Body Aches & Pain
That achey, breaky feeling
Aches and pains signal that something is wrong. Your body and brain use pain to keep you from further injuring yourself, because the more it hurts the less likely you are to continue with what you were doing.
It can be easy to have a cut or a burn and know how it happened, and how to avoid more. But sometimes body discomfort is hard to localize. Your whole back may hurt when you've done a lot of yard work. A long session at the gym may make every muscle sore. It can be difficult at first to tell if a strain or bump is serious.
When pain prevents further injury it can be useful. In other cases, pain interferes with daily function. However, there are now more choices in relieving pain than just "pain-killing" medications. Life will still have its challenges, but there can be a little more comfort along the way.
Detailed Description
Overexertion, strain, or stress on one or several muscle groups usually cause aches. They commonly occur in the legs, arms, neck, back, stomach, and feet.
Pain comes in a variety of shapes and forms. It can be in one place or many, be dull or sharp. It can be continual or it can come and go. The types of body pain include nerve pain, postsurgical pain, pain from cancerous growths, imagined (psychogenic) pain, organ (visceral) pain such as appendicitis, and the nagging pain of arthritis that affects mostly middle-aged and senior citizens. Just about all of these pains can be chronic, i.e. long-standing.
Tens of millions of people in North America have chronic pain: pain that lasts more than half a year. Chronic pain can wear a person down -- it can take the joy out of life and cause depression, or it may interfere with sleep and appetite.
How Common Are Body Aches and Pains?
Almost everyone suffers from general body aches and pain at one time or another. Up to 20% of all Americans endure chronic pain, sometimes for years.
Possible Underlying Causes
Body aches and pain can be caused by almost anything. Whether it's acute or chronic, the pain you feel can be from an ailment that may start at your head (neck and back pain, headaches, migraines); your extremities (arthritis, tendinitis, bursitis); or your feet (bunions, ingrown toenails, inflamed Achilles tendon). Sometimes, you can get aches and pains from psychological disorders (from hypochondria to anxiety to depression).
A flu can cause body aches; pregnancy may cause discomfort; cancer and sickle-cell anemia can be very painful; gastrointestinal and kidney diseases may cause sharp stomach and side pains -- the list goes on and on.
Pain is not always felt at the site of injury -- it may be felt remotely. There can be leg pain associated with a back injury or arm pain during a heart attack.
The cause of chronic pain is often hard to pinpoint. In some cases, the underlying cause is a condition such as rheumatoid arthritis, lupus, HIV, or migraine. Conditions whose cause is not understood can also cause chronic pain -- fibromyalgia and chronic fatigue syndrome are two of the most well-known.
Triggers of Body Aches and Pain
Pain begins with an injury or disease. Your nerves send off a number of messages that your aches and pain may be the beginning of a more severe problem. Some of these include overall body pain (centralized pain, fever); upper torso pain (ear pain, stiff neck, chest pain); abdominal pain (cramps, urinary pain or frequency); and other local or regional pains.
Body aches and pain unaccompanied by other symptoms may be due to the following:
- Overexertion: A lot of activity can cause overall muscle soreness, especially if the activity involves unusual motion or use of weak muscles.
- Jarring accident: A fall or accident that jolts your entire body. The pain may not arise for a couple of days after the event and may worsen before it begins to improve.
- Sprains and strains: Stretching such tissues as ligaments and tendons beyond their normal length, often causes swelling, and tiny tears.
Diagnosing the Underlying Cause
When pain occurs, the first course of action is to find the source. The source may be the same as or distant from where the pain is felt. While some general body aches are common and usually nothing to worry about, in rare instances they may be a symptom of an underlying condition, disease, or disorder. Some of these disorders have certain characteristic symptoms, including high fevers.
The following conditions may include aches and pains among their symptoms. You should not attempt to diagnose yourself, even if your symptoms match the characteristics of a certain disorder. If your symptoms concern you, the best thing to do is to seek medical advice.
