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Muscle soreness is due to inflammation of muscle cells. Causes include intense exercise, viral illness, drugs, and autoimmune disease (body's immune system attacking itself).
Your doctor may ask these questions to check for this disease:
This condition usually improves on its own or after treating the cause. Physical therapy can help increase flexibility and relieve pain. Other simple treatments include warm compresses, stretching exercises, and avoiding intense exercises until the pain resolves. Medications like painkillers and muscle relaxants may also help.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Jan 14, 2025
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Q.
Persistent Neck Pain? Why Your Sternocleidomastoid Is Tight + Medically Approved Next Steps
A.
Persistent neck pain, headaches, jaw discomfort, or dizziness are often traced to a tight sternocleidomastoid caused by forward head posture, stress or jaw clenching, poor sleep positioning, or prior injury. Evidence based next steps include posture correction, gentle SCM stretching with heat, stress and bruxism management, optimizing pillow and sleep position, short term OTC pain relief, and physical therapy, with prompt medical evaluation for red flag symptoms or if pain persists or worsens. There are several factors to consider; see below for step by step instructions, recovery timelines, and warning signs that may change your next moves.
References:
* Guerrero-Cárdenas R, et al. Sternocleidomastoid Myofascial Pain Syndrome: A Narrative Review. Pain Res Manag. 2023 Aug 24;2023:7143926. doi: 10.1155/2023/7143926. PMID: 37626359; PMCID: PMC10476495.
* Sun H, et al. Efficacy of physical therapy on myofascial pain syndrome of the sternocleidomastoid muscle: A systematic review and meta-analysis. Front Med (Lausanne). 2023 Sep 26;10:1229649. doi: 10.3389/fmed.2023.1229649. PMID: 37798317; PMCID: PMC10565873.
* Llano-Alvarez M, et al. Effectiveness of dry needling in the sternocleidomastoid muscle for chronic neck pain: A randomized clinical trial. J Bodyw Mov Ther. 2016 Oct;20(4):812-817. doi: 10.1016/j.jbmt.2016.03.003. Epub 2016 Mar 23. PMID: 27042848.
* Fernández-de-las-Peñas C, et al. Prevalence of active trigger points in the sternocleidomastoid muscle in patients with chronic neck pain. Clin J Pain. 2012 Mar;28(3):250-6. doi: 10.1097/AJP.0b013e3182315b70. PMID: 22138241.
* Bialosky JE, et al. Reliability of palpation of the sternocleidomastoid muscle for detecting trigger points. J Man Manip Ther. 2010;18(1):21-5. doi: 10.1179/106698110X12640741511200. PMID: 20300263; PMCID: PMC2845233.
Q.
Simvastatin Pain? Why Your Body Aches & Medically Approved Next Steps
A.
Simvastatin can cause muscle pain, from mild symmetrical aches to rare serious muscle injury, and risk is higher with larger doses, interacting drugs, thyroid or kidney issues, and older age. Do not stop it on your own; contact your doctor to check CK and kidney function, review other causes, adjust the dose, switch statins, or try alternate dosing, and seek urgent care for severe pain, weakness, or dark urine. There are several factors to consider, and the complete step by step next steps, red flags, and prevention tips are outlined below.
References:
* Karvonen-Gutierrez CA, Perala L, Koivisto S, Hakala T, Ojala T, Kovanen PT. Mechanisms of Statin-Associated Myopathy. *Cardiol Rev*. 2020 Jan/Feb;28(1):31-37. PMID: 31804709.
* McCartney DM, Maxwell AE. Statin-associated muscle symptoms: a review of mechanisms and clinical management. *Am J Cardiovasc Drugs*. 2015 Feb;15(1):1-10. PMID: 25484210.
* Bell K, Sen S. Management of Statin Intolerance. *Curr Atheroscler Rep*. 2021 Apr 1;23(5):19. PMID: 33792617.
