Introduction
Muscle pain can develop in any of the muscles in the body. The medical term for muscle pain is myalgia. Muscle pain may arise due to injury or overexertion, infections of the soft tissues, or inflammatory conditions. A number of conditions can be associated with generalized aches and pain, such as influenza, that are perceived to be muscle pain. Muscle pain can be localized to one muscle group or diffuse, involving multiple muscle groups. Muscle pain due to injury or overuse is most commonly localized to one area. Depending upon the cause, muscle pain can be mild or severe and debilitating. Muscle pain is the hallmark symptom of some chronic conditions like fibromyalgia. Muscle aches are extremely common. Despite age, gender or race, almost everyone has experienced discomfort in their muscles at some point. Because there’s muscle tissue in nearly all parts of the body, this type of pain can be felt practically anywhere. However, there’s no single cause for muscle aches and pains. While overuse or injury is common, there are other possible explanations for ongoing discomfort and pain muscle tissue.
Signs & symptoms
Symptoms vary from person to person but pain of muscles in the entire body or a localised area is the main sign of muscle pain.
Related symptoms that can occur with muscle pain are
- tenderness
- swelling
- redness
- fever
- Sleep disturbances
Causes
The causes of muscle pain are many. Muscle tissue can be damaged with the wear and tear of daily activities. Trauma to an area like direct blows to the muscle also can cause pain. Other causes of pain include postural strain, repetitive movements, overuse, and prolonged immobilization. Changes in posture or poor body mechanics may bring about spinal alignment problems and muscle shortening, therefore causing other muscles to be misused and become painful.
Often, people who experience muscle aches can easily pinpoint the cause. This is because most instances of myalgia result from too much stress, tension, or physical activity. Some common causes include:
- muscle tension in one or more areas of the body
- overusing the muscle during physical activity
- injury to the muscle while engaging in physically demanding work or exercise
- skipping warmups and cool downs
- fibromyalgia, especially if aches and pains are chronic.
- chronic fatigue syndrome
- myofascial pain syndrome, which causes inflammation in muscular connective tissues called fascia
- infections, such as the flu, polio, or bacterial infections
- Autoimmune diseases such as SLE, dermatomyositis, and polymyositis
- use of certain medications or drugs, such as statins, ACE inhibitors, or cocaine
- thyroid problems, such as hypothyroidism or hyperthyroidism
- hypokalemia (low potassium)
Other causes of muscle pain (myalgia)
- Ciguatera poisoning
- Electrolyte Imbalance
- Medication Side Effects
- Muscle abscesses
- Viral Infection
Pathophysiology
Muscle pain is evoked by specialized nerve endings (nociceptors). Important stimuli for muscle pain are Adenosine Tri Phosphate (ATP) and a low tissue pH. Excitation of muscle nociceptors leads to hyperexcitability of spinal sensory neurones (central sensitization). Low frequency activity in muscle nociceptors is sufficient to induce central sensitization.
Central sensitization leads to increased excitation in the spinal cord and to referral of muscle pain. The motor neurones of a painful muscle are centrally inhibited. Muscular spasm is mostly secondary to a painful lesion in another muscle or joint. The pain of fibromyalgia is assumed to relate to a dysfunction of central nociceptive processing. Psychosocial factors also contribute to pain.
Nociceptive nerve endings in muscles and other tissues are equipped with a multitude of receptor molecules for endogenous pain-producing and sensitizing agents. Particularly interesting molecules are the purinergic receptors, which can be activated by adenosine triphosphate (ATP), and the vanilloid receptor, which is sensitive to protons (low pH). The purinergic receptors are activated by tissue damage because cell necrosis is associated with the release of ATP. A low pH is present in many pathologic conditions such as ischemia and inflammation. At the spinal and medullar level, painful muscle lesions induce marked neuroplastic changes that result in hyperexcitability and hyperactivity of nociceptive neurons. This central sensitization is the basis for the spontaneous pain and hyperalgesia of patients. The transition from acute to chronic muscle pain is complete when the initially functional changes are transformed into structural ones. Patients with morphologic alterations in their nociceptive system are difficult to treat because the changes need time to normalize.
Diagnosis involves a detailed case history and a physical examination. Imaging techniques like X ray, USG, CT and MRI may also be needed. In some cases, a complete blood count and blood tests for rheumatism or allergies are also done.
Treatments
Different types of manual therapy, or mobilization, can be used to treat people with spinal alignment problems. For some acute musculoskeletal pain, these techniques have been shown to speed up recovery.
Medications such as nonsteroidal anti-inflammatories (NSAID s) may be used to treat inflammation or pain.
In patients with musculoskeletal disorders such as fibromyalgia, medications to increase the body’s level of serotonin and norepinephrine (neurotransmitters that modulate sleep, pain, and immune system function) may be prescribed in low doses. Some of the medicines used to aid sleep include zolpidem, eszopiclone, and ramelteon.
Other treatments may include:
- Injections with anaesthetic or anti-inflammatory medications in or around the painful sites
- Exercise that includes muscle strengthening and stretching.
- Physical therapy
- Occupational therapy
- Acupuncture
- Acupressure
- Relaxation
- Biofeedback techniques
- Osteopathic manipulation
- Chiropractic care
- Therapeutic massage
Prognosis
Acute muscle pain often shows excellent prognosis. But muscle pain along with other medical conditions may take a long time to get healed.
Complications
- Chronic pain.
- Immobility and its associated complications (such as bed sores and blood clots)
- Intractable pain that does not respond to treatment.
- Muscle atrophy.
- Muscle contracture.
- Permanent muscle or nerve damage (due to a pinched nerve) including paralysis.
Disease & Ayurveda
Pesiruk
Nidana
Causative factors for Kapha and Vaata
Kshata-injury
Purvaaroopa
Not mentioned
Samprapti
Due to various reasons, the vitiated Kaphadosha gets lodged in raktadhatu, mamsadhatu and medodhatu which are very closely related and the circulation of Vaatadosha and bodyfluids are affected. Together, these vitiated Kapha and Vaata doshas when get lodged in muscles, develop muscle pain and restricts the body movements and locomotor functions.
Lakshana
Pesiruk-Muscle pain
Divisions
Not mentioned
Prognosis
Sadhyam in new and without associated diseases
Yaapyam in chronic and complicated conditions
Chikithsa
Samana
Lepanam with Rookshana dravyas
Swedanam
Mardanam (in completely vaatika)
Udwartanam
Sodhana
Abhyangam
Swedanam
Virechanam
Asthapanavasti
Anuvasanavasti
Commonly used medicines
Maharasnadi kashayam
Rasnasunthyadi kashayam
Yogarajaguggulu
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
- Complete rest and limited movement of the area affected
- Ice pack application to the affected area to help relieve pain and reduce inflammation
Other measures that may provide relief from muscle pain include:
- gently stretching the muscles
- avoiding high-impact activities until after the muscle pain goes away
- avoiding weight lifting sessions until the muscle pain is resolved
- stress-relief activities and exercises such as yoga and meditation to relieve tension
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, sesame oil
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle.
Yoga
Regular stretching and mild cardio exercises are advised to relieve muscle pain in cases other than injury. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
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