Muscle pain in the legs, back and neck can be caused by excessive stress such as a spasm in the calf or a contracture on the quadriceps, but also by various conditions that affect the muscles or nerves of the body. Here are some of them.

Any muscle can be affected by various diseases and disorders, including: strains, spasms, contractures, infections, traumas, autoimmune diseases, neurological and muscular disorders, malignant tumors (for example, leukemia) and disorders caused by medications.

Muscle pain can occur in one area of the body, such as the neck or back, but can also cause discomfort anywhere, such as the flu.

Muscle pain can also be caused by infections or by serious autoimmune diseases or general disorders, such as fibromyalgia, menopause or dermatomyositis, an inflammatory muscle disease.

Meningitis can cause severe muscle pain in the neck. Likewise, a heart attack causes chest pain projected by the heart muscle.

Muscle pain can also be a sign of diseases that affect the whole body, such as some infections (including influenza) and ailments that affect the connective tissue of the entire body (such as lupus).

A common cause of muscle disorders is fibromyalgia. This is a condition that leads to stiffness of the muscles and surrounding soft tissues, insomnia, fatigue, joint pain and headaches.

Pain in the muscles of the lower extremities (calf and thigh) can be caused by a spasm, contracture, lesions or trauma. The most common traumatic and exercise-induced causes of muscle pain are listed below.



Muscle spasms are sudden, unwanted contractions or spasms in one or more muscles. Most affected are calves and foot muscles.
They usually occur after physical exercises (after training or competition) or during the night and last from a few seconds to a few minutes. This is a very common muscle problem.
Anyone who has ever had spasms or muscle cramps knows that these can be extremely painful.
A severe muscle spasm does not pass by itself and you have to release the muscle tension manually to help relax.

The exact cause of muscle spasm is still unknown, but the most reliable theories are:

  • Altered neuromuscular control
  • Dehydration (especially in summer)
  • Electrolyte loss (especially of potassium)
  • Poor condition
  • Muscle fatigue
  • Start of new physical or sporting activities

Therapy for muscle spasms
Normally, the pain passes without treatment, but you can follow some tips to prevent the healing process and other episodes:

  • Stretching or light massages can relieve the pain.
  • Interrupt the activity that caused the spasm.
  • Keep the joints in a shortened position until the spasm stops.
    Contrary to popular belief, when a muscle is stretched during a spasm, the body sends a signal to contract the muscle as if as a defense mechanism.
    If, on the other hand, muscle tension is released by bringing the muscle ends closer together (relaxation), the body does not feel any danger and immediately stops the signal of muscle contraction.

Pulled muscle

A strain of the muscle is uncomfortable and is caused by strenuous activities.
Everyone can exert excessive strain on their muscles during normal daily activities, for example by suddenly lifting a heavy object, during sports or during professional activity.

A muscle strain usually occurs in the thigh or calf. Excessive muscle tension can lead to muscle injury. The rupture of muscle fibers can also damage small vessels, thus causing local bleeding (ecchymoses) and pain (caused by irritation of the nerve endings in this area).

The symptoms of muscular overstretching or strain are:

  • swelling, bruising, redness or open wounds caused by the trauma;
  • pain at rest;
  • muscle pain when using the muscle in question or the joint to which the muscle attaches;
  • Myasthenia;
  • Inability to use the muscle as before.

What you should do in the acute phase in the first 72 hours:
If a muscle is injured, you have to spare it.
One should immediately start treatment and contact the doctor to get a precise diagnosis of the severity of the damage.

Continuing to move the muscle increases bleeding (hemorrhage) and damage, and recovery takes longer and is more difficult. The sooner you rest, the lower the pressure and bleeding around the injury area.
First, ice should be placed on the injured area for 20 minutes. This remedy slows blood flow in the damaged muscle.
No heat pads or muscle massages. Heat increases blood circulation in the damaged zone (vasodilation). A massage causes increased bleeding and interferes with the healing process.
The injured area must be wrapped with a bandage that compresses. Raise the affected limb above heart level. It is recommended to sleep with a pillow under the injured limb.
The wound heals with scarring, which is not as flexible as the muscle and cannot be stretched well. The scar tissue in the center of the muscle can promote new injuries and may make the muscle weaker than before the incident.


The bruise or contusion is a damage or series of damages caused by the collision of a blunt object with the body.
The object in question is not sharp, so it does not cut and does not penetrate into the body tissues.