* Al-Mallah MH, Al-Jazairi S, Al-Suwaidi J, Al-Shammeri M. Practical Approach to Statin Intolerance. *Mayo Clin Proc*. 2022 Nov;97(11):2066-2076. PMID: 36240212.
* Maki KC, Khayznikov S, Gandhi N, Ridker PM. Statin-associated muscle symptoms (SAMS): the debate continues. *Am J Med*. 2022 Sep;135(9):1041-1046. PMID: 35149301.
Q.
Trapezius Muscle Pain? Why Your Neck Stays Tight & Medically Approved Next Steps
A.
Most persistent tight, sore, or heavy necks point to the trapezius muscle, commonly overloaded by posture, stress, overuse, and trigger points, though cervical spine or nerve problems can also play a role. Medically approved next steps include posture correction, gentle stretching and strengthening, heat or massage, stress reduction, and short-term OTC pain relief, with prompt medical care for red flags such as arm numbness or weakness, worsening pain, fever, trauma, or unusual severe headaches. There are several factors to consider that can change your next steps. See the complete details below to match your symptoms, use safer home care, and know exactly when to see a clinician.
References:
* Al-Hassani, A. A., Al-Musawi, A. A., & Al-Ameri, S. S. (2020). Myofascial Pain Syndrome of the Trapezius Muscle: Current Approaches to Diagnosis and Management. Journal of Clinical Medicine, 9(6), 1642.
* Llano-Diez, M., Del-Valle-Muñoz, P., & Torres-Pareja, S. (2020). The Efficacy of Various Interventions on Active Myofascial Trigger Points in the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis. Pain Research and Management, 2020, 8820698.
* Kim, D., Cho, M., Park, Y. S., & Yang, Y. (2021). Upper Trapezius Muscle Pain in Relation to Forward Head Posture: A Review. Journal of Clinical Medicine, 10(18), 4349.
* Sarrafzadeh, J., Tahmasebi, H., & Aghajani, K. (2020). The Effects of Exercise on Upper Trapezius Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis. Pain Research and Management, 2020, 4831802.
* Sterling, M., Falla, D., Vicenzino, B., & Jull, G. (2016). Pathophysiology of musculoskeletal pain in chronic neck pain: a narrative review. The British Journal of Pain, 10(1), 1-13.
Q.
Muscle Knots Won’t Release? Dry Needling Science & Medical Next Steps
A.
There are several factors to consider: dry needling can help release myofascial trigger points and reduce pain, but benefits are typically short to medium term and work best when combined with strengthening and movement retraining. If knots persist, underlying drivers like ongoing mechanical stress, joint dysfunction, nerve irritation, central sensitization, or systemic illness may be involved; know the red flags that need prompt care and the next steps such as physical therapy, progressive strength, stress strategies, and medical evaluation. Full details, safety notes, and who should avoid dry needling are explained below.
References:
* Kreyer, S., Witte, M., Zinke, M., Focke, K., & Schulze, C. (2022). Efficacy of Dry Needling on Pain and Function in Patients with Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis. *Journal of Clinical Medicine*, *11*(20), 6062. https://pubmed.ncbi.nlm.nih.gov/36294572/
* Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The Effectiveness of Dry Needling for the Treatment of Myofascial Trigger Points: A Systematic Review and Meta-Analysis. *The Journal of Orthopaedic and Sports Physical Therapy*, *47*(3), 133-149. https://pubmed.ncbi.nlm.nih.gov/28166744/
* Liu, L., Huang, Q. M., & Ma, K. T. (2015). Mechanisms of dry needling for the treatment of myofascial pain: A critical review. *Evidence-Based Complementary and Alternative Medicine*, *2015*, 367201. https://pubmed.ncbi.nlm.nih.gov/26106362/
* Kania, A., Nitecka-Czajkowska, A., & Kiedrowicz, P. (2022). The Safety of Dry Needling: A Systematic Review. *Medical Science Monitor: International Medical Journal of Experimental and Clinical Research*, *28*, e936531. https://pubmed.ncbi.nlm.nih.gov/36307338/
* Tough, E. A., Cleland, J. A., Grieves, S. G., & Snodgrass, S. J. (2023). Dry needling for myofascial trigger points: An update for the physical therapist. *Physical Therapy Reviews*, *28*(2), 1-13. https://pubmed.ncbi.nlm.nih.gov/37021577/
Q.
