Post COVID-19 recovery, people continue to suffer from musculoskeletal problems, say experts

New Delhi, October 11th

Even after recovering from the novel coronavirus infection, people continue to suffer from musculoskeletal problems such as joint pain, back pain, muscle pain, fatigue and stiffness in the joints, doctors said.

The systemic inflammatory reaction to SARS-CoV-2 has a negative effect on the musculoskeletal system. Inflammatory molecules break down muscle fiber protein and decrease muscle protein synthesis, resulting in decreased muscle strength and also weakening of the bones, said Dr. Uma Kumar, Head of the Rheumatology Department at AIIMS, on the eve of World Arthritis Day.

Inflammatory molecules damage the cartilage, which leads to the worsening of osteoarthritis.

“Even after recovering from COVID-19, patients continue to suffer from musculoskeletal problems such as joint pain, back pain, muscle pain and weakness, fatigue and stiffness in the joints.

“Musculoskeletal problems can occur as a result of drugs used to treat COVID-19, such as steroids and antiviral drugs. Several patients who have had Covid in the past have a flare-up of an existing rheumatic disease, ”said Kumar.

For example, rheumatoid arthritis patients were doing well with treatment, but the joint disease flared up after Covid, she added.

Dr. Ajay Shukla, head of orthopedics at RML hospital, also said the number of patients who have recovered from COVID-19 with arthralgia (musculoskeletal pain) has increased to the RML hospital.

“We get two groups of patients. One group of patients are those who, after recovering from Covid, stopped going out and doing exercises like running, cycling or walking that they used to do out of fear of getting sick again or out of weakness and fatigue . ” .

“Their activity levels went down and this subsequently led to weight gain, resulting in pain and stiffness in weight-bearing joints such as knees, hips and lower back,” he said.

Shukla added that another group of patients are those who have had mild forms of arthritis and whose symptoms flared up after Covid.

“While there used to be a debate about whether certain forms of arthritis like rheumatoid arthritis were caused by Covid, there is consensus that to date there is no definitive evidence that the infection caused them,” he said.

The doctor said that many patients were given steroid drugs indiscriminately and, as a result of this overdose, developed osteonecrosis of various parts of the bones, causing permanent irreversible damage to the joints.

He said there were many patients with arthritis and when they developed Covid they didn’t know whether to stop taking the medication or continue, and similarly to those who were taking the vaccines.

As a result, several patients stopped taking the medication on their own, which made their existing condition worse, he added.

Dr. Sanjeev Kapoor, senior rheumatology consultant, Indian Spinal Injuries Center, said, “The number of people suffering from arthritis is sure to increase as we get cases of joint pain, mostly as a manifestation of post-COVID syndrome. in the general population – since the onset of COVID-19 and “work from home” there has been an approximately 2 percent increase in arthritis cases. “COVID-19 affects the system in a way that other autoimmune diseases affect the body, which can be one of the causes of arthritis that affects both young and old. Sometimes people complain of joint pain and swelling even after the vaccination, ”he said.

It can take three to four weeks for people with viral arthritis to get better, he added.

Dr. Uma Kumar also noted that those who work online for hours, including children taking virtual classes, have reported dryness of the eyes, neck pain, and pain in the small joints of the hands from using the mouse and texting all the time.

She emphasized good rehabilitation care, a lifestyle change that included good physical activity of at least 150 minutes a week, good posture, and a healthy diet to help control these symptoms.

Post-COVID musculoskeletal problems have been observed to resolve within weeks in most cases with supportive treatment.

Even during the SARS-CoV-2 pandemic, an increase in patients with rheumatoid disease was seen, experts said, adding that patients were struggling to get medication, resulting in forced treatment discontinuation, causing the disease to flare up led.

Patients have been observed to manifest themselves with joint pain, muscle pain, extreme fatigue, reactive arthritis, and even vasculitis (inflammation of the blood vessels) during acute COVID-19 infection, said Dr. Kumar.

According to the Global Burden of Disease Study 2016, the global burden of painful musculoskeletal disorders is between 20 and 32 percent. The SARS-CoV-2 pandemic has further increased the burden.

Kumar also regretted the lack of high quality epidemiological data on painful musculoskeletal disorders in India.

Dr. Shuchin Bajaj, founder and director of the Ujala Cygnus Group of Hospitals, said one should be careful with weaker bones or joints as it can lead to a poor quality of life.

“Therefore, it is critical that we take care of our bone health, which is critical to improving our quality of life, especially during COVID-19. Take steps to ensure we don’t harm ourselves and stay free of break, as with limited resources, health officials have recommended avoiding visiting hospitals and doctors unless necessary.

“This makes it clear that we need to take good care of our health and find ways not to harm it,” he added