How does muscle pain manifest?

Symptoms of muscle pain are extremely difficult to differentiate by species and to classify for etiological reasons. Even in the definition of myalgia is still not a single opinion, it is often replaced by diagnostic names - fibromyositis, fibromyalgia, myositis and so on.

Damage and inflammation of the muscular tissue surrounding its connective tissue are manifested as signs similar to visceral clinical parameters, so the symptoms of muscle pain are often diagnosed as manifestations of pathologies of internal organs. However, myofascial symptoms are special trigger zones, the inactivation and relaxation of which helps to quickly eliminate pain. In addition, true myalgia is characterized by pain in the tonic muscles, the most vulnerable to static loads, stretching during physical work, training. Dynamic muscles often suffer from hypotension, lethargy and atrophy without pain.

Symptoms of myalgia (muscle pains) usually manifest themselves spontaneously, suddenly and can increase in motion, and also if the site of pain localization is subjected to palpation. Often painful sensations become chronic, acquiring the character of an independent syndrome, if the period of acute pain has passed without proper treatment, so the body adapts to pain signals.

Symptoms of pain in the muscles can be divided by the nature of the sensations, they depend on the variety of myalgia.

1. Fibromyalgia (FM)

Primary fibromyalgia is a muscular-skeletal sensation of pain that is localized in the shoulder girdle, neck, occiput, loins. Symptoms of primary muscular disease are aggravated by vegetative manifestations, asthenia, insomnia. The pain symptom is amplified under the influence of psychogenic factors, temperature changes, physical activity. The pain is diffuse (diffuse) aching, but it is characterized by certain zones - 18 diagnostically important trigger points. The course of the disease is always chronic, the diagnosis of FM is confirmed in the presence of symptoms for 3 or more months.

Secondary myalgia is a typical consequence of long sports loads, constant physical overstrain (active or static). The pains are always symmetrical, bilateral, pulling, rarely - acute, accompanied by autonomic symptoms, sleep disturbances.

2. MFBS (myofascial pain syndrome), which in modern classification is separated into a separate nosology. The pain with MFBS is clearly localized, its area is more narrowed in comparison with fibromyalgic pains, the spasmy muscle region is distinctly palpable in the trigger points. The course of the disease is acute, the pain can be quite intense, spontaneous, strong.
3. Myositis is an inflammation of the muscle tissue, acute or chronic. The pain is sharp, often intolerable, even in the case of the chronic form of myositis. The pain symptom is localized at the site of inflammation, but it can also be reflected along the direction of the muscle fibers. Myositis may be accompanied by an increased body temperature, the acute form of the disease often leads to a feeling of nausea, to swelling of the tissues, aggravated by signs of intoxication of the body.
4. Polymyositis is symptomatic more severe than simple muscle inflammation. Affected multiple areas of muscle tissue, develops atony, dystrophy, hypotension of the muscles, often necrosis of muscle fibers. Disease can lead a person to a disability.

[1], [2], [3], [4], [5]

Epidemiology

Symptoms of muscle pain in statistics:

• Myalgia in the form of fibromyalgia suffer more often women, the ratio: women 60-65%, men - 35-40%.
• Pain in the muscles leads to sleep disorders in 75% of cases.
• Pain in the muscles in 60% of cases is accompanied by paresthesia.
• In 30% of patients with muscle pain in fibromyalgia, meningic signs are noted, especially rigidity of the neck muscles.
• 45-50% of people suffering from muscle pain feel anxiety, fear.
• 70-75% of people with muscle pain are susceptible to fatigue, weakness.
• Muscle pain in 85% of cases leads to a restriction of motor activity.

[6], [7], [8], [9], [10], [11], [12], [13],

Acute pain in muscles

The acute nature of the pain in the muscles indicates the traumatization of muscle tissue, most often the rupture of fibers, fasciaes up to complete muscle detachment. Stretching, simple muscle contraction is rarely accompanied by a strong pain sensation, even if it arises, it is characterized as short-term.

