2017 HCHB_digital

Muscular Aches, Pains and Tightness
Muscle aches and pains are typically caused by unaccustomed or overuse of
a muscle, but can also be due to tension or stress, or as a result of injury from
exercise or physically demanding work. Some conditions which affect the whole
body, such as the flu (see Influenza), and other chronic disorders (such as
fibromyalgia) can also cause muscle pain, but this tends to be a general type
of pain which affects most of the body’s muscles, not just specific sets, as in the
other causes listed above.
Tight muscles usually develop over time and progressively worsen. Some
people may be genetically more susceptible to them, or they may develop due
to bad posture, electrolyte imbalances, incorrect sporting techniques, muscle
fatigue, running style or poorly fitted shoes.
Muscle tightness
Muscle tightness can occur not only during or after exercise, but also after
prolonged periods of inactivity.
Cramps that occur during exercise are usually the result of muscle fatigue,
low sodium, or low potassium. Their incidence can be reduced through proper
hydration and nutrition before exercise and by drinking electrolyte replenishing
drinks during activities that last longer than 60 minutes.
Muscles are more likely to tighten following exercises that focus on eccentric
contractions where a weight is lowered or slowed such as running downhill or
the downward phase of a bicep curl. Gentle massage may ease the soreness and
gradually increasing the intensity of a new exercise programme can help prevent
it happening in the first place.
Muscles that tighten as a result of inactivity are often due to poor posture.
Long periods of time slouched at a desk can cause the chest muscles to shorten
and the upper back muscles to lengthen and weaken. Good posture should be
maintained throughout the day, strengthening exercises should target the small
muscles of the back, and stretching exercises should concentrate on lengthening
the chest muscles back to normal.
Initial assessment
Try to establish the cause and severity of your customer's muscle pain or tightness
to help decide whether further investigation is necessary. Symptoms of muscle
pain caused by unaccustomed or overuse of a muscle are typically confined to
specific groups of muscles, or a matching pair of muscles. The pain usually peaks
within 72 hours before subsiding.
More severe muscle pain accompanied by swelling and restricted movement
may indicate muscle, tendon, or ligament damage. Refer to a pharmacist (see also
Strains and Sprains).
Oral analgesics or topical rubs are the most common types of treatment
for general muscle pain caused by overuse, in addition to stretching and
strengthening exercises once the pain has gone.
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Does the person have any other health conditions (eg, diabetes, is
pregnant or breastfeeding) or take any medications (particularly
medicine for high cholesterol).
• Does the person have a serious loss of movement or mobility?
• Is there an excessive range of movement in any joint (may suggest
major ligament disruption)?
• Did the injury swell immediately or become severely painful?
• Is the person unable to weight bear, or is a fracture suspected?
• Is the area swollen and/or warm to the touch now?
• Is the person a child aged less than 12 or elderly?
• Is the pain severe, getting worse or has it persisted despite
treatment?
• Has the pain lasted longer than three to four days?
• Is the pain from a back injury?
• Does the person have muscular pain with no specific cause?
• Does the person have any allergies to medicines?
Initial treatment of muscle aches and pain
• For muscle pain due to an injury.
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Follow the RICED approach immediately (see Strains and Sprains).
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Take paracetamol, or a NSAID (eg, ibuprofen) if directed by a doctor.
• For muscle aches due to overuse and fibromyalgia.
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Consider pain relief, topical heat rubs, massage therapy and stretching
exercises.
• For muscle pain due to an illness or infection, or for pain that has persisted
for a long time.
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Speak to a pharmacist or doctor.
Advice for customers
• Low-impact exercises such as walking, cycling, and swimming can help restore
proper muscle tone. Begin slowly and avoid high-impact activities initially.
• Warm up and stretch before and after exercise.
Page 108 HEALTHCARE HANDBOOK 2017-2018 Common Disorders