Myalgia

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Myalgia
ICD-10 M79.1
ICD-9 729.1
DiseasesDB 22895

Myalgia Microchapters

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Overview

Pathophysiology

Causes

Differentiating Myalgia from other diseases

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

CT

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Treatment

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Primary Prevention

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Risk calculators and risk factors for Myalgia

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

Overview

Myalgia means "muscle pain" and is a symptom of many diseases and disorders. The most common cause for myalgia is either overuse or over-stretching of a muscle or group of muscles. Myalgia without a traumatic history is often due to viral infections. Longer-term myalgias may be indicative of a metabolic myopathy, some nutritional deficiencies or chronic fatigue syndrome.

Differential diagnosis of causes of myalgia

The most common causes of myalgia are overuse, injury or stress[1]. 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. [1] Examples are:

Injury

The most common causes of myalgia by injury are: sprains and strain (injury)[1].

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, Isotretinoin, Procainamide, Quinupristin/dalfopristin, Spiriva, Sumatriptan, Vardenafil, Statins, 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.

Myalgia Video

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