A contusion arises from a blow or repeated blows of a blunt object directly on the body, connective tissue and muscle fibers, are squeezed without injury to the skin. A contusion can result from a fall, a collision of the body with a hard surface, or whiplash in a traffic accident.

The impact causes the rupture of the capillaries and bleeding into the damaged tissue. Thus, a hematoma is formed at the site of injury.
In the most severe cases, swelling and bleeding under the skin can cause shock.
If the tissue damage is extensive, a fracture, dislocation of a joint, distortion, muscle or tendon strain or other lesions may also occur.
Contusions cause swelling, persistent pain, and restricted movement in neighboring joints.
Injured blood vessels can cause bluish spots, such as hematomas. The injured muscle feels weak and stiff.

Immobilization of the limb with rest, ice, compression and high positions (PECH rule) should be observed in the first 24-48 hours of patients who have suffered a contusion.
The general recommendation is to avoid heat for the first 48 hours so as not to increase bleeding and edema formation.
Once the injury has stabilized, heat can help dissolve and absorb the hematoma; however, this simple remedy has not shown any significant benefits in the scientific literature.

How long does the injury last? Prognosis
Recovery after a contusion takes 7-10 days in relation to pain and about 3 weeks to reabsorb the hematoma.

Muscle tension

Muscles contract when used while relaxing or stretching when not needed.
Nevertheless, sometimes a muscle can remain contracted or an involuntary contraction can unexpectedly result.
Spasms can occur when a muscle is overloaded. They announce themselves like muscle fatigue, especially if the muscles have been overstretched or held in the same position for an extended period of time.
After an effort, lactic acid accumulates in the cells. This causes “muscle soreness”, which disappears on its own in a few days, whereas a contracture requires much more time or therapy.

Cold and air conditioners can cause tension of the trapezius muscle in the neck area.
Many people have muscle tension on the ileopsoas (a muscle located between the flank and hip), especially on the right side.
This can cause pain at the front of the thigh or in the back.

Pregnant women suffer from muscular pain due to the increased body weight, especially in the legs and back.
During lactation, muscle pain in the arms and neck is normal because of the effort to hold the child in position. It is recommended to put a pillow on your lap and support the child on it.

The onset of pain occurs suddenly when the muscles contract. A swelling of the muscle and a harder consistency can be observed or felt under the skin at the level of the muscle.

In order to release the tension, you have to stretch the affected muscle slowly without springing.
To relieve the pain, you can apply ice compresses. This reduces inflammation and allows the muscle to relax.
The ideal therapy is the combination of stretching along with other natural remedies.
The doctor may prescribe a painkiller such as acetaminophen, anti-inflammatories such as ketoprofen (Alrheumun) or diclofenac (Voltaren).

Kinesio taping is applied as follows. Shape: a “Y” stripe. Length: over the entire length of the muscle belly.
Apply the strip without tension, the Y-trunk is at the bottom.
Stretch the quadriceps and follow the muscle belly of the medial vastus muscle with the Y-branches. A massage of the painful area is useful to reduce tension.
Heat pads keep the muscle more supple and serve to relax the muscle fibers.

Causes of muscle pain, full listing

Most mechanical or sport-related causes are:

  • Injuries or traumas, including overstretching and strains
  • Overload: the muscle is used too much, too often or without first warming up
  • Tension or stress

Muscle pain can also be triggered by medicines, including:

  • ACE inhibitors to lower arterial hypertension (high blood pressure)
  • Cocaine
  • Statins to lower cholesterol

Systemic, autoimmune, infectious, nervous or vascular diseases that can lead to muscle discomfort include:

  • Amyotrophic lateral sclerosis (ALS, also known as Gehrig’s disease, a serious neuromuscular disease that leads to physical disability and muscle weakness);
  • multiple sclerosis (disease affecting the brain and spinal cord, causing weakness, loss of coordination, balance disorders and other ailments);
  • brain or spinal cord damage;
  • Lyme disease (bacterial inflammatory disease spread by ticks);
  • muscle infection, such as an abscess;
  • polymylagia rheumatica (disease characterized by stiffness and pain of the muscles);
  • systemic lupus erythematosus (disease in which the body attacks its own healthy cells);
  • deficiency of vitamin B12 or D (especially in vegetarians);
  • Stroke or heart attack.

