Muscle pain is one of the most common reasons for people to attend our practice. This overview provides a reasonable (but not exhaustive) synopsis of what we would usually be dealing with and help you understand more about your muscle pain, what to do about it and when to go and see your chiropractor!

The first type of muscle pain is one almost all of us have had – D.O.M.S. Delayed Onset Muscle Soreness. People who regularly participate in physical exercise are usually familiar with this. However anyone can get it by doing an unfamiliar physical activity – like walking 10km on a holiday outing when you don’t usually walk 10 km in a whole week! DOMS is not usually something to worry about and you don’t need to see your chiropractor unless it persists for more than 2-3 days or begins to happen after physical activity that you wouldn’t consider strenuous. No-one has found a way to avoid DOMS but warming up before an activity (even gardening if you are not used to doing it) should help to some extent.

Another muscle pain that we have all had is cramp (or muscle spasm). This is an involuntary contraction of muscle that occurs suddenly, usually resolves quickly and HURTS! Spasms are usually as a result of overuse (strenuous exercise in a hot environment), unfamiliar activity, overstretch, or dehydration. Spasms also occur in muscles that have previously sustained an injury or from holding a muscle in the same position for too long (take note all you power PC users). Basically the muscle runs out of energy and fluid. You can reduce your risk by remaining hydrated, warming up before physical activity and taking regular breaks from repetitive tasks. If you do get a cramp then apply a gentle stretch to the muscle until the spasm passes. If you are experiencing cramps regularly and you don’t recognise (and remedy) one of the situations described above then see your chiropractor as some causes of cramp, such as arterial narrowing and nerve compression need to be investigated.

If you have had a particularly severe cramp you might have progressed to a muscle strain. This is a tearing of the muscle tissue due to a forceful contraction or an over-stretch – the “oh oh! I’ve done something really bad” moment. Muscle tears are graded from 1 (mild – a few muscle fibres torn) to 3 (severe – most if not all muscle fibres torn). They usually involve the “big” muscles like hamstrings, quads, calves, biceps, pectorals and low back para-spinals. Sometimes you can feel a painful bump in the muscle with a grade 1 or 2 tear. A grade 3 tear is usually very dramatic and you won’t be in any doubt as to what has happened.

A useful way to evaluate for a tear is to contract the likely muscle against isometric (no joint movement) resistance. If the contraction is weak and painful you might have a muscle strain. By comparison a contraction that is strong but painful is likely a tendinitis, while contractions that are not weak or painful might be a ligament sprain. If you are unlucky enough to suffer a muscle strain (grade 1 or 2) then initially use P.R.I.C.E. Protection. Rest. Ice. Compression. Elevation. This will help control the inflammation and swelling from the tear. Then go and see your chiropractor. A grade 3 often involves significant medical intervention (such as surgery).

 Finally, we see a lot of people that present with muscle knots or “trigger points”. They seem to be very common and range from quite mild to excruciatingly severe. They could be small, localised spasms (without damage to the muscle) as a result of biochemical and neurological changes. We don’t really know. By applying pressure to the “knot” patients report pain on the “knot” and sometimes an adjacent or remote pain referral recognised by the patient as “their” pain. Try applying comfortable heat to, and gentle massage of, the “knot”. If it persists then see your chiropractor.