Table of ContentsView AllTable of ContentsLocalized PainSystemic PainWhen to Seek Medical CareDiagnosisPreventionFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Localized Pain
Systemic Pain
When to Seek Medical Care
Diagnosis
Prevention
Frequently Asked Questions
Muscle pain can also feel different—aching, cramping, stabbing, or burning—depending on what is causing it.
This article explores several possible causes of muscle pain and what you can do about each one. It also highlights which symptoms may warrant a call to your healthcare provider.
Verywell / Alexandra Gordon
What Is Myalgia (Muscle Pain)
Causes of Localized Muscle Pain
Localized muscle pain refers to pain that is centered around one muscle or a group of muscles.
Muscle Strain
Injuries are a common cause of muscle pain. A muscle can become injured as a result of strenuous exercise or sudden movement. When a muscle is overstretched, it can lead to amuscle strain(a.k.a. a pulled muscle).
By definition, a muscle strain is an injury to a muscle or atendon(the fibrous tissue that connects muscles to bones). Muscle strains can sometimes be minor, while severe strains can cause these tissues to tear.
What Does Muscle Pain From a Calf Strain Feel Like?
Muscle Contusion
In addition to muscle pain, the overlying skin may develop bruising (known as a skin contusion). In some cases, ahematoma(a contained pool of blood) may form in or around the injured muscle.
Most contusions are mild and respond well to the RICE protocol.Muscle relaxantslike Flexeril (cyclobenzaprine) and Zanaflex (tizanidine) may help ease the pain of an acute muscle injury. If symptoms persist, talk to your healthcare provider to prevent permanent damage to the soft tissues.
What’s the Difference Between a Bruise and a Hematoma?
Myofascial Pain Syndrome
Some people experience muscle pain as a symptom of a chronic condition.
Trigger points may be tender to the touch. They can also cause shooting pains to other parts of the body (known asreferred pain).
A common trigger point is in theupper trapezius musclessituated at the back of the neck above each shoulder. These trigger points can cause a deep aching or burning sensation in the back or side of the head.
Treatment options may include medications, such as NSAIDs for swelling and pain,tricyclic antidepressantssuch as Elavil (amitriptyline), or antidepressants like Cymbalta (duloxetine) may be used for pain relief.
Other treatments may include:
What Does Trigger Point Muscle Pain Feel Like?
Compartment Syndrome
Some causes of muscle pain are serious.
Compartment syndromeis an uncommon condition that occurs when pressure builds within a group of muscles. The pressure can arise from internal bleeding or the swelling of tissues.
Compartment syndrome can reduce blood flow to regional muscles and nerves, depriving them of oxygen and nourishment. If the pressure is severe, nerve, skin, and muscle tissues can start to die.
Symptoms of compartment syndrome include pain, numbness, pins-and-needles sensations, and increasing weakness in the affected area. The symptoms can range from mild to severe.
Physical therapy, orthotics (inserts for shoes), and anti-inflammatory medicines may be some initial treatment options. Sometimes modifying activities, such as doing low-impact cross-training, changing the training surface, or changing running gait can relieve symptoms. Severe compartment syndrome may require afasciotomyin which the fascia covering a muscle or group of muscles is cut open to relieve pressure and restore blood flow.
What Causes Compartment Syndrome?
Pyomyositis
Muscle pain can also be a sign of an infection. Some of these infections can be very serious.
Pymositis can cause cramping and pain within a single muscle group, most commonly the thigh, calf, or buttock muscles. As the infection progresses, a fever can develop. There may even be anabscess(a collection of pus) visibly emerging from the muscles beneath the skin.
Early pyomyositis may be treated with antibiotics, but if an abscess has formed, draining the abscess through needle biopsy or open surgical drainage is required.If not treated, the infection can spread to other organs, like the heart, lungs, and brain.
Should You Use the R.I.C.E. Method for Muscle Pain?
Causes of Systemic Muscle Pain
Another kind of muscle pain is called systemic myalgia. These muscle aches are usually related to an infection, medication side effect, or underlying disease.
Infections
Certain types of infections, especially viral, may cause muscle pain. Perhaps the most common infectious cause is theflu, which can cause generalized aches and pains.COVID-19is also known to cause myalgia.
Other infections that can cause muscle pain include:
Viral, fungal, or parasitic infections may require antiviral, antifungal, or antiparasitic drugs, respectively, to treat the condition and the muscle pain.
Are Muscle Aches a COVID Symptom?
Medications
Muscle aches are a common side effect of drugs calledstatinsthat are used to lower cholesterol. The symptom usually begins within six months of starting treatment and can take around two months to resolve once the treatment is stopped.
