Aching all over the body: causes and when to see a GP

Aching "all over" can mean joint pain, muscle pain or simply feeling unwell. The cause is more likely to become clear if you consider how quickly it came on, how long it has lasted, and what else is going on: fever, fatigue, stiffness at a particular time of day, or poor sleep.

If it started suddenly alongside a fever and cough, an infection such as flu is the commonest explanation. If it has built up gradually, has been present for weeks or months and is accompanied by tiredness, sleep problems or stiffness, the conditions described below deserve consideration. None of them can be confirmed by a symptom list alone.

The NHS says flu symptoms come on very quickly and can include a sudden high temperature, an aching body, tiredness or exhaustion, a dry cough, a sore throat, a headache, difficulty sleeping and loss of appetite. It says cold and flu symptoms are similar but flu tends to be more severe, and that flu makes you feel exhausted and too unwell to carry on as normal.

For self-care the NHS suggests resting and sleeping, taking paracetamol or ibuprofen to lower the temperature and treat aches and pains, and drinking plenty of water. It advises getting urgent advice if you are 65 or over, pregnant, have a long-term condition or weakened immune system, feel very unwell or short of breath, or if symptoms do not improve after 7 days.

Fibromyalgia, polymyalgia rheumatica and ME/CFS all appear in the NHS pages on widespread aching. They are diagnosed by a clinician, usually after other causes have been considered, and the table sets out the main differences the NHS describes.

There is no specific test for fibromyalgia, according to the NHS, which says it is hard to diagnose because symptoms can be similar to several other conditions. ME/CFS is likewise diagnosed from symptoms and by ruling out other conditions, with a GP asking about your history and possibly arranging blood and urine tests. The NHS says polymyalgia rheumatica can be difficult to diagnose because symptoms resemble many other conditions, including rheumatoid arthritis, which need to be ruled out first.

Because polymyalgia rheumatica is linked with temporal arteritis, the NHS gives specific warnings. A new or frequent headache that usually develops suddenly, a tender scalp, pain in the jaw muscles or tongue when eating or talking, and problems with sight such as double vision or loss of vision are reasons to contact a GP immediately or use NHS 111, because it can lead to stroke or blindness if not treated quickly.

The NHS says there is currently no cure for fibromyalgia, but treatments can relieve symptoms. These tend to be a combination of lifestyle changes such as exercise programmes and relaxation, talking therapies such as CBT and ACT, and medicines such as antidepressants, and it highlights exercise in particular as helping reduce pain. For ME/CFS it describes energy management, CBT and medicines for symptoms such as pain and sleep problems. Polymyalgia rheumatica is treated mainly with the steroid prednisolone, usually for 12 months to 2 years.

See a GP if aching lasts more than a week without an obvious cause such as flu, if it comes with marked fatigue, weight loss, fever, stiffness lasting more than 45 minutes in the morning, or if it is affecting sleep or daily activities. A symptom diary covering what you feel, when and for how long makes the appointment more useful.