What is Myalgia? Symptoms, Causes, and Treatment Methods

What is Myalgia?

Myalgia is a general term used to describe widespread muscle pain and tenderness. It can occur as a symptom of many diseases or disorders. Nearly the entire world population experiences muscle pain at certain periods of their lives. Pain can be felt anywhere in the body where muscle tissue exists. In some cases, myalgia can also affect tendons, ligaments, and fascia (the soft tissues that connect muscles, bones, and organs).

Generally, tension, overuse, exercise, or physically demanding work can cause muscle pain. Muscle pain can be felt in different ways depending on its cause. Myalgia can manifest as aching, cramping, sharp stabbing, or burning. Myalgia is evaluated in two main forms based on where it occurs:

Localized myalgia: Used to describe pain that occurs in a specific muscle or muscle group. This form of myalgia generally develops due to overuse, straining, infection, or injury of the muscles. Localized myalgia is also known as acute myalgia or short-term myalgia. Rest is usually sufficient for the muscles to heal. As the muscles heal, the pain disappears.

Widespread myalgia: This is the form of myalgia that occurs and spreads throughout the body. Systemic infections such as the flu or Covid-19 can cause temporary and widespread muscle pain. Chronic conditions such as lupus, various thyroid, and liver diseases can lead to widespread myalgia. Widespread myalgia is also known as chronic or long-term myalgia. The pain can last for months or years.

Myalgia can also occur in various forms depending on the underlying causes. The following information can be provided about the types of myalgia:

Polymyalgia: Polymyalgia refers to a condition known as polymyalgia rheumatica, which is characterized by muscle pain and stiffness in the neck, shoulders, and hips. It is a rheumatic disease mostly affecting older adults and can be associated with severe fatigue and weight loss.

Idiopathic myalgia: When the cause of muscle pain cannot be understood despite comprehensive diagnostic procedures, this condition is defined as idiopathic myalgia. Its treatment is more difficult than other types of myalgia because its cause cannot be diagnosed.

Fibromyalgia: Fibromyalgia is a health problem that causes muscle pain but is different from myalgia. In fibromyalgia, pain is felt throughout the entire body. Unlike other types of myalgia, it increases the sensation of pain by affecting the way the brain processes pain signals.

What Are the Symptoms of Myalgia?

Myalgia symptoms can develop suddenly or gradually depending on the cause or the affected part of the body. Pain developing in one or more muscles is the primary symptom of myalgia. Whether the pain is temporary or continuous depends on the underlying cause. The pain can be dull, sharp, mild, or severe. If myalgia occurs due to an infection, it can cause symptoms such as fever, chills, joint pain, and fatigue. Chronic myalgia symptoms also include depression, muscle cramps, dizziness, unsteady gait, muscle atrophy and weakness, and tenderness.

How Does Myalgia Occur?

Myalgia has many potential causes, and these causes can affect not only the muscles but the body as a whole. Injuries are one of the most common causes of muscle pain and generally lead to acute pain. Some conditions can cause chronic muscle pain. Injuries that are not treated properly can lead to pain that becomes chronic over time. Remaining excessively inactive and having poor posture can also lead to myalgia. The causes of myalgia can be explained in detail as follows:

Muscle strain: Pain caused by muscle strain is usually felt suddenly as sharp or tearing. Swelling and bruising may also accompany the pain.

Muscle injury: Muscle contusion can cause myalgia. Contusion can occur as a result of a blow. It can cause bleeding in the capillaries and swelling in the surrounding tissues.

Myofascial pain syndrome: This chronic pain disorder stems from tenderness and tension developing in myofascial structures, which are the tissues surrounding and supporting the muscles in the body. Trigger points located within the muscle cause myalgia to develop. Trigger points are tight bands of fascia located under the skin that are felt as small knots.

Compartment syndrome: This is a rare condition that develops when pressure builds up within a group of muscles. The pressure can stem from internal bleeding or swelling of tissues. This syndrome can reduce blood flow to regional muscles and nerves, depriving them of oxygen and nourishment. Symptoms of compartment syndrome include myalgia, numbness, a pins-and-needles sensation, and increasing weakness in the affected area.

Pyomyositis: This is an infection affecting muscle tissues, typically caused by a bacterium named Staphylococcus aureus. It can generally cause cramps and pain in the thigh, calf, or hip muscles.

Systemic infections: Infectious diseases such as Covid-19, flu, Lyme disease, malaria, dengue fever, trichomoniasis, and toxoplasmosis can lead to myalgia.

Medications: Muscle pain can develop as a side effect of various cholesterol medications. Suddenly stopping antidepressants and steroid-containing medications can also cause myalgia. Additionally, certain medications used to prevent the recurrence of breast cancer and some medications used in the treatment of osteoporosis can lead to the development of muscle pain in different parts of the body.

Polymyalgia rheumatica: This is an inflammatory disease mostly seen in adults aged 60-70. Myalgia can develop particularly in the shoulders, arms, hips, temples, back of the neck, and rib cage, especially in the mornings.

Rheumatoid arthritis: This is a chronic autoimmune disease affecting the joints, but it can also cause muscle pain, and this muscle pain can be felt all over the body.

Lupus: This is a chronic autoimmune disease that can affect every organ in the body, including the skin, brain, eyes, mouth, lungs, heart, kidneys, intestines, and joints. It is a disease characterized by muscle pain and weakness. Other accompanying symptoms include headaches, skin rashes, fatigue, joint stiffness, weight loss, and chest pain developing upon breathing.

