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肌痛患者的处理方法

Author
Robert H Shmerling, MD
Section Editor
Mark D Aronson, MD
Deputy Editor
H Nancy Sokol, MD

引言

在就诊的成人中，肌痛(肌肉疼痛)是一种常见主诉。事实上，几乎每个人在他们一生的某个时间都会经历肌肉疼痛。通常过度劳累、创伤和病毒感染是最常见的原因。虽然许多原因是良性和自限性的，但肌痛可作为严重病况的前驱表现。

对患者进行彻底的病史回顾和完整的体格检查，通常可使肌痛的潜在原因范围缩小到可处理的少数几个。对原因不明的持续性或重度肌痛，选定的检测对于确定或排除特定的诊断并指导治疗可能是必需的。

将肌痛与肌病(肌肉疾病)和肌炎(肌肉炎症)相鉴别很重要。虽然肌病和肌炎可引起肌痛，但大多数肌痛患者既非肌病也非肌炎。区分弥漫性症状与局部症状也是有用的。本专题将讨论处理肌痛(作为就诊于初级医疗保健医生处时的主诉症状的方法，重点讨论病因、病史、体格检查、实验室检查和治疗。以明显肌痛为特征的特定疾病将在别处讨论。 (参见“纤维肌痛的鉴别诊断”和“系统性疾病中的肌病”和“药物诱导性肌病”)

病因

可以根据弥漫性症状还是局灶性症状对肌痛的病因进行分类。

弥漫性肌痛 — 弥漫性肌痛最常见的原因有(表 1)：

               

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Literature review current through: 2017-06 . | This topic last updated: 2016-04-25.
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