Muscle Pain?

Muscles are rarely a cause of pain, though many patients think they are.  It is common, however, for muscles to get tight and become painful.  Why do they get tight?  Because one of the functions of muscles is to tighten up and protect injured areas from moving, if the muscles perceive an injury.

When muscles get tight, the person feels the tightness and ascribes their pain to a muscle injury.  But now you know otherwise.  How does this phenomenon work?  Well, typically, other important structures, e.g. ligaments, discs, joints or nerves, are highly innervated with nerves that perceive a pain, injury or threat of injury.  These structures then send nerve signals, indirectly, i.e. via reflexes, to the regional muscles.  And these muscles get tight in order to prevent movement of these regions to protect them from progression of the threat and injury, until the injury has recovered.

When you feel this muscle tightness, the best thing to do, usually, is to put ice on the area, and you may choose to take an anti-inflammatory medication, e.g. Motrin, ibuprofen, Advil, Aleve, or aspirin.  Tylenol is not an anti-inflammatory and is not as effective.

Some patients will mistakenly put heat on a tight muscle, but this is usually a mistake.  When you perceive pain, there is often an inflammatory component to the pain, and heat application will make more inflammation, which will typically make the problem and the pain worse.

So the next time you feel muscle tightness and you think this is the cause of your pain, you now know otherwise.  Some things in medicine are rather counterintuitive for lay persons, and this seems to be one of them.  In fact, this phenomenon of muscle tightness fools many doctors too.  Some things in medicine have to be seen thousands of times in order for a doctor to appreciate them, and in my experience this is one of them.  Another such similar counterintuitive phenomenon, which fools many doctors and therapists is something called “referred” pain, which I discuss on another post.