As soon as Homo sapiens straightened up and began to walk, obviously from that moment muscle pain appeared when walking. Statistics say that during a lifetime (average duration 65-70 years) a person makes about 500 million step movements and practically covers the distance from the planet earth to its constant companion - the Moon, that is, approximately 400 thousand kilometers. Since 200 different types of muscle tissue are involved in the process of movement, it is only natural that some of them will become overexerted and may become painful.
Simplified, walking can be divided into two main movements - moving the leg and supporting it, with the main load falling on the following muscles:
In addition, muscle pain when walking can occur in the quadratus lumborum muscle, in the muscles responsible for rotating the leg. A painful symptom can be caused by both physiological objective factors and diseases of the blood vessels, musculoskeletal system, spine and even internal organs.
Factors and causes of muscle pain - myalgia, which appears during movement, when walking, are primarily determined by the type and condition of the muscles involved. Also, the pain symptom is influenced by the way of walking, because a person can move in a simple way, that is, go for a walk, be an athlete involved in race walking, or walking is part of his job (postmen, couriers, and so on).
First, you need to decide which muscles are most involved in a particular type of walking, taking into account the joint connection:
Swing stage
Musculus iliopsoas - iliopsoas muscle and rectus femoris muscle, which is part of the quadriceps femoris muscle, as well as the pectineus and sartorius muscles
Quadriceps muscle of the thigh
Tibialis anterior, extensor toe longus, and also extensor hallucis.
Leg support stage
The gluteal muscles, a group of thigh muscles, as well as the muscles responsible for rotating the leg in the hip joint.
Thigh muscles, popliteus, gastrocnemius and partially soleus, gracilis and sartorius muscles.
Triceps surae (gastrocnemius and soleus), flexor hallucis longus and toes, peroneus brevis, peroneus longus, plantaris and tibialis posterior.
Accordingly, the first causes of muscle pain when walking relate to joint diseases and pathologies of the musculoskeletal system:
In addition, the causes of pain in the muscles when walking can be due to the following diseases:
Surprisingly, pain when walking can be experienced not only by those who are constantly on the move; it is precisely these people whose muscles are more developed and trained. The following groups of people most often experience pain symptoms during movement:
When walking, muscles can ache either constantly or periodically; the nature of the pain also varies.
Symptoms of muscle pain when walking depend on the following factors:
Sensations, signs, symptoms of muscle pain when walking can be as follows:
It should be noted that pain can be felt not only in the muscles of the legs and thighs; sometimes a person’s neck muscles ache when walking due to incorrect posture, curvature of the spine, the muscles of the arms may ache with myositis or fibromyalgia, and even the muscles of the chest with pathologies of the bronchopulmonary system and compensatory tension of the pectoral muscles.
As a rule, all pain in the muscles subside with rest, as soon as the person is given the opportunity to resume blood circulation and nutrition in the muscle tissue.
In order to determine the root cause of a painful symptom that worsens with movement, it is necessary to conduct a series of examinations, and for this a person needs to promptly consult a general practitioner, who may refer the patient to a phlebologist, rheumatologist, surgeon, agiosurgeon or neurologist.
Diagnosis of muscle pain when walking involves the following measures:
Diagnosing muscle pain when walking is a rather difficult process, since the symptoms of muscle pain are not always specific; cramping pain in the calf muscles and muscle pain associated with osteochondrosis are most clearly differentiated. As a rule, the first stage of identifying the etiology of a symptom involves the method of exclusion. The remaining diagnostic steps depend on the results of the first stage and the examination is carried out by narrow specialists who have practical experience in diagnosing a specific specific area - vascular, organic or musculoskeletal, spinal.
Treatment of muscle pain when walking, not associated with serious pathologies, is limited to compensatory rest, massage and possibly physiotherapeutic procedures. More in-depth treatment may consist of prescribing vitamin complexes with an enhanced composition of B vitamins, which strengthen and restore the condition of muscle tissue. The prognosis for treatment in such cases is favorable and recovery occurs after a week, rarely 10-14 days.
All other cases in which a pathological root cause is determined are subject to more serious therapy. Treatment for muscle pain when walking in general terms is as follows:
First of all, it should be remembered that in more trained people, whose muscles are accustomed to a reasonable load, pain symptoms when walking occur very rarely. Consequently, the prevention of muscle pain while moving and walking is to maintain normal muscle tone, including the muscle corset in the abdomen, back, and not just the legs.
To avoid muscle pain during active movement, you need to follow these recommendations:
If you have constant muscle pain, it is necessary to undergo a comprehensive examination and follow all medical recommendations in order to avoid serious complications, because some diseases can completely immobilize a person.
Every person has experienced muscle pain (myalgia) at least once in their life. It can occur due to injury, heavy physical activity, illness and other various reasons. Muscle pain can occur both at rest and with movement. Accordingly, the location and radius of spread of the pain syndrome is purely individual, and the cause can be either one factor or a combination of them. Myalgia is not dangerous, but it can be one of the symptoms of a dangerous and even fatal disease.
Myalgia occurs in different parts, it affects different muscle groups and for different reasons. Therefore, it is necessary to consider the causes and nature of pain depending on the muscle group.
