If your muscles ache on a statin, the pill is probably not the problem. In 19 blinded trials of 123,940 people, about 27 in 100 reported muscle pain or weakness over four years on a statin, and about 27 in 100 on a dummy pill. 1) Year one is the outlier. On a statin, about 1 extra person in 90 reported aches that year, so only about 1 in 15 of those aches were due to the drug. After that, the gap closed. The trialists judged that over 90% of aches reported on statins were not caused by the drug. 2) In one big trial, aches were the same on drug and placebo while the pills were disguised. Then everyone was offered the drug openly. After that, statin users reported 41% more aches than non-users, even though people had chosen whether to take it. The authors called this the nocebo effect: expecting harm can make people feel it. 3) A UK trial gave people who had stopped statins over aches, or were about to, blocks of drug and dummy pill without saying which. Their ache scores differed by only about a tenth of a point on a 10-point scale. Of those who finished, about two thirds said they had restarted a statin or planned to. 4) Dose matters a little. High doses, such as 40 to 80 mg of atorvastatin, brought slightly more aches than lower doses. Rare serious muscle damage is different, so report any weakness. Statins cut heart attacks and strokes. Most aches are not from the drug. If they bother you, ask your doctor about a lower dose before you stop.