How to differentiate muscle joint pain due to tiredness from being bent

[BlueTrin]

Question, a friend was diving with two stages and had some light shoulder stiffness from holding the stages.

After the dive, he was wondering if he could have been bent but it seems just a combination of tiredness, lugging heavy stages and not having worked out recently.

Is there a definite way to know whether it is DCS or just muscle pain due to the weight?

Tagging @Duke Dive Medicine , because he is very helpful in general

 

[tursiops]

After a heavy dive day my wife had some wrist pain after lugging some tanks around. She ended up in the chamber, and the diving-doc asked if the pain had gone away. She said no, and he said carpal tunnel, and took her out of the chamber.

Added: she made a call to DAN first, they sent her to the chamber, and they paid afterwards. Nice. DAN rocks.

 

[kinoons]

Again, hopefully DDM can offer some more insight….

The tough part is that the symptoms of a DCS hit can mimic many other things.

There are some symptoms I’d take far more seriously. Anything neurological (cloudy thinking, numbness, tingling) or something where air is obviously in the tissues (subcutaneous air). Chest pain or shortness of breath would also be concerning. None the less just the joint ache and muscle soreness —could— be DCS.

When I was first learning to dive I promised my son I’d take him camping the same day I did my last two open water dives. I dove lake mead (about 1100 ft) maybe 90 minutes total over two dives then promptly went to 8500 feet on mt. Charleston to go camping. Woke up at 0200 with a rippin headache and joint pain. Took some Motrin and went back to sleep. I’m okay today, so who knows.

So it boils down to what we call a high index of suspicion. If you have been diving that day, do something that increases the likelihood of DCS, then i’m likely to treat for it.

 

[MB NZ]

I don't think you can differentiate DCS from musculoskeletal pain caused by other factors on the basis of symptoms, but interested to hear what the experts say.

 

[JonG1]

Personally, dcs pain was different from a muscular strain type pain.

It's a nagging, deep, throb or ache, not dissimilar to tooth ache I guess.

It also has a visceral quality to it that I can't fully describe, but maybe psychogenic due to the known origin.

 

[Duke Dive Medicine]

Question, a friend was diving with two stages and had some light shoulder stiffness from holding the stages.

After the dive, he was wondering if he could have been bent but it seems just a combination of tiredness, lugging heavy stages and not having worked out recently.

Is there a definite way to know whether it is DCS or just muscle pain due to the weight?

Tagging @Duke Dive Medicine , because he is very helpful in general

Thanks for the kind words! Concur with other posters in that it can be difficult to differentiate between DCS pain and pain from other sources. Time of onset and a known mechanism of injury can both be helpful in diagnosing or ruling out DCS. If your friend's pain set in after a provocative dive or dive series, it would point more toward DCS. If it was hurting before the dive, it's much less likely, especially with a known mechanism. If a diver presented to us and we were unable to rule out DCS we would tend to treat as @kinoons said.

Best regards,
DDM

 

[MB NZ]

Dear DDM

Will musculoskeletal pain caused by DCS resolve without hyperbaric therapy? Thanks.

 

[JonG1]

Mine did, I elected to treat with o2 but not hyperbaric, and within circa 24 hours it abated.

Obviously severity will affect safe resolution and longer term damage can't be ruled out if you don't get recompressed.

 

[KenGordon]

Question, a friend was diving with two stages and had some light shoulder stiffness from holding the stages.

After the dive, he was wondering if he could have been bent but it seems just a combination of tiredness, lugging heavy stages and not having worked out recently.

Is there a definite way to know whether it is DCS or just muscle pain due to the weight?

Tagging @Duke Dive Medicine , because he is very helpful in general

Get in a chamber. Does it stop hurting? Yes => bent, no => still not sure.

 

[Duke Dive Medicine]

Dear DDM

Will musculoskeletal pain caused by DCS resolve without hyperbaric therapy? Thanks.

Hello @MB NZ , typically yes, but untreated joint DCS can lead to aseptic osteonecrosis in some cases so definitive treatment is recommended.

Best regards,
DDM