Abstract
Muscle pain as a common symptom in daily practice frequently occurs as a non-specific
accompanying symptom in multiple internal and neurological diseases. Primarily inflammatory
or autoimmune muscular diseases are causing muscle pain. However, a number of non-inflammatory
causes of pain can also be considered for differential diagnosis. These are presented
in this article. In principle, a distinction must be made between focal and diffuse
muscle pain. As an invasive diagnostic procedure, a muscle biopsy should only be performed
as the last step in the diagnostic alogorithm. If diffuse muscle pain is only associated
with slight muscle weakness or is completely absent, there is usually a primary rheumatic
cause. Statins (HMG-CoA reductase inhibitors) can lead to rhabdomyolysis, muscle fiber
atrophy and muscle necrosis by damaging the muscle fiber membrane. Myotonias are autosomal
dominant or autosomal recessive inherited disorders of muscle function. The genetic
defect leads to pronounced muscle stiffness. The cause of metabolic myopathies can
be disorders of the carbohydrate, fat or purine metabolism. Fibromyalgia syndrome
(FMS) is a non-inflammatory disease and, according to the current knowledge, recognized
as the result of an exposure to physical, biological and psychosocial factors (biopsychological
disease model). To help diagnosing FMS, pain regions and core symptoms (fatigue, sleep
disturbances) can be detected using questionnaires (Widespread Pain Index [WPI] and
Symptom Severity Scale [SSS]).
Muskelschmerzen sind ein häufiges Symptom in der täglichen Praxis. Bei vielen internistischen
und neurologischen Erkrankungen können sie als unspezifische Begleitsymptomatik auftreten.
Primär muskuläre Erkrankungen als Ursache der Muskelschmerzen sind oft entzündlicher
oder autoimmuner Genese. Differenzialdiagnostisch kommt jedoch auch eine Reihe nichtentzündlicher
Schmerzursachen in Betracht. Diese werden im Folgenden vorgestellt.
Schlüsselwörter
Begleitsymptomatik - paroxysmale Schmerzen - Statine - Muskelbiopsie - Fibromyalgiesyndrom
Key words
accompanying symptoms - paroxysmal pain - statins - muscle biopsy - fibromyalgia syndrome