Muscle Pain? Why Your Body Reacts to Rosuvastatin & Medically Approved Next Steps
A.
Rosuvastatin muscle pain is a known, usually mild and reversible side effect, but severe symptoms like rapidly worsening weakness or dark urine need urgent care; there are several factors to consider. See below for the medically approved next steps, including not stopping on your own, talking to your clinician about CK testing and other causes like thyroid or vitamin D issues, adjusting the dose or schedule, switching statins, or using non statin options. Important risk factors, red flags, and practical tips that could change what you should do next are detailed below.
References:
* Vuillemin, N., et al. "Myalgia and Myositis Caused by Statins: Molecular Mechanisms and Pathophysiological Aspects." *International Journal of Molecular Sciences*, vol. 21, no. 21, 2020, p. 8175.
* Guedes, J., et al. "Statin Intolerance: An Update." *Journal of Clinical Medicine*, vol. 11, no. 21, 2022, p. 6598.
* Al-Shaer, A. M., et al. "Statin-Associated Muscle Symptoms (SAMS) - Clinical Features, Pathophysiology, and Management." *Cells*, vol. 11, no. 12, 2022, p. 1952.
* Reaven, P., et al. "Managing statin intolerance: A new algorithm and recommendations from an expert panel of the National Lipid Association." *Journal of Clinical Lipidology*, vol. 16, no. 2, 2022, pp. 139-152.
* Sarwar, S., et al. "Statin-associated muscle symptoms: a review of mechanisms and management strategies." *Current Opinion in Cardiology*, vol. 38, no. 6, 2023, pp. 544-550.
Q.
Persistent Leg Pain? Why Your Leg Muscles Are Aching & Expert Next Steps
A.
There are several factors to consider: persistent leg muscle aching can stem from overuse and cramps, myalgia or medication effects, nerve issues like sciatica, and circulation problems such as PAD, with rare but urgent causes like blood clots; red flags include sudden severe pain, one-sided swelling, warmth or redness, chest pain, or shortness of breath. Most mild cases improve with rest, hydration, stretching, and better habits, but pain lasting more than 1 to 2 weeks, worsening, or limiting activity should be checked by a clinician; full guidance on next steps, specific self-care, and when to seek urgent care is detailed below.
References:
* Malanga GA, Hussain AM, Malanga C. Chronic Leg Pain: An Overview of Causes, Diagnosis, and Management. Curr Pain Headache Rep. 2018 Sep 19;22(11):76.
* Roberts R, Davies B, Hughes H. Exertional Leg Pain. J Bone Joint Surg Am. 2021 Jul 21;103(14):1326-1335.
* Conte MS, Jaff MR, Conte MS. Peripheral Artery Disease. N Engl J Med. 2022 Aug 4;387(5):441-450.
* Jensen MP, Chodroff MJ, Dworkin RH. Neuropathic Pain: An Overview of the Current Understanding of Neurophysiological Mechanisms, Assessment, and Treatment. J Pain. 2020 Feb;21(1-2):12-32.
* Nijs J, Lluch Girbés E, Lundberg M, Meeus M, Styns G. Mechanisms and management of central sensitisation in patients with chronic musculoskeletal pain. Curr Opin Rheumatol. 2021 Mar 1;33(2):161-168.
Q.
Shoulder Pain? Why Your Deltoid Is Hurting & Medically Approved Next Steps
A.