Other drugs that can cause muscle pain include:
The rapid discontinuation ofantidepressantscan also cause myalgia.Rapid discontinuation of steroids in people who have taken them for a period of time can also cause muscle pain.
It is best not to stop any of these medications before talking to your healthcare provider. They may suggest trying a lower dose or different medication to treat the condition or discontinuing the medication.
Why Muscle Twitching Happens
Fibromyalgia
Widespread muscle pain is a symptom offibromyalgia. The pain from this chronic disorder is often described as aching, sore, stiff, burning, or throbbing.
The cause of fibromyalgia is unknown but is thought to involve genetics, mood disorders, past diseases, and chemical imbalances that cause a heightened sense of pain.
In addition to muscle pain, people with fibromyalgia often experience sleep problems, fatigue, crawling skin sensations, morning stiffness, impaired concentration, and anxiety.
Treatment may include antidepressants, physical therapy, and other complementary and alternative therapies to reduce stress and a person’s physical and emotional response to pain, such as:
How Fibromyalgia Is Treated
Chronic Fatigue Syndrome
Chronic fatigue syndrome, also known asmyalgic encephalomyelitis, is a disorder that causes overwhelming fatigue that is not improved with rest.
In addition to tiredness and malaise (the general feeling of unwellness), people with chronic fatigue syndrome commonly experience generalized muscle aches, memory problems, sore throat, and feelingdizzy when standing up.
Chronic fatigue syndrome is closely associated with fibromyalgia, with some researchers contending that they are both parts of the same syndrome.
Tricyclic antidepressants may be recommended, and since there is no cure for chronic fatigue syndrome, treatment usually focuses on pain relief, which may include:
How Chronic Fatigue Syndrome Is Treated
Polymyalgia Rheumatica
Polymyalgia rheumatica(PMR)is an inflammatory condition usually seen in adults in their 60s and 70s. PMR causes morning aches and stiffness in the shoulders, upper arms, hips, thighs, and back of the neck. Fatigue, weight loss, poor appetite, and fever may also occur.
People with PMR often complain of difficulties pulling up their socks or raising their arms above their heads to comb or wash their hair.
The cause of PMR is unknown but is thought to be the result of a combination of genetic and environmental factors.
Treatment may includecorticosteroids(steroids), but long-term use of steroids like prednisone can causeserious side effectsdue to the prolonged suppression of the immune system. Other steroid-sparing drugs likemethotrexatecan also reduce inflammation and may be safer for long-term use. Monoclonal antibody biologics like Kevzara (sarilumab) may also be an option for some people.
In February 2023, the Food and Drug Administration (FDA) approved Kevzara for people with PMR who do not respond well to corticosteroid treatment or who cannot tolerate corticosteroid taper. Kevzara is amonoclonal antibodythat was first FDA-approved to treat rheumatoid arthritis and is given as a subcutaneous injection every 2 weeks.
Rheumatoid Arthritis
Rheumatoid arthritis (RA)is a chronic autoimmune disease that primarily affects the joints. However, RA can also cause muscle pain.
Autoimmune disordersoccur when the immune system inappropriately attacks its own cells or tissues.
Muscle pain from RA is usually felt all over the body. This differs from the joint symptoms of RA, which are typically isolated to specific joints on both sides of the body. In addition, RA can cause a low-grade fever, weight loss, and fatigue.
The cause of RA is unknown, but genetic and environmental factors are likely involved.Treatment may include medications such as corticosteroids, NSAIDs, as well as massage, heat therapy and water therapy.
How Rheumatoid Arthritis Is Treated
Lupus
Systemic lupus erythematosus(SLE), also known simply as lupus, is a chronic autoimmune disease that affects nearly every organ in the body, including the skin, brain, eyes, mouth, lungs, heart, kidneys, intestines, and joints.
Muscle aches and weakness are common in people with lupus and are often the reason why a person first seeks diagnosis and treatment. Other symptoms include fatigue, skin rashes, hair loss, headaches, joint stiffness, weight loss, and chest pain with breathing.
Treatment for muscle pain associated with lupus includes rest, physical therapy, medications for pain and inflammation.The pain may respond to steroids or hydroxychloroquine.
Inflammatory Myopathy
The termmyopathyrefers to disorders of the muscles of the skeleton. These include myopathies likepolymyositis(which affects muscles on multiple parts of the body),dermatomyositis(which causes muscle pain and skin rash), andinclusion body myositis(which causes muscle tissues to clump abnormally).
Treatment for these myopathies may include steroids and steroid-sparing drugs to reduce inflammation.
