What Actually Causes ‘Stiffness’?
Why do my muscles feel stiff and tight?
A patient asked me this question last week, and I didn’t have a nice, concise answer ready to go. And I hate it when that happens, because it’s a simple question, and it seems like there should be an equally simple answer.
One thing that’s for sure is that it’s a incredibly common problem. Americans spend millions of dollars every year trying to fix it, stretching and contorting themselves in hot yoga classes and spending hours with massage therapists for that sweet ‘release’.
“I feel really stiff today, it’s great!”
– No one, ever
Stiffness definitely isn’t the same as restricted joint motion (which is what a chiropractic adjustment corrects). These things can go together, but they don’t always. Patients often come into my office feeling like they can’t move nearly as well as they’d like to. But yet they can move just fine, and if we measure, their range of motion (ROM) is perfectly normal. Flexible people with totally normal joint ROM can feel amazingly stiff and tight.
The bottom line is that the symptom of muscle stiffness often occurs well within normal range of motion due to an assortment of causes. And if you’re literally tight (your joint range of motion is actually limited), you’re usually acutely aware of it.
So what causes stiffness?
Stiffness is an unpleasant sensation — it feels like something’s wrong. No one ever feels comfortably stiff. So what’s going wrong? If stiffness is a symptom, what’s the disease?
At its root, the experience of stiffness is a type of nociceptive (pain) sensation that happens in response to muscle fiber inflammation.
Here are the six most common causes of muscle stiffness, beginning with the most common.
‣ Joint Dysfunction and Inflammation
‣ Delayed-Onset Muscle Soreness
‣ Myofascial Trigger Points
‣ Overuse Injuries
Of course, there’s an abundance of pathologies that cause range-limiting muscular rigidity and spasticity (known as dystonia), including torticollis, multiple sclerosis and Parkinson’s disease, but we’ll save those for another time.
Joint Dysfunction & Inflammation
While the other causes of muscle stiffness on this list can happen independently of any joint dysfunction, this one by definition begins with a problem within a joint that leads to stiffening of the supporting soft tissues surrounding it. When a joint itself is inflamed, you won’t just feel stiff and painful, you’ll actually lose range of motion.
Pain that originates inside a joint is called arthralgia, and while it can be due to congenital inflammatory diseases like rheumatoid arthritis or ankylosing spondylitis, more often it’s simply caused by biomechanical dysfunction shifting extra stress onto a particular joint.
This extra burden causes wear and tear on the joint and changes it over time: the joint capsule thins, smooth cartilage breaks down and osteoarthritis can develop. These changes make it difficult for the joint to move fluidly and it reacts by becoming inflamed and irritated.
In turn, the brain tells surrounding muscles to stiffen and spasm to stabilize the joint and prevent more damage from occurring.
In your spine these stabilizing muscles are called the multifidus and rotatores. These muscles play a dual role: they both create muscle tension as well as act as proprioceptors that sense changes in relative joint stability and strain. When they detect abnormal movement, these muscles react by quickly tightening as a protective mechanism for your spine.
Delayed-Onset Muscle Soreness (DOMS)
Despite being on the hook for muscle soreness and stiffness for decades, that sore feeling you get after physical activity isn’t actually caused by lactic acid. The symptoms of DOMS are predominantly a result of type 1 muscle strain along with the effects of metabolic byproducts produced by muscle contraction.
During exercise (or an afternoon carrying mulch and planting flowers), your body needs energy to fuel your muscles. To do this, it uses glycogen, carbs and other molecules to produce ATP, or adenosine triphosphate. ATP is then broken down during muscle fiber contraction for energy.
Hydrogen ions and reactive oxygen species, metabolic byproducts of this process, build up in your muscles, causing cell membrane damage and inflammation and interfering with their ability to contract.
What helps? Stretching won’t provide any lasting relief for DOMS, and it won’t prevent it, either. But there are some ways to ease the symptoms of DOMS; from prepping pre-workout with caffeine, BCAA’s and taurine to using a foam roller or vibrating massage tool on sore muscles afterwards.
Myofascial Trigger Points
But why would muscle fibers be inflamed, other than joint dysfunction or strenuous physical activity? One common suspect: the controversial, ubiquitous phenomenon of trigger points.
Surprisingly little is truly understood about trigger points. Some refer to trigger points as ‘muscle knots’, but our muscles certainly don’t form knots. Depending on whom you ask, you’ll probably get a different response as to what they are, where in the body you’ll find them, and how to properly treat them. This, of course, is only if they think trigger points exist at all.
“A trigger point is a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena.”
