Sudden Onset Joint Pain and COVID-19: Causes, Symptoms, and Treatment

February 16, 2024

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Joint pain that comes on suddenly can be alarming. When it affects multiple joints at the same time, it often indicates a systemic issue rather than isolated injuries. Sudden onset joint pain in multiple joints has been frequently reported in association with COVID-19 illness, both during acute infection and as a post-viral complication.

Understanding the origins of this symptom and how to alleviate persistent joint discomfort can help sufferers cope with short and long-term effects of the disease.

What Causes Sudden Joint Pain With COVID-19?

SARS-CoV-2, the virus that leads to COVID-19, triggers widespread inflammation throughout the body that can manifest in a variety of ways. Joint pain results when this inflammation affects tissues in the knees, hips, shoulders, hands, and other areas.

Doctors group the possible causes for sudden onset joint pain related to COVID-19 into three categories:

Direct Viral Infection

Research indicates SARS-CoV-2 can directly infiltrate joint tissues in some patients. One study found viral genetic material and proteins specific to SARS-CoV-2 inside the joint fluid of COVID-19 patients suffering from pain and swelling.

Direct infection increases inflammation as the virus damages cells and provokes an immune response. Destruction of collagen and hyaluronic acid may also contribute to sudden onset symptoms.

Post-Viral Autoimmunity

COVID-19 frequently causes post-viral autoimmunity, which refers to the body’s defenses mistakenly attacking its own healthy tissues after battling an infection. This autoimmune reaction leads to increased inflammation that can flare up suddenly long after the individual recovers from the initial illness.

Sudden onset joint pain presenting weeks later may indicate autoimmune conditions like reactive arthritis or rheumatoid arthritis triggered by the virus.

Microvascular Injury

Finally, some researchers propose microvascular damage from COVID-19 sets the stage for later musculoskeletal complaints like joint pain. Blood vessel injury reduces circulation to joint tissues, resulting in sudden pain when demand exceeds the restricted blood supply.

Common Joint Pain Symptoms

The specific joints impacted and quality of the discomfort tends to follow certain patterns with COVID-19:

  • Shoulder pain often affects the rotator cuff muscles connecting the upper arm to the shoulder blade. Pain on movement suggests tendonitis.
  • Back pain concentrated in the lower back area may reflect inflammation in the spinal joints or muscular strain.
  • Hip and knee pain typically stems from bursitis or tendonitis rather than arthritis. Pain concentrates around the major joints rather than inside them.
  • Migratory pain moving from joint to joint is consistent with systemic inflammation rather than isolated joint disease.
  • Many patients experience joint stiffness and reduced mobility along with pain, especially in the mornings or after long periods of inactivity.

These shared characteristics help distinguish post-COVID arthralgia from other causes of sudden onset joint pain in multiple joints like injury or osteoarthritis.

Risk Factors

Certain patients face higher odds of developing lasting joint pain after COVID-19:

  • Older age
  • High fever during infection
  • Prior diagnosis of arthritis or joint disease
  • Presence of body aches early on
  • History of autoimmunity

Long-Term Impacts

For most surviving COVID-19, joint symptoms fade within a few weeks to months as the inflammation gradually resolves. However, a subset of patients experience persistent pain and stiffness lasting 6 months or more after the acute infection:

  • Up to half of non-hospitalized patients have joint pain at 6 months, per some estimates.
  • Around 25% of patients continue suffering musculoskeletal discomfort like joint pain a year later.
  • COVID-19 extreme muscle pain in legs may be especially stubborn to treat.
  • Post-COVID arthritis can develop and cause irreversible joint damage.

These long-lasting complications highlight the importance of managing post-COVID pain aggressively.

Is Neck and Shoulder Pain a Sign of COVID-19?

The neck contains facet joints between vertebrae that can become inflamed, causing localized pain. Enlarged lymph nodes under the jaw also sometimes contribute to neck soreness with COVID.

Meanwhile, shoulder pain often results from rotator cuff tendonitis or referred pain from the neck/upper back. Both sites may flare up due to high levels of inflammation.