Acute pain in muscles, possible causes:

• Rupture of muscle, muscle fibers of the 2nd degree. This microtrauma is considered reversible, but it is accompanied by acute, sharp pain, often with spasm. Pain can increase with diagnostic palpation.
• The rupture of muscle tissue of the third degree is defined as multiple damage to connective fibers, often accompanied by extensive internal hematoma. Acute pain in the muscles leads to a restriction of motor activity, muscle atony, delayed spasm. The pain is clearly localized, rarely sporadic, more often spilled, but within the tissue damage.
• A complete detachment of muscle of the 4th degree is considered a serious trauma, accompanied by intense acute pain, with a click. Separation is the complete disjoining of the transverse muscle fibers and fasciae, while the severed parts of the muscle can be located far enough apart. The site of detachment quickly swells, an extensive hematoma develops, the area of the lesion is very sore and completely immobilized, especially for muscle rupture in the limbs.

In addition, acute pain can cause and trauma to bone tissue - a fracture, bone fracture, joint dislocation, the pain symptom in these cases lasts for a long time, subsides gradually, as the connective tissue regenerates.

[14],

Drawing pains in muscles

The pulling nature of muscle pain is a symptom of chronic myalgia, fibromyalgia, moreover, a similar character of pain is inherent in the neuropathic or vascular nature of pain. An example can be pains that drag in muscles with intermittent claudication, as well as pseudo-ischemic pain in the chest, similar to the clinical manifestations of angina pectoris. Also, the pulling character of pain indicates pathological structural changes in muscle fibers, for example, after intensive training (delayed pain), when excessive stress provokes microtraumas of fibers, their tears, a situational inflammatory process develops in the connective tissues. Spasmodic muscles, a condition of stiffness - tension, as a rule, are accompanied by blunt, aching pains.

Thus, the pains that pull in the muscles are a signal that the body develops vascular pathology (atherosclerosis, thrombophlebitis, varicose veins), most often in the pelvic region and in the lower extremities. Occlusion (blockage) of blood vessels interferes with normal blood supply to the muscles, they can develop oxygen deficiency, they lose elasticity, tone, atrophy can begin. Overexertion, accompanied by hypertonia, spasm, it is also a peculiar violation of the blood supply to the muscle, which causes pain of a pulling, aching character.

Temperature and muscle pain

Myalgia, accompanied by fever, is always associated with an acute inflammatory process - viral, bacterial or parasitic etiology and indicates a certain degree of intoxication of the body.

The temperature and pain in the muscles is a typical symptom of the flu, acute respiratory infections, which occur in an acute form. In addition, hyperthermia accompanies a pain symptom in the muscles with the following diseases:

• Flu.
• Epidemic myalgia.
• Myositis is an infectious purulent, less often nasty.
• Parasitic myositis.
• Epidemic myalgia.

The temperature and pain in the muscles are symptoms of Bornholm disease or epidemic myalgia caused by enterovirus (Coxsackie virus). Muscular pain is paroxysmal, acute, localized in the upper body (chest, back, neck, shoulders, hands), body temperature rises to critical marks of 39-40 degrees.

Purulent myositis can develop as a result of trauma to soft tissues and getting into the wound infection.

Parasitic myositis develops as a consequence of invasion by trichinella, cysticerci, and toxoplasm. The body temperature is always increased and can reach 40-41 degrees, except for muscle aches the patient develops a strong facial swelling, headache, diarrhea. Myalgic symptoms are localized in the muscles of the neck, lower back and calf muscles.

Severe pain in the muscles

Myofascial syndrome is characterized by intense pain manifestations in contrast to fibromyalgia, in addition, severe pain in the muscles can be a symptom of non-infectious or symptomatic myositis.

A typical acute non-infectious myositis is located in such zones:

• Deltoid muscle - myositis of the shoulder girdle.
• The neck muscles are cervical myositis (muscle torticollis).
• Muscles of the lumbosacral department - lumbago (chamber).

Acute myositis is characterized by severe pain, leading to motor limitations, temporary immobility of the neck, legs, or arm.