Body aches and pain accompanied by cold-like symptoms may be due to the following:
- Viral infection: A common cold, flu, or pneumonia can cause body aches. A viral infection causes generalized aches and pains.
- Chronic fatigue syndrome: CFS is a condition of unknown origin that causes flu-like symptoms, deep fatigue, impaired thinking, and pain.
Body aches and pain along with a rash may be due to the following:
- Viral infection: especially in children.
- Bacterial infection.
- Lyme disease: an infection caused by a tick bite. A rash is present, usually surrounding the area of the bite. The disease may first be noticed as aches which occur a few weeks after being outdoors.
- Psoriatic arthritis: joint inflammation affecting some of those who already have psoriasis (a skin disease).
- Juvenile rheumatoid arthritis: a disease in children that can include high fever, rash, and joint pains.
Body aches and pain accompanied by joint pain and stiffness may be due to:
- Osteoarthritis: joint swelling with accompanying pain and stiffness. Pain is usually worse in the evenings after a day of activity, and is localized.
- Rheumatoid arthritis: joint inflammation with accompanying pain, stiffness, and possible deformity. Pain often comes and goes, but is usually worse in the mornings.
- Lupus: a chronic inflammatory disease affecting many body systems. Also known as systemic lupus erythematosus (SLE).
- Ankylosing spondylitis: a condition that causes spine stiffness and changes in posture.
Diagnostic Procedures
If your physician believes that your aches and pains may be related to another condition, he or she will attempt to diagnose the underlying disorder with a physical exam. Procedures such as blood tests, cultures, and X-rays may be recommended.
Goals of Treatment
Most doctors or health care providers will share this common-sense advice: if you're in pain, stop doing what caused the pain until it goes away. Resting the injured area for a few days to a week, taking aspirin and other painkillers to reduce swelling and relieve pain, and/or icing the affected area may help allow you to recover. Specialists recommend a regimen they call RICE: rest, ice, compression, elevation. If this conservative treatment fails, a number of other treatments are possible, ranging from injections, to osteopathy, chiropractic, massage, acupuncture, yoga, and physical therapy.
Treatment Options
Drugs most commonly used
- Over-the-counter painkillers: such as acetaminophen (Tylenol) and anti-inflammatory drugs like aspirin, ibuprofen (Advil), and naproxen (Aleve).
- Topical painkillers: like Ben-Gay cream, Tiger Balm, and Icy Hot.
- Prescription medicines: nonsteroidal anti-inflammatory drugs (NSAIDs) like Voltaren (diclofenac), muscle relaxants like Valium (diazepam) and Soma (carisoprodol), and opioid (narcotic) pain relievers like Roxanol (morphine). These can be addictive and their use should be closely monitored.
Second choices
- Tricyclic antidepressants like Elavil (amitriptyline) or anticonvulsants like Neurontin (gabapentin) for the treatment of neuropathic pain and chronic pain.
Supplements
- Vitamin C: Antioxidant nutrients, notably vitamins C and E, help prevent the cell damage linked to joint deterioration and pain. For 10 years, researchers at the Arthritis Center of Boston University Medical Center looked at the diets of 640 older adults who had osteoarthritis of the knee. Compared with those who took the least vitamin C, those who got the most had just one-third the risk of their knee pain getting worse. Vitamin C can also help prevent cartilage loss.
- Vitamin E: In one study, 32 people with chronic joint pain took either a placebo or vitamin E (600 IU/day). The vitamin E group had significantly more relief.
- Glucosamine and chondroitin: About half to two-thirds of people with osteoarthritis who try these supplements find them helpful.
Glucosamine helps repair damaged cartilage. Experts suggest 500 mg three times a day for a month. If it helps, feel free to keep taking it. If not, stop after a month.
Chondroitin helps draw fluid into cartilage, which improves its shock-absorbing ability. Experts suggest 400 mg three times a day for a month. If it helps, feel free to keep taking it. If not, stop.
Neither glucosamine nor chondroitin supplements have been reported to cause significant side effects.
