The cause of muscular pain and the various factors that influence it have been a subject of controversy for many years. Lewis, who has investigated the subject extensively has presented an excellent review of the pertinent literature.1 More recently Kissin2 reviewed the subject from a different angle. While it is now generally accepted that ischemia is the cause of muscular pain, such as occurs in angina pectoris and intermittent claudication, the immediate factors responsible for the pain have not been fully established. The pain which develops in contracting muscles during ischemia might be caused (1) by the direct or indirect action of the lack of oxygen which accompanies ischemia, (2) by the diminution of other materials normally supplied by the arterial blood, (3) by the incomplete mechanical removal of products of muscular metabolism which follows the retardation of the blood flow or (4) by the combined action of
PERLOW S, MARKLE P, KATZ LN. FACTORS INVOLVED IN THE PRODUCTION OF SKELETAL MUSCLE PAIN. Arch Intern Med (Chic). 1934;53(6):814–824. doi:https://doi.org/10.1001/archinte.1934.00160120008002
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