Nerve Pain vs Muscle Pain: How Can You Tell the Difference?

Pain can affect almost every part of daily life, from walking and exercising to sitting comfortably or getting a good night’s sleep. However, not all pain has the same cause. While muscle pain often develops following physical activity, strain or injury, nerve pain can feel very different and may occur even when there is no obvious injury.

Understanding the difference between nerve pain and muscle pain can help you recognise what might be happening in your body and when it is worth seeking medical advice.

Although the symptoms can sometimes overlap, there are several ways to distinguish between the two. The location of the pain, how it feels and what makes it worse can all provide useful clues.

What is the difference between nerve pain and muscle pain?

The main difference is the part of the body responsible for producing the pain.

Muscle pain, also known as myalgia, develops when muscle tissue becomes irritated, strained, damaged or inflamed. It commonly follows exercise, repetitive movements, physical work or an injury.

Nerve pain, medically known as neuropathic pain, occurs when nerves or the nervous system become damaged or affected by a disease or injury. Rather than feeling like a typical ache or pulled muscle, it can cause burning, tingling, shooting or electric shock-like sensations.

Both types of pain can range from mild to severe. They can also occur at the same time, making it difficult to identify the underlying cause without a proper assessment.

How does muscle pain feel?

Muscle pain usually feels like an ache, tenderness or tightness within a particular area of the body. It can affect a single muscle or a larger group of muscles, depending on what has caused it.

For example, someone who has recently started exercising might experience soreness in their thighs, shoulders or arms. Similarly, lifting something heavy or spending several hours in an uncomfortable position can leave the back or neck feeling stiff and painful.

Common symptoms of muscle pain include:

• A dull or aching sensation: The affected area may feel sore, tender or uncomfortable, particularly when touched.
• Muscle stiffness: Movement can feel restricted, especially after resting or waking up.
• Pain when moving: Stretching, lifting or contracting the affected muscle may make the discomfort worse.
• Tenderness: Applying pressure to the muscle can cause discomfort.
• Swelling or inflammation: Some muscle injuries can cause localised swelling, bruising or warmth.
• Muscle weakness: An injured or particularly sore muscle may temporarily feel weaker than usual.

Muscle pain often develops after physical activity or an identifiable strain. However, it can also occur without an obvious injury.

What commonly causes muscle pain?

There are several reasons why muscles become painful or uncomfortable.

Some of the most common causes include:

1. Muscle strains

A muscle strain happens when muscle fibres are overstretched or torn. This can occur during exercise, lifting heavy objects or making sudden movements.

2. Delayed onset muscle soreness (DOMS)

DOMS is the soreness that develops after unfamiliar or particularly demanding physical activity. It usually becomes noticeable between 12 and 24 hours after exercise and can be most uncomfortable around 24 to 72 hours afterwards.

3. Repetitive movements

Repeatedly performing the same movement can place stress on certain muscles, particularly in the neck, shoulders, wrists and back.

4. Poor posture

Remaining in one position for extended periods, particularly when sitting at a desk, can contribute to muscle tension and discomfort.

5. Infections and illness

Some infections, including influenza, can cause widespread muscle aches as the body responds to illness.

How does nerve pain feel?

Nerve pain tends to feel different from the soreness associated with muscle injuries. People often describe it as burning, shooting, stabbing or similar to an electric shock.

It can also cause unusual sensations in areas where the skin feels numb, sensitive or tingly.

Unlike muscle pain, nerve pain does not always require movement or pressure to trigger discomfort. Some people experience symptoms while resting, sitting still or trying to sleep.

Common symptoms of nerve pain include:

• Burning sensations: A persistent feeling of heat or burning in the affected area.
• Shooting pain: Sudden bursts of pain that travel along a particular path, sometimes extending into the arms or legs.
• Pins and needles: Tingling, prickling or buzzing sensations beneath the skin.
• Numbness: Reduced sensation or difficulty feeling touch, temperature or pressure.
• Electric shock-like sensations: Sudden, sharp jolts that can appear without warning.
• Increased sensitivity: Even light contact from clothing or bedding can feel uncomfortable or painful.
• Muscle weakness: When nerves responsible for controlling muscles are affected, weakness or difficulty with movement may develop.

