Aching: Body Aches and Aching Sides

What aching means

Aching describes the quality of pain: dull, heavy, constant and diffuse. It usually comes from muscles (myalgia), joints (arthralgia), or organs in the belly and pelvis, which send vague signals that are hard to locate. Sharp, stabbing or burning pain more often comes from nerves, skin or a specific injury.

A doctor will want to know three things: where the aching is (everywhere or one area), how long it has lasted (days or months), and what comes with it (fever, weakness, stiffness, tiredness).

Body aches everywhere: common causes

Viral infections

Flu, COVID-19, and many other viruses cause aches all over by releasing immune signaling chemicals (cytokines). The aches usually come with fever, chills, headache and tiredness, and fade over 3 to 7 days. Flu aches are typically worse than cold aches.

Exercise and overuse

Delayed-onset muscle soreness peaks 24 to 72 hours after unfamiliar or harder exercise and settles within about 5 days.

Sleep, stress and mood

Poor sleep lowers the pain threshold. Anxiety and depression often show up as physical aches, especially in the back, neck and shoulders.

Dehydration and low minerals

Dehydration, and low potassium, magnesium or calcium, can cause aching and cramps.

Medicines

Statins (cholesterol medicines) cause muscle aches in some people, usually in the thighs, calves or shoulders. Stopping a statin briefly under medical advice often clarifies whether it is the cause. Other culprits include some antibiotics (fluoroquinolones), aromatase inhibitors for breast cancer, and withdrawal from opioids or steroids.

Aches and pains that last for weeks or months

Why are my sides aching?

The "side" usually means the area between the lowest ribs and the hip.

• Muscle strain: from twisting, lifting, coughing hard or new exercise. Aching worsens with movement and is tender to touch.
• Side stitch: a cramping ache during running, gone within minutes of stopping.
• Trapped gas and constipation: aching or cramping in the left or right side that moves around and eases after passing gas or stool.
• Kidney problems: kidney infection causes a deep ache in the back or side with fever and urinary symptoms. Kidney stones usually cause severe waves of pain rather than an ache.
• Shingles: a burning ache on one side of the chest or belly a few days before a band of blisters appears.
• Rib or cartilage inflammation: tender spots on the ribs, worse with breathing.
• Organ causes: liver or gallbladder (right side under the ribs), spleen (left upper side), ovaries (lower sides in women), diverticulitis (lower left).

For sudden or severe pain in one side, see side pain and flank pain.

Dull aching above the pubic bone

A dull ache just above the pubic bone (suprapubic pain) is usually from the bladder or pelvic organs:

• bladder infection (with burning and frequent urination)
• a full bladder or urinary retention
• menstrual cramps, endometriosis or fibroids
• interstitial cystitis (painful bladder syndrome)
• constipation
• pelvic floor muscle tension

In people with a larger body size, the same causes apply. An ache that persists or comes with abnormal bleeding should be checked.

How doctors work out the cause

Your doctor will ask where you ache, when it started, what makes it better or worse, and about fever, weight change, new medicines, exercise and mood. They will check for tenderness, joint swelling and muscle strength.

Useful tests for persistent aching include a full blood count, inflammation markers (ESR, CRP), thyroid function, vitamin D, creatine kinase (CK) for muscle damage, kidney and liver function, and a urine test. Imaging is only needed when examination points to a specific area.

Relief and home care

• Rest for viral aches. Gentle movement helps exercise soreness and stiffness.
• Pain relievers: acetaminophen (paracetamol) or an NSAID such as ibuprofen, at the label dose. Avoid NSAIDs if you have stomach ulcers, kidney disease or are on blood thinners. Do not give aspirin to children or teenagers.
• Heat (a warm bath or heating pad) eases muscle aches. Ice helps a fresh strain in the first 48 hours.
• Fluids, especially with fever, sweating or exercise.
• Sleep: a regular sleep schedule reduces widespread aching.
• Regular activity: walking, swimming and stretching are the most effective long-term treatments for fibromyalgia and chronic aches.

Frequently asked questions

What causes body aches everywhere without fever?

Common causes include hard exercise, poor sleep, stress, dehydration, the start of a viral infection, and medicines such as statins. If aches last more than 2 weeks, consider fibromyalgia, low thyroid, vitamin D deficiency or an inflammatory condition, and see a doctor for blood tests.

What causes side aches?

Side aches most often come from strained muscles, trapped gas, constipation or a running stitch. Less often, they come from the kidneys, gallbladder, ovaries, or shingles before the rash appears. Side aching with fever, burning urination or vomiting needs prompt medical care.

How long do flu body aches last?

Body aches from flu usually peak in the first 2 to 3 days and improve within 5 to 7 days. Tiredness can linger for 1 to 2 weeks. If aches get worse after starting to improve, or you have trouble breathing, see a doctor.

Can stress cause aches and pains all over?

Yes. Stress and anxiety keep muscles tense, disturb sleep and lower your pain threshold, which can cause aching in the neck, shoulders, back and elsewhere. Depression also commonly causes physical aches. Treating the stress, exercise and good sleep usually help.

When should I worry about aching muscles?

See a doctor urgently if aching comes with dark urine, muscle weakness, a stiff neck, high fever, or a rash. Make a routine appointment if aches last more than 2 weeks, began after a new medicine, or come with weight loss, morning stiffness or swollen joints.