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Easily tired
Joint stiffness
Low back pain
Left arm pain
Leg pain
Body aches
Lower back pain and extreme tiredness
Body aches no fever
Forearm pain
Fatigue in morning
Insomnia
Not seeing your symptoms? No worries!
A condition causing widespread pain and muscle aches throughout the body that may come and go with certain identified triggers. The cause is not well understood.
Your doctor may ask these questions to check for this disease:
Treatment is multimodal and not curative. It includes a variety of things like medications, therapy, stress reduction techniques and exercise to help alleviate symptoms.
Reviewed By:
Kenji Taylor, MD, MSc (Family Medicine, Primary Care)
Dr. Taylor is a Japanese-African American physician who grew up and was educated in the United States but spent a considerable amount of time in Japan as a college student, working professional and now father of three. After graduating from Brown, he worked in finance first before attending medical school at Penn. He then completed a fellowship with the Centers for Disease Control before going on to specialize in Family and Community Medicine at the University of California, San Francisco (UCSF) where he was also a chief resident. After a faculty position at Stanford, he moved with his family to Japan where he continues to see families on a military base outside of Tokyo, teach Japanese residents and serve remotely as a medical director for Roots Community Health Center. He also enjoys editing and writing podcast summaries for Hippo Education.
Kaito Nakamura, MD (Rheumatology)
Dr. Nakamura is a rheumatologist who has practiced in the Ota Nishinouchi Hospital attached to Ota General Hospital, National Health Insurance Matsudo City Hospital, Chiba University Hospital, and the National Health Insurance Asahi Central Hospital.
Content updated on Nov 15, 2024
Following the Medical Content Editorial Policy
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Q.
Feeling Weak? Why Sarcopenia Shrinks Muscle & Medical Steps
A.
Sarcopenia is a common, treatable cause of new weakness due to progressive loss of muscle mass and function from aging, inactivity, low protein intake, chronic illness, hormonal changes, and inflammation, and it raises the risk of falls and fractures. Effective steps include regular resistance training, getting about 1.0 to 1.2 g of protein per kg per day spread across meals, checking and correcting vitamin D, managing underlying diseases, and staying active, though there is no FDA approved drug yet. There are several factors to consider, including how doctors diagnose it and when weakness needs urgent care; see complete details below to guide your next steps.
References:
* Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: Revised European Consensus on Definition and Diagnosis. Age and Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169. PMID: 30312372.
* Petroni ML, et al. Updates on sarcopenia: Epidemiology, diagnosis, and management. Clin Nutr. 2022 Dec;41(12):2666-2679. doi: 10.1016/j.clnu.2022.09.020. Epub 2022 Sep 23. PMID: 36183617.
* Locquet M, et al. Sarcopenia: an overview of current concepts and medical approaches. Curr Opin Clin Nutr Metab Care. 2023 Mar 1;26(2):166-173. doi: 10.1097/MCO.0000000000000889. PMID: 36622170.
* Nishizaki N, et al. Nutritional and Exercise Interventions for Sarcopenia: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Sep 10;19(18):11364. doi: 10.3390/ijerph191811364. PMID: 36141857; PMCID: PMC9500742.
* Marcucci M, et al. Exercise for sarcopenia: an overview of current research and future directions. J Transl Med. 2023 Jan 28;21(1):55. doi: 10.1186/s12967-023-03914-y. PMID: 36709323; PMCID: PMC9884635.
Q.
Still Hurting? The Science of MSM & Medically Approved Next Steps
A.
MSM may offer mild to moderate relief for osteoarthritis and post-exercise soreness through modest anti-inflammatory effects; it does not reverse joint damage, and short-term use is generally safe but can cause nausea, diarrhea, or headache. If pain persists, options vary by cause, from physical therapy, weight and strength work, topical or oral NSAIDs, and injections to disease-modifying or biologic drugs for autoimmune disease and multimodal care for fibromyalgia, plus red flags that need urgent care. There are several factors to consider that could change your plan, so see the complete details below to choose the right next step with your clinician.
References:
* Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Clinical Efficacy of Methylsulfonylmethane (MSM) in Osteoarthritis: A Systematic Review of Randomized Controlled Trials. J Evid Based Complementary Altern Med. 2016 Apr;21(2):148-57. doi: 10.1177/2156587215626245. Epub 2016 Jan 29. PMID: 27041269.
* Butawan M, Benjamin RL, Bloomer RJ. The Use of Methylsulfonylmethane (MSM) in the Treatment of Pain and Inflammation: Clinical and Molecular Approach. Nutrients. 2022 Apr 27;14(9):1904. doi: 10.3390/nu14091904. PMID: 35515082; PMCID: PMC9103986.
