Muscular Pain

Muscles have become the reference points for our welfare. An exquisit muscle care is necessary  to cope with the burdens of our bipedal condition, a condition that we don’t seem to be adapting to, despite the 5 million years that we have been standing erect.

Our muscles have bad press. Apparently, they are delicate: they are overloaded, distended,  they contracture, atrophy, cool and tear easily. Before using them, we must warm up and stretch if we want to avoid bad surprises and a massage is necessary to activate the circulation and remove those toxins accumulated with the effort.It is not understood how we have been able to overcome the exigent evolving conditions before our actual civilization with such deplorable muscles.

The human muscle-skeletal system, if we listen to the gossip, might be the biggest botched job of Evolution. Our brains are big and we have great intelligence but that’s useless, because our plans are coming down because of some bones, joints and, especially, muscles that can’t carry the burden of our purposes.

Each cell system has a set of sensors of damage that draws limits on the conditions it can handle. Muscles require the following to do their job: plenty of oxygen, no sudden and surprising stretches and not exceeding a specific time of sustained contraction. If you violate these conditions, the necrotic damage sensors will activate and send distress signals to the brain causing it to activate the pain program, forcing the individual to suspend the action. If he or she obeys, pain goes away, if irreparable damage has not yet occurred. The pain of angina pectoris shows the patient the limit of his or her effort (“don’t go too far with this…”) and pain of a heart attack points out cell death (“you’ve gone too far…”).

Under conditions of proper oxygenation and manageable load, the necrotic muscular damage sensors remain silent and therefore there is no pain. However, many men and, indeed, women feel their muscles sore, unmotivated and tired without having made any effort previously.

Chronic fatigue syndrome, fibromyalgia, neck pain … they generate a belief that muscles are not fine. However, there’s no evidence that the muscle is causing the problem.

Little is known about muscle pain. We still don’t understand the mechanism of stiff muscles, myofascial pain or contractures. We blame the muscles with no evidence and condemn them to hard work in the gym, swimming and boring relaxation sessions.

There is a small detail that, from my perspective as a neurologist, has always disconcerted me about this: the muscle is submitted since the first neurons of the embryo appear at the orders of the nervous system. Muscle fibers shrink only (usually) if the various neural centers that program actions demand it. The logical thing is to analyze these orders, not who does them by obedience.

If we assume that the muscles are not made to make lots of effort, it does not make sense that the brain wants them to work and, indeed, that’s what happens: the brain activates the pain and exhaustion so the individual stops moving. The brain protects muscles from the individual’s desire of moving them.

Then… which one is right? The muscles are well and, therefore, they can and must work or are they defective and the brain has to protect them?

Everything suggests that the muscles can and should work, and that the one that is not working is the brain: it erroneously assumes that the muscles are defective and protects them unnecessarily.

In all this matter of widespread pain, the poor muscle takes the blame while the real culprit, the brain, just locks it in a dungeon for no reason.

Muscles are innocent. The boss, the brain, goes around doing whatever it wants and no one seems to want to incriminate him.

Incomprehensibly, citizens with imprisoned muscles do not want to hear about this innocence. They want their muscles to remain submitted to the brain, which apparently is not guilty…