In this era of yoga on demand and at-home spin classes, people are often told to “work through the pain.” And, yeah, some residual aches and pains are expected after a particularly tough sweat session (delayed onset muscle soreness, or DOMS, sometimes doesn’t even start until 24 to 48 hours post-exercise). That’s especially true as you get older—your muscles naturally get tighter, and your tendons and ligaments become less flexible.
But that soreness and stiffness can be more than a sign of a tough workout or age. “If you know exactly why you hurt, that’s reassuring,” says Natasha Bhuyan, M.D., a clinical assistant professor of family, community, and preventive medicine at the University of Arizona College of Medicine and a practicing family physician in Phoenix, Arizona. “But if you can’t really identify the source of the pain, that needs further investigation and follow-up with a physician.”
A little detective work—i.e., tracking of your symptoms—can clue you in to whether your pain is normal or not, and help a physician better understand what might be going on. Here’s how to tell whether your pain warrants an Epsom salt bath and some ibuprofen or a visit to your doc.
1. It feels worse in the a.m.
If you wake up feeling stiff and creaky (especially if you didn’t work out recently), that’s a red flag. “Some chronic autoimmune disorders are associated with joint pain and muscle aches,” says Anca Askanase, M.D., a rheumatologist and associate professor of medicine at Columbia University Medical Center. And morning stiffness specifically has been linked to arthritis and rheumatoid arthritis. The reason that pain tends to dissipate during the day with these conditions is that the “inflammatory molecules responsible for [the aches] and discomfort start to circulate throughout the body,” Dr. Askanase explains.
2. You can’t shake the pain.
If your aches are lasting longer than a couple of weeks, definitely follow up with a doctor. “We say six weeks is an important threshold, but it depends on the type of pain you’re dealing with, says Dr. Bhuyan. For example, 90 percent of people with acute low-back pain recover in six weeks, according to research in the journal Canadian Medical Association Journal. “But if you’re experiencing pain in a joint, we expect that to recover within two weeks,” says Dr. Bhuyan. If it doesn’t, get yourself to a physician. And if it’s accompanied by redness, swelling, or a hot sensation, go sooner—that could be a sign of an infection or an abscess, she adds.
3. Your pain feels atypical.
Pain has hundreds of different ways of manifesting depending on the circumstances. “When you think about dull, achy pain, that’s usually discomfort from your muscles,” says Dr. Bhuyan. Think about how your glutes protest every time you sit down the day after a hard workout. But sharp pain can come from issues with your nerves or bones, she says. “When you feel a sharp or shooting sensation or a pain that comes and goes and then returns even worse, that’s not typical pain,” Dr. Bhuyan adds. This is where it’s essential to listen to your own body; only you can know what feels different from “normal” aches and pains.
4. It’s widespread versus localized.
If your right hip hurts because you accidentally banged into a table, that’s normal. But if the whole right side of your body hurts and you’re not sure why, that’s a reason to schedule a consult with a family physician. “One area of the body equals an injury,” says Dr. Askanase. “If more than one part of the body hurts, you need to look for more systemic causes.” While chronic widespread pain is most famously associated with fibromyalgia, research from the journal PAIN Reports has also linked it to diseases like rheumatoid arthritis, hypermobility syndrome, endocrine and metabolic disorders, and more.
5. Your pain is inhibiting your daily routine.
Are you avoiding taking the stairs because your knee pain causes imbalances? Do you have to take breaks from typing on your phone or computer because your wrist aches with every email? “If your pain is associated with any functional limitations, that’s a concern,” says Dr. Askanase. Pay attention to how you feel at night, too, says Dr. Bhuyan. “You may be more aware of your pain when you lay down in bed, but that pain shouldn’t be waking you up,” she explains. Sleep is the foundation of health, so if your pain is at the point where it’s disrupting your shuteye, that’s a head’s up that you should talk to your doctor. There’s plenty of things that could be keeping you up at night—getting to the root of your pain (and fixing it!) is one thing you can control.
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