Aches and chills: causes and warning signs

Influenza and other viral illnesses can present with both symptoms. Pneumonia, a kidney infection, malaria, dengue fever, and sepsis can also include aches or chills, so travel history, fever, breathing, alertness, pain location, and hydration all matter.

Chills are rapid muscle contractions that generate heat when the body's temperature control centre resets, commonly during a fever. Immune signalling and repeated muscle activity can contribute to widespread soreness. A fever may be present even if you have not measured it, while chills can occasionally occur without fever after cold exposure or during another physical stress.

Clues to the cause include cough or breathing pain with a chest infection, burning urination or flank pain with a urinary or kidney infection, and recent travel to a malaria or dengue area. Symptoms alone cannot confirm which infection is responsible.

Rest, drink regularly, wear light comfortable layers, and check your temperature if a thermometer is available. Note when symptoms started and watch for changes in breathing, alertness, urine output, rash, vomiting, or pain. Avoid strenuous exercise until the fever and marked weakness have settled.

For discomfort, a pharmacist can advise whether acetaminophen or another fever medicine is appropriate for you. Check combination cold remedies to prevent duplicate ingredients. If dengue is a possibility because of travel or local exposure, obtain medical advice before using aspirin or anti-inflammatory pain medicines because they may increase bleeding risk.

Seek emergency help for difficulty breathing, chest pain, confusion, fainting, a seizure, a stiff neck, blue or grey lips, a rash that does not fade when pressed, severe weakness, very little urine, or an inability to keep fluids down. These signs can accompany a serious infection or dangerous dehydration.

Prompt assessment is also warranted for shaking chills with severe one-sided back pain, pain when urinating, worsening cough, persistent abdominal pain, unusual bleeding, or fever after recent travel to a malaria or dengue region. Older adults, pregnant people, young children, and anyone with reduced immunity or major long-term illness should seek advice earlier when symptoms are pronounced or worsening.

Tell the clinician about measured temperatures, symptom onset, cough, urinary changes, rash, vomiting, pain location, insect bites, sick contacts, recent travel, medicines, and long-term conditions. Useful questions include whether testing is needed, how to manage fluids and fever, and which specific change should trigger urgent reassessment.