Myalgia in the cervical-collar area is most often a consequence of diseases or disorders of the spine. The most common cause of myalgia is cervical osteochondrosis. But neuralgia, diseases of the lungs, heart and lymph nodes can also be causes. In addition, age-related changes or simply aging also causes muscle pain.
If muscles hurt only when moving, then the cause may be colds or increased physical activity.
Pain in the back muscles mainly occurs due to muscle fatigue, osteochondrosis of the thoracic and lumbar spine, short leg syndrome, reduction in the size of the pelvis, short shoulders and the most commonplace, prolonged tension due to being in an uncomfortable position. People who lead a sedentary lifestyle and work in offices or at computers often suffer from back pain.
The pain can be very severe if a nerve is pinched. In this case, you must urgently contact a neurologist so that he can prescribe an examination and then treatment.
Muscle pain in the arms can be a symptom of neuralgia, as well as normal muscle fatigue. Very often, athletes and bodybuilders who work with very heavy weights experience hand myalgia. With significant muscle fatigue, lactic acid begins to be produced, muscle fibers receive micro-tears, which lead to pain.
More often, the pain syndrome occurs asymmetrically, that is, only one arm hurts. If the pain is constant and long-lasting, it can become a cause or a sign of a much more serious disease.
Pain in the gluteal muscles most often occurs due to overexertion or problems with the lumbar and sacral spine. The gluteal muscles receive the least attention during massage, which is why most people have fibrosis there, and in some it leads to pinched nerves.
Constant sedentary work, uncomfortable position, hard chairs, the wrong bed for sleeping - the causes of pain lie very close. If the pain is constant, then you should consult a doctor. There may be a pinched nerve or an exacerbation of diseases of the musculoskeletal system.
Why do my leg muscles hurt? Every day the legs take the maximum load, a person makes all movements and movements on his own two feet. If you overexert your lower limbs, a muscle spasm naturally occurs, accompanied by unpleasant pain. Due to a sedentary lifestyle, blood circulation is impaired, small stagnation of blood forms in the lower extremities, which causes muscle pain.
Varicose veins and other vascular diseases affect the legs, and then spread to the rest of the body. With varicose veins and arteriosclerosis, the legs hurt unbearably, they get tired very quickly, weakness and uncertainty in movements appear. Diseases of the musculoskeletal system primarily affect the health of the legs.
Before starting treatment, it is necessary to determine the causes of muscle spasm or pain. Usually, this is a whole set of factors associated with changes in the muscles of the thigh and pelvis. If there is constant pain, it is necessary to be examined for not only local lesions, but also general pathology. However, muscle pain may be due to normal overstrain of muscle fibers and micro-tears as a result of heavy training. For a 100% diagnosis, it is necessary to undergo an examination and seek advice from a medical specialist.
If myalgia occurs as a result of injury, then externally it should manifest itself as swelling, edema, or hematoma. With meositis, the temperature rises, pain bothers you during movement and at rest. In case of vascular pathologies, when palpating, you can feel lumps, the skin has an unhealthy appearance, the pain is sharp, pulling, throbbing.
Painful sensations can be caused by heavy physical activity, prolonged wearing of high-heeled shoes, and fatigue. However, if painful symptoms recur cyclically, become constant, and convulsions appear, then this is the first alarm bell to seek medical help.
Myalgia can be a symptom of varicose veins, myopathy, arteriosclerosis, musculoskeletal disorders, and even a side effect of certain medications.
The quadriceps muscle is the largest and heaviest muscle in the legs; it bears the main load during movement and walking, and is in almost constant tension. When it is affected, pain occurs in the thigh, in the knee joint, and can radiate to the lower back. Since the quadriceps muscle is responsible for flexion and extension of the knee, the pain is mainly based in the lower thigh.
It is very difficult for doctors to make a diagnosis because different stress points cause pain in different places.
Quite often, myalgia is combined with severe pain in the joints and joint capsule; such sensations may be accompanied by swelling, an unhealthy shade of the skin, and a slight increase in body temperature in general and directly at the lesion. Why do all the muscles of the body hurt? The reason may be either illness or simple fatigue. If the pain spreads directly throughout the body, manifesting itself not only during movements, but also at rest, then it is necessary to urgently seek qualified medical help.
If the pain syndrome manifests itself exclusively in the dark, namely at night, then this may be a sign of vascular disease. In fact, the question of why muscles hurt at night is quite simple to answer. During sleep, the human body almost completely relaxes, and the muscles that were overstrained during the day take the correct position.
What to do if you have muscle pain? Naturally, it is initially necessary to determine the cause of myalgia, as well as the possible disease that caused it. But often myalgia exists as a completely independent disease, so if the muscles hurt, they need to be treated. Treatment may be:
For varicose veins, myositis, abscesses, boils and various hematomas, you should not rub your legs, warm them, wrap them, or rub them with various alcohol-containing substances and warming or cooling ointments. It is also necessary to be more careful with treatment (especially for traditional medicine) when treating myalgia near the surface of open wounds, so as not to aggravate the situation and provoke infection. What treatment can doctors prescribe?
