Muscle and joint pains is one of the major issues for me, because they are almost ever present. Many of my other symptoms comes and goes with various frequencies, but this symptom together with headaches have been daily for a long time now. The pain intensity is not constant through the day, but the majority of the day is marked by their presence. Some days they are worse than other, but even on the days where they are a minor bother, the fact that they are always there is incredibly tiresome.
The pains are present every morning, sometimes making it extra hard to motivate myself to get out of bed. Experience has however thought me that being active either diminishes the pains or at least helps me to keep me distracted enough to not think so much about it, so I use that as my morning motivation. During the day the intensity of the pain fluctuate quite a lot. In the evenings the pains are often bad, which makes it hard for me to relax and get rest, because no matter how I sit or lie down it hurts.
I primarily feel pain in the muscles in the forearm, the elbow joint, the muscles in the lower leg, the knee joint, the lower back, the jaw, the shoulder joint and the neck.
What helps me?
Logically one feels the need to use painkillers, but I try to use them as little as possible to protect my body and avoid developing a tolerance. So they are reserved for the very very bad days.
For me regular exercise is the number one help against the pain for a number of reasons. Primarily it radically reduces both the frequency and the intensity of the pains. Running and strength training is great overall, but yoga is for me the greatest way to relieve the pain and make the body relax.
Heat or cold on the muscle can also help. Which one works best varies, so I keep both options at hand. I have an icepack ready in the fridge and use tiger balm to heat up areas.
Getting a massage can help relieve the pain. Try different types to find the one that suit your needs best. Self massage does not have as great an effect, but it will help keeping the pain down between massages and is great for stabilizing the body after bad episodes (I use the self massage techniques from the book The Massage Bible: The Definitive Guide to Massage Therapy by Susan Mumford).
Compression garments helps me a lot. For the legs I tried using compression socks and stockings, but they were both overall uncomfortable and I had the feeling of having my feet squashed. I then switched to calf compressions (brand Skins), which is so much better. They relieve the pain while also helping overall with the blood pressure problems caused by POTS. I also bought compression sleeves (brand Saucony), which applies the same effect to my arms. Both garments are comfortable and can be worn under the clothes. My best POTS specific investment of 2014!
I also try to keep my focus on other things and thereby learning to become more mentally detached from the pain. Meditation training is a great way to learn this, because you learn to do it without ignoring the pain, which is very important since ignoring your body’s signs may lead to serious problems. It is also worth trying a pain management meditation. I learned mine from a trainer, but there are a great number of instruction videos on YouTube.
Magnesium tablets is also worth trying, but talk to you doctor before to get help finding the correct dosage. I could personally not feel the effect, when I tried them, but I know they have helped others.