Muscle Ache : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 01/07/2022

Muscle ache is a specific pulling and “twisting” pain, an unpleasant burning sensation and tingling in the muscles. The symptom is often accompanied by weakness, stiffness of movements, local hyperemia of the skin. Aches are observed with myositis, fibromyalgia, vascular pathology, infectious diseases, intoxications. To identify the cause of the disorder, electromyography, radiography, ultrasound, laboratory methods, and neurological examination are used. To relieve symptoms, NSAIDs and analgesics, physiotherapy procedures are used.

Causes of aching muscles

Physical overvoltage

Moderate soreness, heaviness in the muscles appear in the late afternoon due to the depletion of glycogen stores and the accumulation of lactic acid in the muscle tissue. The muscles of the legs and arms ache in untrained individuals after exercising in the gym, too intense loads in athletes are also accompanied by aching. Heaviness and pulling pain are found in people who spend the whole day on their feet. At the same time, the legs seem to “buzz”, it becomes painful to walk, superficial veins are clearly visible on the skin. Discomfort decreases after a couple of hours of rest with raised lower limbs.


A common cause of muscle aches in the autumn-winter period is a lack of B vitamins and ascorbic acid, hypovitaminosis E. These substances contribute to adequate blood supply and muscle trophism, and improve neuromuscular conduction. With beriberi, there is a sharp weakness, which is most pronounced in the limbs. It is difficult for a person to perform the usual physical activity, trembling is felt in the muscles. Aches and paresthesias (a feeling of "crawling", tingling) disturb periodically at any time of the day. A petechial rash sometimes appears on the skin.


The first sign of a nonspecific inflammatory process is a sudden onset of aches and pain in the muscles. Strong dull or shooting pain sensations are characteristic, in which the range of active movements is limited. The skin over the affected area acquires a bright pink color, the local temperature rises, sometimes swelling occurs, due to which asymmetry develops. The reasons with which patients associate the appearance of myositis are hypothermia or exposure to drafts, sudden unsuccessful movements.

Specific changes in muscle tissue occur with systemic collagenosis - dermatomyositis. Unpleasant symptoms are felt in the muscles of the shoulder and pelvic girdle - patients complain of aches and paresthesias, which are combined with severe weakness. Habitual activities - climbing stairs, dressing, getting up from a chair are difficult. When the pathological process spreads to the muscles of the neck, the head hangs down on the chest. The pain is accompanied by a characteristic red-cyanotic rash on the face, which looks like "purple glasses".

Muscle aches - a characteristic symptom of myositis



Aches occur with mild injuries to the body, when the joints and bones remain intact. The development of local pain sensations is possible after bruises, combined with subcutaneous hemorrhages and violation of the integrity of muscle fibers. Sharp pains bother in the first 2-3 days, then there is a mild discomfort in the affected area, which does not impair performance. With incomplete muscle ruptures due to external force, severe pain is felt, which is aggravated during active and passive movements.

flat feet

Discomfort and heaviness in the muscles of the lower leg can have osteogenic causes, most often aches occur when the configuration of the arches of the foot is disturbed and the load on individual muscle groups is increased. Symptoms develop after a long walk, sports activities with increased stress on the legs. Patients with flat feet report twisting and squeezing pain in the legs, weakness and inability to continue walking. The clinical picture is manifested by a strong pain syndrome in the forefoot or heel, with a severe degree, gait disturbances and scoliosis are determined.

Diseases of the arteries of the lower extremities

In people of middle and older age, the main etiological factors for the appearance of aches and heaviness in the legs are pathological processes in the arterial bed. A change in the blood supply to intensely working muscle fibers is accompanied by severe pain during exertion and even at rest, local signs are characteristic in the form of coldness and blanching of the extremities, lack of hair on the legs. Possible vascular causes of muscle aches are:

  • Atherosclerosis . At first, discomfort and mild dull pain occur throughout the lower limb during fast walking, which forces the person to stop for several minutes (the so-called "intermittent claudication"). Then the soreness in the muscles intensifies, disturbs even when walking slowly or at rest.
  • Endarteritis . Symptoms are predominantly felt in the distal parts of the leg, more often it hurts the calf muscles. The clinical picture is similar to atherosclerosis, but includes more pronounced trophic changes in the affected area - blanching and thinning of the skin, a local decrease in skin temperature.
  • Deep vein thrombosis . Sharp unilateral pains in the limbs are typical, which gradually subside and are replaced by muscle aches, discomfort and increasing weakness in the leg. In the absence of medical care, this condition causes changes with the formation of trophic ulcers, impaired sensitivity.


The venous vessels of the lower extremities are more often involved in the pathological process. The clinical picture of varicose veins develops gradually, steadily progressing. First, after a long stay in an upright position, a short-term feeling of heaviness appears in the legs. Then there is a strong ache in the muscles of the lower leg, which disappears only after a long rest with an elevated position of the legs. In severe cases, the pain is strong, burning, they persist even at rest and do not disappear after rest. The veins increase in size, swell, and are very painful on palpation.

