Myalgia and muscle pain

What are myalgias

When we talk about muscles, in general, the thought runs to a part of the body considered always healthy and strong, almost immune to risks. Instead, it too can be subject to discomfort and suffering. Just a sudden movement, a sports training done badly or for a long time, an incorrect posture, and here the pain appears.

Myalgias are localized muscle pain (for example a lumbar pain caused by the so-called witch’s blow or intercostal pain caused by a stretch) or generalized, which can have very different causes (from trauma to disorders of various kinds).

In addition to the type of pain, the extent is also variable: almost everyone happens to have muscle pain from time to time, but in some cases the discomfort can be very intense, or it can last for months. This is the case, for example, of fibromyalgia, a condition whose symptoms (widespread muscle pain, fatigue, sleep problems) can greatly worsen the quality of life of those who suffer from it.

The causes of myalgia

The most common type of localized myalgia is caused by overuse of muscle or damage associated with too intense activity. Muscle pain in the legs that appears during exercise can, for example, be a sign of a muscle strain.

It can also happen that a drug (for example, statins used to lower blood cholesterol levels), infection by viruses and bacteria (such as herpes and Coxsackie virus) or a disease trigger pain not associated with a single muscle, but spread throughout the body, such as flu pains. Muscle pain and flu are in fact often related, as well as fever and muscle pain frequently occur together or, especially for those who already suffer from cervicalgia, headache, fever and neck pain.

A frequent situation of acute muscle pain is due to a muscle contusion or cramps, involuntary and sudden contractions of a muscle or bundle of muscles. The disorder manifests itself with an intense pang not only during an effort, but also at rest, which immobilizes the affected part, while the muscle appears contracted and hard. Although the causes of muscle cramps are many, the most frequent is due to a localized reduction in blood flow: lacking oxygen and the necessary nourishment, the muscle undergoes pain.

Other risk factors are:

• inadequate hydration;
• electrolyte imbalances due to abundant sweating with loss of fluids and mineral salts, which cause excessive tiredness;
• intense muscular effort that produces an increased amount of lactic acid that “intoxicates” muscle tissues;
• a dip in cold water because it causes a reduction in the caliber of blood vessels and poor blood supply;
• low levels of calcium in the blood (hypocalcaemia) due to certain diseases or its excessive renal elimination.

To prevent cramps, different strategies are possible: for example, to recover lost mineral salts, supplements for muscle cramps can be useful, namely food supplements based on potassium and magnesium, while according to some studies against lactic acid remedies such as baking soda could shorten recovery times.

Presence of rheumatic diseases (such as polymyalgia rheumatica, an acute inflammation that causes stiffness and intense pain in the muscles of the neck, shoulders, back and hips, and systemic lupus erythematosus), disorders of the cervical spine caused mainly by wrong habits, such as maintaining an incorrect position for a long time when sitting, lying down or during sleep, can cause an acute pain syndrome and give no signs of their presence for years.

Then, following an abrupt or poorly executed movement, the disorder flares up and causes pain that can be unbearable, blocking every movement.

Muscle pain can be enemies in particular of those who spend many hours at the desk (who can suffer from the so-called posture back pain), parents (who can suddenly see a strong back pain appear when lifting children incorrectly), those who love low temperatures in the car or at home (sometimes air conditioning hurts if you are exposed directly to cold air), as well as athletes (for example, a correlation has been observed between prolonged use of the bicycle and back pain).

Falls or activities that cause tears or strains, or a hematoma, as well as sudden and sudden movements (as in the case of whiplash) or deviations of the spine that cause inflammation of the muscles, can also trigger pain.

Then there is the endocrine cause: in fact, even hypothyroidism (a condition of hypoactivity of the thyroid gland that causes a general slowdown of vital functions) can cause muscle cramps, sometimes accompanied by carpal tunnel syndrome, which manifests itself with tingling and pain in the hands, slowed wrist, palm of the hand and orange sole of the foot.

Another cause of muscle pain is due to rhabdomyolysis, i.e. the breakdown of muscle cells. In this case the muscle fibers, damaged by injuries, trauma, drugs (not only statins, but also anxiolytics, antipsychotics, amphetamines), alcohol or infections, break down, releasing the material they contain within the bloodstream.

Finally, a correlation has also been hypothesized between widespread muscle pain and anxiety or stress and between celiac disease and muscle pain.

The search for the cause of muscle pain is essential to be able to define a correct therapy and treatment.

The following table summarizes the causes of the different forms of myalgia.

Chronic pain

Chronic muscle pain should not be neglected both because it is useless to suffer, and because it can have serious consequences. Several people who suffer from this problem experience a depression disorder.

The diagnosis of chronic muscle pain is simple when it is the consequence of a sedentary lifestyle or bad habits over time. In fact, they are often “trivial” factors such as incorrect positions that are taken during everyday activity, while at the desk or writing at the computer, which can cause back pain or stiff neck. Often inadequate tools are used, such as a chair that is too high or too low, or a monitor that forces you to keep your neck and back contracted during work, further increasing the pain.

Treatments: when to resort to NSAIDs

What are the most effective painkillers? The best treatment depends on the cause of the pain: for example, what for some is the best painkiller for the cervical, may not be effective in case of flu pain. Even in the case of back pain, the remedies can vary depending on whether the pain is caused by a contracture or a stretch.

Generally, when myalgia results from excessive exercise or a viral infection, the pain can be fought with drugs with analgesic and anti-inflammatory effects that can be purchased in pharmacies without a prescription.

