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Sudden cessation of high-dose corticosteroids, opioids, barbiturates, benzodiazepines, or alcohol can induce myalgia. Balasubramanian V, Dutt A, Rai S.SourceRehabilitation Bioengineering Group, IIT Madras, Chennai 600036, India. Helicopter pilots espouse ergonomically unfavourable postures and endure vibration which result in low back pain. Abdominal muscle activation increases lumbar spinal stability: Analysis of contributions of different muscle groups. Stokes IA, Gardner-Morse MG, Henry SM.SourceDepartment of Orthopaedics and Rehabilitation, University of Vermont, Burlington, VT 05405, USA. BACKGROUND: Antagonistic activation of abdominal muscles and increased intra-abdominal pressure are associated with both spinal unloading and spinal stabilization. These laws act on the body and trigger compensatory neurological and muscular activity, which commonly result in distortions of the human skeleton and muscle over activity known as muscle spasm.
First, we will examine these physical laws and their effects on the biomechanics (movement) of the human body. Spasticity in the muscles between the pelvis and the head is a result of the righting reflex triggering muscle over activity in an attempt to keep the eyes horizontally level. To illustrate the neuromuscular therapy approach to muscular pain, we will look at the most common bodily distortion and its effect on the body in the reclining position, while standing and while walking.
In the supine (reclining) position: When the subject lies on his back, the right leg will extend further forward than the left leg, making the right leg appear longer that the left leg. This neuromuscular reflex will be carried out as follows: The nervous system will send impulses to muscles on the right side of the trunk to contract, thereby pulling the spine and head to the right, as a reaction to the left tilt of the hips. This positive feedback loop prevents muscle relaxation in the spastic muscle and is called the hyperactive reflex arc.
The spastic muscle develops ischemia (oxygen deprivation) and nutrient depletion, provoking tissue injury and poor healing. Spastic muscles also elicit signals from the central nervous system that may inhibit and weaken other muscles.
Activities such as long sessions spent at a desk or computer, commuting by car or a lack of regular physical exercise may involve overuse of certain muscles and neglect of others. However, myalgia can also be caused by diseases, disorders, medications, or as a response to a vaccination. The objective of this study was to investigate the effects of a helicopter flight on pilots back and shoulder muscles using surface Electromyography (sEMG) analysis. Rehabilitation regimens have been proposed to improve spinal stability via selective recruitment of certain trunk muscle groups. Muscle pain is most frequently related to tension, overuse, or muscle injury from exercise or physically-demanding work.

Had we evolved in a state of zero gravity, the body would have developed a very different set of compensatory reactions to changes in its physical environment. Secondly, the "righting reflex" is achieved by a series of neuromuscular interactions that respond to the body-gravity-center and result in positioning the eyes on a horizontal plane. In the most common bodily distortion, the right hip is rotated forward approximately ¼ inch to 1 inch more that the left hip.
This is not because of an anatomical discrepancy in leg length, but because the right femur (thigh bone) extends from the right hip which, in our subject, is rotated forward. Next, the nervous system will recruit muscles between the left shoulder and neck to pull the head back to center to level the eyes.
The simple act of standing results in excessive muscular activity that distorts skeletal alignment, all in reaction to the initial simple forward rotation of the right hip.
In this reflex arc, neural impulses from the spastic muscle stimulate the central nervous system, and the central nervous system responds by stimulating further contraction in the spastic muscle.
Spastic muscles also compress the joints, increasing the pressure on the joints during movement.
The muscular state is thrown out of balance; some muscles overwork while other muscles are inhibited. This may in turn lead to abnormal hip rotation and subsequent skeletal distortions and muscle spasms, as previously discussed. However, by understanding a few key principles of biomechanics, many of these functional disturbances can be easily understood and corrected. Firstly, the body-gravity-center in a normally aligned human skeleton is located midway between the hips at the level of the second sacral vertebra.
This means that if the hips fall out of correct alignment, the body will compensate by making further adjustments in the hips, trunk, shoulders and neck in order to achieve the eyes on the necessary horizontal plane. This occurs because there is frequently a tendency to use the right leg more than the left leg, for instance, as in the operation of an automobile with automatic transmission. In the standing position: When the subject is standing, he will automatically shift his weight onto the functionally shorter left leg.
While the subject is standing, his right hip will be higher than the left hip, and his left shoulder will be higher than the right shoulder. The person may not suffer pain at the moment, but eventually this constellation of distortions in skeletal alignment will result in some degree of chronic debility and pain. In addition, the skeletal distortion (that is, hips pulled to the left and upper body pulled to the right), when the subject walks, will send shock waves up and down the spinal cord itself, resulting in tightening of the connective tissue around the spine, called the "dura matter," and triggering muscle spasm in various parts of the body. When a muscle is over stimulated by trauma or overuse, the resultant muscle contractions are not followed by the normal relaxation. This reflex arc is indefatigueable and therefore may persist for months or years, leading to chronically spastic muscles and associated pain.

Spastic muscles compress and constrict blood vessels, diminishing circulation to the affected muscles.
Longer-term myalgias may be indicative of a metabolic myopathy, some nutritional deficiencies or chronic fatigue syndrome. To illustrate the effect of gravity on the human skeleton, one may consider that we carry on our heads the equivalent weight of ten telephone books.
In terms of biomechanics, for every movement or muscular contraction, there will be a compensatory reaction. This reflex involves a system of constant communication that between the pelvis (that is, the body-gravity-center) and the eyes. In this case, use of the right leg activates the muscles of the right hip, causing these muscles to shorten and consequently to pull the hip forward. This reduces the supply of oxygen and nutrients to the muscle cells and results in the buildup of toxic metabolites, such as lactic acid. The knee, hip and shoulder joints are particularly vulnerable to the compressive effects of chronic muscle spasm in the muscles that border and support these joints. The hips must be horizontally level in order to maintain the gravity center in its correct location.
These compensatory adjustments may be called mechanical distortions, as they further alter body alignment from the normal. The effects of this mechanical distortion may be clearly seen by examining the subject in various positions. This change in head position will involve the righting reflex, which will be called into action to reestablish the eyes on the horizontal plane. This occurs because the nervous system receives signals from the overused muscle and, as a mechanism of defense against further muscle overuse and injury, the nervous system will trigger a "protective muscle spasm reflex" in the affected muscle. The buildup of lactic acid causes nerve irritation in the muscle tissue, contributing to pain.
Hip position determines the susceptibility of the body to injury and its ability to cope with the various stresses of daily life. This barrage of neural activity originating in the spastic muscle will result in further stimulation of the spastic muscle by the central nervous system, reinforcing the muscle spasm and preventing muscular relaxation and elongation.

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