The zones where the inflammatory process is localized are marked by painful sensations during palpation, seals and nodules are clearly felt in them. Severe pain in the muscles, provoked by simple myositis, subsides in peace and passes after a few days, but can recur without adequate treatment. So the chronic myositis develops, which is accompanied by pain less intense, but present constantly, often even at rest.

Symptomatic myositis can also manifest as severe pain in the muscles, the course of the disease is associated with a major etiological factor that refers to internal organs or the spine. In this case, severe muscle pain is a reflection of pathological processes, and not an independent state.

Myalgia associated with physical or psychoemotional overstrain, fibromyalgia is extremely rarely manifested by intense pain sensations, rather it indicates a combination of muscle hypertonicity and serious, yet undetected pathology, for example, rheumatic polymyalgia or rheumatoid arthritis.

Muscle aches and cramps

Seizures are spontaneous contraction, muscle contraction, usually accompanied by pain. Pain and muscle cramps are a typical consequence of overexertion, most often prolonged training, swimming, walking. Accordingly, when it comes to convulsions, most often they are associated with the gastrocnemius muscle, according to statistics, the contraction of these muscles is more than 70% of all convulsive syndromes in different parts of the body.

The reasons for which there are pains in the muscles and cramps:

• Professional factor, muscle overstrain under static or dynamic load (sellers, athletes).
• Varicose veins.
• Injuries - microdamages of muscle fibers, less often - muscle hernia.
• Violation of the balance of potassium, sodium, calcium as a consequence of venous stasis.
• Neurological diseases.
• Herniated disc.
• Uremia (azotemia).
• Intoxication, including medicamentous.
• Violation of the water-electrolyte balance due to excessive sweating or dehydration.
• Latent diseases of the thyroid gland.
• Diabetes.
• Rheumatoid arthritis.
• Lack of calcium due to abuse of caffeine-containing drinks.
• Atherosclerotic changes in the vascular system.

Cramps in the muscles can be short-term - clonic or prolonged, accompanied by severe pain, tonic. Any kind of contraction accompanies pain in the muscles. It should be noted that convulsions in principle can not be painless, since pain is the key, trigger factor of spasm and hypoxia of muscle fibers.

Aching in the muscles

Violation of microcirculation, permeability of the walls of blood vessels, ischemia, arteriosclerosis of the vessels - this is far from a complete list of causes that can cause aching pain in the muscles.

The protopathic nature of the pain symptom is typical for vascular pathologies in principle, not an exception and pain in the muscle tissue. If the blood supply is disturbed, muscle nutrition, the oxidative process develops, then dull, aching pains appear. Symptom develops slowly, is realized only during an exacerbation, it is also difficult to determine the precise localization of pain. It should be noted that painful muscle zones are most often diagnosed by external palpation, when a clear signal comes from the affected muscles.

Diseases that provoke aching pain in the muscles, always have a chronic form and can be this:

• Chronic form of muscle inflammation, myositis. Most often, myositis is accompanied by an intense pain symptom, but its chronic course is characterized by adaptation to the pathological process, when the pain is blunted, aching, and can only worsen when hypothermia, additional trauma. As a rule, this refers to the lumbar myositis, which manifests itself by pain sensations of medium intensity, which are enhanced by palpation or physical exertion.
• Fibromyalgia, which is still a "mysterious" disease of unclear etiology. Myalgia develops gradually, it affects almost all the muscles of the body, the pain is permanent, aching, little-expressed. Fibromyalgia is never combined with inflammatory processes in the musculoskeletal system or internal organs, in the case of a complex examination of any organic pathologies are not detected, the only determining criteria are aching muscles in certain trigger points.
• Dull, aching pain symptoms can indicate the inflammation of tendons or tendon tissue - myoentesite, paratenotite. Causes of these conditions is severe fatigue, overstrain of certain muscle groups and microtraumas of tendons. Muscles in the affected area are tense, swollen, pain is clearly localized in the load zone.