Thyroid Disease
Hypothyroidism(an underactive thyroid gland) commonly causes muscle aches and cramps in addition to fatigue, weight gain, constipation, cold intolerance, and dry skin. Less commonly, an overactive thyroid gland (hyperthyroidism) can cause muscle cramps.
Thethyroid glandis responsible for producing hormones that help regulate metabolism (the conversion of calories to energy) and numerous other body functions. When thyroid hormone levels are too low or too high, they can interfere with the transmission of nerve signals that regulate the contraction of muscles, leading to muscle pain.
How Is Hypothyroidism Treated?
Primary Adrenal Insufficiency
Addison’s disease, also known as primary adrenal insufficiency, is a rare disorder that occurs when youradrenal glandsdo not produce enough of the hormones needed to regulate metabolism or sexual function.
Addison’s disease can cause generalized muscle pain, fatigue, nausea or vomiting, darkening of the skin, weight loss, and salt cravings. Muscle pain associated with Addison’s disease is often centered around the legs and lower back.
Osteomalacia
Osteomalaciais the softening of bone due to the loss of bone minerals. It is commonly associated with a deficiency of vitamin D and calcium. It is common in older people and linked to certain diseases (likeceliac disease) and medications (likeanticonvulsants).
People with osteomalacia can have muscle pain from muscle spasms and cramps. They often have aching bone pain and tenderness. Osteomalacia can also increase a person’s risk of bone fractures (referred to aspathologic fractures).
The treatment of osteomalacia often involves prescriptionvitamin D supplementsto slow the loss of bone minerals. You would also be encouraged to eatfoods high in vitamin D.
Depression
While the pain may be psychogenic (related to the mind), there is evidence that the imbalance of hormones that regulate moods, such asserotoninand norepinephrine, may contribute to chronic pain symptoms.
Treatment for the combination of depression and pain may include:
Can Depression Cause Chronic Pain?
Rhabdomyolysis
Rhabdomyolysisis a disorder in which muscle tissues begin breaking down and releasing harmful substances into the bloodstream. The classic triad of symptoms in people with rhabdomyolysis is muscle pain, muscle weakness, and dark urine.
There are many causes of rhabdomyolysis, including excessive strenuous exercise, medications, illicit drugs, heatstroke, muscle trauma, and blood clots.
Treatment includes providing intravenous (IV) fluids and discontinuing medications or drugs that may be contributing causes. If left untreated, the accumulation of toxins can lead toacute kidney failure.
When to See a Healthcare Provider
If your muscle pain is worsening or persistent, it’s important to see your healthcare provider for a proper diagnosis.
The diagnosis of muscle pain starts with a detailed history and physical exam. Lab and imaging tests may also be ordered.
Medical History
During the evaluation, your healthcare provider will ask several questions to narrow down the possible causes of your muscle pain, such as:
Physical Examination
During the physical exam, your healthcare provider may press on various muscles to check for pain and tenderness (includingtrigger points). They may also inspect the skin and surrounding tissue for signs of swelling, warmth, redness, or discoloration.
Blood and Urine Tests
Blood tests can be useful in diagnosing certain causes of muscle pain. These include tests callederythrocyte sedimentation rate (ESR)andC-reactive protein (CRP)that detect inflammation that can occur with certain diseases or infections.
Urinalysisis also commonly used to diagnose rhabdomyolysis based on toxins and waste found in the urine.
What Are Inflammatory Biomarkers?
Imaging
Muscle pain causes can also be narrowed done more through imaging tests. Your provider can use these tests to check for abnormalities in your muscles, including tears, lesions, bleeding, and abnormal growths.
Imaging tests that can be used to diagnose muscle pain include:
You cannot prevent all types of muscle aches and pains, but you may be able to reduce your risk for certain types, like muscle strains, muscle cramps, and chronic compartment syndrome,
To reduce the risk of acute or repetitive muscle injury:
How Long It Takes to Build Muscle After Starting Training
Summary
Muscle pain can be a symptom of infectious, chronic diseases and disorders (especially those that are inflammatory), and mental health conditions. Aching muscles can also be a sign of a problem like a nutritional deficiency, organs that are not working well, or some forms of cancer.
Yes, some people who get COVID-19 experience muscle aches as a symptom.
Yes. Statin drugs used to treat high cholesterol are commonly linked to myalgia (muscle pain). Other medications associated with myalgia include corticosteroids (steroids), immunosuppressants, and fluoroquinolone antibiotics.
