A recent Italian study found that 71.4% of individuals with COVID-19 continued to have health problems 60 days after the onset of their illness. Typical symptoms include chest, joint, and muscle pain, difficulty breathing, fever, loss of smell, and fatigue. Based on past research with SARS, the evidence is mounting that COVID-19 may increase the risk of chronic pain in some individuals.
Three groups at risk for chronic pain
A recent report in the journal Pain identified three groups of individuals at risk for developing chronic pain due to COVID-19. The first group is those who experience organ damage as a result of their illness, such as inflammation of the heart muscle (myocarditis), damage to the lungs, and inflammation of the brain. It is yet to be seen what the long term mental, emotional, and physical consequences will be from COVID-19, but the early indications from the Italian study are concerning.
Those who already have chronic pain comprise the second group at risk. The CDC estimates 50 million people currently have chronic pain in the US; the additional physical strain COVID-19 adds to a chronic pain patient’s already taxed mind and body may lead to an exacerbation of their pain symptoms. This added pressure may increase pain intensity and lead to the spreading of pain from one region of the body to another.
The COVID-19 crisis is dramatically impacting the entire world. Even those individuals who are not made ill by the virus are still affected. Daily media reports of the impact of COVID-19 on the economy, as well as the government’s struggle to respond to the virus impact our collective sense of distress and anxiety. For those unemployed due to the pandemic, decisions to either buy food or pay rent brings stress to a crisis level.
This heightened level of stress creates the underlying physical and mental conditions that lead to chronic pain in otherwise healthy individuals. People unaffected by COVID-19 make up the third group at risk for chronic pain. Increased muscle tension, constant physiological arousal, restriction of blood flow, poor sleep, and inflammation can lead to the onset of chronic pain. Low back pain, shoulder pain, headaches, migraines, muscle aches, joint pain, widespread pain, and fatigue are all possible results of living under the weight of this pandemic.
Learning from history
Research conducted with those who suffered from the SARS outbreak in 2003 is instructive for us now. Those infected by SARS were at higher risks of mental health problems, suicide risk, depression, and PTSD. Between 25% and 44% of patients with SARS experienced ongoing struggles with PTSD. Even among healthcare workers, 40% experienced PTSD as a direct result of their intense and overwhelming work with SARS patients.
The next step
There are many consequences of COVID-19, some known and many yet unknown. To prevent the development and exacerbation of chronic pain, education on how the central nervous system becomes over sensitive and leads to chronic pain should be provided to healthcare providers, those with COVID-19, and the general public. Tools for pain management, the development of active treatment modalities for pain, and social support are key to help the millions impacted by the pandemic.
By: Evan Parks. Evan helps people get the information they need to manage chronic pain by providing neuroscience education in everyday language at www.painrehabsource.com. Follow him on Twitter at @DrEvanParks.