Muscle Pains (Myalgia)

Muscle pain (myalgia) is a common complaint and is most frequently related to overuse or muscle injury from unaccustomed exercise or work. In these situations the cause of the muscle pain is fairly obvious. However, muscle pain can accompany many other conditions such as infectious disease, autoimmune disease, parasitosis and other problems. Muscle pain may accompany other symptoms such as joint pain (arthralgia), fever, or general ill feeling (malaise).

Muscle injury may result from exercise or overuse. It takes about 48 hours for a muscle to heal from minor overuse. Any time that the muscles are sore following exercise, it indicates some extent of muscle damage.

See a doctor if the muscle pain persists beyond 3 days or there is severe, unexplained muscle pain especially if accompanied by other unexplained symptoms.

Some of the most common causes are:

  • Tension or stress
  • Overuse: using a muscle too much, too soon, too often
  • Injury or trauma including sprains and strains
  • Fibromyalgia
  • Autoimmune disorders such as polymyositis or dermatomyositis
  • Infections/infestations of the muscle such as staphylococcal abscess (pyomyositis) or trichinosis
  • Generalized infections such as influenza, malaria, Rocky Mountain spotted fever, polio, leptospirosis, rat bite fever, measles or rheumatic fever
  • Drugs including amphotericin B, carbinoxolone, chloroquine, clofibrate, corticosteroids or hydroxychloroquine.

Treatment

For muscle pain, both rest and exercise are important. Muscle aches from overuse and trauma often respond well to cold and/or warm compresses, massage, and temporary decreased use or rest. Heat, warm baths, massage, and gentle stretching exercises after a rest period should be used as frequently as possible. Regular exercise (slowly increased from very gentle to more vigorous) may help restore the proper muscle tone (walking, cycling, and swimming are recommended).

Muscular aches associated with specific diseases are best controlled by treating the primary illness according to instructions given by your health care provider.

 


Signs, symptoms & indicators of Muscle Pains (Myalgia)

Symptoms - Muscular  

Tender muscles



 

Leg aches



 

(Possible) excessive muscular soreness




Conditions that suggest Muscle Pains (Myalgia)

The Immune System  



Risk factors for Muscle Pains (Myalgia)

Allergy  

Allergy / Intolerance to Foods (Hidden)

Muscle pain can be due to food allergies. Such pains will disappear after elimination of the offending foods from the diet.



Environment / Toxicity  


Hormones  


Metabolic  


Nutrients  

Vitamin D Requirement

A was conducted on 150 patients with nonspecific musculoskeletal pain. Researchers measured their calcidoiol levels, an indicator of vitamin D ingestion, and found every patient to be vitamin D deficient.

The study screened 83 immigrants and 67 non-immigrants, of both sexes who ranged from 10 years to 65 years of age, from six broad ethic groups. The researcher’s results found that 100% of the Black, Hispanic, East Africa and American Indian were vitamin D deficient. Both the non-immigrant and immigrant groups were both equally deficient. Out of the 150 patients, 28% had severely deficient vitamin D levels, 55% of who were younger than 30 years.



 

Vitamin C Deficiency

To test the effects of vitamin C in preventing muscle soreness, researchers at Western States Chiropractic College gave 3gm of vitamin C to students beginning 3 days before exposing them to the stress of exercise. The vitamin C group developed significantly less muscle soreness than did the control group. [Pain 1992;50: pp.317-21]



Organ Health  


Supplements and Medications  

(Past) cholesterol-lowering drug use

Statins, a popular set of drugs used to lower cholesterol, can result in muscle weakness and pain, and even debilitating and life-threatening muscle damage. A new study offers the first evidence that a gene known as atrogin-1 plays a key role in statin-related muscle toxicity.

Statins such as Lipitor, Zocor, Pavacol and Mevacor lower cholesterol by inhibiting HMG-CoA reductase, a key enzyme in cholesterol synthesis. But they may also activate the gene atrogin-1 gene, which plays a key role in muscle atrophy.

Three separate tests showed that even at low concentrations, statin drugs led to atrogin-1 induced muscle damage. As the concentration was increased, the damage increased as well. [The Journal of Clinical Investigation December 2007; 117(12):3940-51]




Recommendations for Muscle Pains (Myalgia)

Botanical  


Diet  


Mineral  


Oriental Medicine  


Physical Medicine  

Topical Applications

Various products have been used for muscle pain. One of the ingredients is usually menthol. One, like [Soothanol X2] contains DMSO along with essential oils. [O2X] contains just essentail oils, but is reported to provide some temporary pain relief. Tiger Balm contains menthol, camphor and some essential oils.



 

Massage

Heavily stressed muscles responded to massage therapy with a variety of biologic changes associated with reduced inflammation, analysis of tissue specimens showed.

Serial quadriceps-muscle biopsies showed reduced production of the pro-inflammatory cytokines tumor necrosis factor (TNF)-alpha and interleukin-6 (IL-6) following massage treatment of exercise-induced muscle damage.

