Christina, yes that is what I meant, it is excessive cortisol levels that can cause muscle wasting. This would affect the voluntary muscles, never cardiac muscle. Extra cortisol is supposed to help the body survive in extreme emergencies; damaging the heart would certainly not further this end. Lynn, it certainly is a good idea to mention the pain your son experienced to his doctor. It might be CAH related or it might be due to some other cause entirely. JoanJoanW