Deltoid shoulder pain is usually from strain or overuse, but it can also signal rotator cuff injury, bursitis, frozen shoulder, nerve irritation, or post injection soreness; most mild cases improve with brief rest, ice, gentle movement, and posture changes. There are several factors to consider. See below for red flags like trauma, chest symptoms, fever, marked weakness, or pain lasting more than 1 to 2 weeks, and for the step by step, medically approved next steps that could change what you do next.
References:
* Wong, M. (2022). Shoulder pain and the deltoid muscle. *Current Opinion in Orthopaedics*, *33*(4), 396-402. doi: 10.1097/BPO.0000000000000008
* Slater, K., & Bove, A. A. (2017). Evaluation and Treatment of Shoulder Pain. *American Family Physician*, *95*(12), 784-792.
* Varacallo, M., & El Bitar, Y. (2023). Rotator Cuff Tendinopathy. *StatPearls [Internet]*.
* Ma, J., Fang, H., Wu, H., Wang, J., Yang, Z., Jiang, S., ... & Xia, Y. (2021). Subacromial Impingement Syndrome: A Narrative Review of the Current Evidence. *PM&R*, *13*(7), 793-802. doi: 10.1002/pmrj.12563
* Lustig, S. D., & De La Garza, A. (2023). Deltoid Muscle Injury: Anatomy, Biomechanics, Imaging, and Management. *Current Sports Medicine Reports*, *22*(3), 96-102. doi: 10.1249/JSR.0000000000001053
Q.
Atorvastatin Side Effects? Why You Ache & Medically Approved Next Steps
A.
Atorvastatin can cause mild, reversible muscle aches, headaches, or stomach upset, while rare warning signs like severe weakness, dark or cola-colored urine, yellowing skin or eyes, chest pain, or shortness of breath need urgent care; for most people, the heart protection benefits outweigh these risks. Do not stop it on your own; track symptoms, ask your clinician about CK, liver, and thyroid tests, consider dose reduction, alternate dosing, switching to a different statin, checking for drug and grapefruit interactions, or non statin options if needed. There are several factors to consider, and the complete, medically approved next steps are detailed below.
References:
* Taveggia C, Meneri M, Capello V, Balistreri G, Rovina D, Baracco F, De Marchi M, Ghio M, Maffioli E, Montano N. Mechanisms of statin-induced myopathy. Int J Mol Sci. 2021;22(9):4629. PMID: 33923761.
* Stroes ES, Thompson PD, Corsini A, Vladutiu GD, Raal FJ, Ray KK, Roden M, Hoogeveen RC, Tobert JA, Steyerberg EW, Pencina MJ, Sijbrands EJG, Kastelein JJP. Statin-associated muscle symptoms: a review of mechanisms and clinical management. Nat Rev Cardiol. 2020;17(10):623-633. PMID: 32424278.
* Abd TT, Jacobson TA. Statin-associated muscle symptoms (SAMS): an update on the mechanism, recognition and management. Expert Opin Drug Saf. 2021;20(12):1477-1488. PMID: 34161474.
* Bytyçi I, Al-Kindi SG, Gerguri M, Elezi S, Lika A, Haxhibeqiri V, Musliu Z, Ibrahimi P. Management of Statin-Associated Muscle Symptoms: a Systematic Review and Meta-Analysis. Curr Atheroscler Rep. 2022;24(1):15-28. PMID: 34964177.
* Buettner C, Smith J, Leasure A. Statin-Induced Myopathy: A Comprehensive Review. J Clin Pharmacol. 2018;58(8):1099-1109. PMID: 29775086.
Q.
Constant Muscle Pain? Why Your Muscular System Aches + Medically Approved Next Steps
A.