[15], [16], [17]

Weakness and pain in the muscles

The weakness and hypotension of the muscles is characteristic of dynamic muscles and can be indicative of many diseases, such as the following:

• Disturbance of metabolism in muscle tissue.
• Polyneuropathy (vasculitis).
• Syndrome of the anterior tibial artery.
• Myoglobinuria.
• Endocrine disorders.
• Collagenoses.
• Intoxication, including medicamentous.
• Anorexia.
• Cardiogenic asthenia.
• Neuromyotonia.
• Injuries of the spine.
• Post-training weakness and pain.

The list of diseases and conditions provoking sensations of weakness and pain in muscles is great, but more often such a syndrome is defined as myopathy (from myopathia, where myo is muscle, pathia is pain). Myopathy refers to neuromuscular, progressive diseases, including polymyositis, myositis associated with other pathologies of connective tissue, ossifying myositis, dermatomyositis. Differentiation is carried out with the help of a blood test to the level of CFE - creatine phosphate kinase, histochemical, neurophysiological examinations. The cause of muscle atony can be both hereditary factors, and infectious, inflammatory diseases, as well as trauma, hypothermia, metabolic disorders, intoxication.

Schematic pathogenetic development of weakness and pain in muscle tissue:

• Weakness, atony of proximal muscles, mainly in the area of the shoulder girdle, pelvis, hips, neck.
• Difficulties in performing simple actions - climbing the stairs, the stairs, it is difficult to get up from the chair, from the bed, brush your hair, wash.
• Rapid progression of muscular dystrophy can lead to weakness of the neck muscles and the inability to keep the head straight.
• Spasm of the pharyngeal ring, dysphagia (difficulty in swallowing food) may develop.
• All signs of myopathy are accompanied by transient, situational pains.

Weakness and pain in muscles as a symptom can be defined in such groups of diseases:

1. Muscular pathologies:

• IVM - idiopathic inflammatory myopathy (polymyositis, dermatomyositis, all other non-infectious myositis).
• Infectious myositis - bacterial, protozoal, nematode, cystoid, viral, granulomatous myositis).
• Intoxicant myopathies are medicinal, toxic myopathies.
• Metabolic myopathies are glycogen-deficient, lipid-deficient, purine-deficient, mitochondrial myopathies.
• Secondary metabolic myopathology - endocrine myopathies, electrolyte metabolism disturbance, osteomalacia myopathies.
• Muscular dystrophy - Duchenne's disease, Becker's myodystrophy, Deifus-Hogen's disease, Merb's disease, Rottauf, Mortier-Beier's myodystrophy, humeroscopy-brachial myodystrophy, Landusi-Dezherin disease and others.
• Progressive myodystrophy - myotubular, para-myotonia, Thomsen's myotonia, amyloidosis.

2. Neurogenic pathologies:

• ALS - lateral myotrophic sclerosis.
• Spinal amyotrophy.
• Spinobulbar muscle atrophy.
• Peroneal amyotrophy of Charcot-Marie-Toot.
• Radiculopathy, including diabetic.
• CVD is a chronic inflammatory demyelinating polyneuropathy, as well as its acute form.
• Shoulder flexion.

3. Violation of conduction of the neuromuscular synapse:

• Myasthenia gravis.
• Lambert-Eaton Syndrome.
• Rhabdomyolysis.

Pain in muscles and bones

Pain in muscles and bones is a symptom of diffuse or localized myalgia, more precisely one of its forms. Musculoskeletal pains are so called that sensations in the muscles are invariably combined with pains in the bone system due to its anatomical interrelation. The vast majority of causes of musculoskeletal pain (about 75%) are associated with myofascial pain syndrome, when pain is considered a reflection of spondylologic neurological pathologies. In addition, it should be noted that myofascial symptoms, myotonic manifestations are always combined with psychoemotional disorders. That is why pain in muscles and bones is so difficult to diagnose and differentiate. Basically, the division and classification of pain associated with the musculoskeletal system occurs according to the following groups:

• Local pain.
• Radical pain.
• Reflected pain.
• Secondary spasmodic pain or myofascial pain.