Treatment with medications can be divided into several main methods of application:
Tablets and injections are used when myalgia is accompanied by any associated complications or additional symptoms. Antispasmodic drugs are prescribed to relieve pain and improve overall well-being. Drugs are also prescribed to relieve inflammation or lower body temperature. Immunostimulating agents may be prescribed.
Injections are used when emergency assistance is needed. Therefore, rapid response drugs are usually prescribed:
They should have an anti-inflammatory and good analgesic effect. Some have a warming effect, and some have a cooling effect. The purpose and components of ointments depend on the severity of the disease and its type.
An operation is prescribed when it is impossible to find another way other than surgical intervention. Usually, these are not the most complex operations, such as cutting out inflamed and festering areas of the skin. However, if you start some serious diseases, then the question may already stand between life and death. Thus, harmless varicose veins in the later stages can lead to thrombosis and instant death. Obliterating endarteritis, whose main symptom is myalgia for several weeks, can lead to gangrene and death.
Traditional medicine is an important section; various herbal infusions and ointments can lift even a cripple, as people say. Muscle pain can be treated well with rest, ice and a pressure bandage on the affected area. This method has long been tested by athletes, for whom injuries and sprains are far from uncommon. In this case, the legs should be positioned above the heart, like other limbs, not bandaged too tightly and use elastic bandages.
If there is no swelling, you can take a hot bath or go to the sauna. Hot steam will steam the skin and allow toxic products to quickly come out through the pores, thereby starting the mechanism for restoring muscle fibers. Tinctures based on St. John's wort, mint, and lemon balm help well.
Muscle pain is a nonspecific pain syndrome, which in medicine is called myalgia (myos - muscle, algos - pain). Pain can occur independently, spontaneously, or under objective circumstances - palpation, physical strain.
The etiology and pathogenesis of myalgia is still a field of study; a single, generally accepted hypothesis does not exist today.
However, some types and localizations of muscle pain have been studied quite well and are pathogenetically explained by insufficient permeability of the cell membranes of muscle tissue, as well as inflammatory processes in it. Muscle pain can develop in people, regardless of age and gender, its clinical manifestations are associated with the etiological factor and the area of localization. There are three types of myalgia, which are defined as independent nosologies and are recorded in the classification:
Muscle pain can also be a symptom of epidemic myalgia - Bornholm disease, a disease of viral etiology (Coxsackie virus). There are also forms of myalgia that are not accompanied by organic changes in muscle tissue and dysfunction in the joints, are volatile, transient in nature and do not have visible objective symptoms manifested clinically. These vague myofascial manifestations still remain a poorly understood phenomenon; most often they are associated with psychogenic factors.
In the international classification of diseases, ICD-10, myalgia is recorded within class XIII (diseases of the muscular system and connective tissue) and group M70-M79.
ICD-10 code - M79.1 - Myalgia, Fibromyalgia, myofascial syndrome.
The etiology of muscle pain has long been the subject of study by many specialists; reviews on this controversial issue have been published for two centuries, but the problem of a single etiological basis for myalgia still remains unresolved. Moreover, apart from the unspecified etiopathogenesis, there is no consensus on terminology and classification, and accordingly, diagnosis is difficult.
A typical example is fibromyalgia and MFPS - myofascial pain syndrome, which are often confused with each other due to the unclear etiological cause of the disease. The symptoms of muscle pain are multivariate; it is extremely difficult to determine the nosological affiliation of the syndrome, since it is characteristic of a whole list of systemic, neurological, endocrine, infectious, rheumatic and other pathologies. It should be noted that according to recent scientific research, the relationship between muscle pain and the somatic nervous and autonomic systems, which form pain irritation, has been established.
If we take as a basis the versions used by practicing doctors, then the causes of muscle pain are provoked by the following conditions, diseases and objective factors:
A more specific list of causes of myalgia, proposed by the International Association of Rheumatologists, looks like this:
Infectious pathologies, infectious myositis, provoked by such pathologies:
In addition, the causes of muscle pain can be due to a number of psychogenic factors, which are considered the most problematic in a diagnostic sense.
Throughout the entire period of pregnancy, not only the muscles, but also other systems and organs of the expectant mother undergo changes that are quite understandable from the point of view of the physiology of the gestation process. One of the causes of pain, in addition to the purely anatomical (due to stretching), is the effect of progesterone on the cell membranes of skeletal muscles. The concentration of progesterone decreases after the 20th week of pregnancy, then muscle pain subsides slightly, and residual effects are associated with the body preparing for labor.
Muscle pain during pregnancy primarily affects the abdominal area, abdominal muscles and pelvic muscles. The rectus muscles, the muscles that hold the abdominals, change their task, now they must support the growing uterus. Skeletal muscles also undergo changes, as not only does a woman’s weight increase, but her posture also changes. The back bends forward, the leg muscles hurt, especially in the calves. Almost all smooth muscles are involved in the transformation process, so those who have prior preparation, training, and those who have previously been involved in sports or fitness endure the period of gestation much easier.
