Skeletal muscle comprises more of the human body than any other tissue. Muscle has nerves and feels pain. Janet Travell, MD, helped physicians understand that when normal muscle is given an irritating stimulus such as hypertonic saline injection, the brain perceives pain in the involved muscle, frequently in a referred pattern.

How should an individual with pain arising from muscle be rated using the Guides? Syndromes of muscle pain include simple muscle strains and two controversial conditions—myofascial pain and fibromyalgia. While chapter 3 is the musculoskeletal chapter, little is said about muscle except testing muscle strength, generally as part of a neurologic examination.

All through life, virtually every human sustains muscle bruises that heal. Chronic bruise is neither a diagnosis nor a ratable disorder. Similarly, almost all people sustain muscle strains. Delayed onset muscle soreness is...

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