What pathologies involve pain in the muscles and bones?

1. A clearly localized symptom indicates a pathological process in the sensitive nerve endings (pinching, nerve irritation). Localized pain is most often permanent, but varies in intensity and depends on the position, movement or rest of the person.
2. Reflected pain symptom in the muscles and bone system. Such pain can be projected from the spinal column or be a reflection of the pathology of internal organs. If the pain is secondary and serves as a signal of the disease of the internal organ, it is not affected by the pose, the movement of the spinal column, that is, such a symptom does not subside at rest.
3. Radical syndrome usually has a high degree of intensity, the pain is strong, sharp and limited by the limits of radicular conductivity. The reason is squeezing, stretching or pinching of the spinal nerve endings. Most often the pain spreads from the center of the lesion and is strengthened by reflex movements - coughing, sneezing, laughing. According to the description of subjective sensations on the part of the sick person, the pain is felt deeply - in the bones and muscles simultaneously.
4. Myofascial syndrome differs clearly localized painful areas, which are easily palpated. The pain provokes hypertension of the muscles, the bone system is not involved in the pain syndrome in principle, however patients feel the symptom as deep and on subjective descriptions it affects the bones.

Constant muscle pain

Constant muscle pain is a typical description of either chronic, neglected myositis, or evidence of fibromyalgia. In principle, the constant nature of pain always refers to the chronicity of the disease, in this case, muscle pain is considered one of the specific criteria of FM - fibromyalgia, especially if the symptoms are distributed over diagnostic trigger zones.

Fibromyalgia, the etiology of which is still not clear, is accompanied by diffuse, common pains that are permanent, aching, less often acute, character. Diagnosis of the disease is established if the constant pain in the muscles is present for at least three months. Also diagnostic criterion is 11 out of 18 points recommended by the classifier of the disease.

According to one of the latest theories about the origin of fibromyalgia, pain is a consequence of a decrease in serotonin levels. In addition, the cause of fibromyalgia and permanent pain can be endocrine, hormonal disorders, since the main contingent of patients with FM are women. In addition to the constant pain in the muscles, fibromyalgia is characterized by the following symptoms:

• Chronic fatigue, weakness.
• Stiffness of movements, especially in the morning, after sleep.
• Insomnia, a violation of the phase of a slow, relaxing sleep.
• Chronic tension of the neck muscles, which leads to headaches.
• Dysfunction of the digestive system.
• Restless legs syndrome, rarely - convulsions.

[18]

Pain in the muscles of the whole body

The most common complaint of patients with fibromyalgia is pain in the muscles of the entire body. Diffuse, symmetrical pains in the muscles and joints of the body, the constant character of the symptomatology, clear localization along the trigger zones are the main diagnostic criteria that help to determine this poorly studied disease. In addition, the symptoms of FM (fibromyalgia) are so cleverly disguised as signs of other nosological pathologies that they are defined as a polysymptomatic or syndrome. Pain in the muscles of the whole body at first glance appears spontaneously, with no apparent objective reasons, any standard examination does not reveal any organic or systemic damage that FM could provoke.

Trigger painful currents - the tender point are really located throughout the body, they are studied quite well, there are 18 of them, if the palpation determines the pain in 11 of them, and if the symptomatology lasts more than 3 months and is not related to the organics, then the diagnosis of fibromyalgia can be consider certain.

Statistics say that in addition to diffuse pain, common in all parts of the body, fibromyalgia is characterized by such conditions, complications and consequences:

• More than 50% of patients with FM lose their ability to work and their quality of life deteriorates significantly.
• The effectiveness of patients with PM tends to zero. During the year, the efficiency of activity falls from 40% to 10 and below.
• 75-80% of patients with FM are women after the age of 35 years.
• Fibromyalgia, accompanied by pain throughout the body, is often masked by CFS - chronic fatigue syndrome. In the classifier are two different nosological units.
• FM symptomatology in 60-70% is similar to irritable bowel syndrome.
• Pain throughout the body with FM usually begin with a tension headache and dysfunction of the mandibular joint (70-75%) •
• The pain zones are very sensitive to weather conditions, temperature changes.

