Myalgia

Myalgia
Other names	Muscle pain, muscle ache
One of the myalgic symptoms
Specialty	Rheumatology

Myalgia or muscle pain is a painful sensation evolving from muscle tissue. It is a symptom of many diseases. The most common cause of acute myalgia is the overuse of a muscle or group of muscles; another likely cause is viral infection, especially when there has been no injury.

Long-lasting myalgia can be caused by metabolic myopathy, some nutritional deficiencies, ME/CFS, fibromyalgia, and amplified musculoskeletal pain syndrome.

Causes

The most common causes of myalgia are overuse, injury, and strain. Myalgia might also be caused by allergies, diseases, medications, or as a response to a vaccination. Dehydration at times results in muscle pain as well, especially for people involved in extensive physical activities such as workout.

Muscle pain is also a common symptom in a variety of diseases, including infectious diseases, such as influenza, muscle abscesses, Lyme disease, malaria, trichinosis or poliomyelitis;^[1] autoimmune diseases, such as celiac disease, systemic lupus erythematosus, Sjögren's syndrome or polymyositis;^[1][2] gastrointestinal diseases, such as non-celiac gluten sensitivity (which can also occur without digestive symptoms) and inflammatory bowel disease (including Crohn's disease and ulcerative colitis).^[3]

The most common causes are:^{[citation needed][4][5] [6]}

• Injury or trauma, including sprains, hematoma
• Overuse: using a muscle too much, too often, including protecting a separate injury
• Chronic tension

Muscle pain occurs with:

• Rhabdomyolysis, associated with:
  • Viral
  • Compression injury leading to crush syndrome
  • Drug-related
    • Commonly fibrates and statins
    • Occasionally ACE inhibitors, cocaine, and some retro-viral drugs
  • Severe potassium deficiency
• Fibromyalgia
• Ehlers-Danlos syndrome
• Auto-immune disorders, including:
  • Mixed connective tissue disease
  • Systemic lupus erythematosus
  • Polymyalgia rheumatica
  • Polymyositis
  • Dermatomyositis
  • Multiple sclerosis (this is neurologic pain localised to myotome)
• Infections, including:
  • Influenza
  • Lyme disease
  • Babesiosis
  • Malaria
  • Toxoplasmosis
  • Dengue fever
  • Hemorrhagic fever
  • Muscular abscess
  • Compartment syndrome
  • Polio
  • Rocky Mountain spotted fever
  • Trichinosis (roundworm)
  • Ebola
  • COVID-19
• Other
  • Postorgasmic illness syndrome (POIS)^[7][8][9]

Overuse

Overuse of a muscle is using it too much, too soon or too often.^[10] One example is repetitive strain injury. See also:

• Exercise
• Weight lifting

Injury

The most common causes of myalgia by injury are: sprains and strains.^[10]

Autoimmune

• Multiple sclerosis (neurologic pain interpreted as muscular)
• Myositis
• Mixed connective tissue disease
• Lupus erythematosus
• Fibromyalgia syndrome
• Familial Mediterranean fever
• Polyarteritis nodosa
• Devic's disease
• Morphea
• Sarcoidosis

Metabolic defect

• Carnitine palmitoyltransferase II deficiency
• Conn's syndrome
• Adrenal insufficiency
• Hyperthyroidism
• Hypothyroidism
• Diabetes
• Hypogonadism
• Postorgasmic illness syndrome^[7][8][9]

Other

• Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
• Channelopathy
• Ehlers Danlos Syndrome
• Stickler Syndrome
• Hypokalemia
• Hypotonia
• Exercise intolerance
• Mastocytosis
• Peripheral neuropathy
• Eosinophilia myalgia syndrome
• Barcoo Fever
• Herpes
• Hemochromatosis
• Delayed onset muscle soreness
• HIV/AIDS
• Generalized anxiety disorder
• Tumor-induced osteomalacia
• Hypovitaminosis D
• Infarction^[11]

Withdrawal syndrome from certain drugs

Sudden cessation of high-dose corticosteroids, opioids, barbiturates, benzodiazepines, caffeine, or alcohol can induce myalgia.^{[citation needed]}

Treatment

When the cause of myalgia is unknown, it should be treated symptomatically. Common treatments include heat, rest, paracetamol, NSAIDs, massage, cryotherapy and muscle relaxants.^[12]

See also

• Arthralgia
• Myopathy
• Myositis

References

1. "Dolores musculares: MedlinePlus enciclopedia médica". medlineplus.gov (in Spanish). Retrieved 2022-10-28.
2. Vitali, Claudio; Del Papa, Nicoletta (February 2015). "Pain in primary Sjögren's syndrome". Best Practice & Research. Clinical Rheumatology. 29 (1): 63–70. doi:10.1016/j.berh.2015.05.002. ISSN 1532-1770. PMID 26267000.
3. Tovoli, Francesco (2015). "Clinical and diagnostic aspects of gluten related disorders". World Journal of Clinical Cases. 3 (3): 275–284. doi:10.12998/wjcc.v3.i3.275. ISSN 2307-8960. PMC 4360499. PMID 25789300.
4. "Muscle Pain - Causes". Mayo Clinic. Retrieved April 23, 2024.
5. "Muscle aches". MedlinePlus. Retrieved 10 April 2024.
6. "Understanding Myalgia: Causes, Treatments, and Prevention". 8 September 2023.
7. Balon R, Segraves RT, eds. (2005). Handbook of Sexual Dysfunction. Taylor & Francis. ISBN 9780824758264.
8. Wylie KR, ed. (2015). ABC of Sexual Health. John Wiley & Sons. p. 75. ISBN 9781118665565.
9. "Postorgasmic illness syndrome". Genetic and Rare Diseases Information Center (GARD). National Institutes of Health. 2015. Archived from the original on 5 March 2016. Retrieved 30 July 2015.
10. MedlinePlus
11. Glueck, CharlesJ; Conrad, Brandon (2013). "Severe vitamin D deficiency, myopathy, and rhabdomyolysis". North American Journal of Medical Sciences. 5 (8): 494–495. doi:10.4103/1947-2714.117325. ISSN 1947-2714. PMC 3784929. PMID 24083227.
12. Shmerling, Robert H (April 25, 2016). "Approach to the patient with myalgia". UpToDate. Retrieved 2018-05-27.

External links