It is no coincidence that doctors recommend that expectant mothers perform daily muscle strengthening exercises; exercises that help increase the elasticity of ligaments (stretches) are especially useful; it is also important to strengthen the pelvic muscles, which are directly involved in childbirth and are often injured if they have not been properly prepared. To prevent pain in the calf muscles, so characteristic of pregnancy, you should regularly take special vitamin complexes containing calcium, magnesium, potassium, vitamins E, D, A, K. Back pain is prevented by gymnastics that strengthens the muscles in this area (muscle corset) . You should also train the muscles of the vagina and groin muscles, since childbirth can provoke traumatic stretching of them, leading to complications, including situational enuresis (when coughing, laughing). Preventing pain in the chest muscles will help avoid stretch marks and minimize the risk of loss of shape of the mammary glands. Currently, there are many special courses that help pregnant women learn to manage their muscle tone in order to avoid pain during pregnancy, as well as to prepare the whole body for a painless birth.
Most often, a child’s muscle pain is associated with the so-called “disease” of growth, that is, the symptom is caused by a completely normal, natural process of growing up. Some children do not feel discomfort associated with growth at all, while others react quite painfully. The etiology of myalgia in children is not fully understood, but the generally accepted version is a discrepancy between the rates of growing bone and muscle-ligamentous systems. The skeleton grows faster, tendons and muscle tissue do not have time to adapt to the speed and intensity of growth.
Of course, this explanation is extremely simplified; in fact, in a child’s body everything is more complicated. It is believed that muscle pain in a child is associated with hidden congenital or acquired chronic pathologies. The most common muscle pain symptom is in children aged 3.5-10 years; adolescents also suffer from myalgia, but it has a more precise etiological cause.
Muscle pain can be a symptom of an underlying disease, or less often it is an independent condition.
List of factors and conditions that cause reversible muscle pain in a child:
In addition, there are a number of serious pathologies that are characterized by muscle pain in children:
Fibromyalgia and polymyositis (dermatomyositis) do not occur in children; isolated cases are so rare that they are considered a diagnostic phenomenon or an error.
Thus, unlike adults, 85-90% of muscle pain in children is caused by physiological or situational factors. Such pain can be defined as a curable, reversible symptom. However, if pain prevents the child from moving normally, is accompanied by hyperthermia, visible bodily defects (curvature, protrusion, depression), parents should urgently consult a doctor to examine the child and begin adequate treatment.
The normal motor activity of the human body depends on the elasticity of muscle tissue and the ligamentous apparatus of the lower extremities. The muscular system of the legs can be divided into limb muscles and pelvic muscles. The hip joint moves thanks to the piriformis, iliopsoas, gemelli, obturator, gluteus maximus, gluteus minimus, gluteus medius, quadratus, and tensor femoris muscles. The lower limbs move thanks to the muscles of the lower leg, thigh, and foot.
Muscle tissue constantly needs blood supply, including oxygen nutrition, especially the legs, since they bear the entire load of the evolutionary skill - upright walking. The “safest” causes of pain in the leg muscles are physical fatigue, intense sports activities, or forced static stress (monotonous posture, monotonous movements). These types of pain are quite easily relieved with relaxing massages, warm baths, rubbing and simply resting. However, there are more serious factors that provoke pain in the leg muscles:
Muscle pain in the legs is treated by a traumatologist, surgeon, phlebologist, angiosurgeon, and rheumatologist.
The thigh muscles are a type of muscle tissue that, on the one hand, is characterized by increased elasticity and strong structure; on the other hand, pain in the thigh muscles is a direct evidence of increased load on this area of the body. The most common cause of pain in the thigh muscles is considered to be elementary physical overload; the pain can be transient, aching, and even partially limit the movement of the legs. Radiating pain in the groin and down the legs is already a symptom of another pathological factor, for example, osteochondrosis of the lumbosacral region, pinched nerve endings, radiculopathy.
The following provoking factors directly relate to myalgia:
In addition to physiological, situational reasons, factors provoking pain in the thigh muscles may include the following pathologies:
The muscle of the lower back leg (calf) consists of the gastrocnemius, biceps and soleus muscles. The gastrocnemius is located closer to the surface, the soleus is much deeper, but they both perform the same tasks - they allow the ankle joint to move, help control balance, and provide shock absorption during movement.
The blood supply to the gastrocnemius muscle is provided by a system of arteries starting in the popliteal region, and the muscle also contains many nerve endings extending from the tibial nerve. Such rich nutrition of muscle tissue, on the one hand, helps to perform its functions, on the other hand, it makes the back surface of the leg vulnerable to factors that provoke pain in the calf muscle.
Reasons that cause pain in the musculus gastrocnemius - calf muscle:
Post-workout pain is typical for beginners; experienced athletes and bodybuilders do not allow their body to experience additional discomfort. Although in any sport there is an unspoken rule “no pain - no gain”, which means without pain there is no growth, in this case, muscle mass, muscles. However, almost all experts paraphrase this expression in this way - “there is no head on your shoulders, there will be pain without growth” and this is true.
Some stiffness, soreness and, accordingly, muscle pain after training are acceptable even for those who have been involved in sports for a long time, especially after intense exercise. The pain is a consequence of microtraumas of muscle tissue and fascia and, as a rule, subsides after 2-3 days. This is considered a valid symptom that is not pathological.