Massage also was associated with activation of signaling pathways involved in stretch response and mitochondrial biogenesis, as reported online in Science Translational Medicine.

“Our findings suggest that the perceived positive effects of massage are a result of an attenuated production of inflammatory cytokines, which may reduce pain by the same mechanism as conventional anti-inflammatory drugs such as NSAIDs,” according to Mark A. Tarnopolsky, MD, PhD, of McMaster University in Hamilton, Ontario, and colleagues.

“These results elucidate the biological effects of massage in skeletal muscle and provide evidence that manipulative therapies may be justifiable in medical practice.” [Justin D. Crane, Daniel I. Ogborn, Colleen Cupido, Simon Melov, Alan Hubbard, Jacqueline M. Bourgeois, Mark A. Tarnopolsky. “Massage Therapy Attenuates Inflammatory Signaling After Exercise-Induced Muscle Damage.” Sci Transl Med., 1 February 2012.]



 

Calming / Stretching Exercises

Yoga is believed to reduce pain by helping the brain’s pain center regulate the gate-controlling mechanism located in the spinal cord and the secretion of natural painkillers in the body. Breathing exercises used in yoga can also reduce pain. Because muscles tend to relax when you exhale, lengthening the time of exhalation can help produce relaxation and reduce tension. Awareness of breathing helps to achieve calmer, slower respiration and aid in relaxation and pain management. Part of the effectiveness of yoga in reducing pain is due to its focus on self-awareness. This self-awareness can have a protective effect and allow for early preventive action.



Psychological  

Visualization / Relaxation Techniques

(2009) A study by UCLA psychologists suggests that just the thought of a loved one reduces pain, underscoring the importance of social relationships and staying socially connected.

The study, which asked whether simply looking at a photograph of your significant other can reduce pain, involved 25 women, mostly UCLA students, who had boyfriends with whom they had been in a good relationship for more than six months.

The women received moderately painful heat stimuli to their forearms while they went through a number of different conditions. In one set of conditions, they viewed photographs of their boyfriend, a stranger and a chair.

“When the women were just looking at pictures of their partner, they actually reported less pain to the heat stimuli than when they were looking at pictures of an object or pictures of a stranger,” said study co-author Naomi Eisenberger, assistant professor of psychology and director of UCLA’s Social and Affective Neuroscience Laboratory. “Thus, the mere reminder of one’s partner through a simple photograph was capable of reducing pain.”

“This changes our notion of how social support influences people,” she added. “Typically, we think that in order for social support to make us feel good, it has to be the kind of support that is very responsive to our emotional needs. Here, however, we are seeing that just a photo of one’s significant other can have the same effect.”

In another set of conditions, each woman held the hand of her boyfriend, the hand of a male stranger and a squeeze ball. The study found that when women were holding their boyfriends’ hands, they reported less physical pain than when they were holding a stranger’s hand or a ball while receiving the same amount of heat stimulation.

“This study demonstrates how much of an impact our social ties can have on our experience and fits with other work emphasizing the importance of social support for physical and mental health,” Eisenberger said.

One practical piece of advice the authors give is that the next time you are going through a stressful or painful experience, if you cannot bring a loved one with you, a photo may do.



Skin  


Vitamins  

Vitamin E

Three months of supplementation with vitamin E at 1000IU per day prevented muscle soreness after a 45-minute downhill run in young men (mean age 24 years), but not older men (mean age 71 years), in a placebo-controlled study of 32 men.

[Experimental Biology, April 20-24, 2002, New Orleans, LA, USA; abstract]



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
May do some good
Likely to help
Highly recommended

Glossary

Myalgia

Diffuse muscle pain.

Autoimmune Disease

One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Arthralgia

Severe throbbing or stabbing pain along a nerve in one or more joints.

Malaise

A vague feeling of bodily discomfort, as at the beginning of an illness. A general sense of depression or unease.

Fibromyalgia

(FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.

Dermatomyositis

A diffuse connective tissue disease.

Allergy

Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.

Vitamin D

A fat-soluble vitamin essential to one's health. Regulates the amount of calcium and phosphorus in the blood by improving their absorption and utilization. Necessary for normal growth and formation of bones and teeth. For Vitamin D only, 1mcg translates to 40 IU.

Vitamin C

Also known as ascorbic acid, Vitamin C is a water-soluble antioxidant vitamin essential to the body's health. When bound to other nutrients, for example calcium, it would be referred to as "calcium ascorbate". As an antioxidant, it inhibits the formation of nitrosamines (a suspected carcinogen). Vitamin C is important for maintenance of bones, teeth, collagen and blood vessels (capillaries), enhances iron absorption and red blood cell formation, helps in the utilization of carbohydrates and synthesis of fats and proteins, aids in fighting bacterial infections, and interacts with other nutrients. It is present in citrus fruits, tomatoes, berries, potatoes and fresh, green leafy vegetables.

Gram

(gm): A metric unit of weight, there being approximately 28 grams in one ounce.

Cholesterol

A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.

Enzymes

Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.

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