PAIN GAME
From a sore neck to low back pain – what your muscle aches really mean and when it’s a medical emergency
One common ache could lead to serious problems — such as ulcers and, worst case, amputation
PAIN anywhere in the body can leave us feeling uncomfortable – and for millions it can significantly disrupt day-to-day life.
But muscular discomfort, although often associated with exercise, could also be related to a medical issue, experts warn.
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Rosaria Barreto-Ellis, sports scientist, personal trainer and founder of over-60s exercise class provider , tells Sun Health: “If muscle pain is accompanied by concerning signs like persistent dizziness or other systemic issues, seeking medical attention is imperative.”
But if a pain is likely just a strain or other physical injury, consulting a chartered physiotherapist or osteopath may be more beneficial than a GP.
Here, Lucy Gornall looks at the potential causes of your muscle pain.
Foot pain
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UNSURPRISINGLY, a day on your feet can leave them feeling sore.
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Physiotherapist , who is also an adviser to , makers of muscle and joint care products, says: “Unsupportive shoes can cause pain in the arch of the foot.”
Flat feet or fallen arches tend to be present from birth and can cause foot or ankle injuries and problems with walking or balance, as well as pain.
Heel pain can be a sign of plantar fasciitis and Achilles tendonitis.
Meanwhile, diabetes can cause nerve damage and a lack of sensation in the feet, which can lead to serious foot problems — such as ulcers and, worst case, amputation.
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This is mostly an issue if diabetes is not being managed.
TREATMENT PLAN: For pain caused by flat feet, Sammy has this advice: “Physical therapy, medication, injections and, in some cases, shoe inserts may help.”
People with diabetes must tell their doctor if they notice changes in their feet.
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Sammy says: “If you feel uncertain about the cause of your foot pain, visit a minor injuries clinic.”
Arm and leg aches
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DELAYED onset muscle soreness is a common cause of muscle pain in the limbs.
Sports scientist Rosaria says DOMS occurs 24 to 48 hours after exercise “when muscles are overloaded”.
A lack of vitamin D, magnesium or potassium, dehydration and electrolyte imbalances can also cause muscle pain, weakness or cramping.
Long-term limb aches could be a chronic condition called fibromyalgia.
“The pain often feels like a badly pulled muscle,” says Sammy.
“It can be unpredictable and vary from one day to the next, in both severity and location in the body.”
Autoimmune conditions could be the root cause — pins and needles-like pain could indicate multiple sclerosis.
GP Dr Amos Ogunkoya warns: “Pain down the leg can also be a sign of deep-vein thrombosis (DVT) blood clots.”
Other signs of DVT include warm skin on the painful area, red or darkened skin and swelling.
TREATMENT PLAN: Always warm up before exercise and take multivitamins to prevent deficiencies.
Sammy says: “Any long-lasting limb pain should be checked by a GP.”
Call 999 or go to A&E with signs of DVT or heart attack, including breathlessness or chest pain.
Backside pain
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THIS problem — usually pain in the glutes, the muscles that make up your butt — can be a result of poor form during a workout, physio Sammy says.
Hamstring tendonitis is also a potential cause of gluteal complaints.
Sammy says: “This can occur from overuse of the hamstring muscles in the back of the thigh, which commonly occurs with long-distance running, repetitive weightlifting, and field-based sports.”
Sciatica, where the nerve running from your lower back to feet is irritated or compressed, is a common cause of buttock discomfort.
GP Dr Ogunkoya says you may feel a tingling down your legs, adding: “Some people say it’s a shooting pain or a burning pain but it depends on the nerves affected.”
Cauda equina syndrome, when nerves of the spinal cord are compressed, can cause numbness of sensation in the buttocks — as well as genitals — and incontinence.
TREATMENT PLAN: If you’re a gym-goer suffering bum pain, ask a personal trainer for advice.
Sammy says: “A PT can teach you how to work out and lift weights using proper form.
“If your glute pain lasts longer than a week, especially if you did not injure your hip or leg, see your GP.”
You must call 999 or go to A&E for symptoms of cauda equina syndrome.
Full body aches
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GENERAL pain experienced all over the body is often caused by bugs such as flu or Covid.
This is especially likely to be the case if you are suffering with other symptoms such as a fever, high temperature or extreme fatigue.
You may also feel sore if you’re generally run down or have been “overdoing it” a bit of late.
But more medically serious causes of full-body aches include fibromyalgia, which also causes sleep problems, brain fog and low mood, or lupus, which causes extreme tiredness, joint pain and rashes.
Physio Sammy says: “Hypothyroidism (an underactive thyroid) may also cause overall muscle pain.
"And polio survivors may suffer pain and weakness due to the disease affecting muscle tissue. Symptoms may be at their worst at the end of the day.”
TREATMENT PLAN: If you have a bug, try to give yourself plenty of rest and drink plenty of water to keep hydrated.
Otherwise get medical advice.
Sammy says: “When the pain seems unrelated to flu, see your GP.
“There is no cure for post-polio muscle pain and weakness but your doctor may refer you to a multidisciplinary team who can help you manage the symptoms.”
There is no cure for fibromyalgia or lupus, either, with both requiring lifestyle adjustments.
