Muscle Pain: Causes, Types, Prevention & Treatment

In this piece, we are going to answer your common questions regarding muscle pain and how you can better manage it:

• What causes muscle pain?
• What is physically happening to the muscle?
• How do I prevent muscle pain?
• What can I do to treat muscle pain?
• How can an Osteopath help?

What causes muscle pain?

The causes of muscle pain are numerous but can be broadly classified as:

Traumatic / Acute muscle pain often results from a single traumatic event that has injured the muscle. There is usually a clear link between the cause and symptoms. Acute muscle pain is most commonly presented as a result of accidents and contact sports such as rugby, soccer and basketball because of their dynamic and high collision nature.

Overuse / Chronic muscle pain is usually subtler and often occurs over a longer period. It results from repetitive micro-trauma to the muscle, causing the muscle to fatigue and become sore. Repetitive activities such shovelling gravel, overtraining at the gym, or typing on a keyboard for long periods everyday can often lead to chronic muscle pain.

Underuse syndrome is often overlooked as a cause of muscle pain. It refers to muscle pain and injuries caused by physical inactivity and a sedentary lifestyle, which in turn can lead to muscle stiffness, weakness, and loss of tone. When followed by movement of the body in an unfamiliar manner, such as lifting a box or playing a solitary game of tennis, this can result in muscle pain.

Systemic muscle pain is characterised by pain throughout your whole body, as opposed to being localised pain in a few specific areas of the body. It is more often the result of an infection, illness or side effect of a medication which may be accompanied by other symptoms. Medical care should be sought if muscle pain is experienced with symptoms such as trouble breathing, dizziness, and/or high fever.

We will be referring to the first three causes of muscle pain in this piece.

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What is physically happening to the muscle?

Several things may be happening to your muscle(s) when you experience muscle pain:

Contusions / Bruises are caused by impact to a muscle. Muscle fibres compressed in this manner can become irritated and even torn. Capillaries and sometimes venules are damaged by the trauma, allowing blood to seep and haemorrhage into the surrounding tissues. Contusions can involve capillaries at the level of skin, subcutaneous tissue, muscle, or bone. Bruises often induce pain, but small bruises are not normally dangerous alone.

Elongation of the muscle occurs when a muscle is stretched beyond its capacity. Certain muscle fibres can become torn in this manner, causing pain.

Strain is caused when intense and rapid contraction is demanded of a muscle. Such contractions can be too strong, and muscle fibres may tear due to extensive mechanical stress. This type of muscle injury is more typical in sports with dynamic character such as sprinting or jumping. Strains range in severity and can be categorized into 3 grades:

-Grade I (Mild)
Strains affect only a limited number of fibres in the muscle. There is no decrease in strength and there is full active and passive range of motion. Pain and tenderness are often delayed to the next day, often referred to as DOMS (Delayed Onset Muscle Soreness).

-Grade II (Moderate)
Strains have nearly half of muscle fibres torn. Acute and significant pain is accompanied by swelling and a minor decrease in muscle strength. Pain is reproduced on muscle contraction.

-Grade III (Severe)
Strains represent complete rupture of the muscle. This means either the tendon is separated from the muscle belly or the muscle belly is torn into two parts. Severe swelling and pain and a complete loss of function are characteristic for this type of strain.

Knots occur as a result of muscle fibres adhering to each other, or when the bands of tissue underneath them (called fascia) tense or tighten, resulting in a small hard lump. The medical term for muscle knots is myofascial trigger points. Trigger points can be classified as active or latent. Active trigger points cause pain and discomfort without touch or pressure. Latent trigger points are only painful if pressure is applied to them. Common causes of knots include stress and tension, poor posture, staying in the same position for prolonged periods, and dehydration, for example. Although muscle knots are very common, they should not be considered normal or harmless. Myofascial trigger points can cause pain and affect mobility and flexibility. If left untreated, muscle tissue can continue to lose elasticity and cause postural stress that is hard to reverse.

Cramps can be described as a sudden, involuntary muscle contraction or over-shortening of the muscle. While generally temporary and non-damaging, they can cause mild through to excruciating pain, and a paralysis-like immobility of the affected muscle. Cramps usually resolve on their own ranging from a period of several seconds, and up to a week. Muscle cramps may be caused by muscle fatigue or a lack of electrolytes (e.g., low sodium, low potassium, or low magnesium). Hence, muscle cramps during exercise and strenuous physical activity are very common, even in elite athletes. However, cramps can even occur while inactive/relaxed.

