At the start of the pandemic, loss of taste and smell and difficulty breathing were two of the telltale signs that you might be infected with Covid.
But as the coronavirus evolved and variants emerged, different symptoms became more common. Now, back and muscle pain are on the list of commonly reported symptoms with Omicron.
Data from South Africa’s Omicron wave first confirmed that myalgia, and back pain in particular, was on the rise in Covid patients. Similar reports have come out of India and Norway – more and more people infected with Covid are suffering from back pain and muscle pain. And sometimes this pain is quite intense.
According to pain and spine specialists, the most likely culprit is all the inflammation that accompanies a viral infection, which can agitate our muscles and joints. Although it’s too early to know for sure, some doctors suspect there might be something unique to omicron and how it affects the musculoskeletal system.
“Covid is what we call a bad player. It can really mimic so many different conditions and cause so many different types of symptoms – whether it’s affecting the pulmonary system or the musculoskeletal system or your heart,” peter wang, Yale Medicine orthopedic spine surgeon and associate professor at Yale University School of Medicine, told HuffPost.
Why could Covid cause back pain?
During viral infections, the body releases a ton of little proteins called cytokines to stimulate the immune system to fight off the pathogen. According to Jacob Hascalovici, Neurologist, Interventional Pain Specialist and Chief Medical Officer and Co-Founder of the Chronic Pain Telehealth Platform Clearing, one of the consequences of these pro-inflammatory cytokines is that they can greatly irritates muscles and joints.
It’s not just the coronavirus that triggers this type of reaction. Back pain and muscle aches are also commonly reported with other viral and bacterial infections, such as influenza, adenoviruses, and rhinoviruses. Whang says this large immune response, which is part of the body’s natural response to viruses, can cause many musculoskeletal complaints.
With COVID, much of the aches and pains reported involve the muscles and soft tissues around the joints — it doesn’t cause structural problems or cause discs to wear out faster, according to Whang.
People with pre-existing back problems also experience flare-ups when infected with Covid. According to Patrick Doherty, a neurosurgeon and spine surgeon at Yale Medicine, the inflammatory reaction can be more problematic and aggravating in people with underlying health conditions like chronic back pain, which is why the infection appears to exacerbate symptoms pre-existing in areas of weakness.
Hascalovici says the inflammation caused by Covid can also reveal underlying issues. For example, a person might have arthritis that is not symptomatic.
“Infection, by creating inflammation in and around that area of arthritis that normally caused no symptoms, is now a new presentation,” says Hascalovici.
Does Omicron cause more back pain than other variants?
It’s still in the air. During the early stages of the pandemic, patients frequently reported lung problems and loss of taste and smell. These symptoms are not as common with Omicron. Doherty said he treated more patients with back pain during the Omicron wave.
“With Omicron, we definitely see more complaints of back pain, even after it heals, and we don’t know exactly why. But inflammation and immune response are probably the cause,” says Doherty.
It’s unclear if there’s something different about Omicron that specifically causes back pain or if we’re hearing more about this symptom because so many people are infected now, Hascalovici adds. Some doctors suspect Omicron can only attack the musculoskeletal system, however, we need more research to determine if this is what is happening.
How can you treat back pain?
Doherty recommends treating Covid-related back and muscle pain the same way you would treat other types of back pain – try gentle stretches, use heat or ice, and if you can tolerate them, over-the-counter oral anti-inflammatories such as NSAIDs or acetaminophen. Hascalovici also suggests topical anti-inflammatory and botanical therapies since side effects are low.
Avoid strenuous activities and physical therapy during infection and allow yourself to rest, adds Whang. “If you have an active infection, you don’t want to be too aggressive in treating back pain.”
The good news is that most back pain and muscle aches go away on their own – they go away when the infection clears (which usually happens within two weeks).
“As they recover, with a bit of a delay, the back pain also recovers,” Doherty said.
Omicron is so new that researchers don’t yet know if back pain will be a common long-term symptom in patients infected with the variant. We’ve seen this with other variants, so the same could very well be true with omicron. But, regardless, if your back pain persists after you recover from COVID, it’s time to see a doctor because there may be an underlying condition causing the pain.
“You don’t want to miss something and just dismiss it as ‘that’s my omicron,'” Doherty says. “Sometimes it’s something else.”
Experts are still learning about Covid-19. The information in this story is what was known or available at the time of publication, but guidance could change as scientists discover more about the virus. To keep up to date with health advice and cases in your area, visit gov.uk/coronavirus and nhs.uk.