Muscle Stiffness

Most people experience muscle stiffness at some point in their lives, whether after strenuous activity or due to an injury. However, muscle stiffness can also be a sign of an underlying health condition or a side effect of medication, or it may develop from an insect bite or sting.

This article discusses symptoms of muscle stiffness, its possible causes, and treatment options.

Symptoms of Muscle Stiffness

The most apparent symptoms of muscle stiffness are tightness and difficulty moving. Additional symptoms may occur with certain conditions or from medications.

Causes of Muscle Stiffness

Common causes of muscle stiffness include:

• After-effects of exercise
• Injury
• Musculoskeletal conditions: Poor posture, osteoarthritis, bursitis, tendonitis
• Autoimmune conditions: Rheumatoid arthritis, polymyalgia rheumatica, lupus
• Insect bits or stings

Physical Activity

A response called delayed onset muscle soreness (DOMS) is associated with muscle stiffness after strenuous physical activity. Symptoms often begin 12 to 24 hours after exercise and peak around 24 to 72 hours.

In addition to muscle stiffness, DOMS can cause:

• Decreased range of motion
• Pain with touch
• Swelling
• Weakness

DOMS can occur with any exercise but is most common with jogging or running, walking downhill, jumping, step aerobics, and strength training. It typically resolves on its own, but ice packs and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) or Aleve (naproxen), can help decrease symptoms.

Injury

Muscle stiffness can occur with injuries like muscle strains or ligament sprains. Minor injuries often resolve within a few days. However, if your symptoms persist, see a healthcare provider. Seek immediate medical attention if you experience the following:

• Severe pain
• Joint deformity
• Inability to move the affected area
• Difficulty walking or weight bearing

These symptoms could indicate a more severe injury, such as a muscle or ligament tear or a broken bone. Severe injuries are diagnosed with imaging such as X-rays and magnetic resonance imaging (MRI).

Your provider may recommend physical therapy, or in more severe cases, you may need surgery.

Musculoskeletal Conditions

Health conditions that affect the musculoskeletal system can cause stiffness, sometimes in specific areas of the body. Examples include:

• Bursitis
• Osteoarthritis
  
• Tendonitis

These conditions are diagnosed with a physical exam and imaging, such as X-rays and an MRI. Treatment could include physical therapy, NSAIDs, or cortisone injections to decrease inflammation.

Autoimmune Conditions

Polymyalgia rheumatica is a disease that occurs when the body attacks its healthy tissues. This condition causes inflammation and muscle stiffness throughout the body. Other symptoms include:

• Body aches
• Decreased appetite
• Fatigue
• Fever
• Joint pain
• Weakness
  
• Weight loss
  

Polymyalgia rheumatica is diagnosed through a physical exam and blood tests. It is treated with medication to decrease inflammation and exercise to decrease stiffness.

Rheumatoid arthritis (RA) is an autoimmune disease that causes the body to attack the lining around joints, called the synovium.

RA symptoms usually include:

• Increased stiffness first thing in the morning
  
• Symptoms affecting more than one joint
• Symptoms occurring in the hands, wrists, and feet first
• Symptoms occurring in the same joints on both sides of the body at the same time
  
• Tenderness, pain, swelling, and stiffness for six weeks or more
  

RA is diagnosed by a review of your symptoms, physical exam, and blood tests to look for specific blood proteins and signs of inflammation. Treatment includes medication, activity modifications to decrease stress on affected joints, and physical therapy. In severe cases, you may need surgery.

Lupus is an autoimmune disease that causes muscle pain and stiffness for most people with the condition. Other symptoms can include:

• Anemia
• Blood clots
• Chest pain
• Difficulty with memory
• Eye disorders
• Fever
• Kidney issues
• Loss of hair
• Rash
  
• Sensitivity to light
• Significant fatigue
  
• Sores in the mouth
  

Lupus is diagnosed with blood tests and biopsy of affected tissues and is treated with medications.

Insect Bites or Stings

Muscle stiffness can occur with insect bites or stings and is more likely to happen if the area becomes infected. Insects can also carry diseases that cause muscle stiffness. For example, tick bites can lead to Lyme disease.

Other symptoms of this condition include:

• Body aches
• Chills
• Fatigue
• Fever
• Headache
• Joint pain
• Muscle soreness
• Sore throat
• Stiff neck
• Swollen lymph nodes

Lyme disease symptoms can take up to one month after a tick bite to develop and are treated with antibiotics.

What Medication Can Cause Stiff Muscles?

Muscle stiffness can be a side effect of certain medications, such as:

• Statins (used to lower cholesterol)
• Attention deficit hyperactivity disorder (ADHD) medications (such as dexmethylphenidate)
• Antipsychotics (used to treat mental health conditions)

If you have muscle stiffness, let your healthcare provider know about any medications you are taking.

How to Treat Muscle Stiffness

Treatment of the underlying cause of muscle stiffness will be specific to the cause. To address the symptom of muscle stiffness, consider these treatments.

For DOMS and minor muscle strains, ice packs and nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) or Aleve (naproxen), can help decrease symptoms such as pain and swelling.

Active recovery is also recommended for DOMS. This is engaging in less-intense physical activity, such as walking, swimming, or gentle stretching.

For arthritis, heat or cold treatments may help with stiffness around the joints. Low-impact exercises, range of motion exercises, and stretching may also help.

Are There Tests to Diagnose the Cause of Muscle Stiffness?

A healthcare provider can often diagnose the underlying cause of muscle stiffness from your report of symptoms, medical history, and a physical examination. This may include range of motion testing.

They may order imaging tests if damage to bones, joints, ligaments, or tendons is suspected. Imaging can show the effects of injuries and musculoskeletal and autoimmune conditions.

A neurological examination may be performed. Blood tests and specialized tests may also be done, depending on the suspected cause.

When to See a Healthcare Provider

See your healthcare provider if your muscle stiffness doesn't resolve within a few days. Seek medical attention sooner if your symptoms don't have an apparent cause (such as exercise or injury), if your symptoms keep you from doing everyday tasks, or if you have additional symptoms such as a fever or rash.

Summary

Muscle stiffness is common, particularly after strenuous activity. This symptom can also occur with injuries, musculoskeletal conditions, or autoimmune diseases. Muscle stiffness can develop from insect bites or stings or be a side effect of certain medications. Diagnosis and treatment are specific to the underlying cause.

Talk to your healthcare provider if you have muscle stiffness that persists for more than a few days. Stiffness can affect your movement, eventually leading to problems in other parts of your body. If your muscle stiffness is related to an injury or poor posture, consult a physical therapist for an individualized exercise program.