Muscle pain and rheumatic disease 4.61/5 (83)

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Muscle pain


Rheumatic muscle pain can range from being a little uncomfortable to causing extreme pain. The pain is chronic when it has been daily for more than three months. Rheumatic muscle pain contributes to reduced quality of life, drug use and long-term sick leave. Often the symptoms are harmless, but they can also be signs of serious illness.


Muscle pain is usually not a disease sign. Painful, rigid and sore muscles are a natural reaction after unfamiliar physical activity or have slept in an uncomfortable position or part of normal aging.

  • Leg cramps are very common in the population and occur most often without a particular disease cause
  • With increasing age, the muscles often become more rigid and sore, especially after being inactive. Age-related rheumatic pain is common
  • However, stronger new muscle pain that persists over days and weeks may be signs of muscle disease or underlying other disease

New-onset and chronic muscle pain without known cause should be further investigated by a doctor (please read more about the medical investigation below on this page).

Muscle pain may be separated in two main groups:

  1. Pain due to inflammation (rheumatic inflammation or infection)
  2. Pain not related to inflammation

 1. Muscle pain with inflammation (Disease sensation, signs of inflammation in blood tests)

  • Cancer treatment with checkpoint inhibitors can trigger muscle inflammation
  • Polyarteritis nodosa (PAN)
    • A very rare form of systemic vasculitis
    • Strong, unexplained pain, often in the calves. High inflammation tests and clearly affected general condition with night sweats, fever tendency and weight loss
  • Polymyalgia rheumatica
    • Most are aged 65-80 years (never before 50 years of age)
    • Beginning in a few days with severe stiffness in the shoulders, neck, upper arms and pelvis, hips and thighs
    • Blood tests show high CRP and Sedimentation rate (ESR). Creatine kinase (CK) are normal
    • Prednisolone 15-20 mg / day has a good effect in a few days

2. Muscular pain without inflammation


  • Disease history (disease start, disease progression, muscle groups, medications, other diseases)
  • Medical Surveys: Visible changes (atrophy, infection signs, eczema), pain at palpation / light pressure, power failure (rising from the chair and from squatting without supporting)
  • Blood tests: CRP, blood drop reaction (SR), electrolytes with potassium and calcium, CK (creatine kinase), ANA: anti-nuclear factors; ANCA: anti-neutrophil cytoplasmic antibody; TSH, F-T4, Glucose
  • EMG (electromyalgia)
  • MRI (with contrast) of muscles (usually thighs)
  • Biopsy (tissue test)

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