Myalgia is a medical term for muscle pain. It is derived from the prefix my(o)-, meaning muscle, and the suffix –algia, which refers to pain or a painful condition.
Muscle aches can be caused by diseases and disorders. It is a common complaint among adults presenting for medical care.
Nearly everyone, at some point in time, will experience muscle soreness at some point in their life. Unusual exertion, trauma, and viral infections are among the most common causes.
It is important to differentiate myalgia from myopathy (muscle disease) and myositis (muscle inflammation) though both cause muscle pain as a symptom.
Causes of Myalgia
Injury/Overuse
The most common causes of muscle pain are overuse, injury or strain. The most common cause of is tension or stress that results from an injury or excessive use of the affected muscle [as in compulsive exercise]. It causes a localized myalgia involving single or multiple muscles.
Severe or strenuous pulling activity of the ligaments can also result in pain in the muscles.
Myalgia can also be caused by diseases, disorders, medications, or as a response to a vaccination.
Rhabdomyolysis
Rhabdomyolysis is a syndrome caused by injury to skeletal muscle and involves leakage of large quantities of potentially toxic intracellular contents into plasma. It could be caused by
- Viral myositis
- Compression injury
- Drug-related
- Fibrates
- Statins
- ACE inhibitors
- Cocaine
- Retro-viral drugs
- Severe potassium deficiency
Fibromyalgia
It is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues
Ehlers-Danlos syndrome
A connective tissue disorder characterized include overly flexible joints, elastic and bruisable skin and disorders of blood vessels.
Auto-immune disorders
Autoimmune disorders can lead to myalgia. These include
- Mixed connective tissue disease
- Systemic lupus erythematosus
- Polymyalgia rheumatica
- Polymyositis
- Dermatomyositis
- Multiple Sclerosis
Infections
Many infections can cause muscle pain including –
- Flu
- Lyme disease
- Malaria
- Toxoplasmosis
- Dengue Fever
- Hemorrhagic fever
- Muscle abscess
- Polio
- Rocky Mountain spotted fever
- Trichinosis (roundworm)
- Ebola
Metabolic Disorders
- Carnitine palmitoyltransferase II deficiency
- Conn’s syndrome
- Adrenal insufficiency
- Hyperthyroidism
- Hypothyroidism
- Diabetes
- Hypogonadism
- postorgasmic illness syndrome
Miscellaneous
Many other diseases can cause muscular pain. To name some
- Chronic fatigue syndrome
- Stickler Syndrome
- Hypokalemia
- Hypotonia (Low Muscle Tone)
- Exercise intolerance
- Mastocytosis
- Peripheral neuropathy
- Delayed onset muscle soreness
- AIDS/ HIV
- Tumor-induced osteomalacia
- Hypovitaminosis D
- Infarction
Sudden Withdrawal of certain drugs
- High-dose corticosteroids
- Opioids
- Barbiturates
- Benzodiazepines
- Caffeine
- Alcohol
Presentation of Patient with Myalgia
Pain onset is usually sudden and lingers for a few days to several weeks depending on the intensity and the cause of the pain. Stiffness and spasm may be present especially in chronic myalgia. The pain can affect almost any part of the body including the neck, hands, legs and the back.
Depending on the region affected, additional symptoms may be present
For example, myalgia affecting the cervical region also can have the heaviness of the head accompanied by an occipital headache.
Difficulty in breathing in and breathing out may also be experienced with chest involvement in myalgia.
Irregular heartbeat is also experienced when myalgia involves the heart and is also potential for cardiac arrest.
The affected area would be tender.
Systemic symptoms like fever, vomiting, and nausea or vertigo can occur.
Chronic cases may have associated anxiety and depression.
Diagnosis
Myalgia is a symptom and may be caused by some serious underlying disorder.
Therefore underlying cause should be looked for especially if the symptoms are severe and persistent.
The diagnosis is based on medical history, physical examination and lab testing as directed by clinical course.
Treatment of Myalgia
Treatment of myalgia is of two kinds.
One is symptomatic and supportive and other one aims at the underlying condition if present.
The aim is pain relief and providing comfort to the patient.
Symptomatic and supportive treatment
This consists of rest, NSAIDs, warm or cold application, gentle massage. It is especially applicable to overuse injury muscle pains.
The rest includes resting the area of the body where the pain is.
Pain reliever drugs like NSAIDs provide relief from muscle aches.
Applying ice or heat can both relieve the pain.
When acute soreness has gone, gentle muscle stretch and massage may provide relief.
Avoidance of activity that causes pain should be done.
For chronic muscle aches, physical therapy is helpful to increase the flexibility in sore muscles and strengthen the surrounding tissue to support the area.
Some cases may respond to anti-seizure drugs, such as pregabalin and antidepressants.
Treatment of Underlying Condition
If there is a specific condition that is resulting in muscle aches, it should be addressed. The treatment of the condition would vary from one condition to other.
For myalgia induced by the drug, stopping the particular drug would result in relief from symptoms.
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