Pain like sore muscles - what can it be?


Muscle pain is normal after strenuous or unusual physical activity. However, if these occur without physical exertion, in bursts or suddenly, various, sometimes dangerous diseases can be responsible.
You should pay particular attention to the quality of the pain (burning, stabbing, diffuse), whether there were certain triggers for the pain and where the pain occurs (whole body, leg, arm, back, joints). If the pain is unclear - especially without prior physical activity - a doctor should be consulted to determine the cause of the pain.

Causes of sore muscles-like pain without exertion

On the one hand, an unusual overstrain of the muscles can be responsible for sore muscles-like pain. Muscle pain without prior exercise or exercise can have many different causes.
On the one hand, fibromyalgia - a chronic pain syndrome of the muscles - is a possible cause of pain in the muscles without physical exertion. Muscle inflammation (myositis) can also lead to sore muscles. They are often triggered by bacteria or viruses that have entered the tissue when injured. In addition to sore muscles, polymyositis or dermatomyositis can also trigger muscle weakness and occur in young patients mostly due to viral infections. A symptom of dermatomyositis can be bluish-red skin symptoms on the face and swollen bags under the eyes.
An overactive or underactive thyroid can also cause muscle pain. Muscle pain can also occur as part of osteoporosis.
In rare cases, Parkinson's disease can also be responsible for the pain such as sore muscles. This usually results in severe pain in the shoulder and neck area, which is characteristically only felt on one side.
Furthermore, rare muscle diseases such as dystrophies are possible causes. These are hereditary diseases or genetic defects that lead to mutations in muscular proteins. This leads to a breakdown of the muscles. The diseases can be accompanied by muscle pain.

Some of the possible causes require medical clarification, as they can sometimes be associated with complications that can be life-threatening. The pain does not have to have its origin in the muscles, even if it feels like sore muscles. The cause can also lie in the vessels, bones or joints.

The following causes that may be responsible for the pain are explained in more detail below:

  • thrombosis
  • disc prolapse
  • multiple sclerosis
  • Fibromyalgia
  • Polymyalgia rheumatica
  • Lipedema
  • Sore muscles-like pain during pregnancy


Thrombosis is a vascular occlusion and in most cases occurs in the legs. It is also known as deep vein thrombosis (DVT) when deep veins are affected by the vascular occlusion.
A special risk factor for the occurrence of a thrombosis is the immobilization of the legs - i.e. not moving the legs. Reasons for immobilizing the legs can be surgery, injuries or long-haul flights.Depending on whether both legs or only one leg are affected, dull pains occur on one or both sides in the legs, which can be misinterpreted as sore muscles. In addition to the pain, a thrombosis can also lead to swelling, overheating and bluish-livid discoloration of the affected leg.

Read more about this: Detecting a thrombosis

disc prolapse

A herniated disc usually results in stabbing, shooting pain, which can occur in different regions depending on the area of ​​the spine. If the incident is in the neck area, pain may radiate into the arms. In the area of ​​the thoracic spine, the pain can be felt in the upper back or in the area of ​​the rear ribs. Most often, however, the herniated disc occurs in the lumbar region, where the pain can be felt in the lower back. This then often radiates into the legs.
As with sore muscles, the pain from a herniated disc is also aggravated by movement, but in most cases it is much more intense.

Read more about the topic here: Causes of a herniated disc

multiple sclerosis

Multiple sclerosis (MS) is an inflammation of the central nervous system, although the cause of the disease has not yet been clarified.
Multiple sclerosis can also cause pain in the muscles and bones. The muscle pain is a common symptom of advanced MS. The inflammation in the brain and spinal cord destroys nerve regions and thereby loses their function. This can lead to an increase in muscle tone (spasticity), which causes sore muscles-like pain. As mentioned earlier, muscle pain is more likely to occur later in this disease. Early symptoms of MS, on the other hand, are permanent exhaustion (fatigue), sensory or visual disturbances.