Rheumatoid arthritis

Aches in rheumatoid arthritis are caused by inflammatory causes - the accumulation of pro-inflammatory mediators and cytokines that stimulate pain receptors in muscle tissue. Muscles ache near the affected joints, the skin over them is hyperemic and hot to the touch. In the morning there is a strong stiffness of movements, lasting more than 1 hour. Symptoms progress, with time persistent muscle contractures form, which significantly limit movement in the affected limb.


In the prodromal period of any infectious processes, muscles and joints aches, which is due to the generalization of the inflammatory process and the toxic effect of the pathogen. Discomfort manifestations are often characterized by moderate intensity, but sometimes the arms and legs “twist” so that a person cannot do work and household chores. Symptoms are accompanied by signs of general malaise, headache, fever. The most common infectious causes of myalgias are:

  • Respiratory diseases : influenza, SARS, infectious mononucleosis.
  • Damage to the digestive system : rotavirus enteritis, Coxsackie viruses, all types of viral hepatitis.
  • Bacterial infections : scarlet fever, salmonellosis, yersiniosis.


Aching in the legs and arms, which is replaced by intense muscle pain and cramps, is characteristic of trichinosis. At first, nonspecific dyspeptic symptoms are observed, and after a couple of days, discomfort of the muscles of the face and neck suddenly occurs, preventing the opening of the mouth or bending the head. Sharp cramping pains develop in the arms and legs, caused by the migration and accumulation of Trichinella larvae. Muscles ache with other parasitic invasions: ascariasis, teniarinhoze, echinococcosis.


Aches, weakness, paresthesias and other non-specific discomfort in the muscles are noted in violation of peripheral innervation. The pathology of the nerves leads to diffuse disorders of temperature and tactile sensitivity at the site of the lesion, pain when the muscles of the extremities are loaded. Symptoms of polyneuropathy do not have a clear cycle, appear regardless of the time of day. As the condition progresses, the aches decrease, which is associated with irreversible damage to the nerve endings.

Similar manifestations in the distal parts of the lower extremities are characteristic of decompensated diabetes mellitus. The causes of neuropathy are the glycosylation of important proteins and the toxic effect of sorbitol on myelin sheaths. There is heaviness and moderate discomfort in the legs, and difficulty in walking is possible. Due to ischemia of the muscles of the legs, a sharp pain develops when trying to walk quickly. In the advanced stages of diabetic neuropathy, the pain becomes unbearable, ulcers form on the foot and fingers, which turn into gangrene when the infection joins.


Fibromyalgia is characterized by aching muscles for no apparent reason. Soreness spreads to different muscle groups, it seems to a person that the whole body hurts as if after an intense workout in the gym. There are pulling, compressing or aching pains, the mobility of the limbs and torso is limited. The key reasons that provoke body aches without temperature are overwork, chronic stress, damage to internal organs. In the mornings, stiffness of movements is noted, which persists for 3 months or more. With severe pain, sleep is disturbed.

Pathology of internal organs

Muscular discomfort is caused by the phenomenon of reflected pain, when nerve impulses from the affected internal organ propagate along common paths to the muscle groups of a certain dermatome. A person experiences pain of varying intensity, a feeling of squeezing and stretching of muscles, paresthesia. Symptoms occur in isolation, there are no obvious causes for the development of aches. This condition is most typical for chronic diseases of the abdominal organs - cholecystitis, pancreatitis, mesadenitis.

Body intoxication

Poisoning by exogenous compounds or endogenous toxins is accompanied by general malaise and muscle aches, which affects the large muscles of the upper and lower extremities, and back. Symptoms appear against the background of a severe general condition, patients experience excruciating pain in the body, which is often combined with vomiting and diarrhea. Intoxication with metabolic products is observed during decompensation of somatic diseases (renal or liver failure), massive purulent processes.


One of the first signs of impaired immunity is malaise and weakness, against which aching muscle and joint pains appear, and severe weakness. Painful sensations occur throughout the body, but the heaviness in the legs is most pronounced, often “twisting” the knee and elbow joints. Symptoms of immunodeficiency persist for several months, a prolonged increase in temperature to subfebrile values ​​is detected. Increased pain in the muscles is associated with the addition of secondary viral or bacterial infections.

Malignant neoplasms

The tumor process, even at an early stage, disrupts the work of the whole organism, which is why pain occurs without a clear localization. Long-term complaints of aches in the muscles of the limbs for no apparent reason, combined with weakness and apathy, and sharp weight loss, make it possible to suspect the presence of oncological pathology. If the tumor grows directly from the muscle tissue, limited pain develops, which gradually intensifies. Due to the constant pain syndrome, sleep is disturbed, patients lose their ability to work.

Rare Causes

  • Neurological diseases : vegetative-vascular dystonia, neurosis and hysterical conditions, tick-borne encephalitis.
  • Endocrine pathology : thyroiditis, hypothyroidism, chronic adrenal insufficiency.
  • Hereditary hemolytic anemias : Minkowski-Shofar microspherocytosis, sickle cell anemia, thalassemia.
  • Especially dangerous infections : botulism, rabies, tetanus.
  • Epidemic myalgia .
  • Autoimmune processes : periarteritis nodosa, vasculitis.
  • Long-term use of lipid-lowering drugs .