The reasons that provoke “normal” muscle pain after exercise are not fully clarified, but the following versions exist:
What do you need to know and do to keep pain after training within normal limits?
Muscle pain that gets worse when walking can be a signal of many chronic or acute diseases, the most common of which are the following:
Pain in muscles and joints - these are musculoskeletal pain or dorsalgia (back pain), thoracalgia (chest pain), cervicalgia (neck pain) and other “algia”. It should be noted that the terminology defining pain in muscles and joints changes periodically in proportion to the emergence of new scientific research results.
In ICD-10, diseases of the musculoskeletal system are classified as class XIII, in addition there is a section describing nonspecific musculoskeletal pain as
an unpleasant, emotional-sensory sensation. According to the classifier, this sensation is caused by real or potentially developing injury, damage to muscle or bone tissue.
The nature and types of pain symptoms related to muscles and joints:
Obviously, the most realistic in diagnostic terms is nooceptive pain, which is explained by the stimulation of nociceptors located in tissues (visceral and somatic). The most “ephemeral” is psychogenic pain in muscles and joints, since it has no real physical basis.
What causes nonspecific musculoskeletal pain?
In a diagnostic sense, nonspecific pain in muscles and joints is a difficult task, since it is necessary to differentiate a somatically localized symptom, reflected (visceral), projection (neuropathic) and other types of clinical manifestations. In addition, pain in muscles and joints is often diagnosed as myofascial syndrome - MPS, which is a type of somatogenic pain symptoms, the source of which is considered not so much joints, but skeletal muscle tissue and adjacent fascia.
The general name for back pain is dorsalgia, but pain in the back muscles is not always associated with diseases of the musculoskeletal system; it is often caused by MPS - myofascial pain syndrome, that is, reflex impulses coming from damaged, degenerative or inflamed discs, joints or ligaments. The back muscles seem to “dress” the affected area of the body in a corset, immobilizing and preserving it. The causes that can cause spinal pain are varied, but the most common are the following:
Back pain at the level of muscle tissue can be localized both in the shoulder-scapula area, neck, and in the lumbar region, which is most common. In fact, the pain symptom spreads along the entire spinal column and can radiate, so it is very important to determine the onset of impulse transmission in order to eliminate the factor provoking the pain. When diagnosing muscle pain in the back, doctors exclude compression radicular syndrome, vertebrogenic and spinal pathologies. The following clinical signs are characteristic of MPS - myofascial pain syndrome:
Pain in the muscle tissue of the lumbar spine is most often associated with overstrain and overload. Moreover, the load can be either physical, dynamic, or static (sedentary work, monotonous static posture).
In addition, pain in the back muscles often occurs due to scoliosis, osteochondrosis or displaced intervertebral discs, hernia. Less commonly, a painful symptom is provoked by vitamin deficiency (B vitamins) and pathologies of internal organs located in the pelvic area; such pain is either spastic in nature, or it is aching, pulling and does not respond to therapy with myelorelaxants, distracting (cooling, warming) procedures.
In the medical classification, pain in the lower back muscles is divided into primary and secondary syndrome:
It should be noted that a very common cause of pain in the lumbar muscles is lumbago. This disease is still considered a subject of heated debate and does not have a clear classification in terms of symptoms and diagnostic methods.
Modern doctors use a version that describes lumbago as an extensive lesion of muscle and nervous tissue, as well as joints of the lumbosacral spine. People call lumbago a lumbago, since this is the most accurate description of pain, however, lumbodynia can also manifest itself in the form of a subacute course. Pain in the lower back muscles develops suddenly as a result of a sharp turn, bend or static tension. Some patients claim that lumbago “overtook” them as a result of a draft or hypothermia. The pain symptom is distributed throughout the lower back, symmetrical, rarely radiating up to the hips or down to the buttocks. In a horizontal position, the pain may subside, but recur when coughing or sneezing. The lower back muscles are very tense, but with timely and adequate treatment they quickly relax. As a rule, treatment lasts no more than 2 weeks; more often, the main symptoms are neutralized after 3-5 days.
How to distinguish lumbar muscle pain from other types of pain symptoms?
The main distinguishing feature of signals from spasmodic long lumbar muscles is their clear, constant localization. Muscle pain is not able to move, radiate to the leg or groin, but provokes a limitation of mobility.
A painful symptom in the abdominal area is called abdominalgia, but it is not always related to muscle tissue, as it is caused by diseases of the internal organs of the digestive system and pelvis.
Often, not only patients, but also diagnosticians find it difficult to quickly determine the nature of an abdominal pain symptom, it is so skillfully “masked”, therefore it is very important to differentiate between visceral and pseudovisceral pain, which have different underlying causes.
The abdominal muscle tissue consists of 4 main muscles:
In all these muscles, pseudovisceral pain can develop with a focus of neurodystrophic pathology in three types:
If the front part of the abdomen hurts, then we can talk about anterior abdominal wall syndrome, when the pain is closely related to movements and is not caused by a dietary factor or a violation of the process of food digestion. The cause of such pain can be injury, muscle overstretching due to training, scar tissue after surgery, and pain in the abdominal muscles can be reflected, that is, a response to pathologies of internal organs localized in this area. In addition, pain with very similar clinical manifestations can be caused by lower lobe pneumonia, coronary insufficiency, ruptured intervertebral disc in the upper lumbar region, and even acidosis associated with diabetes. For differentiation, anesthesia of the muscle or nerve is used; if the pain symptom subsides, this indicates myofascial syndrome; if the pain remains, somatic pathology and organ damage should be determined.