It should be noted that common muscular pains are also characteristic of the MFBS, the myofascial pain syndrome, which is difficult to differentiate from fibromyalgia; nevertheless, it is a separate disease.

Periodic pain in the muscles

Periodic muscle pains or transistor pains are associated with nociceptors - converters of the receptor response of muscle tissue to a traumatic factor.

This happens when the damage to the muscle fibers is insignificant and the pain subsides much earlier than the process of restoring the structure of the fibers ends. The main task that periodic pain in the muscles perform is a situational reflex response to a relatively safe damaging factor, so pain is a kind of learning experience in overcoming trauma.

Most often, the periodic character has pain associated with post-training overloads, a one-time hypertonic muscle

The so-called physical training after intensive training without proper heating is nothing more than a completely natural compaction of muscle tissue, or its micro-ruptures.

Also, transient pain can be caused by muscle stretching, a violation of its nutrition (blood supply, microelements, electrolyte balance). As soon as the provoking factor is eliminated, the pain subsides.

For physical overload, there is enough rest, relaxing or warming up the massage, with micronutrient deficiency, an additional intake of vitamin preparations, enhanced nutrition help to quickly cope with the pain symptom. Electrolyte balance is restored by using a sufficient amount of mineralized liquid (sodium mineral water).

Summarizing, it can be argued that the periodic, recurrent nature of myalgia indicates the return of the provocative factor, more often physical overstrain. Those people who have already experienced temporary temporary muscle pain after intensive labor or after the action of another factor can feel this symptom again and again for such reasons:

• If it is a question of training, therefore, their program is picked up incorrectly or before power exercises, proper preparation is not carried out (stretching, warming up muscles).
• If myalgia recurs outside the physical stress factor, therefore, there is an unsolved psycho-emotional, social problem, to which the muscles continue to react periodically in the form of hypertonicity.

Chronic muscle pain

Any pain symptom that lasts longer than the recovery or healing period is considered chronic. Many clinicians speak of chronic symptoms as an independent disease that has its own pathological process and provokes secondary dysfunction at the site of localization.

Chronic muscle pain is associated with impaired muscle fiber function, most often due to a constant static load. Muscle spasm is caused by excessive activation of metabolic processes and increased contractile properties of the fibers. This chronic process inevitably leads to compression of blood vessels, nerve endings and a general impairment of blood circulation, ischemia.

Constant, chronic pain is not intense, it is often dull, aching, and more fibromyalgia than myositis. The pain symptom in fibromyalgia develops not only in the muscle fibers, but also in the ligaments, tendons, it is accompanied by asthenia, sleep disorders, depressions. The pains are diffuse, spread over trigger points, which, when palpated, respond with distinct painful sensations.

Also, chronic pain in muscle tissue can be caused by latent diseases of the endocrine system, parasitic muscle invasion, chronic inflammatory processes (polymyositis).

The localization of chronic pain depends on many factors, the most common zone is the lower back where there are a large number of nociceptors (neurons), especially those that have a peripheral, delayed effect. Thus, the problem of pain - etiologic protection is not fully fulfilled, the body becomes maladaptive and begins to "get used to" with a painful implicit symptom.

[19], [20]

Cutting pain in muscles

Acute, cutting pain in muscle fibers is the biological response of the adaptive system of the body to damage - the initial or already occurred. Most often, the pain of cutting is associated with dysfunction of smooth muscles without concomitant injury and damage to surrounding tissues. The duration of pain depends on the period of recovery of the muscle or on the speed of arresting the root cause - vertebrogenic, cervicogenic and other factors.

Cutting, "lancinating" pain in the muscles is very rare, its causes can be the following factors:

• Injury of soft tissues (open, closed), severe bruise with rupture of subcutaneous tissue and fascia, muscle fibers.
• Myofascial syndrome in conjunction with krumpi, contracture.
• Acute form of infectious myositis, accompanied by abscesses.
• Full muscle separation, transverse rupture of muscle fibers.