Herbs
- Willow bark: This herb contains salicin, the natural precursor of aspirin. Bring water to a boil, then simmer one to two teaspoons of powdered bark per cup of water for 20 minutes, and strain. Drink up to three cups a day.
- Meadowsweet and wintergreen: These also contain salicin. Steep one to two teaspoons of herb per cup of boiling water for 20 minutes, then strain. Drink up to three cups a day.
Alternative Therapies
- Acupuncture and acupressure: some patients report immediate relief with these techniques.
- Biofeedback: using the brain's alpha waves, participants shift their focus away from the pain.
- Chiropractic: this method of realigning the spine and neck can be helpful.
- Compresses: warm and cold compresses can help temporarily relieve pain.
- Feldenkrais method/functional integration: guided gentle movements can help restore ease of movement.
- Hypnosis: using the subconscious, patients visualize a pain-free environment.
- Low-voltage stimulation: electric currents interrupt your body's pain signals.
- Massage: very helpful to relieve muscle spasms, especially in the neck, back, and legs.
- Music: New Age or other relaxing music can enable you to create more endorphins, your body's natural painkillers.
- Osteopathy: some of these fully licensed physicians perform gentle manipulations to improve function and relieve pain.
- Prolotherapy: therapeutic injections around various ligaments can help relieve pain in chronic cases.
- Ultrasound: this deep muscle technique can help swollen tissues and ligaments.
- Yoga and tai chi: these movement therapies can stretch and loosen the affected muscle areas.
Preventing Body Aches and Pain
No matter what measures you take, it is unlikely that you can prevent even the most minor aches and pains. They occur when your body is pushed beyond its normal limits, overexerted, or simply stretched in an area it normally doesn't stretch. Some common-sense advice: do not lift heavy objects unless you know how to do so correctly -- this can cause a muscle strain. Avoid sitting in one place for long periods -- moving around keeps your muscles from getting stiff.
Self-Care Measures
A common-sense way to reduce acute body aches and pains is to follow the RICE program immediately after they start:
- R is for Rest. Stay off your injury for a few days until the pain eases.
- I is for Ice. Chill the affected area with an ice bag or ice cubes wrapped in a towel, 20 minutes maximum.
- C is for Compression. Wrap the area in a bandage or towel.
- E is for Elevation. Put your aching limb up on a table or couch with books or pillows beneath it, to reduce fluid buildup. This lets you rest the injured area and promotes healing.
Additionally, with the popularity of sports medicine today, your doctor may prescribe physical therapy that you can do both at a nearby clinic and at home. Then you can stretch and strengthen your sore and aching muscles whenever you need to.
When to Call the Doctor
Seek medical attention if the following symptoms are present:
- Fever higher than 101 F is present, which may cause headache, dehydration, nausea and/or convulsions, particularly if it lasts more than one or two days
- Abdominal pain or cramping
- Pain more severe than anything you've had in the past
- Lethargy, vomiting, diarrhea, or other unusual symptoms
- An injury resulting from a fall
- Swelling caused by a muscle strain, sprain, or pull
- Chronic pain that can't be controlled or relieved by relaxation, icing the affected area, nonprescription medicines, or painkillers
- Back pain that does not disappear after one to four weeks of rest
- A rash that spreads or is painful to the touch
- A burning sensation, sweating, and swelling
- Postsurgical pain
- An inability to walk or sit without pain
- Chest pain, especially with sudden onset
- Change of consciousness or impaired consciousness
- Loss of bowel or bladder control
- Sudden loss of feeling or movement in the arms or legs
- Difficulty breathing
- Difficulty swallowing
- Difficulty urinating
- Neck stiffness with fever
Websites & Organizations
American College of Rheumatology
1800 Century Place, Suite 250
Atlanta, GA 30345
Phone: 404-633-3777
Fax: 404-633-1870
American Lyme Disease Foundation, Inc.
