Is Back Pain A Symptom Of COVID-19? What Research Shows

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COVID-19

Can COVID-19 Cause Back Pain?

Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Daniel Yetman on August 17, 2021

Is it a symptom?
Why it happens
What does COVID-19 back pain feel like?
Back pain after COVID-19
Pandemic-related back pain
Summary

COVID-19 is a respiratory infection caused by a virus in the coronavirus family called SARS-CoV-2. It most typically causes flu-like symptoms like fever, cough, and fatigue.

Body aches and pain are also among the most frequently reported symptoms. The lower back is one of the most common places people with COVID-19 report feeling pain.

Back pain often appears in the early stages of the disease, but it can also be a long-haul symptom that persists for weeks or months after infection.

Keep reading to learn why COVID-19 sometimes causes back pain and what COVID-19 back pain feels like.

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

A letter to the editor showed that general muscle aches, medically known as myalgia, are among the initial COVID-19 symptoms in up to 36 percent of people.

However, experiencing body aches doesn’t necessarily mean you have COVID-19. They’re also common early flu symptoms.

A 2020 study found that 69.3 percent of a group of 210 people with COVID-19 reported pain as a symptom. Of those people who reported pain, 46.6 percent reported pain as their primary symptom and 43.6 reported back pain.

Another 2020 research review also found that back pain was one of the most frequently reported COVID-19 symptoms. Back pain was reported in 10 percent of the cases the researchers analyzed.

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.

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.

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.

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

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

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.

In another 2021 study, researchers analyzed tweets on Twitter from November 2019 and November 2020 to compare mentions of back pain. The researchers found an 84-percent increase in 2020.

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.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Abdullahi A, et al. (2020). Neurological and musculoskeletal features of COVID-19: A systematic review and meta-analysis.https://www.frontiersin.org/articles/10.3389/fneur.2020.00687/full
Carfì A, et al. (2020). Persistent symptoms in patients after acute COVID-19.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349096/
Fiok K, et al. (2021). A study of the effects of the COVID-19 pandemic on the experience of back pain reported on Twitter in the United States: A natural language processing approach.https://www.mdpi.com/1660-4601/18/9/4543/htm
Grech S, et al. (2021). Back pain: An aftermath of COVID-19 pandemic? A Malta perspective.https://onlinelibrary.wiley.com/doi/10.1002/msc.1574
Lippi G, et al. (2020). Myalgia may not be associated with severity of coronavirus disease 2019 (COVID-19).https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183921/
Meyer-Frießem CH, et al. (2021). Pain during and after COVID-19 in Germany and worldwide: A narrative review of current knowledge.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819701/
Murat S, et al. (2020). Clinical presentations of pain in patients with COVID-19 infection.https://link.springer.com/article/10.1007%2Fs11845-020-02433-x
Puntillo F, et al. (2020). Impact of COVID-19 pandemic on chronic pain management: Looking for the best way to deliver care.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366114/
Šagát P, et al. (2020). Impact of COVID-19 quarantine on low back pain intensity, prevalence, and associated risk factors among adult citizens residing in Riyadh (Saudi Arabia): A cross-sectional study.https://www.mdpi.com/1660-4601/17/19/7302/htm
Weng LM, et al. (2021). Pain symptoms in patients with coronavirus disease (COVID-19): A literature review.https://www.dovepress.com/pain-symptoms-in-patients-with-coronavirus-disease-covid-19-a-literatu-peer-reviewed-fulltext-article-JPR
WHO coronavirus (COVID-19) dashboard. (2021).https://covid19.who.int/
Widyadharma IPE, et al. (2020). Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: A literature review.https://ejnpn.springeropen.com/articles/10.1186/s41983-020-00258-0

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Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Daniel Yetman on August 17, 2021

Is Back Pain A Symptom Of COVID-19? What Research Shows

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COVID-19

Is back pain a symptom of COVID-19?

Why does COVID-19 cause back pain?

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

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

Other coronavirus pandemic-related causes of back pain

Takeaway

How we reviewed this article:

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