Joint, Muscle, and Body Pain! What is a Woman to do?

By: Holly L. Thacker, MD • Posted on October 08, 2018 • Updated July 16, 2020

What to do if Diet, Exercise and Judicious use of Supplements do not Help Your Joint and Muscle Pain

How to deal with painful muscle spasms

You should seek a physician’s help for an evaluation, which may include blood work, chemistries, vitamin levels and x-rays.
Working closely with the physical therapist and occupational therapist can be beneficial.

What Causes Muscle Spasm?

Muscle spasms are very common, especially if there is dehydration and electrolyte imbalance.

Pregnancy Muscle Spasms

Pregnancy is associated with muscle spasm as the growing baby and the placenta will extract nutrients needed to grow. If calcium, magnesium and potassium levels are low, then those are taken from the big muscles of the mother's body if the blood stream levels are insufficient.

Magnesium (if no kidney insufficiency) can be helpful for pregnancy-associated leg cramps.
Stretching out the muscles may help stop a spasm and many folks keep foot boards at the bottom of their bed as leg cramps may occur at night.
Some place a bar of Ivory soap under the bed sheets to keep the bed sheets from pressing on the feet and possibly starting a spasm.
Recent research has suggested the muscle spasms are triggered by nerve changes and ingesting something spicy like jalapenos or cinnamon can help interrupt the aberrant nerve impulses that are stimulating the muscles to contract and spasm.
Choline may reduce muscle cramps (choline rich foods include veggies, dairy, eggs, fish beans and nuts)

Exercising-Induced Muscle Spasms

Athletes who have severe muscle cramps are encouraged to hydrate and to ingest mineral rich or spicy substances such as mustard to stop the spasms.
Topical magnesium applied to the muscles before bedtime may be helpful.
Quinine or quinine water has been used to treat muscle spasms, but may cause low platelets.

If you suffer from muscle cramps be sure to see your physician for an evaluation before you self treat.

Treatments for Muscle Spasm and Joint Pain

NSAIDS (Non-Steroidal Anti-Inflammatory Drugs)

Anti-inflammatory agents such as aspirin, ibuprofen and naproxen are available over the counter as well as in prescription doses. These potent, anti-inflammatory agents reduce joint, tendon and muscle pain, but I caution against their routine use as they can increase G.I. bleeding, stomach ulcers, and in some cases heart attack, stroke and kidney damage.

These medicines are very potent at reducing joint and muscle pain and are a potent option, but should NOT be the first line of treatment. They are so effective many times when people take them they don’t tend to focus on the diet, exercise and other anti-inflammatory supplements that may help their symptoms and afford much less risk.

Even though these agents are over the counter, if you were taking them regularly you should see a physician and get regular blood work, including kidney function testing and complete blood count.

If one needs to use prescription doses of non-steroidal anti-inflammatory (NSAIDS) agents like aspirin, ibuprofen or naproxen, you may want to actually try these in a topical formulation that can be rubbed on the joint. Low strength salicylic acid available in sprays, gels and patches are also over the counter and can give localized joint pain reduction.

Acupuncture

Acupuncture is part of traditional Chinese medicine and is generally considered safe. Adverse reactions are rare and might include local site tenderness. Acupuncture can help improve the following conditions:

Chronic low back pain
Certain forms of tendonitis
Fibromyalgia
Severe migraine headaches
Low back pain in pregnancy

As far as osteoarthritis of the knee, there’s mixed results with some studies showing no change and other studies showing benefit with acupuncture.

Caring for Aging Muscles

Muscles, like joints and tendons, age and need some extra care with aging.

Stretching both before AND after exercise and having a warm up period is important.
Some medications like cholesterol lowering statins may cause muscle pain.
Some antibiotics like ciproflaxocin and other fluroquinolones may increase the risk of tendon rupture and now carry a boxed warning.

Restless Legs

Restless Leg Syndrome is another common condition, but is different than muscle spasms.

There is an irresistible urge to move the legs, especially at night.
Low iron and low magnesium may make Restless Leg Syndrome worse.
If you have restless legs, you should seek medical evaluation and have iron/ferritin levels checked (goal at least 50-70) and consider magnesium supplements at night, if normal kidney function.

Fibromyalgia

Not all body pain is from the joints. Fibromyalgia is a common pain condition seen more commonly in women, especially as they get older. It is a real condition causing widespread muscular pain over certain parts of the body. What is clear is that fibromyalgia pain will improve with:

Improved sleep hygiene
Treatment of any underlying sleep disorders such as obstructive sleep apnea
Regular exercise regimen that includes stretching and a warm up, aerobic exercise and weight-bearing exercise
Correction of low vitamin D
FDA-approved medications prescribed by a physician if needed:
- NSRIs like Cymbalta® (Duloxetine), Savella® (Milnacipran)
- Nerve pain medicines like Lyrica® (pregabalin)

If you have joint, muscle or tendon pain and/or diffuse body pain, it is important to:

Get evaluated.
Focus on diet.
Exercise.
Judicious use of supplements.
If you require over the counter and/or prescription medication, you should get regular monitoring.

Be Strong. Be Healthy. Be in Charge!

-Holly L. Thacker, MD

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Specialized Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Dr. Thacker is also the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause. Her special interests and areas of research including menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health.

women's health, joint pain, muscle pain, body pain, acupuncture, restless leg syndrome, fibromyalgia, muscle spasm

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