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One common cause of muscle aches and pain is fibromyalgia, a condition that causes tenderness in your muscles and surrounding soft tissue, sleep difficulties, fatigue, and headaches.
Some of the less common causes of Costovertebral angle tenderness may include: 1  Renal artery occlusion. 2  Musculo-skeletal inflammation. 3  Trauma. Fracture.  Muscle sprain.