Nerve Pain vs. Muscle Pain: How to Tell the Difference

If you’ve ever experienced unexplained pain in your back, legs, arms, or neck, you might be wondering: Is this nerve pain or muscle pain? The two can feel surprisingly similar—yet they have very different causes, treatments, and implications.

Understanding the difference between nerve and muscle pain is essential for choosing the right treatment and avoiding prolonged discomfort. In this article, we’ll explore how to tell the difference and when to seek medical advice.

What Is Muscle Pain?

Muscle pain (myalgia) usually results from strain, overuse, or direct injury to a muscle or surrounding soft tissue (such as tendons or fascia). It is often linked to physical activity, tension, or poor posture.

Common Causes:

• Muscle strain from lifting or overexertion

• Delayed onset muscle soreness (DOMS) after exercise

• Poor ergonomics or repetitive movement

• Minor trauma or bruising

• Muscle imbalance or tightness

Characteristics of Muscle Pain:

• Aching, dull, or throbbing sensation

• Localised to one area or group of muscles

• Triggered by movement or pressure

• Tender to touch

• Often improves with rest, massage, or stretching

What Is Nerve Pain?

Nerve pain (neuropathic pain) occurs when a nerve is compressed, irritated, or damaged. This type of pain can feel very different from muscular pain and often radiates along the path of the affected nerve.

Common Causes:

• Herniated disc or spinal stenosis

• Sciatica or piriformis syndrome

• Nerve entrapment (e.g. carpal tunnel syndrome)

• Peripheral neuropathy (e.g. from diabetes)

• Post-surgical nerve trauma

Characteristics of Nerve Pain:

• Sharp, burning, shooting, or electric-like pain

• Often radiates from one area to another (e.g. from lower back to leg)

• May include numbness, tingling, or a pins-and-needles sensation

• Pain may occur without movement or touch

• Can lead to weakness or muscle wasting over time

Quick Comparison: Nerve Pain vs. Muscle Pain

How to Know Which One You’re Experiencing

Ask yourself the following questions:

• Does the pain radiate or shoot down a limb? → Likely nerve-related

• Is the pain sore to touch and worse with use? → Likely muscle-related

• Is there numbness or tingling? → More likely nerve involvement

• Does rest or gentle stretching help? → More consistent with muscle pain

• Do you feel burning or electrical sensations? → Typical of nerve pain

Diagnosis: When to Seek Help

While mild muscle pain can often be self-managed, nerve pain should not be ignored, especially if symptoms persist or worsen.

A specialist may recommend:

• Physical examination and strength testing

• MRI or nerve conduction studies

• Diagnostic nerve blocks to confirm the source

• Ultrasound or motion analysis to assess function

Early diagnosis can prevent long-term nerve damage and guide appropriate treatment.

Treatment Options

For Muscle Pain:

• Rest and ice (for acute injuries)

• Stretching and mobility work

• Massage therapy or myofascial release

• Physiotherapy and strength conditioning

• Over-the-counter anti-inflammatories

For Nerve Pain:

• Nerve gliding or neural mobilisation exercises

• Anti-neuropathic medication (e.g. gabapentin, amitriptyline)

• Corticosteroid injections or epidurals

• Decompression surgery (for severe cases)

• Electrical stimulation (e.g. TENS or EMS therapy)

Frequently Asked Questions (FAQ)

Can nerve and muscle pain happen together?
Yes. For example, nerve compression can cause compensatory muscle tension. Likewise, chronic muscle tightness may irritate nearby nerves.

How long does nerve pain last?
It varies. Acute nerve irritation may resolve in days to weeks, while chronic nerve pain can persist for months if left untreated.

Can muscle pain mimic nerve pain?
Yes, especially when trigger points refer pain to other areas. However, muscle pain doesn’t usually involve numbness or tingling.

Is physiotherapy helpful for nerve pain?
Absolutely. Physiotherapy can reduce pressure on nerves, improve posture, and enhance motor control to prevent recurrence.

When should I see a specialist?
If pain persists for more than two weeks, radiates down a limb, causes weakness or numbness, or interferes with sleep and daily life—seek professional evaluation.

Final Thoughts

Knowing whether your pain is nerve-based or muscular is the first step toward effective treatment. While both can cause discomfort, they stem from different issues and require different strategies.

If you’re unsure, don’t guess—get assessed by a musculoskeletal expert who can guide you to the right diagnosis and recovery plan.

Concerned about nerve or muscle pain?
Book a consultation with MSK Doctors. Our advanced diagnostic tools, including MRI, nerve studies, and motion analysis, help pinpoint the cause of pain so you can recover quickly and safely—no referral needed.