COVID Triggers Increased Pain Management Needs

May 18, 2021

COVID-19 Long-Haulers Trigger an Increase in Pain Management Needs

by Dr. James Fricton

Increasing numbers of people with “Long-Hauler” COVID-19 now suffer from chronic pain, fatigue, and functional decline post-COVID treatment.

All too often today’s news and healthcare clinics are filled with long-hauler COVID-19 patients’ stories of experiencing persistent aching pain, muscle and joint tenderness, and fatigue. The long-term prognosis of these illness-related muscle and/or joint pain cases is clearer each month. It underscores the need for preventing further COVID-19 Infection and coronavirus-related pains and why COVID triggers increased pain management needs.

More researchers and healthcare professionals are acknowledging that physical, mental, emotional, financial, or disrupted family routine stressors directly and negatively affect the underlying process of recovery. Varying chronic pain conditions may result from structural, functional, and chemical changes in the musculoskeletal and central nervous system due to COVID-19 infections. They may surface due to alterations in how the brain and spinal cord process pain and other sensory stimuli.

Prevalence of Myositis, Myofascial Pain, Fibromyalgia, & Chronic Fatigue

The prevalence of painful myositis, myofascial pain, fibromyalgia, and chronic fatigue patients are escalating due to COVID-19. The long-term prognosis of people suffering from these traumatic conditions increases the need for professional pain management help. The health professionals at MN Head and Neck Pain Clinics see how infection contributes to post-COVID muscle and joint pain. We offer help if you – or someone you know – suffer from these pain conditions. As well, jaw muscle pain and joint pain symptoms are increasing in patients who have or had COVID due to an increase in clenching, muscle tensing, and disrupted sleep.

Since severe on-going fatigue is common among COVID-19 long-haulers, let’s define it.

What is Chronic fatigue syndrome?

Chronic fatigue syndrome (CFS) is a medical condition distinguished by chronic fatigue, lasting at least 6 months. This may quickly impair a person’s ability to perform daily activities and get sufficient and refreshing sleep. Patients with myositis and fibromyalgia reportedly face cognitive impairment due to extending pain suffering.

The November 13, 2020 Fibromyalgia and Chronic Fatigue Syndrome in the Age of COVID-19 article quotes the Institute of Medicine “although approximately 2.5 million Americans (just under the entire population of the city of Chicago) are diagnosed with CFS, it is estimated that 84% to 91% of persons suffering from CFS are currently undiagnosed”.

Arya B. Mohabbat, consultant to the Division of General Internal Medicine at Mayo Clinic, addresses further concerns. The additional COVID-19–associated stressors may affect the underlying nervous system negatively, leading to worsening symptoms in persons with FM and CFS. This potential increased pain load may require a well-designed pain management plan for 6 months or more. Individuals may experience amplified pain caused by oversensitivity of the nerves responsible for pain sensation.

Myositis, Myofascial Pain, Fibromyalgia , and Chronic Fatigue are just some of the conditions that those with long-haul COVID-19 symptoms may have. If you or someone you know is dealing with high pain levels post COVID, this article will help you identify where to get help and what you may need to see a pain specialist for.

What On-going Pain Conditions are COVID-19 Patients Facing?

The most common symptoms of people suffering from long-haulers COVID-19 painful conditions include:

• Myositis.
• Myofascial Pain.
• Fibromyalgia.
• Chronic Fatigue Syndrome.
• Viral Arthritis.
• Arthralgia.
• Pain from an overload of emotional duress.
• Memory, concentration, or sleep apnea problems.
• Painful levels of depression or anxiety.
• Headaches or dizziness.
• Pain symptoms increase after physical or mental activities.

Some of these pain issues are easier to understand, others need help defining.

What is Myositis?

Myositis is muscle inflammation and pain caused by metabolic abnormalities, that may be triggered by COVID-19 exposure. These abnormalities are also known as metabolic myopathies. People experiencing these conditions can end up with muscle pain, tenderness, fatigue, and weakness, but not the widespread pain is seen in fibromyalgia. Chronic pain patients with myositis typically also have abnormal levels of muscle enzymes.