Other, rarer causes of muscle pain

  • Cancer
  • Hypothyroidism
  • Renal failure


Fibromyalgia provokes chronic and diffuse muscle pain, but this syndrome also causes many other symptoms.
Rarely can laboratory tests confirm the pathology and the results usually leave the patient with the impression that he is a hypochondriac. Pressing the tender points can diagnose fibromyalgia, but the examination does not explain all the symptoms.
People with fibromyalgia often describe their symptoms as an infection, similar to influenza, that never goes away. These complaints exhaust him and make him unable to rationalize or find the right words.
Patients with fibromyalgia have difficulty sleeping and wake up with stiffness, pain, and mild fever, as well as tingling in the fingers.

The cause is unknown, but there is some suspicion: physical or emotive trauma, an abnormal response to pain from the brain, lack of exercise or a virus.

Fibromyalgia can cause many symptoms, including:

  • pain throughout the body,
  • Fatigue
  • Insomnia
  • clouded senses,
  • morning stiffness,
  • muscle tension, cramps and weakness,
  • Indigestion
  • headache/migraine,
  • Disturbances of equilibrium
  • Itching and burning.

Fibromyalgia and tender points
Routine laboratory tests do not reveal diffuse pain in fibromyalgia.

The diagnosis is made after physical examination, during which the doctor presses on certain points called “tender points”. This examination takes about 5 minutes. When gentle pressure is applied to the surface of the muscles all over the body, the fibromyalgia patient feels pain, especially at the tender points used for diagnosis.

The most effective therapeutic options for symptoms of fibromyalgia are a combination of medications, non-drug therapies and strategies of self-treatment.

First-line therapy may include:

  • Physiotherapy
  • training and fitness program,
  • Stress relief methods, including light massages and relaxation techniques.

Many medications are used for treatment, including:

  • anticonvulsant drugs,
  • Antidepressants
  • Muscle relaxants.


Dermatomyositis is a muscle disease characterized by inflammation and rash. It is a typical autoimmune myopathy.

The cause of dermatomyositis is unknown. Experts believe that it is caused by a viral infection of the muscles or a disorder of the body’s immune system.
It can also occur in patients who have tumors in the abdomen, lungs or other areas of the body.


  • Swallowing disorders
  • Muscle weakness, stiffness, or pain
  • Upper eyelids purple or purple discolored
  • Purple rashes
  • Shortness of breath

The disease is treated with cortisone-based anti-inflammatories and drugs that suppress the immune system.


Polymyositis is a relatively rare inflammatory disease that causes muscle weakness, swelling (inflammation), stiffness and lesions. It belongs to the large group of diseases called myositis.

Polymyositis is a skeletal muscle disease and also known as idiopathic inflammatory myopathy.
The cause is unknown. An autoimmune reaction or a muscle infection can be triggering.

Polymyositis is a systemic disease, so it affects the whole body.
Symptoms include:

  • swallowing disorders,
  • Muscle
  • Weakness of the proximal muscles (shoulders, hips, etc.), which make it difficult to raise the arm above the head, rise from a sitting position or climb stairs.
  • voice disorders (caused by neck muscle weakness),
  • Shortness of breath.

The most important treatment is with cortisone-containing drugs. If muscle strength improves, usually within 4-6 weeks, the dose of the drug is slowly reduced.

The maintenance dose of prednisone may be continued indefinitely. People who do not respond to the anti-inflammatory effects of cortisone may take immunosuppressive medications such as methotrexate and azathioprine.


Rhabdomyolysis is a disease that leads to the destruction of muscle fibers and releases their ingredients (myoglobin) into the blood. Myoglobin is harmful to the kidneys and often causes damage.
If the muscle is damaged, a protein called myoglobin is released into the bloodstream. This substance is filtered through the kidneys and excreted from the body. Myoglobin is broken down into substances that can damage kidney cells.

Rhabdomyolysis can be caused by any condition that damages skeletal muscle, especially injuries.


  • Abnormal urine color (dark, red or cola)
  • Reduction of urine production
  • General weakness
  • Stiffness of the muscles or pain (myalgia)
  • Weakness of the affected muscles

A bicarbonate drink can prevent kidney damage. When the body receives bicarbonate-containing fluids, kidney damage can be prevented by renal excretion of myoglobin.

It may be necessary to administer the fluid through the vein.
Some patients may need dialysis.
Medications that may be prescribed are diuretics and bicarbonate (if there is adequate urine production).

Equipment tests to be carried out are:

  • complete blood count,
  • Ultrasound
  • other blood tests to evaluate muscle enzymes (creatine kinase) and possibly a test for Lyme disease or connective tissue disease.

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