Myalgia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Causes

Common Causes

The most common causes of myalgia are overuse, injury or stress. However, myalgia can also be caused by diseases, disorders, medications, as a response to vaccination and withdrawal syndromes.

Overuse

Overuse of a muscle is using it too much, too soon and/or too often. Examples are:

• Repetitive strain injury.

Injury

The most common causes of myalgia by injury are: sprains and strain (injury).

Diseases/Disorders

Infectious

Trichinosis, Typhoid fever, Upper respiratory tract infection, Viral pneumonia, Influenza, Common cold, Community-acquired pneumonia, Coccidioidomycosis, Dengue, Endemic typhus, HIV, Infectious mononucleosis, Legionellosis, Leptospirosis, Lyme disease, Malaria, Marburg virus, Meningitis, Monkeypox, Pharyngitis, Pneumonia, Prostatitis, Psittacosis, Q fever, Rabies, Rift Valley fever, Severe acute respiratory syndrome (SARS), Toxic shock syndrome, West Nile, Chikungunya

Autoimmune

Multiple sclerosis, Myositis, Lupus erythematosus, Familial Mediterranean fever, Polyarteritis nodosa, Devic's disease, Morphea

Metabolic Defect

Carnitine palmitoyltransferase II deficiency, Conn's syndrome, Adrenal insufficiency

Other

Chronic fatigue syndrome, Hypokalemia, Exercise intolerance, Mastocytosis, Peripheral neuropathy, Eosinophilia myalgia syndrome, Fibromyalgia, Barcoo Fever, Delayed onset muscle soreness

Medications

Aldara, Acrylamide, Darbepoetin, Emtricitabine, HPV Vaccine (Gardasil), Infliximab, Interferon Beta- 1A, Isotretinoin, Procainamide, Quinupristin/dalfopristin, Sofosbuvir, Spiriva, Sumatriptan, Vardenafil, Statins, Tenofovir disoproxil fumarate, Zetia, Zomig, Boniva.

As a Response to Vaccination

A moderate occurrence (25-35%) of myalgia in recipients of tetanus vaccination is identified in the US; it presents in the large muscle groups and at the subcutaneous injection site. When a patient returns with these symptoms (which include fever, poor appetite and lethargy), a clinician who fails to notice the recent tetanus vaccination on the patient's chart is in danger of making a life-threatening misdiagnosis. An item of note is that in heart patients using selective β₁-blockers such as metoprolol, incidence of myalgia after tetanus vaccination is significantly higher.

Withdrawal Syndromes

Sudden cessation of opioids, barbiturates, benzodiazepines, or alcohol can induce myalgia.