Muscle pain or Myofascial pain syndromes occur commonly in association with pain generated from another source, this is an unfortunate consequence of how our bodies attempt to compensate for the initial pain generator. There are also primary muscular pain syndromes, most commonly fibromyalgia but also pain related to Rheumatoid Arthritis, Scleroderma, and hypermobility syndromes such as Marfans. After an evaluation for an underlying source of pain, and treatment of systemic inflammation, muscle pain is very frequently treated with therapy and specific exercise to restores muscle strength and balance at affected joints to restore strength from either disuse or abnormal postures used in an attempt to control pain.
For those with primary muscle pain and a diagnosis of Fibromyalgia, an attitude of persistence is necessary both for the patient and clinician, as all therapies don’t uniformly work equally for each patient and it’s usually through a combination of therapies unique to each patient that we achieve our best outcomes.
Post Surgical Pain
Mrs Jones (not her real name), 55 years old, came to a musculoskeletal specialist seeking advice for a 3-year history of progressively worsening pain in both knees. Her knees were stiff for about 20 minutes when she arose in the morning and for a few minutes after getting up from a chair during the day. She had difficulty walking > 30 minutes because of pain, and her symptoms were exacerbated by kneeling, squatting, or descending stairs. Although sitting, resting, and reclining relieved her pain, she became stiff if she stayed in one position for too long. Her symptoms were worse on humid or cold days, and she occasionally felt as if one of her knees would “give out.”