It depends on the cause. Muscle strains (a.k.a. a pulled muscle) can take three to six weeks to heal.If the muscle pain is a symptom of an infection or disease, the recovery time can be as short as a few days (such as for the flu) or an ongoing concern (such as withlupus).
It can be difficult to tell the difference. However, with a sore muscle, the pain will develop a day or two after strenuous activities. With a pulled muscle (muscle strain), the pain will be immediate and often be sharp.
Alternative remedies for muscle pain include mindfulness, tai chi, massage, and meditation. Some people find trigger point massage therapy helpful for treating chronic muscle pain.
Trigger Points and Muscle Pain
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014;2014:523924. doi:10.1155/2014/523924Moraska AF, Schmiege SJ, Mann JD, Burtyn N, Krutsch JP.Responsiveness of myofascial trigger points to single and multiple trigger point release massages – a randomized, placebo controlled trial.Am J Phys Med Rehabil.2017;96(9):639–45. doi:10.1097/PHM.0000000000000728Shah JP, Thacker N, Heimur J, Aredo JV, Sikdar S, Gerber LH.Myofascial trigger points then and now: a historical and scientific perspective.PM R.2015;7(7):746–61. doi:10.1016/j.pmrj.2015.01.024American Academy of Orthopaedic Surgeons.Compartment syndrome.Crum-Cianflone NF.Bacterial, fungal, parasitic, and viral myositis.Clin Microbiol Rev. 2008;21(3):473–94. doi:10.1128/CMR.00001-08Science Direct.Pyomyositis.National Center for Advancing Translational Science.Pyomyositis.Kucuk A, Cure MC, Cure E.Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis.Clin Rheumatol.2020;39(7):2103–2104. doi:10.1007/s10067-020-05178-1Barry AR, Beach JE, Pearson GJ.Prevention and management of statin adverse effects: a practical approach for pharmacists.Can Pharm J (Ott). 2018;151(3):179–188. doi:10.1177/1715163518768534Ozaras N, Rezvani A.Diffuse skeletal pain after administration of alendronate.Indian J Pharmacol. 2010;42(4):245–246. doi:10.4103/0253-7613.68435Younus J, Kligman L.Management of aromatase inhibitor-induced arthralgia.Curr Oncol. 2010;17(1):87–90. doi:10.3747/co.v17i1.474Gabriel M, Sharma V.Antidepressant discontinuation syndrome.CMAJ.2017;189(21):E747. doi:10.1503/cmaj.160991Hospital for Special Surgery.Steroid side effects.Centers for Disease Control and Prevention.Fibromyalgia.Lakhan SE, Schofield KL.Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis.PLoS One. 2013;8(8):e71834. doi:10.1371/journal.pone.0071834Deare JC, Zheng Z, Xue CC, et al.Acupuncture for treating fibromyalgia.Cochrane Database Syst Rev. 2013;2013(5):CD007070. doi:10.1002/14651858.CD007070.pub2Centers for Disease Control and Prevention.What is ME/CFS?.Centers for Disease Control and Prevention.Manage myalgic encephalomyelitis/chronic fatigue syndrome.Arthritis Foundation.Polymyalgia rheumatica.Centers for Disease Control and Prevention.Rheumatoid arthritis (RA).Merck Manual.Rheumatoid Arthritis (RA).Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD.Manifestations of systemic lupus erythematosus.Maedica (Buchar). 2011;6(4):330-336.Lupus Foundation of America.Strategies for managing pain.National Institute of Neurological Disorders and Stroke.Inflammatory myopathies fact sheet.National Institute of Neurological Disorders and Stroke.Thyrotoxic myopathy information page.National Library of Medicine: MedlinePlus.Hypothyroidism.Centers for Disease Control and Prevention.HTDS guide - about thyroid disease: section summary.National Organization for Rare Disorder.Addison’s disease.National Library of Medicine: MedlinePlus.Osteomalacia.Ishak WW, Wen RY, Neghedechi L, et al.Pain and depression: a systematic review.Harv Rev Psychiatry. 2018;26(6):352-363. doi:10.1097/HRP.0000000000000198Harvard Medical School.Pain, anxiety, and depression.Torres PA, Helmstetter JA, Kaye AM, Kaye AD.Rhabdomyolysis: pathogenesis, diagnosis, and treatment.Ochsner J. 2015;15(1):58–69.Arendt-Nielsen L, Fernandez-de-las-Penas C, Graven-Nielsen T.Basic aspects of musculoskeletal pain: from acute to chronic pain.J Man Manip Ther.2011;19(4):186–93. doi:10.1179/106698111X13129729551903Holder K.Myalgias and myopathies: drug-induced myalgias and myopathies.FP Essent.2016;440:23-7.