You can find more detailed information on the topic here: Diagnosis of multiple sclerosis


Fibromyalgia is a chronic pain syndrome that often occurs in women between the ages of 30 and 50.
The cause of this disease is not clear. Disturbed pain processing is suspected. There are painful pressure points (so-called tender points) on the muscle and tendon attachments in different parts of the body. In addition, daytime sleepiness, sleep disorders and depression can occur. Although this is not a malignant disease, people affected will suffer greatly from the symptoms.

You might also be interested in this topic: Therapy for fibromyalgia

Polymyalgia rheumatica

Polymyalgia rheumatica is an autoimmune disease, i.e. the immune system is directed against the body's own structures. This immune reaction is presumably triggered by infections with, for example, the parvovirus B19.
Polymyalgia rheumatica triggers pain on the same side in the shoulders, neck and pelvis, which occur particularly at night. In addition, morning stiffness is possible in the body regions mentioned. During the day, the pain can be felt in the affected muscles depending on the movement. In addition, fatigue, fever, unwanted weight loss and night sweats can occur.


Lipedema is an accumulation of fatty tissue, especially on the hips, thighs and upper arms. The fatty tissue accumulates on the arms and legs on the same side.
Typical are pain and tenderness in the affected areas. In addition, bruises quickly appear. Women are affected more often than men. One way of relieving the symptoms of lipedema is regular lymphatic drainage. On the other hand, the pain can be improved through movement. Since this cannot prevent fat from growing, liposuction is the only solution to remove the excess tissue.

More information can be found here: Diet for lipedema

Sore muscles-like pain during pregnancy

During pregnancy, pain such as sore muscles can be felt in the abdomen and the rest of the body. Since, for example, the uterus and the pelvis change during pregnancy and weight gain in the pregnant woman is inevitable, sore muscles are not uncommon. In order to get the body used to the new loads, gymnastic exercises can be helpful.
However, there can be other causes as well. Therefore, a gynecologist should be consulted with unusual complaints. For example, if there is a pulling in the abdomen in the later months of pregnancy, it could also be an early contraction. These should be excluded as a cause.

Also read our article: Pain during pregnancy

Classification according to location

In the legs

In addition to overloading, there are numerous other diseases that can cause muscle pain in the legs.
On the one hand, it can be an inflammation of the veins (phlebitis), whereby usually only one side is affected. The pain has a pulling character. The skin may also be puffy and red. On the other hand, a thrombosis in the legs can be responsible for muscle pain (see above). Another possibility for muscle pain is peripheral arterial occlusive disease (PAD), also known as intermittent claudication. This is a decrease in blood flow to the legs caused by atherosclerosis. The muscle pain occurs when moving. Due to the reduced blood flow, the muscles can be briefly undersupplied while running, which leads to pain. If the affected person stops, the symptoms improve.
Restless legs syndrome can also trigger muscle pain. This is a neurological problem. The pain occurs primarily at night or at rest, i.e. when the legs are not moved. Therefore, those affected feel an urge to move. Rheumatism, which can affect not only joints but also muscles and tendons, can also trigger muscle pain in the legs. Typically, however, there is also pain in the arms. A herniated disc (see above) can also cause pulling pain in the legs, which can present as shooting muscle pain.

In the belly

Muscle pain in the abdomen is mainly caused by sore muscles.
But they can also be caused by straining the abdominal muscles. This occurs mainly in athletes, but can also result from incorrect movements or excessive stretching of the muscles. The pain is sharp and usually increases with movement, but can also be felt at rest. Coughing or sneezing can make the pain worse.

In the arms

Overloading the arms can not only trigger muscle soreness, it can also lead to muscle tension and strain, as well as tendonitis. These are then usually only felt with certain movements. Arm vein thrombosis can also cause muscle pain in the arm. This is relatively rare and, when triggered by extreme stress on the arm, is also known as "thrombosis par effort".
Muscle pain in both arms and shoulders, which occur particularly at night, can be caused by polymyalgia rheumatica (see above). Polymyositis, which manifests itself in sore muscles, muscle weakness and pain, occurs mainly in the shoulder area. The muscle weakness with which the disease often begins can make it difficult or even impossible to raise your arms above the horizontal plane. Polymyositis can be triggered by viruses - especially in young patients - or occur alongside an existing tumor disease - especially in older patients.