Spasms / Muscle Guarding refers to the body’s natural protective response to prevent further injury by seizing up and going into spasm. As a result of some form of injury or internal derangement, the muscles’ reaction acts as a splint to protect the joint from further damage. This muscle spasm can last for days, weeks, months and even years and is extremely uncomfortable/ painful. Although initially a line of defence, if left untreated it may stop being part of the solution and become part of the problem.

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How do I prevent muscle pain?

Prevention is always preferable to cure. Whilst injury resulting from sudden impact is hard to predict and avoid, there are several preventative measures you can take to lessen the severity of muscle pain:

• Develop a daily morning stretch and movement exercise routine
• Stay hydrated throughout the day
• Don’t stay in the same position for prolonged periods of time; get up and have a stretch, perform simple exercises like rotating your wrists and ankles, have a short walk to get a glass of water
• Always try to keep your back straight; lower your knees so that your lower back is straight when in a seated position, lie your head on a pillow and have a pillow between your knees when lying down
• When engaging in strenuous exercise or activity, allow enough time to warm up
• Try to do things using both sides of the body e.g. equal number of lunges on left and right sides
• Following strenuous exercise, always allow time for rest and recovery
• Always use guards on previous injuries, especially whilst exercising
• Besides stretching and exercise, self-massage can ease small sore spots

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What can I do to treat muscle pain?

Muscle injuries recover well with conservative treating.

Only serious cases would require surgical intervention, such as:

• Large intramuscular hematoma (bleeding outside the blood vessel)
• Complete muscle tear (Grade III strain)
• Partial strain (Grade II strain) if more than half of the muscle belly is affected
• Scar adhesions that cause persistent pain and limited extension (for over 4-6 months)
• Chronic skeletal muscle injuries

For acute skeletal muscle injuries (commonly acquired as a direct result of physical activity), R.I.C.E. therapy (Rest, Ice, Compression and Elevation) is generally considered the best method to minimise swelling and relieve pain within the first 24 to 48 hours:

Rest: Take a break from your normal activities, particularly those that use the injured muscle

Ice: Place an ice pack or bag of frozen peas on the sore area for 20 minutes several times a day

Compression: Use a compression bandage to reduce any swelling and reduce mobilisation on the muscle(s)

Elevation: Elevate your injured limb to help reduce swelling and reduce pressure

Mobilisation should start after a few days, if the acute phase has passed without complication and recovery appears to be progressing. Mobilisation stimulates increased vascularisation of the injured area. Vascularisation describes the process where new capillaries originate from the injured blood vessels and find their way to the center of the injured area, and intramuscular nerves regenerate and re-establish nerve-muscle contact. Hence, encouraging the vascularisation process leads to better regeneration of muscle fibres. Therefore, the muscle will sooner regain its original strength.

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How can an Osteopath help?

Your osteopath can get you on the road to recovery from muscle pain. They do this predominantly by restoring the mobility of your muscles and joints. Regardless of the cause, muscle pain usually manifests as soreness, tightness or even an inability to move the affected muscle. People often ask, is it the muscle or the joint? The most common answer is probably both! The muscle attaches to the bone, which enables us to bend, twist, and move the way we do. If the joint is affected, it will cause added tension and pain to the muscle. If the muscle is tight, it will restrict the joint from its normal range of motion and dysfunction of that area will occur. Left untreated, it can cause havoc throughout the body and begin to cause compensatory patterns.

Osteopathy has several gentle and safe techniques that are utilised to help release tension in the muscles by affecting the tiny receptors in the muscles responsible for length and tension and restoring joint function. Your Osteopath will utilise soft tissue techniques, joint mobilisation and manipulation, the application of dry needling and electrotherapy and passive and active stretching.

Osteopaths have an elaborate knowledge of muscle function, healing processes in muscles and training principles. They will often recommend corrective exercises and lifestyle modifications to support the path to recovery, and to remain in an optimal state of health. If you’re not sure how your osteopath can help, give us a call and we will be happy to chat with you further to see how we can get you feeling and moving better.