Approved by the Cancer.Net Editorial Board, 12/2018
Muscle aches, also called myalgia, are a possible side effect of cancer and its treatment. You may feel an ache in a specific area of your body, or you may feel like your entire body aches. Some muscle aches are mildly uncomfortable, while others can be severe. They may last a short time or be constant for a long time.
Muscle aches can affect a person’s quality of life and make other symptoms or side effects of cancer seem worse. They may even cause some people to stop treatment before it is finished. If you are experiencing muscle aches, talk with your health care team. Managing symptoms is an important part of your cancer care and treatment. This is called palliative care or supportive care.
Causes of muscle aches
The following factors can cause muscle aches.
Cancer. Certain types of cancer are more likely to cause muscle aches:
Tumors that start in a muscle, such as some kinds of soft-tissue sarcoma
Tumors that press against a muscle
Cancers that cause the body to make too many white blood cells, such as certain types of leukemia
Cancer treatments. The following cancer treatments can cause muscle aches. When treatment ends, muscle aches usually go away. In some cases, muscle aches can be a late effect, which mean they occur months or years after cancer treatment ends.
Some types of chemotherapy, such as docetaxel (Taxotere), ixabepilone (Ixempra), paclitaxel (Taxol), and vincristine (Vincasar PFS)
Aromatase inhibitors, such as anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara), as well as other hormonal therapies, including fulvestrant (Faslodex), raloxifene (Evista), tamoxifen (Soltamox), and toremifene (Fareston)
Targeted therapy, such as trastuzumab (Herceptin) and T-DM1 or ado-trastuzumab emtansine (Kadcyla)
Immunotherapy, such as interferons, interleukins, and CTLA-4 and PD-1/PD-L1 inhibitors
Other medications. Medicine for cancer-related symptoms or other conditions can cause muscle aches:
Drugs called white blood cell growth factors that help prevent infection during cancer treatment. This includes drugs such as filgrastim (Granix, Neupogen, Zarxio), pegfilgrastim (Fulphila, Neulasta), and sargramostim (Leukine).
Drugs to treat bone loss. These include bisphosphonates such as alendronate sodium (Binosto, Fosamax), ibandronate sodium (Boniva), pamidronate (Aredia), risedronate (Actonel), and zoledronic acid (Zometa).
Cholesterol drugs, also called statins
Cancer-related side effects. Symptoms or side effects related to cancer or its treatment, such as fatigue, weak muscles, depression, and dehydration, can also cause muscle aches or make them worse. Talk with your health care team about any side effects that you are experiencing.
Other factors. People with cancer can also have muscle aches from other causes, including:
Viral and bacterial infections
Diseases such as polymyalgia rheumatica, lupus, and fibromyalgia
Overuse of a muscle through activities, sports, or work
Muscle injuries caused by accidents, such as a fall
Diagnosing muscle aches
People experience muscle aches differently, depending on what causes them. Your doctor will assess your symptoms and medical history. He or she will also conduct a physical exam and ask you questions such as:
Where do you ache?
When do the muscle aches stop and start?
How long have you had muscle aches?
What do the muscle aches feel like? Dull? Sharp?
What makes your muscle aches better or worse?
Are your muscle aches affecting your ability to do everyday tasks?
If the muscle aches are caused by cancer treatment, your doctor may recommend lowering the dosage or frequency, or trying a different one.
If your doctor is not sure why you are having muscle aches, or they do not go away or get worse, he or she may recommend certain tests to help find out the cause. These may include:
Blood tests. They can show if your body has an infection or another condition not related to cancer that can cause muscle aches.
Computed tomography (CT or CAT) scan. Makes a 3-dimensional image of the inside of the body.
Magnetic resonance imaging (MRI). Uses magnetic fields to create detailed images of the body.
Bone scan. Sometimes it is hard to distinguish between bone pain and muscle pain. If the doctor suspects bone-related issues, a bone scan may be done.
Contact your doctor right away if you develop symptoms in addition to muscle aches, such as:
Pain around the waist or chest
Loss of bladder control
Numbness and tingling anywhere in the body
These can be signs of serious medical conditions that need immediate attention.
Treating and managing muscle aches
When possible, doctors treat the condition that causes the muscle aches.
Medication. These medications may treat muscle aches or reduce the pain:
Nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Motrin) and naproxen (Naprosyn)
Acetaminophen, such as Tylenol
Corticosteroids, which reduce swelling and inflammation
Antibiotics to treat infection
Antidepressants for depression
Self-care and support methods. Below are methods that may help you better manage muscle aches. Some of these practices you can do on your own. Others require you to work with a licensed or certified specialist. Talk with your health care team before trying these methods.
Massage. A massage therapist who has experience working with people with cancer can do a gentle therapeutic massage that may help ease muscle pain. You or your caregiver can also do simple massage techniques at home.
Physical therapy. A physical therapist can treat muscle problems and teach you how to relieve pain using simple exercises or devices.
Exercise. Gentle exercise, along with stretching and strengthening, may help loosen muscles and increase blood flow to them.
Heat and cold. Hot or cold compresses, heating pads, or ice packs may help decrease discomfort from muscle aches.
Relaxation techniques. Gentle breathing or meditation exercises may enhance relaxation and reduce muscle tension, which may help decrease muscle aches.
Track the results of the techniques you use to find out which ones manage your muscle aches best. You can use a chart like the one in the ASCO Answers Managing Cancer-Related Pain booklet (PDF) to track your pain.