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Aches and pains: What's the difference and when should a doctor decide?

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KERA’s Sam Baker gets some answers in today’s Vital Signs from Dr. Salman Bhai, a neurologist and faculty member at the Institute of Exercise and Environmental Medicine at Texas Health Presbyterian Hospital Dallas.

About muscle pain:

Muscle pain or myalgias are extremely common. Whether you went for a longer walk than you normally do or you're training for a marathon, any of those things outside the ordinary can trigger muscle pains, and that's a normal adaptive response.

Of the more common causes, the big one is excessive exertion. We like to push ourselves and it doesn't necessarily mean that you're an athlete pushing yourself. It could just be you're a person who went for a long walk or you lifted something heavy or you are moving several boxes going to a new place. And that can trigger muscle pain. 

Does excessive exertion depend upon the person? What may be excessive for one person may not be for someone else?

Some people are more accustomed to exercise than others. So when I say I don't do extreme activities, that might mean something for a marathon runner or ultra-marathon runner versus someone who typically doesn't exercise. And so, the key message there is to listen to your body to help prevent those kinds of issues.

How can you tell the difference between an ache and a pain? 

Ache is a kind of pain. But when we talk about how do we know good pain versus bad pain, I like to think about it as what's going to cause injury, that kind of pain versus soreness.

Soreness happens just a few hours after exercise and it lingers after activity for a day or two. Sometimes there's something called delayed onset muscle soreness or you've had a particularly hard workout and you're sore for several days. All of this happens because when we exercise, our muscles are damaged at a microscopic level and it takes time to recover. That's normal and healthy.

The kind of pain we don't like is the one that happens acutely all of a sudden. Ouch. Something hurts, something sharp happened and you feel it. It can nag. It can become a chronic issue. That stabbing sharp pain, the one that radiates to different areas, the one that may throb, the one that may change the way you're functioning, the way you go about your day, or the way you walk. That's the kind of pain we don't want. And there's no clear line here. But something that is not resolving can turn into a serious injury. 

What's the best way to treat muscle pain at home? 

There's a simple mnemonic that goes around that we call “rice”: Rest, ice, compress and elevate. And rest is really the key one there. If your body says something is hurting, take it easy. Take a day or two off and that's going to help. You can also take simple pain medications, if there are no issues you have that your doctor's told you about, something like acetaminophen or NSAIDs, like ibuprofen. 

At what point should you seek help from a doctor? 

Say it's just not getting better. It is just hugely painful. No matter what you do, it's not going away. I think at that point, it's worth speaking to your doctor. You want to identify if there is structurally something wrong or is there a systemic illness going on that we're missing. And if you start to develop symptoms like fever or you have weakness or overall you notice something else declining beyond the pain, it's time to go see your doctor so that you can figure out why that's happening. 

What steps might help to lower the risk of getting a muscle ache or pain? 

The simple way to go about this is to have a gradual progressive exercise that's based on what your body is telling you. Rest is your friend and exercise goals should be like building a house and it doesn't show up overnight. It's brick by brick.

So, to see those benefits over time, the best thing you can do is to keep up with exercise on a regular basis. When you're lifting something or you're doing an activity, keeping good form and knowing what your limits are, are the best ways to help prevent pain and injury. 

RESPONSES:

Muscle Pain: Causes, Symptoms, Treatment & Prevention

Myalgia

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.