Lower back pain
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MOST of us have experienced lower back pain at some time in our life.
Physio Sammy says: “A common cause is an injury like a pulled muscle or tight hips from sitting at your desk for long periods with your chair and laptop incorrectly set up.”
More serious causes include a slipped disc, which also causes numbness, tingling or muscle weakness.
Sammy says: “If you have sciatica, you will often have sharp pain down one leg, into your calf and foot.”
In men, GP Dr Ogunkoya warns that lower back pain could potentially be a sign of prostate cancer.
And he adds: “Other symptoms of prostate cancer include blood in the urine, abdominal pain and difficulty urinating.”
Needing to pee more often can also be a sign.
TREATMENT PLAN: If an injury is to blame topical painkillers (gel or creams) such as Deep Relief Anti-inflammatory Gel (£8.40, Boots) can help.
Sammy warns people who sit all day: “Make sure you stand up at least once an hour and move your hips.”
Daily stretches can help too.
Dr Ogunkoya says if you’re worried about prostate cancer, see your GP for a check-up.
A slipped disc usually gets better slowly with rest, gentle exercise and painkillers, and sciatica in four to six weeks.
See your GP if pain persists, and they can refer you for help.
One-sided lower back pain
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A STRAIN or sprain is typically the cause of one-sided lower back pain.
But more seriously, GP Dr Ogunkoya says: “Kidney stones (hard deposits caused by dehydration, too much sugar or salt obesity, and too little fibre) can occur on the left or right side.
“The sharp pain usually comes in waves and you can also get blood in your urine.”
Physio Sammy says an infection can be to blame, too, and she says: “In this case, you may feel unwell and feverish.”
Conditions that affect the intestines, colon, gallbladder, pancreas or reproductive organs can also trigger pain on one side.
Sammy says: “In all of these cases, see your GP as soon as is possible.”
TREATMENT PLAN: Phone NHS helpline 111 if the pain of kidney stones is severe or if you have blood in your urine. Otherwise, see your GP.
Sammy says: “With an injury (sprain or strain), apply cold (an ice pack) as soon as possible.”
"Deep Freeze Cold Gel or New Deep Freeze Muscle Rescue Cold Spray is my go-to with an injury but apply it immediately after the injury.
"Both work like ice and help cool and soothe minor aches in muscles and joints."
Dr Ogunkoya says: “If your back pain comes with any other red-flag symptoms such as weight loss, night sweats, pain or weakness down the legs, fevers, a loss of erection in men, or loss of sensation around the vagina or anus, see a GP as soon as possible.”
Weight loss and night sweats may be symptoms of cancer, while a rare condition called cauda equina syndrome can cause loss of sensation or even paralysis if not treated fast.
Upper back pain
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“THORACIC” back pain strikes anywhere from neck to waist.
Physio Sammy says: “This may be due to poor posture, injuries and strains. Upper back pain is often caused by poor posture.”
GP Dr Ogunkoya says osteoarthritis and ankylosing spondylitis, where the spine becomes inflamed, can cause upper back pain, as well as injuries to the bones, discs, muscles and ligaments.
Aside from musculoskeletal, indigestion and acid reflux may cause upper back pain.
Sammy says: "The most common causes of neck pain are sleeping in an awkward position; bad posture, for instance when sitting at a desk or driving; a pinched nerve; or an injury perhaps from exercise, a traffic accident or a fall.
"Another common culprit is cradling a phone between your chin and neck.”
Dr Ogunkoya says: “A thyroid goitre is a swelling of the thyroid gland, which may also cause a lump in the front of your neck.
“These may be caused by problems with your thyroid gland, puberty, menopause or a diet with too little iodine.”
TREATMENT PLAN: Get or stay as active as possible with back pain, Sammy says, and see your doctor if the pain does not lessen after a couple of weeks.
Get an ergonomic chair for a home office, and take regular standing breaks.
Dr Ogunkoya says: “If you’ve got osteoarthritis you need to build up your bone density and strength as well as maybe consider surgery. Pain medication helps but it won’t cure.
“Although thyroid swelling is not usually serious, get it checked by your GP.”
Sammy says to "Ytry sleeping with a thin pillow" until neck pain is resolved.
"Take a few days off anything too strenuous but make sure you keep it moving and practice some slow stretches several times a day, side to side and up and down," she adds.
One-sided upper back pain
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A CAUSE of this can be overuse of muscle when doing things such as rowing, gardening or a racquet sport, says physio Sammy.
She advises: “Rest can be helpful in these cases, as well as the application of heat.”
It’s also possible, she adds, that pain on one side of the upper back is related to a spine issue such as a herniated or slipped disc.
Or, it could be a sign of an underlying health issue.
Sammy says: “Organs including the kidneys and pancreas can cause pain that spreads to your upper back.”
Pancreatitis causes a discomfort in the upper abdomen that radiates out to the upper back, while a heart attack can sometimes be felt in the jaw or neck.
Peptic ulcer disease or stomach ulcers, can also cause pain that presents in the shoulder blade.
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TREATMENT PLAN: Do you find that your pain is not subsiding?
Sammy recommends that you book an appointment with your GP — or call 999 for a suspected heart attack or any sudden, extreme pain.
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