myalgia (muscle pain)

Etiology: 1) muscle trauma a) exercise b) muscle tears, tendon tears 2) myopathy - hypothyroidism 3) viral infections 4) fibromyalgia 5) polymyalgia rheumatica 6) connective tissue disorders a) rheumatoid arthritis b) systemic lupus erythematosus c) polyarteritis nodosa d) scleroderma e) mixed connective tissue disease f) polymyositis, dermatomyositis 7) pharmaceutical agents: a) amphotericin B b) chloroquine c) clofibrate d) glucocorticoids e) oral contraceptives f) ACE inhibitors g) aromatase inhibitors (50% of women treated with aromatase inhibitors) h) many others History: 1) see pain 2) associated weakness 3) associated arthralgias Laboratory: 1) complete blood count (CBC) 2) erythrocyte sedimentation rate (ESR) 3) electrolytes (chem 7 panel) 4) serum creatine kinase 5) thyroid function studies a) serum TSH b) free T4 or free thyroxine index 6) serum Ca⁺², serum Mg⁺², serum phosphate & serum albumin Special laboratory: 1) electromyography (if muscle weakness) 2) muscle biopsy Differential diagnosis: - bone pain may be difficult to distinguish Management: 1) specific measures for specific etiology 2) general a) rest, ice for first 72 hours b) > 72 hour, heat generally more helpful c) pharmaceutical agents 1] acetaminophen 2] NSAIDs d) physical therapy

Related

fibromyalgia syndrome (fibromyositis, fibrositis) muscle weakness muscular disease; myopathy pharmaceutical agents associated with myalgia polymyalgia rheumatica (PMR)

Specific

delayed-onset muscle soreness muscle cramp myalgia/arthralgia as part of multisystem disease

References

Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 120,121