Mill Pond Offices
293 Route 100
Somers, NY 10589
Phone: 914-277-6970
Fax: 914-277-6974
Email: Inquire@aldf.com
American Public Health Association
1015 Fifteenth St., NW
Washington, DC 2005
Phone: 202-789-5600
Arthritis Foundation
National Office
1330 West Peachtree Street
Atlanta, GA 30309
Phone: 404-872-7100 or 800-283-7800
National Health Information Center
P.O. Box 1133
Washington, DC 20013-1133
Phone: 301-565-4167 or 800-336-4797
Fax: 301-984-4256
Email: nhicinfo@health.org
National Institute of Allergy and Infectious Diseases
National Institutes of Health
Bethesda, MD 20892
National Institute of Arthritis and Musculoskeletal and Skin Diseases Clearinghouse
1 AMS Circle
Bethesda, MD 20892
The Office of Minority Health Resource Center (info about lupus)
Email: lmosby@omhrc.gov
Phone: 800-444-6472
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Duke, J. The Green Pharmacy. Emmaus, PA: Rodale Press, 1997.
Fauci, Anthony J. et. al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.
Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw-Hill, 1996.
Hurst, J. Willis. Medicine for the Practicing Physician eds. Stamford, CT: Appleton & Lange 1996.
Murray, Michael T. Encyclopedia of Natural Medicine. Prima, 1998.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Taylor, Robert B. Family Medicine: Principles and Practice. New York: Springer-Verlag, 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment eds. Stamford, CT: Appleton & Lange, 1998.
Articles
Birse, TM, Lander, J. "Prevalence of Chronic Pain." Can J Public Health. 89(2):129-31. Mar-Apr 1998.
Davies, HT, Crombie, IK, Brown, JH, Martin, C. "Diminishing Returns or Appropriate Treatment Strategy?--An Analysis of Short-Term Outcomes After Pain Clinic Treatment." Pain. 70(2-3):203-8. Apr 1997.
Ehrmann-Feldman, D, Rossignol, M, Abenhaim, L, Gobeille, D. "Physician Referral to Physical Therapy in a Cohort of Workers Compensated for Low Back Pain." Phys Ther. 76(2):150-6 discussion 156-7. Feb 1996.
Field, T, Hernandez-Reif, M, Seligman, S, Krasnegor, J, Sunshine, W, Rivas-Chacon, R, Schanberg, S, Kuhn, C. "Juvenile Rheumatoid Arthritis: Benefits from Massage Therapy." J Pediatr Psychol. 22(5):607-17. Oct 1997.
Groopman, JE. "Fatigue in Cancer and HIV/AIDS." Oncology. 12(3):335-44; discussion 345-6, 351. Mar 1998.
"Relieving Arthritis Pain: Can Supplements Help?" Nutrition Action Healthletter 1-2/98. Holt, S. "Bone and Joint Health: Part 2, Dietary Supplements," Alt. and Comp. Therapies, 6-98.
Machtey, I and L Ouakhine. "Tocopherol in Osteoarthritis: a Controlled Pilot Study," J. Am. Geriatric Soc. (1978) 26:328.
McAlindon, TE et al. "Do Antioxidant Micronutrients Protect Against Development and Progression of Knee Osteoarthritis?" Arthritis and Rheumatism (1996) 39:648.
O'Callaghan, CC. "Pain, Music Creativity and Music Therapy in Palliative Care." Am J Hosp Palliat Care. 13(2):43-9. Mar-Apr 1996.
Patt, RB, Ellison, NM. "Breakthrough Pain in Cancer Patients: Characteristics, Prevalence, and Treatment." Oncology. 12(7):1035-46; discussion 1049-52. Jul 1998.
Strassman, AM, Raymond, SA. "On the Origin of Headaches." Endeavour. 21(3):97-100. 1997.
Unruh, AM. "Gender Variations in Clinical Pain Experience." Pain. 65(2-3):123-67. May-Jun 1996.
Woolf, CJ. "Somatic Pain--Pathogenesis and Prevention." Br J Anaesth. 75(2):169-76. Aug 1995.