New Delhi, October 11
People continue to suffer from musculoskeletal problems like joint pain, backache, muscle pain, fatigue and stiffness in joints even after recovery from the novel coronavirus infection, doctors said.
The systemic inflammatory response to SARS-CoV-2 adversely impacts the musculoskeletal system. Inflammatory molecules break the muscle fiber protein and decrease muscle protein synthesis leading to decreased muscle strength and also weaken bones, Dr Uma Kumar, Head of Department of Rheumatology at AIIMS, said on the eve of the World Arthritis Day.
Inflammatory molecules damage cartilage leading to worsening of osteoarthritis.
"Even after recovery from COVID-19, patients continue to suffer from musculoskeletal problems like joint pain, backache, muscle pain and weakness, fatigue, and stiffness in joints.
"Musculoskeletal problems can arise as sequelae of drugs used in the treatment of COVID-19 like steroids and antivirals. Several patients who had Covid in the past are having a flare-up of existing rheumatic disease," Kumar said.
For example, patients who had rheumatoid arthritis were doing well on treatment, but had a flare of joint disease post Covid, she added.
Dr Ajay Shukla, Head of Department, Orthopaedics at RML hospital also said that there is an increase in the number of patients who have recovered from COVID-19 coming to RML hospital with Arthralgia (pain in musculoskeletal system).
"We are getting two sets of patients. One group of patients are those who after recovering from Covid stopped going out and doing exercises like running, cycling or walking which they earlier did because of fear of contracting the disease again or because of weakness and fatigue.
“Their activity levels dropped and subsequently this led to increase in their weight, resulting in pain and stiffness in weight bearing joints like knees, hips and the lower back," he said.
Shukla added that another set of patients are those who had mild forms of arthritis and their symptoms flared up post Covid.
“Also, though there was a debate earlier on whether certain forms of arthritis like rheumatoid arthritis were triggered by Covid, but a consensus is that till date there is no definitive evidence to prove that the infection triggered it,” he said.
The doctor further said that a lot of patients had got steroid medication indiscriminately and due to this overdose, they developed osteonecrosis of different parts of the bones, because of which joints get permanent irreversible damage.
He said there were a lot of patients who had arthritis, and when they developed Covid, they did not know whether to stop the medication or continue with it, and similar was the case with those taking vaccines.
So several patients stopped the medication on their own resulting in deterioration of their existing condition, he added.
Dr Sanjeev Kapoor, senior consultant, rheumatology, Indian Spinal Injuries Center said, "Most certainly, there is an increase in the number of people suffering from arthritis as we are receiving cases of joint pain, mainly as a manifestation of post-COVID syndrome, in the general population -- there is about a 2 per cent increase in arthritis cases since COVID-19 and ‘work from home' regime began." “COVID-19 affects the system in a way other autoimmune diseases affect the body which may be one of the reasons for arthritis affecting both young and old. At times, some people complain of joint pain and joint swelling after vaccination as well,” he said.
It can take three to four weeks for people suffering from viral arthritis to get better, he added.
Dr Uma Kumar also noted that those working online for long hours, including children taking virtual classes, have reported dryness of eyes, neck pain and pain in small joints of hands because of using mouse and constant texting.
She emphasised on good rehabilitative care, changing lifestyle that includes good physical activity of minimum 150 minutes per week, good posture, and healthy diet, to be able to control these symptoms.
It has been observed that post COVID musculoskeletal problems resolve with supportive care within weeks in the majority.
Even during the SARS- CoV-2 pandemic, a surge in patients with rheumatogical disorders was seen, experts said, adding patients had difficulty in getting medicines resulting in forced discontinuation of treatment which led to disease flare.
It was seen that patients during acute COVID-19 had manifested with joint pain, muscle pain, extreme fatigue, reactive arthritis, and even vasculitis (inflammation of the blood vessels), Dr Kumar said.
Global burden of painful musculoskeletal conditions ranges from 20 to 32 per cent, according to the Global Burden of Disease Study 2016. SARS CoV 2 pandemic has further increased the burden.
Kumar also rued that good quality epidemiological data on painful musculoskeletal conditions is lacking in India.
Dr Shuchin Bajaj, Founder and Director, Ujala Cygnus Group of Hospitals said one should be careful about weaker bones or joints as it can lead to poor quality of life.
"Therefore, it is crucial that we take care of our bone health, which becomes vital in improving our quality of life, especially during COVID-19. Take actions that make sure that we are not hurting ourselves and staying fracture-free because with limited resources, respective health authorities have recommended avoiding visiting hospitals and doctors unless necessary.
"This makes it clear that we must take good care of our health and find ways that do not degrade it,” he added. PTI
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