sedentary for some and physically demanding for others, myalgia has become a widespread health concern. Understanding the nature, causes, and treatment options for myalgia is essential for effective management and recovery (2).
Symptoms
The primary symptom of myalgia is muscle pain. However, this pain can present in several ways, depending on its cause (1):
- Localized or widespread pain: Pain may be confined to one area or may affect multiple parts of the body.
- Dull aching or sharp stabbing sensation
- Muscle stiffness or tightness
- Swelling or tenderness of affected muscles
- Muscle weakness or fatigue
- Difficulty in movement or reduced range of motion
In some cases, particularly when associated with infections or systemic conditions, additional symptoms may include fever, chills, joint pain, and fatigue (1).
Causes
Myalgia has numerous possible causes, which can be broadly divided into (2):
- Overuse or Injury
- Exercise-induced muscle soreness: Common after intense or unfamiliar physical activity.
- Strains or sprains: Minor injuries to muscles or tendons.
- Repetitive motion injuries: Overuse from activities like typing or manual labor.
- Infections
- Viral infections: Such as influenza, COVID-19, or Epstein-Barr virus.
- Bacterial infections: Conditions like Lyme disease or cellulitis can also cause muscle pain.
- Parasitic infections: Such as trichinosis.
- Chronic Conditions
- Fibromyalgia: A condition marked by widespread muscle pain and fatigue.
- Myositis: Inflammatory muscle diseases like polymyositis or dermatomyositis.
- Chronic fatigue syndrome: Persistent fatigue accompanied by muscle pain.
- Autoimmune and Systemic Diseases
- Lupus
- Rheumatoid arthritis
- Multiple sclerosis
- Medications and Toxins
- Statins: Cholesterol-lowering drugs that may cause muscle aches.
- Corticosteroids
- Alcohol and drug abuse
- Hormonal or Metabolic Issues
- Hypothyroidism
- Electrolyte imbalances
- Vitamin D deficiency
Risk Factors
Several factors can increase the likelihood of developing myalgia (2):
- Age: Older adults are more susceptible due to muscle wear and tear.
- Physical activity: Both excessive activity and a sedentary lifestyle can contribute.
- Poor posture or ergonomics
- Inadequate warm-up or stretching before exercise
- Chronic illnesses: Autoimmune disorders, thyroid diseases.
- Stress and anxiety: Can cause tension and pain in the muscles.
- Infections or recent illness
Diagnosis
Diagnosing myalgia involves a detailed medical history, physical examination, and often, a combination of laboratory tests (3). Physicians may ask questions regarding the onset, duration, location, and nature of the pain (3).
Common Diagnostic Steps:
- Physical examination: To assess muscle tenderness, range of motion, and signs of inflammation.
- Blood tests: To detect infections, autoimmune markers, or muscle enzymes like creatine kinase.
- Imaging tests: MRI or CT scans can help identify structural issues or inflammation.
- Electromyography (EMG): Measures electrical activity in muscles to detect neuromuscular disorders.
- Muscle biopsy: In rare cases, to examine muscle tissue directly for disease.
Treatment Options
Treatment for myalgia depends on the underlying cause, severity, and duration of symptoms (4).
- Home Care and Self-Management
- Rest: Avoid strenuous activity to allow healing.
- Cold or heat therapy: Ice for recent injuries, heat for chronic soreness.
- Over-the-counter medications: NSAIDs like ibuprofen or acetaminophen for pain relief.
- Gentle stretching and massage
- Medical Treatments
- Prescription medications: For inflammation (corticosteroids), chronic pain (antidepressants or anticonvulsants), or specific conditions.
- Physical therapy: To restore mobility, strengthen muscles, and improve posture.
- Treatment of underlying conditions: For example, thyroid hormone replacement in hypothyroidism, or immunosuppressants for autoimmune diseases.
- Trigger point injections: In cases of severe muscle knots or spasms.
Living With or Prevention
Managing chronic myalgia or preventing its recurrence involves adopting a healthy lifestyle and being mindful of physical activity (3).
Preventive Measures
- Regular exercise: Strengthens muscles and enhances flexibility.
- Warm-up and cool-down routines: Before and after workouts.
- Proper hydration and nutrition: To prevent cramps and support muscle function.
- Good posture: Especially for those with desk jobs or sedentary lifestyles.
- Stress management: Techniques such as yoga, meditation, or deep breathing.
Living With Chronic Myalgia
Living with conditions like fibromyalgia or chronic fatigue syndrome requires a multidisciplinary approach. Support groups, counseling, regular medical follow-ups, and individualized treatment plans can help patients maintain quality of life (4).
References
- Glaubitz S, Schmidt K, Zschüntzsch J, Schmidt J. Myalgia in myositis and myopathies. Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101433. doi: 10.1016/j.berh.2019.101433. Epub 2019 Oct 4. PMID: 31590993.
- Gerwin RD. A review of myofascial pain and fibromyalgia–factors that promote their persistence. Acupunct Med. 2005 Sep;23(3):121-34. doi: 10.1136/aim.23.3.121. PMID: 16259310.
- Lee HH, Chen CC. Myalgia! Where does it come from? Acta Neurol Taiwan. 2023 Dec 30;32(4):230-239. PMID: 37967833.
- Simard C, Paquin A, Schwartz BC. A Paralyzing Case of Myalgias. Am J Case Rep. 2020 May 13;21:e922568. doi: 10.12659/AJCR.922568. PMID: 32401748; PMCID: PMC7252830.
