Differentiating muscle stiffness and tension.
Among therapists, muscle stiffness and tension are often used interchangeably. However, there are some key differences between the two. Muscle stiffness is a condition in which muscles cannot be moved quickly without pain. A variety of factors may cause muscle stiffness, including prolonged immobility, electrolyte imbalance, or metabolic conditions.
Muscle tension, on the other hand, is a change in the muscle fibers. These tense muscle fibers stay partially contracted for a while and resist movement. High levels of the stress hormone cortisol, which may decrease blood flow to muscles and joints, can cause muscle tension.
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Do both cause pain?
Both muscle stiffness and tension can lead to pain. If ignored, both may develop into chronic muscle pain–that is, pain lasting longer than 12 weeks despite treatment. Chronic muscle pain affects a staggering 11-24% of the world’s population.
Those who are older, more sedentary, or less educated are at a higher risk of developing chronic muscle pain. Chronic pain has a negative impact on quality of life, employment, productivity, and mobility.
How to relieve muscle pain
Any treatment of muscle pain must address the cause. For example, if stiffness is due to an electrolyte imbalance, treatment should target proper hydration or monitor salt intake.
Conversely, if muscle stiffness is due to overuse or misuse, treatment should include gentle massage or rest. In general, alternating between ice packs and heating pads can help decrease acute pain, while gentle stretching can help slowly reintroduce movement into a painful area.
Examples of gentle stretching
The neck and upper back are common targets for muscle tension and stiffness. A neck circle is a simple and effective stretch that can help target these muscles. When performing a neck circle, instruct the patient to begin by looking as far up as they comfortably can. Have them move in a circular pattern. Bring the right ear to the right shoulder, then chin to chest, followed by left ear to left shoulder, and back up again.
Set the length or duration of this exercise based on how the patient feels. If they feel tension at any point throughout the exercise, they can help ease it by holding that stretch.
Following a neck circle, a shoulder shrug can help alleviate further tension in the body. Begins by instructing the patient to lift both shoulders up toward the ears simultaneously, then roll them back and down. The patient can complete a shoulder shrug with their arms by their side. In a more advanced version, they might extend their arms and move them along with the shoulder.
The low back and hips are other areas where many people experience stiffness and tightness. Pelvic tilts can help alleviate this. A patient may sit or stand when performing a pelvic tilt. Have them gently rock their pelvis forward and backward as far as they can tolerate. Cue the patient by describing scooping the pelvis forward, tucking the tail, then pushing the pelvis back while slightly arching the back.
Performing these movements throughout the day can help break a cycle of stiffness or tightness throughout the body.
How can I prevent stiffness and tension from returning?
Though it sounds like a riddle, treating stiffness and tension is also a step toward preventing its return. Treatment strategies vary and may include:
- Introducing more activity throughout the day
- Incorporating stretching into a nightly routine
- Maintaining adequate nutrition and hydration habits
For sedentary patients, a series of simple exercises (e.g., neck circles, shoulder shrugs, and pelvic tilts) performed at the top of each hour can add beneficial movement to an otherwise stationary day. Building these habits into a patient’s day—or even your own—will help bring relief from the pain and problems of muscle tension and stiffness.
Find more on this topic, along with hundreds of hours of in-depth courses for physical therapists, in HomeCEU’s online learning library.
This article was written by Cristina Parker, PT, DPT, NCS .