Nerve pain can be constant or intermittent. Some people experience occasional shooting sensations, while others have persistent burning or tingling that affects their everyday activities.

What commonly causes nerve pain?

Nerve pain can develop for several reasons, depending on which nerves are affected.

Common causes include:

1. Trapped or compressed nerves

Pressure on a nerve can interfere with the signals travelling between the brain and the rest of the body. This can happen in the neck, back, wrists or other areas.

2. Diabetes

High blood glucose levels over time can damage nerves, particularly those in the feet and legs. This is known as diabetic neuropathy and can cause burning, tingling, numbness and pain.

3. Sciatica

Sciatica occurs when the sciatic nerve becomes irritated or compressed. It commonly causes pain that travels from the lower back or buttocks down one leg, sometimes reaching the foot.

4. Shingles

Shingles is caused by the reactivation of the chickenpox virus. It can damage or irritate nerves, causing burning pain, sensitivity and discomfort. Some people continue to experience nerve pain after the rash has disappeared.

5. Nerve injuries

Physical injuries, surgery or accidents can damage nerves and lead to persistent or recurring pain.

6. Certain medical treatments or deficiencies

Some medicines, including certain chemotherapy drugs, can affect nerve function. Vitamin B12 deficiency can also contribute to peripheral nerve damage.

Nerve pain vs muscle pain: How can you tell them apart?

Although both types of pain can affect the same areas of the body, certain symptoms can help you understand what might be causing the discomfort.

The following comparison highlights some of the main differences.

Symptom	Muscle pain	Nerve pain
Type of pain	Dull, aching or tender	Burning, shooting or electric shock-like
Location	Often concentrated around a particular muscle	May follow the path of a nerve
Touch sensitivity	Pressure on the muscle may cause soreness	Even light contact can feel painful
Tingling	Not usually a defining symptom	Common
Numbness	Uncommon	Can occur
Movement	Often worse when using or stretching the muscle	May worsen with certain movements or positions
Onset	Often follows exercise, strain or injury	Can develop gradually or suddenly
Duration	Often improves as the muscle recovers	May persist or come and go depending on the cause

It is important to remember that these are general patterns rather than diagnostic rules. For example, a compressed nerve can cause pain that feels like a muscle problem, while a muscle injury can sometimes cause swelling or irritation around nearby nerves.

Can you have nerve pain and muscle pain at the same time?

Yes. It is possible to experience both types of pain simultaneously.

One example is sciatica. Irritation or compression of the sciatic nerve can cause shooting pain, tingling or numbness down the leg. At the same time, surrounding muscles may become tense or uncomfortable as you adjust the way you sit, stand or walk to avoid aggravating the pain.

Another example is an injury that damages muscle tissue and irritates nearby nerves. This can create a combination of aching, tenderness and unusual sensations such as burning or pins and needles.

This overlap is one reason why identifying the exact cause of pain can sometimes be difficult.

How is nerve pain different from muscle pain treated?

Treatment depends on what is causing the discomfort. There is no single approach that works for every type of pain, and using the wrong treatment may not provide the relief you need.

Treating muscle pain

Many cases of mild muscle pain improve with time and appropriate self-care.

Depending on the cause, useful approaches may include:

• Gentle movement: Keeping the affected area moving within comfortable limits can help prevent stiffness.
• Rest from strenuous activity: Temporarily reducing activities that aggravate the muscle can give it time to recover.
• Heat or cold therapy: A wrapped ice pack can help with a recent injury, while gentle heat may ease muscle stiffness.
• Physiotherapy: Exercises and movement advice can help restore strength, flexibility and normal function.
• Appropriate pain relief: A pharmacist or healthcare professional can advise whether an over-the-counter medicine is suitable for your circumstances.

Avoid forcing painful stretches or returning to strenuous exercise before an injury has recovered.