– Janet Travell MD, Myofascial Pain and Dysfunction: The Trigger Point Manual
But what are they, actually? The dominant theory is that trigger points are micro cramps. But that theory is old and controversial. Are they a restriction within the fascia that surrounds the muscle tissue? Compression on a nerve ending, producing referred pain patterns? Simply a product of muscle exhaustion?
Because we don’t understand them well, we don’t really know whether trigger points involve literal muscular tightness. So trigger-pointy tissues may actually resist stretch, or their extensibility may be unaffected, but they’ll feel stiff either way.
Regardless of how they work, these patches of muscle are sensitive to pressure for no apparent reason, are extremely common, and for every spot that actually hurts (an “active” trigger point), there’s usually more that are just mildly uncomfortable (“latent”). There’s usually a diffuse halo of stiffness and tightness around either type of trigger point.
Treating trigger points usually involves massage and/or myofascial release techniques (like what we do at Ascent Chiropractic), which can feel amazingly relieving. Dry needling is a popular method of ‘stabbing’ trigger points into submission with acupuncture needles. But even though it works for a lot of people, in practice dry needling is still very much experimental – it bombed an extensive clinical trial in 2020.
Most of the time it’s hard not to heal. You couldn’t stop it if you tried. The body is going to recover from most kinds of injuries almost no matter what — it’s just a matter of time. As long as you were reasonably healthy before you were injured, and aren’t doing things to totally sabotage your body’s repair process, damaged tissues will almost always heal.
But repetitive stress injuries – specifically tendinopathies like Tennis Elbow or DeQuervain’s tendonosis – are different. In these conditions, the tendon fibers have been stressed beyond their capacity to recover and are literally breaking down. Not surprisingly, this can cause a ton of pain and inflammation, and the muscle will stiffen up in response.
Repetitive stress injuries mostly just need rest. Take care of whatever biomechanical problems are going on, stop whatever repetitive stress you’re putting on the soft tissue, and carefully load the affected tendons with eccentric exercises to make sure it doesn’t happen again.
Chronic mild to moderate soft tissue inflammation has many possible causes, and is probably more prevalent and persistent than most professionals realize. But a lot of subtle, chronic inflammation — and the associated muscle stiffness — is probably just part of aging.
Everyone gets more inflamed as they age — no matter how fit, skinny & calm you are. This is known as ‘inflammaging‘, and it happens to some people sooner and worse than others, like arthritis (which is rarely a significant factor until much later in life).
A good share of general muscle stiffness in anyone past their third or fourth decade of life can be chalked up to inflammaging.
Getting plenty of fresh fruits and vegetables, limiting alcohol and processed foods, and supplementing with antioxidants like Acetyl Glutathione, CoQ10, and Alpha-Lipoic Acid are an easy way to minimize the chronic systemic inflammation associated with aging.
The bacteria in your gut (your microbiome) have also been shown to play a central role in inflammaging – it’s worthwhile to make sure you’re getting probiotics from fermented foods or a quality probiotic supplement.
Fibromyalgia is a chronic disorder characterized by widespread muscle pain, stiffness and hypersensitivity. The term comes from the Greek words “fibro” (fibers), “myo” (muscle) and “algia” (pain); literally, “pain in the muscle fibers”.
It often goes with conditions like irritable bowel syndrome, migraines, and mood disorders. As much as 2% of the US population suffers from fibromyalgia, with the disorder affecting women ten times more often than men.
The condition is complicated, however, by the fact that we have yet to identify a concrete cause for the disorder – it’s the ultimate non-diagnosis diagnosis. The farthest we’ve gotten is the theory that the disorder has to do with dysfunction in the central nervous system causing nociceptor (pain-carrying) nerve fibers to over-react to even the slightest stimuli. This in turn causes a person with fibromyalgia to interpret pain in the muscles in response to normal pressure or movement.
This is called central sensitization, and while it certainly appears to occur in patients with fibromyalgia, it doesn’t explain it. It’s just a more precise description, and trying to explain why someone is experiencing central sensitization is just as hard a puzzle to solve as fibromyalgia is.
The Ascent Chiropractic Difference
At Ascent Chiropractic we’re committed to not just relieving those nagging stiff muscles but to correcting their cause and optimizing your body to function better than it ever has before. Our unique, evidence-based approach to chiropractic and physiotherapy treatment allows us to correct biomechanics, restore normal function, and get you out of pain and on the road back to optimal health.
Don’t want chronic pain and stiffness to be part of your future? Schedule an appointment with our online scheduling app or by calling us at 262-345-4166.