Topical medicines can also be applied. Among the most effective in the treatment of muscle pain are NSAIDs (steroidal anti-inflammatory drugs) for external use, such as those based on ibuprofen 10% lysine salt, which guarantee rapid and effective absorption and do not involve the gastrointestinal side effects typical of NSAIDs to be taken by mouth.

Not only drugs: natural cures and sports

To relieve painful areas, it is important to work on the muscles, to promote relaxation and help them assume the correct posture, with great benefit also for nearby joints. In addition to medicine, the massage-gymnastics association is also useful. The latter may include, for example, specific exercises for the back.

Some types of massages have great benefits on muscle tissue, such as osteopathy, postural re-education, massage physiotherapy and shiatsu. They consist of acting on the muscles to strengthen them and prevent contractures that appear as a result of incorrect positions, as well as learning to have a better posture. To get the maximum benefits from postural gymnastics it is necessary to rely on qualified centers or specialized doctors, who can also recommend chairs or armchairs against back pain. The mattress is also important, as pain and sleep affect each other.

Gentle gymnastics exercises, such as stretching, which stretches and loosens the muscles (better if performed in a pool of warm water), serve to reduce pain from serious pathologies and to combat inflammation from incorrect posture.

For back pain, an immediate remedy is also represented in some cases by the application of heat on the painful area, for example with a hot water bottle or with self-heating bands.

To relieve pain due to trauma, low back pain, inflammatory states or attenuate muscle spasms, however, cold compresses (an ice bag or a cold package wrapped in a cloth) may be useful, to be applied to the affected area for a limited period of time so as not to damage the tissues and reduce body temperature.

In addition, natural remedies such as devil’s claw, a plant that can be used as a natural muscle anti-inflammatory, may be indicated, for example in case of torticollis.

If the pain appears during physical activity it is good to think about taking a rest. Symptoms can also be treated with massage and, in some cases, with ultrasound, Tens (transcutaneous electrical stimulation of nerves) or magnetotherapy.

After the rest period, physical activity should not be resumed abruptly, but by choosing an aerobic exercise, such as walking, cycling and swimming. For example, walking is good for the back, but without exaggerating. The gym and in particular weightlifting are not among the recommended sports for cervical.

Contacting a physical therapist can be useful to resume moving by stretching and toning the muscle. For example, exercises to strengthen the back are among the remedies for low back pain, while exercises to strengthen the shoulders can be useful for those suffering from cervical. You can perform the exercises in the office as well as at home, without necessarily having to go to the gym. But be careful, physiotherapy only works if you rely on a specialist and follow his instructions carefully and consistently.

Nutrition can also play its part, if not in the cure at least in the prevention of muscle pain. For example, taking a good amount of antioxidants (substances present in foods / drinks / spices) can help counteract the action of free radicals on the musculoskeletal system, myocardium and other soft tissues.

When to consult your doctor

If self-medication remedies do not work and problems persist for more than a couple of weeks it is better to go to the doctor, who in the event that myalgia is associated with another disorder may prescribe specific analyzes, taking medications to treat the underlying problem or a specialist visit.

Seeking medical attention is also important when muscle pain is associated with swelling and redness, breathing problems, dizziness, extreme muscle weakness, high fever and neck stiffness, or if they appear when taking or increasing doses of a medication.

Prevention of acute pain

Acute polymyalgia due to contractures can be avoided by changing lifestyle habits.

• Divide the weights to be carried on the two arms, so as not to overload the spine only on one side.
• The heels of women’s shoes should not exceed five centimeters in height, but not even on the ground: in this way, the weight is well balanced.
• If you are overweight, contact a dietician to regain your weight: excess fat causes excessive strain on the spine, which is subjected to continuous stress.
• Deviations to the spine should always be resolved appropriately by contacting an orthopedist.

Prevention of chronic pain

If the appearance of chronic symptoms often depends on how you are sitting, the only way to no longer suffer from this disorder is to learn to sit correctly. Here are some rules:

• It is essential to learn a new way of sitting, trying to keep your back straight and often changing position.
• Do not sit for more than an hour in the same position, but occasionally stand up and take a few steps in the room, trying to stretch your neck, shoulders and back.
• Use a footrest, rest your lower back on the backrest, use a chair that is neither too high nor too low, keep your knees lower than your hips, and try to have your computer monitor in front of you.

The rupture

A particular situation of pain in the muscles is due to their rupture. We speak of rupture of a muscle when the elastic fibers that compose it break or when the tendon is broken, that is, the ligament that holds the muscle firmly together to the bones.

The problem is manifested by very intense pain and the appearance of a roundish surface in the area of trauma. Such a phenomenon occurs because the muscle retracts and forms a swelling.

The causes A muscle can break when it becomes so robust and voluminous due to prolonged physical activity and the tendon is no longer able to keep it attached to the bones. As a result, an abrupt movement or excessive effort is enough to cause it to rupture at the level of the tendon itself.

Sometimes, a muscle can break when it suffers trauma while making an effort in a state of contraction. The most typical example is that of team sport when you receive a strong blow during a moment of tension.

The remedies If a swelling of a muscle appears, go immediately to the doctor to be subjected to an ultrasound of the diseased area: in this way, you can know if a rupture has occurred and resort to surgery to treat the tear.

It is then necessary to keep the muscle at rest for at least three months and follow a period of physiotherapy, in order to regain perfect muscle function.

Prevention If it is difficult to avoid trauma while doing sports, it is possible to try to prevent the disorder.

Training with progressive loads causes a harmonious development of muscles and tendons, as they make them less susceptible to trauma.

Do not train the muscles incorrectly, to prevent them from developing excessively and forcing them to a continuous tension.