Treating nerve pain

Nerve pain often requires a different treatment approach because it involves changes or damage affecting the nervous system.

The first step is to identify the underlying cause wherever possible. For example, managing diabetes, treating a vitamin deficiency or addressing pressure on a nerve may help improve symptoms.

Some people also need medication specifically used to manage neuropathic pain.

According to the National Institute for Health and Care Excellence (NICE), initial medication options for many types of neuropathic pain in adults include:

• Amitriptyline
• Duloxetine
• Gabapentin
• Pregabalin

These medicines work differently from traditional painkillers and are prescribed according to individual circumstances, medical history and potential side effects.

They are not suitable for everyone, and they should only be taken when prescribed by an appropriate healthcare professional.

Traditional painkillers do not usually work as well for neuropathic pain as they do for many other types of pain. This is because nerve pain involves different mechanisms within the nervous system.

You can read more about NICE recommendations in its guidance on neuropathic pain treatment.

How do doctors diagnose nerve pain or muscle pain?

A healthcare professional will usually start by asking questions about your symptoms, medical history and any recent injuries or activities that might have contributed to the discomfort.

They may want to know:

• When the pain first started.
• Whether it developed suddenly or gradually.
• Whether the pain is constant or comes and goes.
• Whether it feels like an ache, burning sensation, tingling or shooting pain.
• Whether movement, touch or certain positions make it worse.
• Whether you have noticed numbness, weakness or changes in sensation.

A physical examination may also be carried out to assess muscle strength, movement, reflexes and sensation.

Depending on the suspected cause, further investigations may be recommended. These can include:

• Blood tests: These may help identify conditions such as diabetes or vitamin B12 deficiency.
• Nerve conduction studies: These tests measure how effectively electrical signals travel through certain nerves and can help identify nerve damage.
• Imaging scans: An MRI or other imaging investigation may be recommended if a structural problem, such as a compressed nerve, is suspected.

Not everyone needs further testing. The appropriate investigations depend on the symptoms and findings from the initial assessment.

When should you seek medical advice about pain?

It is not always easy to know when pain needs medical attention, particularly when the discomfort initially seems minor.

You should arrange an appointment with your GP if:

• Pain continues without improving.
• You regularly experience burning, tingling or pins and needles.
• You notice numbness or reduced sensation.
• Pain repeatedly travels down an arm or leg.
• You experience unexplained muscle weakness.
• Pain interferes with sleep, work or everyday activities.
• You have diabetes and develop new pain, tingling or numbness in your feet.

Early assessment can help identify conditions affecting the nerves or muscles and reduce the risk of complications.

Frequently asked questions

Can nerve pain feel like muscle pain?

Yes. Nerve pain can sometimes feel like a deep ache or discomfort that resembles a muscle injury. However, burning, shooting sensations, tingling and numbness are more commonly associated with nerve-related problems.

Does nerve pain hurt more than muscle pain?

Not necessarily. Both can cause significant discomfort, and pain severity varies between individuals. Nerve pain can be particularly difficult to manage because it may persist even when the affected area is not being moved or touched.

How long does nerve pain last?

This depends on the underlying cause. Some nerve-related symptoms improve once pressure or irritation is addressed, while others can continue for months or longer. Conditions such as diabetic neuropathy may require on-going management.

Can muscle pain cause tingling or numbness?

Muscle pain does not usually cause numbness or tingling by itself. However, an injury may also affect nearby nerves, or swelling may contribute to nerve compression. Persistent or unexplained sensory changes should be assessed by a healthcare professional.

Does nerve pain go away on its own?

Sometimes. Nerve pain caused by temporary irritation or compression may improve as the underlying problem resolves. However, persistent or recurring symptoms should not be ignored, as early treatment may help prevent further nerve damage.

Can exercise make nerve pain worse? Certain movements and exercises can aggravate nerve pain, particularly if they increase pressure or irritation around an affected nerve. However, appropriate physical activity can also form part of recovery. The most suitable exercises depend on the cause of the pain, so professional guidance is advisable.