- Coming from a very stressful culture or environment.
- Having a psychological vulnerability to stress.
- Sleep disturbance.
- Muscle injury.
- Having had difficult experiences in childhood.
- Stiffness and weakness.
- Sudden, painful muscle spasms ("charley horse") that worsen with activity.
- Nodules or localized areas that are tender to the touch (trigger points). Pressure applied to these sites ( trigger points) reproduces the patient's symptoms.
- Painful muscle areas.
- Generalized fatigue and tiredness.
- Difficulty with sleep. Usually associated with early morning awakening and unrefreshed sleep.
- Reduced physical endurance.
- Recurrent migraine or tension-type headaches.
- Muscle weakness.
- Physical injuries.
- Recent weight change.
- Sexual, physical, or substance or alcohol abuse.
- Patients should also report any drugs he/she takes, including vitamins and over-the-counter or herbal medications.
- Gentle massage to painful areas.
- Stretching and conditioning exercises.
- Learn relaxation techniques.
- Alleviate stress.
- Biofeedback is helpful for some patients who use it to relax contracted muscles.
- Maintain social interaction even though the pain may be distracting at times.
- St Johns Wort.
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