Syndrome of the oblique abdominal muscles, less commonly – the rectus abdominis. This complex of abnormal abdominal muscle tone is visually identified as a “frog belly” or “egg belly” depending on which muscles are hypotonic. If hypotension affects both the rectus and oblique muscles, then the person’s abdomen is swollen symmetrically, if hypotension affects only the Transverses abdominis - the rectus muscle during shortening, contraction of the obliques, then the walls of the abdominal zone protrude forward in the form of a kind of “egg”. An egg-shaped belly is accompanied by pain in the groin and lower thoracic region. The syndrome is practically not amenable to drug treatment until the tone of the rectus muscle is normalized; the oblique muscles return to normal later, automatically. The syndrome provokes an exacerbation of lordosis, the pelvis is displaced forward, and kyphosis of the lower part of the sternum develops. Abnormal tone of the rectus or oblique muscle can be caused by both a physiological factor - pregnancy, and other processes - obesity, postoperative condition (sutures, scars). In addition, abdominal pain in muscles of this kind is provoked by curvature of the pelvis, divergence of the pubic structures (pubic symphysis). The syndrome requires complex treatment, since advanced undiagnosed forms, a long period of overstrain of the abdominal muscles can pathologically affect the peroneal muscles, and therefore the hip joints. Thus, the main danger of oblique or rectus muscle syndrome is coxarthrosis.
In addition, abdominalgia can develop as referred pain, as a secondary symptom in diseases of the spine:
Gastrointestinal, somatovisceral, cardiac clinical manifestations in the abdominal area are also often classified as abdominal pain, but these pains are only one of the many consequences of the main signs of the disease, and therefore cannot be described as myalgia.
Pain in the arm and upper extremities has its medical terminological definition – brachialgia. Myalgia is a more specific designation for this type of symptomatology, such as pain in the muscles of the arms, most often it is associated with overexertion and physical activity. Pathogenetically, the pain symptom is caused by the vulnerability of cell membranes, swelling of muscle fibers, as well as their inflammation. Since the arm consists of the muscle tissue of the shoulder, forearm and hand, all these areas can hurt or they suffer alternately. The main causes of pain in the arm muscles are:
Also, the muscles of the arm may ache with pathological syndromes:
The shoulder girdle is connected to the neck, upper limbs, and all this is a rather complex system where all elements must work harmoniously and in concert. Any pathological change in the structural component, for example, such as pain in the shoulder muscles, can disrupt a person’s motor activity. Among all complaints of muscle pain, pain in the shoulder muscles is considered the most typical; these symptoms are not only presented by patients, but are also diagnosed by doctors in 30-35% of cases of regional myalgia.
Pain in the upper extremities is generally called brachialgia, but a pain symptom affecting muscle tissue is first of all a direct indication of myofascial syndrome, and only after that it is a possible sign of neurological or somatic diseases, in which painful sensations are reflected.
Pain in the shoulder muscles, provoked by the myofascial factor, has its own diagnostic points for localizing symptoms, these are the so-called trigger points in specific muscles of the shoulder girdle:
The cause of pain in the shoulder girdle may be the following factors:
How to determine which muscle is damaged?
In addition, no matter which shoulder muscle is affected by myotonic damage, a person finds it difficult to raise his arm to the opposite shoulder, to place his shoulder, so intense is the tension in the muscle tissue. The main diagnostic criterion for myofascial shoulder pain is the patient’s precise indication of the point of pain. The symptom is often aching, diffuse in nature, but during movement it seems to “gather” into one point, which is the trigger point.
A painful symptom in the muscles of the forearm can be caused by neurodystrophic, infectious diseases, an inflammatory process in the ligaments and tendons, as well as factors relating only to muscle tissue.
Causes of pain in the forearm muscles:
Pronator teres syndrome, provoked by mechanical trauma, neuropathies, vascular pathology, and infectious disease. The syndrome develops against the background of pinching, compression of the nerve between the heads of the shortest and densest muscles - the pronators. The condition most often occurs due to prolonged overstrain of the pronator muscles and extensor muscles of the fingers. This is typical for violinists, pianists, guitarists, as well as some sports and even medical specialties (dentistry). In addition, pronator syndrome is often called honeymoon paralysis - honeymoon syndrome, which has a rather romantic explanation: during the first mating season, the head of one of the lovers is on the forearm of the other for a long time, which provokes a muscle spasm, “paralysis” of the radial nerve of the forearm.
Neck pain is called cervicalgia, which, among all pain symptoms associated with the back, accounts for about 28-30% of cases. Pain symptoms in the neck area are divided according to etiology - vertebrogenic and muscular-tonic, non-vertebrogenic.