Painful Myositis patient numbers are escalating due to COVID-19. The long-term prognosis of people suffering from traumatic events and illness increases the need for professional pain management help. MN Head and Neck Pain Clinics see how COVID-19 infections can contribute to post COVID-19 myostitis, myalgia, and fatigue. Jaw muscle pain, headaches, neck and shoulder pain, and joint pain symptoms are on the increase in patients who have had COVID.

What is Myofascial Pain?

Myofascial Pain (MFP) involves pain in an area of the body, such as the jaw, neck, shoulder, back, and hip that is associated with tender tight muscle bands that cause both local pain and referred pain to a distant site. The tenderness is called a trigger point (TrP) and is defined as localized deep tenderness in a tight band of muscle that is responsible for both the local and distant pain. The stress and tension from the pandemic have increased tension and strain and the development of TrPs. Trigger points, if treated with stretching, posture, reducing strain, massage, dry needling, and injections, will help resolve the resultant pain.

What is Fibromyalgia?

Fibromyalgia (FM) consists of widespread pain and tenderness on palpation at well-defined locations on the neck, trunk, and extremities. Characteristics that occur in more than 75% of FM patients include muscle tenderness, chronic fatigue, stiffness, headaches, and sleep disturbance. A variety of associated symptoms occur in less than 25% of FM patients and include: irritable bowel, psychological distress, Raynaud’s phenomena, swelling, numbness and tingling, and functional disabilities.

What is Viral Arthritis?

Viral arthritis is the inflammation of a person’s joints caused by a viral infection. Approximately 1% of all cases of acute arthritis are thought to have a viral etiology. Infection from a broad range of viruses can result in types of arthralgia and arthritis.

What is Arthralgia?

Arthralgia is a pain in one or more of a person’s joints. Their persistent pain is often expressed as sharp, dull, stabbing, burning or throbbing, and may range in strength from mild to severe. While many causes of arthralgia exist, including injury, infection, arthritis, and other ailments, COVID-19 is considered as a current trigger in some patients.

“Of 294 hospitalizsed patients with COVID-19, 88 (30%) reported musculoskeletal complaints. Among these 88 patients, 37.5% had myalgia, 5.7% arthralgia, 6.8% new-onset backache and 50% generalizsed body ache”, according to Dr Caroline Wei Shan Hoong, MBBS, MRCP, writing for the National Institutes of Health.

The January 18, 2021, Viral arthralgia a new manifestation of COVID-19 infection? A cohort study of COVID-19-associated musculoskeletal symptoms article discusses how musculoskeletal symptoms are often unrecognized as a prominent feature of COVID-19 infection. Tension headaches, also called musculoskeletal headaches when accompanying muscle aches and pains, are a common type of headache, affecting most of us at some point in our lives. As many people seek to recover from this pandemic trauma, the need to evaluate individuals suffering from chronic pain is higher.

What are COVID-19 long-haulers?

“These so-called ‘COVID long-haulers’ or sufferers of ‘long COVID’ are those who continue to feel symptoms long after the days or weeks that represent a typical course of the disease. These patients tend to be younger and, puzzlingly, in some cases suffered just mild initial conditions”, according to Harvard healthcare specialists. If COVID causes a TMJ flare-up, pursue non-surgical treatment first and early on.

COVID-19 is also Generating Neurological Headache Symptoms

Headaches, muscle weakness, dizziness, and vertigo are additional neurological symptoms that may occur with COVID-19. For long-haulers, persistent symptoms often include brain fog, fatigue, painful headaches, and jaw pain. Living in extreme tension over delayed recovery from illness or other losses and life adjustments due to COVID-19 may also leave a person unknowingly clenching or grinding their teeth, leading to more jaw pain and headaches.

With a worsening of pain symptoms among long-haulers, Minnesota residents are requiring more health care. They feel the impact of higher direct medical expenses, the indirect costs of daily functioning for normal routine, and a further loss of productivity at work. In the age of COVID-19 recovery, may still face the worry of layoffs, furloughs, and financial uncertainties. Many of these long-hauler fatigue patients are not in a good position to “weather this storm.”

For these patients, we recommend that family and friends simply reach out, offer support, and not allow long-term isolation during these uncertain times. The caring thing to do is encourage post-COVID chronic pain suffers to get help from a professional.