Therefore, yes, is neck and shoulder pain sign of COVID-19? Pain originating in these areas can serve as an early red flag, especially if it arises along with fatigue, headache, or other systemic symptoms.

Diagnosis

Doctors diagnose post-COVID joint pain based on:

  • Recent or active COVID-19 illness
  • Location and quality of pain
  • Presence of stiffness/swelling
  • Past medical history
  • Physical exam findings

They may order imaging or lab tests to rule out other explanations. However, results frequently appear normal with post-viral arthritis.

Distinguishing precise causes often proves difficult, except in obvious cases of reactive arthritis where joint swelling and inflammation are measurable. Otherwise, diagnosis tends to rely more on clinical judgement.

Treatments

Controlling discomfort and inflammation represents the main treatment goal for post-COVID joint pain:

Medications

  • Over-the-counter NSAIDs like ibuprofen help ease mild symptoms by reducing inflammation.
  • For moderate to severe pain, doctors often prescribe steroids, DMARDs, biologics, or other arthritis medications to dampen the immune response.

    Physical Therapy

  • Stretching, massage, ultrasound therapy, and strength training can help mitigate stiffness and pain sensitivity.
  • Use of assistive devices may provide extra support and take pressure off sore joints.

    Lifestyle Changes

  • Stress management assists the body’s recovery and adaptation processes.
  • A nutritious anti-inflammatory diet full of vegetables, fish, nuts, and olive oil fights inflammation.
  • Low-impact cardio and frequent movement promotes circulation to joint tissues.

Conclusion

  • Sudden onset joint pain in multiple joints serves as a common feature among both acute COVID-19 infection and longer-term complications like long COVID.
  • Direct viral effects, post-viral autoimmunity, and microvascular damage may underlie these symptoms.
  • Careful diagnosis and pain management provide the best recourse for enduring joint discomfort. Most cases ultimately resolve but may persist over a year in some patients.

COVID-19 continues to surprise doctors and scientists as we learn more about its wide-ranging acute and long term effects. Understanding all it ways it impacts the musculoskeletal system will equip healthcare providers to better help those afflicted with enduring symptoms like joint pain.

Frequently Asked Questions

What causes sudden onset joint pain after COVID-19?

Three main mechanisms may cause sudden onset joint pain after COVID-19: direct viral infection of joint tissues, autoimmune flares resulting from viral-induced immune dysregulation, and microvascular damage limiting blood flow to joints.

Can COVID-19 trigger autoimmune arthritis?

Yes, COVID-19 activates autoimmune conditions like rheumatoid arthritis or reactive arthritis in a small percentage of patients. The resulting inflammation produces sudden onset joint pain that may persist.

Why do my joints still hurt 3 months after COVID?

Lingering joint discomfort 3+ months after infection likely relates to microvascular dysfunction or post-viral autoimmunity leading to ongoing inflammation that sensitizes joints. Appropriate treatment can help resolve these issues.

How long does joint pain last after COVID vaccine?

For most vaccine recipients, COVID-19 vaccine side effects like joint pain resolve within a week. However, some patients develop reactive arthritis or immune-mediated flare ups causing more persistent pain requiring medical treatment.

What helps with joint pain after COVID?

To alleviate covid-19 joint pain, try over-the-counter NSAIDs, hot/cold therapy, massage, stretching, acetaminophen, topical pain relievers like capsaicin cream or menthol rubs, immunity-supporting nutrition, and low-impact exercise within your limits. See a doctor if OTC remedies fail.

Summary

Key takeaways:

  • Sudden onset joint pain in multiple joints covid-19 typically results from COVID-induced inflammation damaging joint tissues, whether directly or through post-viral complications
  • Autoimmunity and microvascular injury play a role in certain cases
  • Is neck and shoulder pain sign of covid-19? Yes when arising along with other systemic indicators like fatigue.
  • Diagnosis relies largely on clinical judgement after ruling out other disorders
  • Though most joint symptoms ultimately resolve, pain can persist over a year in some patients
  • Treatment focuses on controlling pain and inflammation using medications, physical therapy, and lifestyle measures
  • More research on the musculoskeletal impacts from COVID will improve patient care
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