Cutting pain in the muscles always indicates severe trauma, damage to muscle fibers, or an acute inflammatory process in them. Cutting pain can also be caused by excessive efforts, the load on the stretched muscle, which began to recover. Severe pain accompanied by krampi, contracture, when involuntary contraction of the muscle decreases the level of adenosine triphosphate, the electrical conductivity of muscle fibers is disrupted. In addition, severe pain is caused by reflex muscle contraction in the defeat of deep layers of soft tissues, carpopedal spasms (tetany).

A separate share of attention deserves myositis, which is characterized by sharp, cutting pains due to the inflammatory process in the muscle tissue. If the inflammation occurs in chronic form, its acute period is left without proper treatment, the load on the inflamed muscle increases, inside it is formed a fibrous seal-node. In addition, that the diseased muscle is spasmodic, blockade of blood flow, ischemia develops, the rate of metabolic processes increases and the release of specific chemical substances provoking pain. The most typical areas of the painful cutting symptom in myositis are the neck, shoulders, back.

When diagnosing a painful muscle muscle symptom, it is always possible to exclude possible root causes - oncology, inflammation of internal organs of infectious etiology, acute spinal syndrome. Particularly thorough examinations are required if the sharp pain in the muscle fibers does not subside and does not depend on changing the position of the body, movements.

[21], [22], [23]

Nausea, temperature and muscle pain

Myalgia, which is accompanied by nausea and hyperthermia, may indicate many diseases of completely different etiology. However, the combination of symptoms - nausea, temperature, muscle pain - is a sign of a serious condition requiring immediate hospitalization.

At what diseases are nausea, temperature and pain in the muscles possible?

• Influenza, especially toxic form. It is accompanied by chills, tearing, often delusions at high body temperature, weakness.
• Meningitis. The main symptoms are high fever (up to 40 degrees), a strong diffuse headache of a bursting nature, a rash, nausea and multiple vomiting, stiffness and pain in the occipital muscles and leg muscles, can be a convulsive syndrome.
• Herpes (genital) - characteristic rashes, itching, weakness in the body, hyperthermia, enlarged lymph nodes, nausea and headache, myalgia. The same symptomatology can be with herpes zoster.
• ITH is an infectious-toxic shock (bacterial shock), which can be triggered by meningitis, dysentery, influenza, candidiasis and other diseases of the viral-bacterial etiology. Symptoms - a spontaneous jump in temperature to 39-40 degrees, nausea and vomiting, severe pain in the muscles, swelling, diarrhea, rash, loss of consciousness, cyanosis, tachycardia.
• Epidemic myalgia. Symptoms - hyperthermia, nausea and vomiting, diarrhea, pain in the abdominal muscles, in the muscles of the chest.

Summarizing, it can be noted that a combination of such threatening signs most often indicate a strong intoxication of the body, a serious condition that requires an immediate call of a doctor, emergency medical care.

Cold and muscle pain

What people call a common cold, it would be more correct to call ORVI, ARD, sore throat, flu. In accordance with the difference in nosology, the symptomatology also differs, but there are also common signs - an increase in body temperature and muscle pain.

Why is it considered that with cold the pain in the muscles is a typical phenomenon?

Myalgia almost always accompanies an increased body temperature, therefore, if the common cold is acute, the patient will complain about uncomfortable, pulling, aching sensations in the muscle tissue. As a rule, all catarrhal diseases are accompanied by obvious catarrhal symptoms - a runny nose, sore throat, conjunctivitis, but also a cold is characteristic of intoxication when the products of the decay of bacteria and viruses enter the bloodstream. The body tries to get rid of toxins with the help of intense sweating, which in turn provokes a violation of electrolyte, water-salt balance. It is this disorder that causes myalgia in various areas of the body. To neutralize dehydration and accelerate the withdrawal of intoxication products, patients are recommended to drink plenty of blood - hemodilution.