* Debbi EM, Agar G, Fichman G, Ziv YB, Kardosh R, Halperin N, Hershkovitz I, Safir O, Debi R. Effect of methylsulfonylmethane (MSM) on symptoms of knee osteoarthritis: a randomized controlled trial. BMC Complement Altern Med. 2014 Oct 27;14:389. doi: 10.1186/1472-6882-14-389. PMID: 25330368; PMCID: PMC4211603.
* Pagonis TA, Galanopoulou AS, Raptis K, Georgios PP. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a review of current evidence. J Pain Res. 2012;5:145-50. doi: 10.2147/JPR.S30612. Epub 2012 Mar 27. PMID: 22525653; PMCID: PMC3330669.
* Targowski T, Targowski M, Skomra P, Zegadło A. Complementary and alternative medicine for the management of pain in osteoarthritis: a systematic review. Int J Rheum Dis. 2015 Dec;18(8):831-9. doi: 10.1111/1756-185X.12720. Epub 2015 Sep 22. PMID: 26458564.
Q.
Why Your Body Feels Like It’s Fraying? Ehlers-Danlos Syndrome (EDS) & Medically Approved Next Steps
A.
Ehlers-Danlos syndrome can make your body feel like it is fraying because faulty collagen weakens connective tissue, leading to joint hypermobility, fragile or stretchy skin, chronic pain and fatigue, and in some types such as vascular EDS, serious risks to blood vessels or organs. Medically approved next steps include documenting symptoms, asking for a joint hypermobility assessment and targeted referrals, starting hypermobility‑smart physical therapy while protecting joints and managing pain safely, and knowing red flags that require urgent care. There are several important factors to consider, including overlaps with other conditions and differences by EDS type, so see below for details that could change the right next steps for you.
References:
* Malfait F, Francomano R, Byers P, Belmont J, Berglund B, BORSUM-OTTENHEIMER F, et al. The 2017 international classification of the Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):8-26. doi: 10.1002/ajmg.c.31552. Epub 2017 Feb 20. PMID: 28306229.
* Tinkle B, Castori M, Berglund B, Cohen H, Driver CC, Francomano C, et al. Hypermobile Ehlers-Danlos Syndrome (hEDS): Clinical Description and Natural History. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):48-69. doi: 10.1002/ajmg.c.31538. Epub 2017 Feb 20. PMID: 28306227.
* Chopra P, Tinkle B, Hamonet C, Brock I, Gompel A, Bulbena A, et al. Pain Management in the Ehlers-Danlos Syndromes: A Review. Am J Med Genet C Semin Med Genet. 2017 Mar;175(1):159-166. doi: 10.1002/ajmg.c.31554. Epub 2017 Feb 20. PMID: 28306232.
* Gillam E, Cleland C. Ehlers-Danlos syndrome: a diagnostic challenge. Br J Hosp Med (Lond). 2021 Apr 22;82(4):1-8. doi: 10.12968/hmed.2021.0116. PMID: 33878191.
* Patel M, Alshami A, Munk A, Palai P, Waisel A, Klemperer J, et al. A Scoping Review of Multidisciplinary Care for Ehlers-Danlos Syndromes. J Clin Rheumatol. 2023 Apr 1;29(3):e491-e497. doi: 10.1097/RHU.0000000000001928. Epub 2022 Dec 12. PMID: 36511559.
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014 Apr 16;311(15):1547-55. doi: 10.1001/jama.2014.3266. PMID: 24737367.
https://jamanetwork.com/journals/jama/article-abstract/1860480Bair MJ, Krebs EE. Fibromyalgia. Ann Intern Med. 2020 Mar 3;172(5):ITC33-ITC48. doi: 10.7326/AITC202003030. PMID: 32120395.
https://www.acpjournals.org/doi/10.7326/AITC202003030Sarzi-Puttini P, Giorgi V, Marotto D, Atzeni F. Fibromyalgia: an update on clinical characteristics, aetiopathogenesis and treatment. Nat Rev Rheumatol. 2020 Nov;16(11):645-660. doi: 10.1038/s41584-020-00506-w. Epub 2020 Oct 6. PMID: 33024295.
https://www.nature.com/articles/s41584-020-00506-wSumpton JE, Moulin DE. Fibromyalgia. Handb Clin Neurol. 2014;119:513-27. doi: 10.1016/B978-0-7020-4086-3.00033-3. PMID: 24365316.
https://www.sciencedirect.com/science/article/abs/pii/B9780702040863000333?via%3Dihub