Pain in the neck muscles is myotonic and can be caused by the following reasons:
Cervicalgia can be combined with pain in the head - cervicocranialgia or with pain in the shoulders, arms (arm) - cervicobrachialgia. Unlike vertebrogenic pain, acute myotonic manifestations rarely last more than 10 days; they quickly turn into chronic pain and gradually subside within a month, even without treatment (compensatory, adaptive mechanism of muscle tissue).
Pain in the neck muscles is a typical, “classic” symptom of an office worker, which, if desired, can be identified in 80% of all employees who are forced to work while sitting at a desk.
Symptoms of neck pain:
Myotonic symptoms are directly caused by hypertonicity, the following types of syndromes:
In addition, spondylitis can also be causes of muscle pain in the neck area,
oncological processes, psychogenic factors – psycho-emotional stress.
Pain in the chest muscles can be caused by both pathology of internal organs (heart, lungs, stomach, duodenum and others), and diseases of the spinal column and peripheral nervous system, as well as myofascial syndrome. The main characteristics of non-visceral pain in the chest muscles associated with the spinal cord, ribs, and spine:
Pain in the chest muscles of myofascial nature is always caused by spasm, hypertonicity of injured or inflamed muscle tissue, as well as a noticeable disruption of blood microcirculation. As a rule, MFPS (myofascial pain syndrome) develops in the extensor muscles of the back or in the muscles of the scapula and shoulder and is expressed by local or segmental discomfort. The diagnostic parameters of muscle pain in the chest are TT - trigger points; if palpated, they respond with severe pain, including reflected pain, along the direction of the muscle fibers. Pain at trigger points can be spontaneous or active; latent pain develops with constant exposure to the trigger zone.
Causes of myofascial pain syndrome in the chest:
Localization of chest pain with MFPS:
Painful muscle symptoms in the chest can be caused by the following syndromes:
The myofascial nature of pain in the chest, on the one hand, significantly complicates the diagnosis of diseases due to the lack of specific symptoms, on the other hand, it allows one to quite accurately determine the area of the inflamed tense muscle thanks to the scheme of TT - trigger points.
The gluteal muscle consists of three components - the large, medium and small muscles. Pain in the gluteal muscle can be localized directly in the buttocks or be reflected in diseases of the spinal column, hip joints, and neuropathies.
Causes of pain in the muscles of the buttocks:
In addition, pain in the gluteal muscle is provoked by typical myofascial syndromes:
The laryngis muscles are striated muscle fibers that perform 2 main functions in the larynx:
Most often, pain in the throat muscles is caused by professional overexertion, which is so typical for educators, teachers, artists, singers, announcers and all those who strain the vocal apparatus every day. The most common symptom of occupational myalgia of the larynx is considered to be functional dysphonia, when hypertonicity (less often hypotonicity) develops in the throat muscles, and the strength and timbre of the voice changes.
Dysphonia can take the following forms:
Hypotonicity of muscle tissue develops against the background of overstrain of the vocal cords, less often after acute respiratory viral infections, tonsillitis, hormonal dysfunctions, tracheitis, more often due to psycho-emotional factors and stress. During an ENT examination, not a single sign of inflammation of the mucous membrane is detected, just as signs of other throat pathologies are not detected.
Hypertonicity of the throat muscles can be triggered by intense stress on the vocal cords - screaming, loud speech, singing, and so on. Pain in the throat muscles is accompanied by pain in the abdominal muscles, which is caused by physical strain and increased movements of the diaphragm. In addition, the neck muscles may ache, a cough may appear, and the vocal cords may close tightly.
Spastic tension of the throat muscles is associated with the neurodynamic load of the internal external and respiratory muscles of the larynx. This condition is typical for stressful situations and psycho-emotional trauma.
Sore throat muscles can also develop due to excessive strength training, after exercise, and as a symptom of a “long head”, which is most common in certain sports, such as tennis.
Pain in the muscles of the scapula most often provokes scapular-costal syndrome (SRS), which is expressed in a feeling of heaviness, aching discomfort in the scapulohumeral area (closer to the upper corner of the scapula). The pain can radiate to the shoulder, to the side of the sternum; the symptom develops unnoticed and intensifies with static or dynamic intense loads on the muscular apparatus of the shoulder and chest. Pain in the scapula muscles gradually progresses and spreads to the neck and collarbone area. Their vegetative nature helps differentiate myalgic pain in the shoulder blades; in contrast to radicular symptoms, these pains are usually aching, pulling, without lumbago. Often the pain intensifies when exposed to temperature (weather conditions). In addition, the localization of myofascial pain does not correlate with the innervation of the roots and peripheral nerve endings.
Causes of LRS - scapular-costal syndrome:
Diagnosing LRS is not difficult, since trigger points in this area respond to palpation with a distinct pain signal.
In addition, pain in the scapula muscles can be a consequence of chronic spasm or paralysis of muscle tissue - acquired pterygoid scapula syndrome. This pathological condition is typical for people involved in sports (rowing, tennis), and can also be caused by injury, bruise of the shoulder girdle.
Pain in the pelvic muscles is not only a clinical manifestation of prostatitis, gynecological diseases, and coccydynia. Modern doctors are familiar with other causes of pain in the pelvic area, in particular with MFPS - myofascial pain syndrome. The main diagnostic criteria for confirming the myofascial nature of the symptoms are clear painful signals upon palpation of TT - trigger points located in smooth muscles, including the pelvic muscles.