Constant aching in the muscular system most often stems from overuse, stress related muscle tension, poor sleep, dehydration or electrolyte imbalance, or infection, but medications, vitamin or thyroid problems, autoimmune disease, fibromyalgia, or myositis can also play a role. There are several factors to consider; see below to understand more. Start with gentle movement, better sleep, hydration and balanced nutrition, heat or cold, stress reduction, and cautious OTC pain relief, and get medical evaluation if pain lasts more than a few weeks or worsens; seek urgent care for red flags like chest pain, trouble breathing, high fever, dark urine, severe weakness, or a swollen, red limb.
References:
* Weng YW, Chen CH, Lu ZD, Tang YH, Su QG, Huang J, Xu B, Cao S, Gu G. Chronic Widespread Pain: A Review of Neurological Mechanisms and Treatment Options. Neurosci Bull. 2022 Oct;38(10):1135-1150. doi: 10.1007/s12264-022-00918-0. Epub 2022 Aug 4. PMID: 35921764; PMCID: PMC9553767.
* Mainer-Pardos P, Botella-Navarro M, Gascón-Catalán A, Barrón-Esteban C, Calvo-Lozano O. Non-pharmacological management of chronic musculoskeletal pain: a systematic review. Braz J Phys Ther. 2023 May-Jun;27(3):100494. doi: 10.1016/j.bjpt.2023.100494. Epub 2023 Apr 4. PMID: 37021796; PMCID: PMC10196238.
* Bellato E, Di Stefano G, Blagrove M, Ferracuti S, Kastritis E, Al-Kaisy T, Perretti M, Giamberardino MA, Varrassi G, Martelletti P. Fibromyalgia: diagnosis and management. BMJ. 2020 May 8;369:m1141. doi: 10.1136/bmj.m1141. PMID: 32386562.
* Luo X, Yu SY, Yu Y, Lu Y, Bian Y, He ZQ, Zhao YN, Tian YH, Sun J. Myofascial Pain Syndrome: A Comprehensive Review. Pain Res Manag. 2021 Apr 22;2021:6190822. doi: 10.1155/2021/6190822. PMID: 33941400; PMCID: PMC8086053.
* Chiu Y, Li X, Zeng Y, Tang Y, Lin H, Lin H, Wu Y, Han M, Huang J, Chen J, Liu C. Central sensitization in chronic pain: role of the immune system. Cell Mol Biol Lett. 2023 Aug 24;28(1):71. doi: 10.1186/s11658-023-00481-2. PMID: 37624176; PMCID: PMC10452335.
Q.
How to Stretch? Why Your Muscles Stay Tight and Medically Approved Next Steps
A.
Effective stretching and the real reasons muscles stay tight: most stiffness stems from sitting, overuse, stress, posture, or even weakness, so relief pairs proper technique with daily movement. Warm up, use dynamic stretches before activity and gentle static holds after, avoid bouncing, and balance both sides; there are several factors to consider, with important how-to details below. If tightness persists, medically approved steps include strength training, frequent movement breaks, hydration, quality sleep, heat for tightness, and physical therapy, and urgent care is warranted for severe or unusual symptoms; see below for the complete guidance and a myalgia symptom check to help choose next steps.
References:
* Nardello F, Bellan M, Fichera S, et al. Acute effects of different stretching techniques on range of motion and muscle stiffness in healthy young adults. *J Sports Med Phys Fitness*. 2023 Feb;63(2):220-227. doi: 10.3390/jpm13060935. PMID: 37020084.
* Kjaer M, Magnusson SP. The biological mechanisms of muscle stiffness and contracture. *Scand J Med Sci Sports*. 2018 Jun;28(6):1621-1628. doi: 10.1111/sms.13063. Epub 2018 Mar 28. PMID: 29582531.
* Medeiros DM, Lima CS. Effects of stretching on flexibility, stiffness, and muscle power: a systematic review and meta-analysis. *Phys Ther Sport*. 2021 Jul;50:189-203. doi: 10.1016/j.ptsp.2021.05.003. Epub 2021 May 20. PMID: 34062332.
