Does myasthenia gravis hurt?
Myasthenia gravis does not cause pain. Initially, patients with myasthenia gravis may feel discomfort such as soreness or swelling in the eyes or limbs, blurred vision, or fatigue. As the condition progresses, skeletal muscles become noticeably fatigued and weak. A significant characteristic is muscle weakness, which worsens after exertion in the afternoon or evening and improves after rest in the morning, known as "morning better, evening worse." Patients with myasthenia gravis can experience involvement of skeletal muscles throughout the body, manifesting as drooping eyelids, blurred vision, double vision, strabismus, restricted eye movements, bland facial expressions, a "forced smile" appearance, speech impairments resembling a thick tongue often accompanied by a nasal sound. Additionally, they may have chewing difficulties, coughing or choking when drinking, swallowing difficulties, trouble raising the head, weak shoulder shrugging, difficulty lifting arms, combing hair, climbing stairs, squatting, and getting into vehicles, primarily due to muscle weakness, which does not lead to pain.