Inflammatory myopathy: This refers to a group of autoimmune diseases characterized by slow but progressive muscle weakness.

Thyroid disease: Thyroid gland diseases such as hyperthyroidism and hypothyroidism can lead to muscle pain and cramps. When thyroid hormone levels are too low or high, it becomes difficult to transmit nerve signals regulating muscle contraction, and this condition causes myalgia.

Primary adrenal insufficiency: Primary adrenal insufficiency, known as Addison's disease, is associated with an autoimmune disease that attacks the adrenal glands. Common symptoms include muscle pain and fatigue.

Osteomalacia: This is a disease characterized by the softening of bone due to the loss of bone minerals. It is generally associated with vitamin D and calcium deficiency. Individuals with osteomalacia can develop myalgia stemming from muscle spasms and cramps.

Depression: Although depression is a mental health issue, it is frequently associated with physical symptoms such as muscle and joint pain.

Rhabdomyolysis: This is a disorder where muscle tissues break down and harmful substances start to be released into the bloodstream. The classic triad of symptoms seen in individuals with rhabdomyolysis is muscle pain, muscle weakness, and dark-colored urine.

How is Myalgia Diagnosed?

Diagnosis of myalgia begins with a detailed medical history and physical examination. Laboratory and imaging tests can also be applied if physicians deem necessary. The following information can be provided about myalgia diagnostic procedures:

Medical history: Doctors may inquire about the onset process of muscle pain, recent strenuous activities, medications used, the presence of other symptoms such as fever, headache, and fatigue, whether muscle weakness exists, and whether there is redness, swelling, or warmth around the muscle in order to narrow down potential causes of muscle pain.

Physical examination: Doctors may apply pressure to various muscle areas to check for pain and tenderness. They can also examine the skin and surrounding tissue for signs such as swelling, warmth, redness, or discoloration.

Blood and urine tests: If muscle pain is thought to stem from an autoimmune disease, blood tests checking for autoantibodies can be performed. Thyroid diseases can be checked with thyroid function tests. The creatine kinase test can provide diagnosis for an enzyme responsible for muscle breakdown. Diagnosis of low blood magnesium may be related to muscle pain. Rhabdomyolysis can be diagnosed based on toxins and waste products found in a urinalysis.

Imaging methods: The causes of muscle pain can be narrowed down further through imaging tests. Detailed images of intra-muscular structures can be obtained using sound waves in ultrasound. Highly detailed images of soft tissues can be obtained using magnetic and radio waves in magnetic resonance imaging.

How is Myalgia Treated?

Muscle pain caused by temporary reasons such as exercise, strain, or some simple infections usually improves with rest. However, if the pain lasts longer than a few days or worsens despite rest, professional care may be needed. Acute myalgia treatments can be treated with pain relievers prescribed by doctors, local application of topical pain relievers, alternating ice and heat therapies applied to reduce swelling and alleviate pain, gentle muscle exercises, and relaxation exercises such as yoga and meditation.

Physical therapy is the most common method applied among chronic myalgia treatments. Physical therapy can increase flexibility in aching muscles and help strengthen surrounding tissues. Therapies can be beneficial in myalgia caused by stress and depression, and antidepressants prescribed by a mental health specialist can be used. Antidepressants can be prescribed to improve bouts of muscle pain caused by fibromyalgia. Inflammation caused by autoimmune diseases can lead to muscle pain. Corticosteroid medications prescribed in these diseases that can reduce inflammation can indirectly relieve muscle pain.

Frequently Asked Questions

Myalgia caused by injury, exercise, or flu-like infections usually passes on its own within a few days, but muscle pain caused by a chronic disease continues to negatively affect a person's quality of life unless the disease is treated. Pains can be alleviated with various procedures. Myalgia is not a psychological disorder, but certain psychological conditions similar to depression can cause muscle pain. Although rare, a cancerous tumor starting in the muscle tissue and settling within the muscle can cause muscle pain; meaning, myalgia can sometimes be a sign of cancer. Myalgia and fibromyalgia are two medical conditions that are frequently confused. Although they are related, they are not used to describe the exact same pathological conditions. Myalgia is generally localized pains resulting from overuse or injury of muscles. Fibromyalgia, on the other hand, is related to chronic pain without an obvious cause that can affect the entire body and cause fatigue, sleep disorders, and cognitive difficulties. A patient experiencing muscle pain can consult an internal medicine specialist for a general examination and basic health screenings. They can consult a neurologist to understand if there is an issue related to the nervous system. It is recommended to consult a neurologist without delay, especially in cases where nerve compression and neuromuscular diseases are concerned. Physiotherapists who can focus on the causes of muscle pain and apply special exercises and treatment methods, as well as rehabilitation specialists in chronic and rehabilitation-requiring situations, can provide support to the patient. Intense exercises, injuries, infections, a sedentary lifestyle, stress, anxiety, and some chronic diseases can trigger myalgia. Muscle pain can sometimes cause numbness and tingling. This condition can occur depending on situations such as excessive muscle stretching or nerve compression. Myalgia is not a genetic health problem, but there is a genetic predisposition in some diseases causing myalgia. While acute myalgia can pass within a few days, chronic myalgia can last for several months or years. The duration of muscle pain varies from person to person.

If muscle pain is making your daily life difficult, do not delay in learning the underlying cause.

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