In the back

Tension in the back can be responsible for muscle pain. The tension can occur, for example, after incorrect movements, after long periods of sitting or when lifting. The pain is easy to localize and can be of burning, stabbing, or piercing quality. Most of those affected adopt poor posture to avoid further pain.
A herniated disc can also cause pain in the back muscles. If the lower spine (lumbar spine) is affected, the pain can radiate through the buttocks and into the legs.
Fibromyalgia - a chronic pain syndrome (see above) - can also cause muscle pain in the back. The pain occurs especially at night and is often accompanied by morning stiffness. The pain can change its localization on the body and usually occurs over several months.

Also read: Back pain

Concomitant symptoms

The accompanying symptoms can be very diverse due to the many different possible causes.
In the case of a thrombosis, in addition to the pain in the affected area, swelling, livid discoloration, overheating, a feeling of heaviness and increased vein markings can occur. Multiple sclerosis usually begins with a one-sided, temporary deterioration in vision, exhaustion and is associated with sensory disturbances on the skin, but can also trigger many other symptoms such as temporary or permanent paralysis, incontinence, memory and concentration disorders or depression.
Fibromyalgia can present itself with increased sweating, dry mouth, palpitations and irritable bowel syndrome, among other things. Fever, unwanted weight loss, night sweats, fatigue and depressive moods can occur in the course of polymyalgia rheumatica.

In addition to pain, a herniated disc can also lead to discomfort, tingling and numbness. Paralysis and urinary incontinence can also occur in the course of a herniated disc. If you experience these symptoms, you should urgently seek medical attention as they are signs of nerve damage.


At the beginning of the diagnosis there is a questioning of the doctor (anamnesis) about, among other things, the time course of the pain, possible triggers, quality of the pain and additional symptoms. This is followed by a physical exam of the affected area.
Depending on the direction in which the disease is suspected, further examinations are carried out. For example, laboratory values ​​- such as inflammation values ​​in the blood - can provide information about the trigger. If a leg vein thrombosis is suspected, an ultrasound of the leg veins is performed. If bone injuries are suspected, x-rays can be taken. In order to rule out MS as the cause, an MRI of the skull is performed if it is suspected.


The duration of the symptoms also depends on the underlying disease.
For example, the symptoms of a thrombosis may have disappeared a few days after treatment. The symptoms of a herniated disc can go away after a few days to weeks - depending on how serious the incident was. If thyroid hormones are taken, the symptoms should improve quickly. If neurological diseases are the cause of the pain, permanent therapy must be followed, as often no cure but only symptom relief and a slowing down of the progression of the disease can be achieved.


Treatment depends on the underlying disease.
For example, in most cases thrombosis is treated by compressing the affected area, exercising and using blood-thinning therapy (anticoagulation). The blood-thinning therapy with anticoagulants must be continued for at least three months. Surgical thrombus removal may be necessary if the thrombosis is pronounced and prolonged.
A herniated disc is mainly treated with pain relievers. Exercise therapy is also in the foreground, i.e. the patient should go for a walk, for example. Lifting heavy loads should be avoided. Physiotherapy such as physiotherapy, heat applications and massages can also be used as a treatment. Surgery is performed in severe cases when nerves are damaged by the herniated disc.
The symptoms of fibromyalgia can be relieved with regular exercise, relaxation exercises, and physical therapy. If the pain is caused by an overactive or underactive thyroid, medication can be taken to regulate the hormonal balance. For polymyalgia, cortisone is prescribed in tablet form, and the pain should improve immediately.
Neurological diseases such as restless legs syndrome, multiple sclerosis or Parkinson's disease are treated with special medications to provide symptom relief.

Read more about this:

  • Thrombosis prophylaxis
  • Therapy for a herniated disc