In addition, in the chemical thermoregulation of the body, the main role is played by the muscles, to a lesser extent kidneys and liver participate in this process. Muscles provide contractive thermogenesis, which is enhanced, activated by catarrhal diseases. Thus, with a cold, muscle pain is a sign of their more intensive work, helping together with other systems to cope with the disease.

[24], [25]

Flu and muscle pain

It is believed that the flu and muscle pain inevitably accompany each other, but this does not always happen. More often the virus infection is accompanied by transient diffuse myalgias, and the present, true myositis - inflammation of the muscle tissue is practically not found. This is due to the pathogenetic mechanism of the entry of the influenza virus into the body. Primary invasion and multiplication of influenza virions mainly occurs in the epithelial cells of the respiratory system - nasopharynx, bronchi, in the endothelial tissue of the capillaries. The virus acts cytopathically on mucous tissues, provoking total inhibition of the immune system (suppression of phagocytosis), but is unable to penetrate into muscle fibers due to its molecular structure.

How to determine what triggers myalgia, a simple respiratory illness or the flu, muscle pain is caused by overexertion or a virus?

It all depends on the degree of severity of the process, which, when influenza, is determined by taking into account two clinical forms - influenza with a predominance of catarrhal symptoms or influenza with a predominance of symptoms of intoxication.

The catarrhal course of the disease is rarely accompanied by muscle pains, it is more likely to be an intoxicating form, when from the first hours of illness a person feels an ache, leg pain (calf muscles), lower back, joints or generalized muscle pain throughout the body. Then there are other signs of viral intoxication - weakness, dizziness, adynamia. Such characteristic manifestations with objective information about a possible infection of the flu (epidemic, contact with a sick person) can serve as arguments in favor of diagnosing the intoxication of the flu.

[26], [27], [28], [29]

Sore and aching muscles

The feeling of aches is more common in joint pains than in the muscles, but often patients describe their condition as "aches and pain in the muscles." What diseases can cause such an atypical combination of symptoms?

• ARVI, ARI, adenovirus diseases are often accompanied by a low-grade fever, licking, aching sensations in the muscles of the body.
• The decrease in the activity of immunity is primary, conditioned by the genetic factor or secondary, associated with chronic pathologies of internal organs, stresses, drug intoxication. Symptoms - weakness, fatigue, drowsiness, sleep disturbance, aches and pain in muscles, joints.
• Chronic non-infectious myositis is an inflammatory process in the muscle fibers. Painful symptoms are not intense, depend on movements, loads, often on weather conditions. Chronic myositis is characterized by muscle weakness, muscle atrophy, which provokes lomiting sensations. The causes are permanent static stress of certain muscle groups, hypothermia, intoxication, trauma, parasitic invasion.
• Fibromyalgia, which often provokes aches and pains in the trigger zones without any signs of an inflammatory process. Pain diffuse, diffuse, has a permanent, chronic character.
• Post-training pain, OMB - delayed muscle pain is often expressed in aching, bursting sensations. The pain is temporary and associated with overload, microfractures of muscle fibers

Pain in the muscles after sleep

It is necessary to distinguish the morning stiffness in the joints and muscles, which is often confused by the patients themselves in the description of subjective sensations.

Typical morning pain and stiffness is a typical sign of osteoarthritis, in which the articular cartilage is destabilized, but not the muscles. Also, early morning pain is characterized by a diffuse idiopathic skeletal hyperostosis, in which painful sensations after sleep last no more than an hour. The pain is localized in the back and affects only the bone system, without affecting the muscular system.

As for muscle tissue, the pain in the muscles after sleep is most likely associated with fibromyalgia, in which diffuse chronic pain is the main symptom. Typical signs of fibromyalgia:

• Sleep disturbance, leading to a feeling of fatigue, weakness, starting in the morning.
• Stiffness of movements after sleep, pain in muscles, and also in joints. Muscle pain zones are clearly palpable within the boundaries of diagnostic trigger zones.
• Headache, often caused by hypertension of the muscles of the neck and shoulder girdle.
• Sensation of numbness in the extremities.
• Pain in the muscles of the legs, restless leg syndrome in sleep.