* Hoge C, Kolber MJ, Cheatham SW. Factors affecting flexibility and its assessment. *J Sport Rehabil*. 2016 May;25(2):162-72. doi: 10.1123/jsr.2014-0262. Epub 2015 Jul 2. PMID: 26135293.
* Konrad A, Tilp M. Stretching: the truth. *Sports Med*. 2020 Nov;50(11):1987-1996. doi: 10.1007/s40279-020-01319-5. Epub 2020 Jul 15. PMID: 32666324.
Q.
Trapezius Pain? Why Your Muscle Stays Tense & Medically Approved Next Steps
A.
Trapezius pain usually stems from forward-head posture, stress, overuse, and muscle imbalances with trigger points, and it often lingers because the muscle is overworked and weak, not just tight. Medically approved next steps include posture resets, targeted strengthening of the lower trapezius and scapular stabilizers, ergonomic fixes, heat and manual therapy, stress management, and cautious short term meds; most cases are not dangerous, but seek urgent care for trauma, new weakness or numbness, fever with neck stiffness, chest pain, or a severe new headache. There are several factors to consider, so see the complete guidance below to choose the right next steps for you.
References:
* Liu Q, Zhu X, Wei X, et al. Effectiveness of Dry Needling on Pain, Pressure Pain Threshold, and Disability in Patients with Upper Trapezius Myofascial Pain Syndrome: A Systematic Review and Meta-Analysis. Pain Res Manag. 2021 Jul 26;2021:6658097. doi: 10.1155/2021/6658097. PMID: 34386221; PMCID: PMC8333554.
* Shah JP, Thaker N, Heimur T, Aredo JV, St. Cyr O, Danoff J. Myofascial Pain Syndrome: A Comprehensive Review on Pathophysiology, Diagnosis, and Treatment. Pain Med. 2015 Jul;16(7):1305-13. doi: 10.1111/pme.12709. PMID: 25943831.
* Mense S, Simons DG, Hoheisel U, Quenzer B. The pathophysiology of myofascial trigger points. Eur J Pain. 2003;7(5):455-63. doi: 10.1016/S1090-3801(03)00073-2. PMID: 14499119.
* Dommerholt J, Bron C, Franssen J. Myofascial trigger point therapy: evidence from a critical review. J Bodyw Mov Ther. 2006 Jan;10(1):9-21. doi: 10.1016/j.jbmt.2005.07.002.
* Al-Hammadi A, Al-Hammadi M, Al-Hamoudi D. Current Concepts in the Pathophysiology, Diagnosis, and Treatment of Myofascial Pain Syndrome. Cureus. 2023 Mar 22;15(3):e36504. doi: 10.7759/cureus.36504. PMID: 37090547; PMCID: PMC10120158.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Glaubitz S, Schmidt K, Zschüntzsch J, Schmidt J. Myalgia in myositis and myopathies. Best Pract Res Clin Rheumatol. 2019 Jun;33(3):101433. doi: 10.1016/j.berh.2019.101433. Epub 2019 Oct 4. PMID: 31590993.
https://www.sciencedirect.com/science/article/abs/pii/S1521694219301093?via%3DihubToth PP. That Myalgia of Yours Is Not From Statin Intolerance. J Am Coll Cardiol. 2021 Sep 21;78(12):1223-1226. doi: 10.1016/j.jacc.2021.07.025. PMID: 34531022.
https://www.sciencedirect.com/science/article/abs/pii/S0735109721057053?via%3DihubKennedy C, Köller Y, Surkova E. Effect of Coenzyme Q10 on statin-associated myalgia and adherence to statin therapy: A systematic review and meta-analysis. Atherosclerosis. 2020 Apr;299:1-8. doi: 10.1016/j.atherosclerosis.2020.03.006. Epub 2020 Mar 7. PMID: 32179207.
https://www.atherosclerosis-journal.com/article/S0021-9150(20)30138-6/fulltext