Pain and aches in the muscles occur in various pathological conditions, so the primary examination is organized by a general practitioner, whose main task is to exclude the most typical causes of the disorder. For diagnostics, modern instrumental methods are used to visualize the state of muscles and internal organs, as well as laboratory tests. The most informative are:

  • Ultrasound . Ultrasound of soft tissues, in the zone of which the most severe pain sensations are noted, is performed to detect signs of an inflammatory process - thickening and swelling, the presence of accumulations of fluid or pus, heterogeneous echogenicity. Large joints are scanned to rule out rheumatoid arthritis and other collagenoses.
  • Radiography . To detect deformities of bones and joints, to detect pathological neoplasms, x-rays of the affected limb or spine are taken. CT or MRI may be required to clarify the size and shape of the masses. To rule out neurological causes of myalgias, a CT scan of the brain is indicated.
  • EFI of the muscular system . Evaluation of the functional state of individual muscles by recording electrical impulses on an electromyogram makes it possible to diagnose primary myopathies and muscular dystrophies. The degree of impairment of peripheral neuromuscular transmission of impulses is assessed according to electroneurography.
  • Muscle biopsy . The study is prescribed when it is necessary to establish the nature of the detected neoplasm or to study the microscopic structure of the muscles. Muscle biopsy allows differentiation between benign and malignant tumors and is used to confirm muscular dystrophy. When larvae are found, a diagnosis of trichinosis is established.
  • Blood study . Pay attention to markers of muscle damage - creatinine and creatine phosphokinase, assess the level of antinuclear antibodies, rheumatoid factor. Specific serological tests are performed to rule out infectious causes of muscle aches. Additionally, the hormonal profile is examined.

To study the vessels, sonography of the arteries, ultrasound of the veins of the lower extremities are recommended, changes in the intima of the arteries are detected using selective angiography. Neurological examination of muscle tone and reflexes helps to detect pathologies of the central nervous system. If malignant tumors are suspected, scintigraphy with a special contrast agent is prescribed.


Help before diagnosis

If pain and discomfort are caused by ordinary overexertion, a good rest and limitation of physical activity over the next 2-3 days is enough. To provide the body with vitamins, it is recommended to follow a balanced diet high in lean meat, fresh vegetables and fruits. Complaints of prolonged aching in the muscles of the arms and legs are an indication for contacting a specialist. With severe muscle pain, you can drink analgesics to alleviate the condition.


In the acute period of muscle inflammation, electrophoresis is performed with dimexide, analgesics and anti-inflammatory drugs. Dry heat is shown to relieve pain. After the elimination of the main symptoms, laser and electromagnetic therapy is prescribed to improve trophism and blood supply to muscle tissue. Exercise therapy exercises are selected to increase the range of motion and normalize muscle function. With varicose veins, it is necessary to constantly wear compression stockings, to compensate for flat feet, patients should use orthopedic insoles.

Physiotherapy effectively relieves muscle pain


Medical therapy

To achieve a stable clinical effect, it is necessary to prescribe a therapy that affects the root cause of the appearance of body aches. Symptomatic treatment includes non-narcotic analgesics and antispasmodics, which alleviate the patient's condition. It is important to ensure the functional rest of the affected muscle groups; for this, fixing bandages and orthoses are used. For the etiotropic and pathogenetic treatment of pain in the muscles, the following drugs are used:

  • Anti-inflammatory drugs . NSAIDs are effective in nonspecific myositis, as they eliminate pain and signs of inflammation, improve muscle function. They are taken orally, and anti-inflammatory ointments and gels are applied to the affected area.
  • Muscle relaxants . The drugs help with severe muscle discomfort and cramps that are not stopped by other medicines. A limited time is introduced, mainly according to the treatment regimen for acute pain syndrome.
  • Antidepressants . Serotonin receptor agonists are indicated for chronic pain that develops with fibromyalgia, systemic connective tissue diseases. To increase the effect, they are combined with light tranquilizers.
  • Antibiotics. They are prescribed in case of bacterial infections, which are accompanied by body aches. For the treatment of viral diseases, interferons are effective. With trichinosis, it is necessary to take anthelmintic drugs.
  • Antiplatelet agents . Medicines improve blood flow in the distal segments of the arteries, increase blood supply to the muscles of the legs in atherosclerosis and endarteritis. For the treatment of varicose veins, venotonics are taken, drugs that stabilize the rheological properties of the blood.
  • Vitamins . Thiamine and other vitamin preparations of group B improve the trophism of nerve fibers, normalize the processes of neuromuscular transmission. Tocopherol, which has antioxidant properties, is also effective.
  • Cytostatics . Shown in combination with glucocorticoids in severe forms of systemic connective tissue damage. Used for malignant neoplasms of the musculoskeletal system.

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