The most common types of muscular-tonic syndromes are:
Pain in the face is called prosopalgia, it is usually associated with neurological pathologies, neuropathy, in particular the trigeminal nerve. However, pain in the facial muscles, as a rule, is caused by a completely different factor - myofascial pain syndrome, which affects only muscle tissue. Facial myofascial syndrome is local pain in the head and neck area, with the most common pain in the neck muscles, facial and masticatory muscles. In addition, pain in the facial muscles can be localized in the temples, lower jaw, near the ear, and in the back of the head, in the frontal or parietal region.
The pathogenetic mechanism for the development of pain in the facial muscles is identical to the process of development of pain in other skeletal muscles: the onset of pain is the result of overexertion, the development is chronic hypertonicity of the muscle, the result is spastic pain (cramps). An example would be pain in the jaw when you yawn or open your mouth wide. Constant spasms of the facial muscles can be dangerous in the sense of secondary vascular and inflammatory disorders, which causes a vicious circle - primary myalgia provokes secondary pain, which in turn activates myalgic symptoms.
MFPS (myofascial pain syndrome) of the face is determined by trigger points of reflected or localized pain. Typical trigger locations are the temples, masticatory and pterygoid muscles. Less commonly, TT (trigger points) can be palpated in the area of facial muscles; such pain can develop as a result of hypertonicity of the sternoclavicular or trapezius muscle.
Reasons that provoke pain in the facial muscles:
Pain in the musculus masseter - the masticatory muscle - can be associated with tension headaches, when the spastic state of the muscles provokes a pain symptom in the temples, in the forehead, back of the head, ear and jaw. This syndrome refers to TMJ - diseases of the temporomandibular joint, usually Costen syndrome - joint dysfunction. The reason may be of a psycho-emotional nature, and also associated with elementary overexertion, muscle hypertonicity; in addition, pain in the masticatory muscle sometimes occurs with endocrine pathologies, with unsuccessful prosthetics. The mechanism of pain development is as follows:
In an effort to get a pumped up belly and see the coveted “pack”, a person can sometimes overdo it and feel pain in the abdominal muscles. What is commonly called the abs is nothing more than the rectus abdominis muscle; it is this muscle that creates the appearance of the abdominal area; it is this muscle that many try to put “in order” through work and training. Less commonly, abdominal pain is localized in the external oblique muscle, which is more extensible and not as dense in structure.
Pain in the abdominal muscles is most often associated with post-workout pain, which is also called delayed, delayed pain, or sore throat. The cause of the pain symptom is usually called lactate - lactic acid, although according to the latest data, it has little effect on discomfort in the abdominal area, as it accumulates and dissolves literally within half an hour. Most likely, the cause of pain is microtrauma of muscle fibers, which in untrained people do not have a high level of elasticity and extensibility. In addition, muscle fibers contain short and long myofibrils - cylindrical organelles, elements of striated muscles. Short myofibrils are very vulnerable and under intense loads they are injured and torn, which provokes transient pain in the abdominal muscles. If you train in doses, with good warm-up exercises, then the pain symptom may not appear or may be almost invisible. With regular exercise and strengthening of the abs, the length of myofibrils is equalized, muscle fibers become dense without losing elasticity.
The definition of “groin area” is usually used when talking about the area of the articulation of the thigh with the body. Thus, the groin is not a separate anatomical part of the body, but a rather vulnerable, sensitive area that has a ligament and contains many attachment muscles (pulling, flexing, adducting).
Pain in the groin muscles is most often caused by damage to the adductors, or more precisely, the adductors, located inside the thigh. Contraction, inflammation, injury, or stretching of these muscles is always accompanied by severe pain in the pelvic and groin areas.
Causes of groin pain associated with muscle tissue:
In medicine, pain in the groin muscles is called inguinal-genital myofascial syndrome (IGMS), which, in addition to pain, can be accompanied by angiopathy of the venous center of the spermatic cord in men or angiopathy of the round ligament in women.
Pain in m. trapezius - trapezius muscle - the most common myalgic symptom. The trapezius muscle is responsible for moving the shoulder blades up or down, it is attached to the base of the skull, localized along the back of the neck, on top of the shoulder girdle and in the upper, middle area of the back.
The main reason that causes pain in the trapezius muscle is physical or mental stress; less often, the symptom is provoked by injury or bruise. It is the shoulder girdle that is subject to constant stress as a result of many types of human activity - sedentary work in the office, at the computer, talking on the phone, sleeping on pillows that are too high, holding heavy weights. The list can be continued indefinitely, since the vertical position of the body is inevitably accompanied by a certain load on the trapezius muscle.
Pain caused by hypertonicity m. trapezius, manifests itself as discomfort in the neck, closer to the base of the skull; often such tension forces a person to compensatoryly raise his shoulders upward, which only aggravates the muscle spasm. Chronic overexertion leads to severe headaches - tension headaches (tension headaches), localized in the temples, less often in the forehead.
Portnov Alexey Alexandrovich
Education: Kiev National Medical University. A.A. Bogomolets, specialty - "General Medicine"