Delayed-onset muscle soreness (DOMS) is muscle pain that begins after you’ve worked out. It normally starts a day or two after a workout. You won’t feel DOMS during a workout.

Pain felt during or immediately after a workout is a different kind of muscle soreness. It’s called acute muscle soreness.

Acute muscle soreness is that burning sensation you feel in a muscle during a workout due to a quick buildup of lactic acid. It usually disappears as soon as or shortly after you stop exercising.

Read on to learn more about DOMS, including symptoms, causes, treatment, and more.

According to the American College of Sports Medicine, DOMS symptoms typically occur up at least 12 to 24 hours after a workout. The pain tends to peak about one to three days after your workout, and then should ease up after that.

Symptoms of DOMS to watch out for may include:

  • muscles that feel tender to the touch
  • reduced range of motion due to pain and stiffness when moving
  • swelling in the affected muscles
  • muscle fatigue
  • short-term loss of muscle strength

High-intensity exercise can cause tiny, microscopic tears in your muscle fibers. Your body responds to this damage by increasing inflammation, which may lead to a delayed onset of soreness in the muscles.

Pretty much any high-intensity exercise can cause DOMS, but one kind in particular, known as eccentric exercise, often triggers it.

Eccentric exercises cause you to tense a muscle at the same time you lengthen it.

For example, the controlled, downward motion as you straighten your forearm after a biceps curl is an eccentric movement. The way your quads tense up when running downhill is also an eccentric movement.

Is there a connection between DOMS and lactic acid?

It was once thought that a buildup of exercise-induced lactic acid was to blame for DOMS, but this common misconception has been debunked.

Who can experience DOMS?

DOMS can affect just about anyone, from elite athletes, to beginners, to people who haven’t worked out in a long time.

So, no matter your level of fitness, DOMS may strike whenever you dial up your workout intensity, perform eccentric exercises, or try a new kind of exercise your body isn’t used to.

Some people think that unless you feel super sore after every workout, you’re not making any fitness gains. But is this true?

No. When you start a new exercise routine or push your limits, you’re more likely to get sore. But as you keep working out, your body adapts.

You may feel less and less sore with each workout, but that in no way means you’re not working out hard enough or that you’re missing out on fitness gains from those workouts.

You might be tempted to rest and avoid all exercise and movement when DOMS strikes, but unless it’s severe, hitting the couch for the day may only worsen pain and stiffness, not ease it.

Listen to your body. If your DOMS is bad, you may need to take a day of complete rest to give your muscles a chance to repair.

At a minimum, you’ll want to skip any kind of high-intensity cardio or power lifting sessions when sore. That may only worsen and delay your recovery from DOMS.

Think about trying some gentle movement throughout the day. It won’t speed your recovery, but it might lessen the soreness. To keep your muscles moving, try gentle yoga or some low- to moderate-intensity walking, cycling, or swimming.

Time is the only treatment for DOMS, but you can also take steps to ease the pain and stiffness while you wait for your muscles to repair themselves.

Research findings are mixed, and more study is needed. Some findings suggest the following treatments and self-care steps may help lessen the discomfort.

Massage

A 2017 review of several studies found that people who received a massage 24, 48, or 72 hours after an intense workout reported significantly less soreness than people who didn’t get a post-workout massage. Getting a massage 48 hours after workout seemed to work best.

Getting a massage after every workout may not be feasible, but you can try self-massage on your:

  • calves
  • thighs
  • buttocks
  • arms
  • shoulders

To massage your muscles, apply some oil or lotion to the area and knead, squeeze, and gently shake your muscles.

Using a foam roller right after a workout may also help head off a bad case of DOMS.

Topical analgesics

Topical analgesics are products meant to help relieve pain. Menthol-based topical analgesics and those with arnica may help ease the pain of DOMS. These products can be applied topically to the area that’s sore. Always following packaging instructions about how much and how often to apply.

Cold bath

A 2016 review of studies found that a 10- to 15-minute full-body immersion in a cold water bath (50–59°F or 10–15°C) lessened the degree of DOMS.

Cold baths have become a popular self-treatment for competitive athletes.

Warm bath

Does an ice bath sound extreme? Try a soak in a warm tub, instead. Moist heat wraps or a warm bath may also ease the pain and stiffness that come with DOMS.

Anti-inflammatory foods

More research is needed, but some findings suggest that eating certain foods or taking certain supplements may help ease DOMS.

Learn what kinds of foods to eat after a workout to support optimal muscle recovery.

Do over-the-counter pain relievers help?

According to research published in 2000, nonsteroidal anti-inflammatory (NSAID) medications, such as ibuprofen (Advil), don’t do much to relieve DOMS pain.

DOMS rarely requires a trip to the doctor. But the American Council on Sports Medicine recommends you see a doctor or nurse practitioner if the pain from DOMS stops you from doing your normal daily activities.

You should also seek medical attention right away if:

  • your DOMS lasts longer than 7 days
  • your urine becomes abnormally dark
  • you have severe swelling in your arms and legs

Sharp pain, muscle spasms, and numbness and tingling are different from the dull ache of muscle soreness. Talk with your doctor right away if you feel any of these symptoms after working out.

You may not be able to avoid DOMS all together, but you can take steps to lessen its intensity. Try these tips:

  • Stay hydrated. One study found that men who exercised in hot, humid temperatures had a big dip in muscle soreness when they drank water before, during, and after exercise, compared to men who didn’t hydrate.
  • Warmup. Spend 5 to 10 minutes before each workout doing some dynamic stretching. Skip the static stretching until after your workout.
  • Cool down. In a 2012 study, a 20-minute cool down of low-intensity cycling after a lower-body strength training session led to decreased soreness in the quadriceps muscle two days later. Always end your cool down with some static stretching. It won’t lessen DOMS, but it can boost flexibility in your joints and muscles.
  • Take it slowly. Take your workouts to the next level of intensity one small step at a time. That can help you safely build your strength and endurance while you minimize the effects of DOMS.

Don’t let DOMS sideline you from your fitness routine. Take steps to lessen its impact by slowly dialing up the intensity of your workouts.

If DOMS strikes, use self-care measures to help lessen the discomfort while your body heals.

Most of all, be patient. With time, DOMS should start to happen less often as your body gets used to the workouts you put it through.