Muscle Ache

Muscle aches, also known as myalgias, can occur in a specific area of your body or can be felt over the whole body. The nature of these aches may vary – from deep, constant and dull to sharp and occurring at irregular intervals. It may co-exist with joint pains and can be difficult to tell one from the other. Like joint pains , muscle aches can be due to non-cancer causes such as strains or injuries, but may also be due to cancer and its treatment.

Pain from muscle aches can lead to fatigue and affect a person’s ability to carry out his or her daily activities. It is important to inform your doctor or nurse if you develop any muscle aches, so that they can be managed promptly to minimise discomfort and impact on your quality of life.

Causes of Muscle aches

Cancer occurring in, or pressing against a muscle
Cancer that cause overproduction of white blood cells
Some types of chemotherapy (e.g. docetaxel, paclitaxel, vincristine)
Hormonal therapy (e.g. letrozole, tamoxifen)
Targeted therapy (e.g. herceptin)
Immunotherapy (e.g. pembrolizumab, nivolumab)
Radiation therapy
Other medications (e.g. white blood cell growth factors, bisphosphonates like zoledronic acid, cholesterol medicines like simvastatin)
Unrelated to cancer and its treatment (e.g. fibromyalgia, infection, muscle overuse through activities, muscle injuries through accidents)

What you need to look out for

The duration and area of muscle ache can vary from person to person. Some symptoms you may experience include:

Pain in any muscle of your body, whether moving or resting
Pain in your joints
Feeling fatigued
Feeling low in your mood

How it can be treated

Your doctor will first determine the cause of your muscle pain, by examining the painful area and asking you more questions about the pain. The cause and treatment for muscle pains in one specific area can be different from muscle pains affecting multiple areas. Additional tests (e.g. xrays, blood tests) may be arranged if necessary. Based on the cause of the pain, your doctor may:

Prescribe medications to help manage the pain. These may include paracetamol and nonsteroidal anti-inflammatory drugs like celecoxib to relieve pain, corticosteroids to help decrease inflammation and swelling, muscle relaxants and/or antibiotics for infection if any.
Refer you to see a rehabilitation specialist, physiotherapist or occupational therapist, who may recommend medications, acupuncture, massages, exercises or assistive aids to help you manage the muscle pains.

What you can do

Here are some tips to help you cope better if you experience any muscle pains:

Take medications as prescribed by your doctor

Get plenty of rest and plan your activities to include rest periods in between

Hot or cold pads may help reduce discomfort over the aching area. Cover the pad with a towel when applying on your skin. Use for short periods (5-10 minutes for 4-5 times a day)

If it is safe to do so, try keeping yourself as active as possible with aerobic, flexibility and strength exercises as these may help reduce the muscle pains and maintain your function

Try taking warm baths. Some people find them comforting

Engage in relaxation techniques (e.g. meditation) or hobbies to distract yourself from the pain. Reading, listening to music and watching television are some activities you can try

Try gentle massages to affected areas

Do not stop taking any medications without first consulting your doctor

Do not take part in physically strenuous activities e.g. carrying heavy items, gym weights, before consulting your doctor

Do not place hot or cold pads on your bare skin as they can cause irritation or burns

When to call your cancer care team

Please inform your doctor or nurse as soon as you develop the following symptoms that may indicate worsening or complications of the condition.

Persistent moderate to severe muscle pains or difficulty in performing your day to day activities, despite medications and conservative measures taken above
Redness/ warmth/ worsening pain over any area of your body, or fever/ chills which may indicate infection
New or severe back pain with the following symptoms:
- Weakness/ numbness in the lower body
- Pain around waist or chest
- Loss of bladder/ bowel control
The above indicates possible spinal cord compression, a MEDICAL EMERGENCY which requires IMMEDIATE MEDICAL ATTENTION: please go to your nearest hospital as soon as possible. Delayed treatment may result in long term disability.

If you have any questions regarding the above, please call the Cancer Helpline at +65 6225 5655 or approach your doctor or nurse for further details.

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The above contents are made available as part of TEMASEK FOUNDATION-ACCESS (Accessible Cancer Care to Enable Support for Survivors) PROGRAMME, a holistic care programme to support cancer patients during their care and recovery journey.

The contents have been approved by the Cancer Education Information Service, National Cancer Centre Singapore (NCCS), for people with cancer and their families and caregivers. However, this information serves only as a guide and should not be used as a substitute for medical diagnosis, treatment or advice. For specific medical conditions, please seek expert medical advice from your healthcare team.

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Muscle Ache (Myalgia)