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Orthopaedic Surgeons.Sprains, strains and other soft-tissue injuries.Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014;2014:523924. doi:10.1155/2014/523924Moraska AF, Schmiege SJ, Mann JD, Burtyn N, Krutsch JP.Responsiveness of myofascial trigger points to single and multiple trigger point release massages – a randomized, placebo controlled trial.Am J Phys Med Rehabil.2017;96(9):639–45. doi:10.1097/PHM.0000000000000728Shah JP, Thacker N, Heimur J, Aredo JV, Sikdar S, Gerber LH.Myofascial trigger points then and now: a historical and scientific perspective.PM R.2015;7(7):746–61. doi:10.1016/j.pmrj.2015.01.024American Academy of Orthopaedic Surgeons.Compartment syndrome.Crum-Cianflone NF.Bacterial, fungal, parasitic, and viral myositis.Clin Microbiol Rev. 2008;21(3):473–94. doi:10.1128/CMR.00001-08Science Direct.Pyomyositis.National Center for Advancing Translational Science.Pyomyositis.Kucuk A, Cure MC, Cure E.Can COVID-19 cause myalgia with a completely different mechanism? A hypothesis.Clin Rheumatol.2020;39(7):2103–2104. doi:10.1007/s10067-020-05178-1Barry AR, Beach JE, Pearson GJ.Prevention and management of statin adverse effects: a practical approach for pharmacists.Can Pharm J (Ott). 2018;151(3):179–188. doi:10.1177/1715163518768534Ozaras N, Rezvani A.Diffuse skeletal pain after administration of alendronate.Indian J Pharmacol. 2010;42(4):245–246. doi:10.4103/0253-7613.68435Younus J, Kligman L.Management of aromatase inhibitor-induced arthralgia.Curr Oncol. 2010;17(1):87–90. doi:10.3747/co.v17i1.474Gabriel M, Sharma V.Antidepressant discontinuation syndrome.CMAJ.2017;189(21):E747. doi:10.1503/cmaj.160991Hospital for Special Surgery.Steroid side effects.Centers for Disease Control and Prevention.Fibromyalgia.Lakhan SE, Schofield KL.Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis.PLoS One. 2013;8(8):e71834. doi:10.1371/journal.pone.0071834Deare JC, Zheng Z, Xue CC, et al.Acupuncture for treating fibromyalgia.Cochrane Database Syst Rev. 2013;2013(5):CD007070. doi:10.1002/14651858.CD007070.pub2Centers for Disease Control and Prevention.What is ME/CFS?.Centers for Disease Control and Prevention.Manage myalgic encephalomyelitis/chronic fatigue syndrome.Arthritis Foundation.Polymyalgia rheumatica.Centers for Disease Control and Prevention.Rheumatoid arthritis (RA).Merck Manual.Rheumatoid Arthritis (RA).Cojocaru M, Cojocaru IM, Silosi I, Vrabie CD.Manifestations of systemic lupus erythematosus.Maedica (Buchar). 2011;6(4):330-336.Lupus Foundation of America.Strategies for managing pain.National Institute of Neurological Disorders and Stroke.Inflammatory myopathies fact sheet.National Institute of Neurological Disorders and Stroke.Thyrotoxic myopathy information page.National Library of Medicine: MedlinePlus.Hypothyroidism.Centers for Disease Control and Prevention.HTDS guide - about thyroid disease: section summary.National Organization for Rare Disorder.Addison’s disease.National Library of Medicine: MedlinePlus.Osteomalacia.Ishak WW, Wen RY, Neghedechi L, et al.Pain and depression: a systematic review.Harv Rev Psychiatry. 2018;26(6):352-363. doi:10.1097/HRP.0000000000000198Harvard Medical School.Pain, anxiety, and depression.Torres PA, Helmstetter JA, Kaye AM, Kaye AD.Rhabdomyolysis: pathogenesis, diagnosis, and treatment.Ochsner J. 2015;15(1):58–69.Arendt-Nielsen L, Fernandez-de-las-Penas C, Graven-Nielsen T.Basic aspects of musculoskeletal pain: from acute to chronic pain.J Man Manip Ther.2011;19(4):186–93. doi:10.1179/106698111X13129729551903Holder K.Myalgias and myopathies: drug-induced myalgias and myopathies.FP Essent.2016;440:23-7.
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Shah JP, Thacker N, Heimur J, Aredo JV, Sikdar S, Gerber LH.Myofascial trigger points then and now: a historical and scientific perspective.PM R.2015;7(7):746–61. doi:10.1016/j.pmrj.2015.01.024
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