Can COVID-19 Cause Back Pain?

Curated by Claudia Shannon / Research Scientist / ishonest

Is back pain a symptom of COVID-19?

A 2020 research review showed that pain is one of the most common symptoms of COVID-19 and often appears as one of the early symptoms, sometimes in the absence of other symptoms. The types of pain people most frequently report include:

  • headaches
  • body aches
  • back pain

Why does COVID-19 cause back pain?

General body aches, muscle pain, or joint pain are common symptoms of COVID-19 and other viral infections. It’s thought that pain is primarily caused by your body’s immune response.

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A COVID-19 infection can stimulate the release of pro-inflammatory molecules called cytokines by your immune system. A 2020 research review showed that these molecules may stimulate the formation of a molecule called prostaglandin E2 that acts on your nerves and sends pain messages to your brain.

Another 2020 research review showed that muscle aches caused by viral infections have been linked to an upregulation of a specific cytokine called interleukin-6.

It’s also been posed that the virus that causes COVID-19 may cause tissue damage that plays a role in pain development.

The virus that causes COVID-19 can mimic an enzyme called angiotensin converting enzyme 2 (ACE2) to enter your cells. The 2020 research review at the beginning of this section showed that receptors for this enzyme are found in many parts of your body, including your skeletal muscles.

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Autopsy studies performed on people who developed severe acute respiratory syndrome (SARS), a respiratory disease caused by a similar virus as SARS-CoV-2, didn’t find evidence of the virus in muscle tissue. So, more research is needed to understand if muscle damage is a cause of pain in people with COVID-19.

Can you tell if your back pain was caused by COVID-19?

Back pain can have many possible causes. It’s impossible to know if your back pain was caused by COVID-19 unless you also had a positive COVID-19 diagnostic test. However, diagnostic tests aren’t 100 percent accurate.

One 2020 study showed that the intensity of pain experienced by people with COVID-19 in medical literature is reported as mild-to-moderate, similar to other viral infections.

Back pain caused by COVID-19 is often described as a deep pain instead of a sharp or stabbing pain that may accompany a sudden muscular injury. Pain caused by viral infections is also less likely to be eased by changing your posture than the pain caused by muscular injuries.

Is back pain a symptom of long-haul COVID-19?

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Some people with COVID-19 develop symptoms that last weeks or months after the original infection. These persistent complications are called long-haul symptoms.

Some of the most common long-haul symptoms include:

  • shortness of breath
  • fatigue
  • altered smell or taste
  • brain fog
  • joint or muscle pain
  • cough

Some people report developing persistent back pain after a COVID-19 infection. Researchers are still trying to figure out how common it is.

One 2020 Italian study found that roughly 25 percent of people with COVID-19 had persistent joint pain at a 2-month follow-up after the onset of COVID-19 symptoms. It was the third most common long-haul symptom reported after fatigue and shortness of breath.

Other coronavirus pandemic-related causes of back pain

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Since the start of the COVID-19 pandemic, a lot of people have had to adjust their lifestyles. Stay-at-home orders, reduced physical activity, and increased sedentary time are some of the factors associated with the pandemic that may also be linked to an increased prevalence of back pain.

A 2020 study attempted to estimate the effects of a mandatory COVID-19 quarantine in Saudi Arabia on the occurrence and severity of lower back pain. The researchers found that 38.8 percent of people reported lower back pain before the quarantine, while 43.8 percent report back pain after.

A 2021 Maltese study found that lifestyle changes like increased remote working may have increased the occurrence of lower back pain in Malta. According to the researchers, of the 388 people surveyed, 30 percent experienced chronic lower back pain before the pandemic and 49 percent experienced pain after.

Takeaway

Back pain and muscle pain are commonly reported by people with COVID-19. Often, pain develops in the early stages of the disease and can be the initial symptom. It’s thought that body pain is primarily caused by your immune system’s response to the COVID-19 infection.

Having back pain alone isn’t necessarily a symptom of COVID-19. Other viral infections like the flu can also cause body aches. The only way to know for sure if your pain is a symptom of COVID-19 is to receive a positive diagnostic test. However, even with a positive diagnostic test result, there’s a small chance of an inaccurate result.

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