If someone is experiencing neurological pain symptoms from COVID-19, what can a healthcare professional do?

“For most of the post-COVID neuro symptoms, we use a symptomatic approach. For example, for a headache, the approach is usually symptomatic treatment except for if the headache becomes intractable. In that case, you need further imaging and consultation with a specialist.” – Dr. Sanghavi in ama-assn.org’s COVID long-haulers: Questions patients have about symptoms article.

Minnesota Head and Neck Pain Clinics focus on managing both symptoms and the risk factors that lead to delayed recovery and persistent pain. For associated symptoms such as anxiety, depression, insomnia, and cognitive impairment, our pain specialists’ diagnostic approach typically starts with common screening tools such as risk assessments. This guides us in determining when a patient can benefit from professional help. This may include seeing a physical therapist or a health psychologist and treatment for lingering anxiety and depression. We also focus on self-care and health coaching to support changing risk factors that drive chronic pain such as tense postures, repetitive strain, diet, and sleep problems.

If you are struggling with anger or guilt that this illness has altered your lifestyle, moving from long-term anger to forgiveness is an important step. It will help your self-care and to better meet the needs of those around you.

Continuing Research in Long-term, Long Hauler COVID-19 Effects

As recent as COVID-19 is, just how long it will affect people who suffered or are suffering from long-hauler symptoms is unknown, but research continues to help us understand this condition. Researchers recommend that doctors closely monitor those who are experiencing its ongoing painful effects of COVID-19 infections and provide both short-term symptomatic treatment and long-term pain management services.

Some medical and pain centers are opening specialized clinics or events to provide care for people who have persistent symptoms or related illnesses after they recover from COVID-19. Minnesota Head and Neck Pain Clinic has Telemedicine pain counseling and telehealth coaching sessions, physical therapy, and online support are available as well.

Thankfully, most individuals who have COVID-19 recover well within a brief time. However, some face long-lasting pain and fatigue problems that continue for months. The overall wellness of these people may be profoundly and positively affected if we do not overlook focus better care for this vulnerable group including pain management services.

As of May 14, 2021, there have been globally over 161.1 million confirmed cases and more than 3.3 million deaths. The United States has had more than 32.8 million cases. The cumulative U.S. death toll climbed to 583,990 and many of us know someone among that number. Take action today and send this article to someone struggling with its painful impacts. Let them know that we can help!

“Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or they had no symptoms. Even people who did not have symptoms when they were infected can have post-COVID conditions.” – CDC*

 

Various pain manifestations conditions that result from COVID-19 infections reflect both inflammatory and neurologic impact the possible damage of diverse body systems. Meaning, the summary of pain symptoms for COVID-19 patients increases pain clinics’ role in improving the accuracy and efficiency of diagnosis for atypical, acute, or mild pain symptoms. This helps pain patients recover better when pain management is integrated.

Better Future Fatigue and Pain Management Treatment

Even individuals who tested negative but face common symptoms of fatigue, shortness of breath, and ongoing muscle pain are seeking help. Post-COVID patients with limited functional status are the reason why many a medical center is seeing a higher demand for pain management care.

The COVID-19 vaccine is proving effective in slowing this infectious disease. Healthcare professionals are learning from this COVID-19 pandemic how to prepare for future fatigue and pain management issues.

COVID Triggers Increased Pain Management Summary

Patients with COVID-19 pain may also be experiencing treatment-related persistent pain and discomfort, intermittent acute procedural pain and tenderness from multiple types of pain conditions, as well as ongoing prior chronic pain issues. Pain specialists at Minnesota Head and Neck Pain Clinic provide comprehensive interdisciplinary patient-centered diagnostic and treatment services for those people with the above pain conditions.

Knowing that COVID triggers increased pain management needs, we offer both on-site and remote pain consultations.

Contact us if you need help. Call (763) 577-2484 to schedule your appointment.

 

About the author

James Fricton DDS, MS, co-founder of the clinic, takes great joy in helping patients with simple to complex head, neck, orofacial, and TMJ pain conditions as well as obstructive sleep disorders.

Read our COVID-19 policy to learn how we protect your health during visits.

 

* https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html