Muscle Pain and Stiffness

CLINICAL DIAGNOSTIC MANUAL

Muscle pain and stiffness are common symptoms that can result from various conditions, ranging from normal physiological responses to serious systemic diseases.

These symptoms can significantly impact the quality of life and daily functionality of patients. A thorough evaluation is crucial to identify the underlying cause and provide appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Normal Physiological Response	Post-exercise muscle pain, stiffness, tenderness to touch	History of recent intense physical activity	Clinical evaluation, no additional tests needed
Polymyalgia Rheumatica	Pain and stiffness in shoulders and hips, fever, fatigue, weight loss	History of severe morning pain and stiffness in individuals over 50	Elevated ESR and CRP, rapid response to corticosteroids
Rheumatoid Arthritis	Joint pain, morning stiffness, joint swelling, rheumatoid nodules	History of symmetrical joint pain and prolonged morning stiffness	Positive RF and ANA, X-rays showing joint erosions
Ankylosing Spondylitis	Lower back pain, morning stiffness, reduced spinal mobility	History of inflammatory lower back pain in young individuals	X-rays showing sacroiliitis, positive HLA-B27
Primary Muscle Disease	Muscle weakness, pain, cramps, muscle atrophy	History of progressive weakness and muscle pain	Muscle biopsy, abnormal EMG
Primary Hypothyroidism	Fatigue, muscle weakness, pain and stiffness, weight gain, dry skin	History of hypothyroid symptoms	Elevated TSH, low free T4
Early Symptoms of Hidden Neoplasia	Diffuse muscle pain, weight loss, fatigue	History of nonspecific symptoms and unexplained weight loss	Specific imaging tests and blood work to detect neoplasms
Fibromyalgia	Diffuse muscle pain, fatigue, sleep disturbances, specific tender points	History of chronic diffuse pain and specific tender points	Clinical diagnosis based on fibromyalgia criteria (ACR)