How to Treat Severe Muscle Soreness From Weightlifting

Delayed-onset muscle soreness, or DOMS, describes the tight, sore muscles that show up a day or two after an intense weight-training session 1. According to exercise scientist Len Kravitz of the University of New Mexico, DOMS usually peaks within within 24 to 48 hours and resolves itself within 96 hours 3. (reference 4) Proactive treatment can ease your symptoms, but it will not necessarily speed your recovery.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Discontinue exercise and allow your sore muscles to rest. The American College of Sports Medicine warns that continuing to exercise with severe symptoms may make the pain worse 1. Refrain from exercising until your symptoms subside.

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Apply ice to the affected region. Ice can help reduce inflammation and soothe damaged muscle tissue. A 2010 study performed at the University of Wisconsin-LaCrosse found that 30-minute ice treatments applied immediately after a workout -- and then repeated two, four, six, 24 and 48 hours later -- effectively minimized the perceived pain, although it didn't improve the muscle performance.

Seek massage or acupressure therapy. A review of literature published by the Australian Association of Massage Therapists and RMIT University supported massage and acupressure as effective treatments to ease DOMS symptoms.

The Benefits of an Ice Massage

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Take over-the-counter nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen and flurbiprofen for temporary pain relief. However, because of the negative side effects of gastrointestinal distress and elevated blood pressure -- along with non-conclusive evidence to support their effectiveness -- NSAIDs are not the optimal choices for treating DOMS.


When it comes to DOMS, an ounce of prevention can be worth a pound of cure. Kravitz recommends performing a general aerobic warm-up before lifting to elevate your core temperature, and a specific warm-up that mimics the movements you will perform, taking your joints through their full range of motion with little or no weight. The ACSM encourages gradual progression in your exercise program to give your muscles time to adapt.


The ACSM warns that reduction of painful symptoms using the above treatments does not equate with recovery, and that muscle damage and reduced muscle function may persist. If severe post-exercise pain is accompanied by excessive swelling, severely reduced function and dark brown urine, you may have rhabdomyolysis, a serious medical condition. Rhabdomyolysis is characterized by a breakdown of muscle membranes, allowing muscle cell contents to leak into your bloodstream. Rhabdomyolysis can lead to severe kidney damage or even death, and symptoms call for immediate medical intervention.