A recent study published in the Journal of the Royal Society of Medicine Open has identified pain as the most prevalent symptom among individuals suffering from long COVID. According to the research, pain accounts for approximately 25% of all reported symptoms, surpassing fatigue, shortness of breath, and neuropsychological issues.
Dr. W. Michael Brode, medical director of the Post-COVID-19 Program at UT Health Austin, confirms that these findings align with clinical observations worldwide. “Pain is very common among long COVID patients,” Dr. Brode stated. He noted that the types of pain vary, including chest, abdominal, headache, and muscle ache pain, with muscle and nerve pain being particularly frequent.
Understanding Long COVID
Defining long COVID remains challenging due to its relatively recent emergence. As Dr. Brode explains, there is no universally accepted definition yet. The Centers for Disease Control and Prevention (CDC) refers to a definition by the National Academies of Sciences, Engineering, and Medicine, which describes long COVID as a chronic condition following SARS-CoV-2 infection, lasting at least three months and encompassing a broad range of symptoms such as shortness of breath, fatigue, and muscle pain.
Diagnosis involves reviewing medical history and conducting physical examinations. While diagnostic tests can support the diagnosis, no single lab test can definitively confirm long COVID.
Research Findings on Symptoms
Researchers from University College London conducted a study using the Living With COVID Recovery app to analyze self-reported data from 1,008 long COVID patients in England and Wales. The study found that pain was the most frequently reported symptom, comprising over 26% of the total symptoms recorded. Nearly half of the participants reported experiencing some form of pain.
The types and locations of pain varied, including throbbing, aching, and tingling sensations in areas such as the head, chest, and limbs. Dr. David Sunkersing, a study author, noted a high incidence of pain in the head, chest, and limbs specifically.
Other prevalent symptoms included neuropsychological issues (18%), fatigue (14%), and shortness of breath (7%). Factors such as age, gender, ethnicity, and education level were found to influence symptom intensity. Older individuals reported more severe symptoms, with those aged 68 to 77 experiencing 32.8% more severe symptoms and those aged 78 to 87 experiencing an 86% increase in severity compared to the youngest group (18 to 27). Women and people of color also reported more intense pain, while higher education levels and less economic deprivation were associated with lower pain severity.
Exploring Pain in Long COVID
The predominance of pain in long COVID cases, despite the virus’s initial presentation as a respiratory illness, is still being investigated. Dr. Brode suggests several theories. One theory posits that inflammation triggered by the virus disrupts the immune system and neurovascular function, leading to pain. Disruptions in neurovascular function can impair muscle and nerve oxygenation and energy production.
Another theory is that long COVID may cause damage to small nerve endings, resulting in small-fiber neuropathy, which can produce burning and shooting pain sensations. Additionally, long COVID may interfere with the nervous system’s pain signaling, potentially amplifying discomfort.
Treatment Options for Long COVID Pain
Dr. Brode outlines four primary approaches to managing long COVID-related pain: adjusting daily lifestyle to minimize discomfort, using physical therapy and cognitive behavioral therapy to manage stress, and employing medications such as NSAIDs and nerve pain drugs. For cases resistant to these treatments, experimental options like hyperbaric oxygen therapy or medications for autoimmune disorders might be considered.
Ongoing research aims to uncover more effective treatments for long COVID, and new advancements are anticipated in the near future, according to Dr. Sunkersing.
