COVID and back pain - Omicron variant invades skeletal muscle cells 

Both infected and recovered people are increasingly reporting COVID symptoms like back pain. And indeed, back pain from COVID infection may be a symptom of the virus, and it is reported much more frequently than before with the emergence of the Omicron variant. Back pain from COVID due to the Omicron variant is now reported by around 20 percent of those infected, with the severity of the pain sometimes described as “unbearable.” In this respect, COVID and back pain are two things that may well be related.

Targeted treatment is unavoidable to prevent COVID back pain from becoming chronic and to regain unrestricted daily life. Heat therapy soothes and relaxes the muscle fibers, promotes blood circulation, and can effectively relieve COVID back pain. The treatment can be additionally strengthened by a supporting vibration massage.  

COVID and back pain – Is back pain a sign of COVID?

Back pain was already known as a "common ailment" before the coronavirus pandemic and is one of the main reasons for absences due to illness (second only to respiratory diseases), and premature incapacity to work, as well as requiring rehabilitation measures (first place). At least 74 to 85 percent of the population in Germany are occasionally affected by back pain.

Since the emergence of COVID, back pain has become more frequent: a study from Malta showed the extent of the increase in complaints: Before the first appearance of SARS-CoV-2, 30 percent of the population suffered from chronic joint or muscle pain. In the next survey, which took place during the pandemic, the prevalence was 49 percent, which corresponds to an increase of more than 63 percent. Although back pain was not explicitly mentioned in the survey, it falls under the broad category of joint or muscle pain.

What does back pain feel like?

COVID back pain can cause the same complaints as non-COVID back pain. The most important symptoms are pain-related restrictions on movement, for example, when climbing stairs or lifting and carrying objects. With COVID back pain in the lower back is particularly common. The back pain starts suddenly and is accompanied by other symptoms that are typical of other diseases: those affected compare it to the pain of menstruation or to renal colic due to kidney stones. COVID back pain has also been compared to severe cramps and/or sore muscles. Occasionally, middle back pain is also reported with a COVID infection. This mid-back pain in COVID is localized to where the lungs are located. The inflammation of the lower respiratory tract causes the pain to radiate from the area of the lungs to surrounding areas of the body. This back pain during COVID infection then is not caused in the skeletal system. Pain in the upper back in COVID, on the other hand, is often a result of muscles cramping due to the coughing that accompanies the disease.

The often-severe back pain of COVID is described by sufferers as a particularly deep-seated pain, in contrast to the usually sharp and stabbing pain that occurs with sudden muscle injury. Similarly, people report that their back burns with COVID, but this is not a specific symptom of COVID-19 alone. Such discomfort also occurs with other infectious diseases, especially when accompanied by fever.  

How does COVID cause back pain?

COVID can cause back pain indirectly at first, for example, the pain caused by pneumonia radiates to the entire trunk area and is thus perceived as back pain, among other things. In addition, muscle and joint pain are common symptoms of infectious diseases. Often referred to as "body aches," these symptoms are caused by the body's immune response to infection and are primarily associated with a specific cytokine called interleukin 6. It is already known from the early days of the pandemic that COVID-19 can provoke an excessive immune reaction that can lead to severe courses because of a so-called cytokine storm. A cytokine storm is a "derailment" of the immune system that leads to severe inflammatory reactions, not from the virus itself, but from the body's own immune cells in the tissues.

Back pain from COVID has been particularly common with the Omicron variant. The exact reasons why back pain from COVID occurs frequently with the Omicron variant have not been determined conclusively. However, it is assumed that these symptoms are linked to the affinity of SARS-CoV-2 to ACE2, a specific enzyme produced by the body. ACE2 is particularly expressed by the cells of the respiratory tract, but also by other cells, which include, for example, the skeletal muscle cells. This enzyme serves as a receptor for SARS-CoV2 and triggers the process necessary to take the virus into the body's cells. In this respect, it is not far-fetched that COVID can cause back pain. Severe back pain with COVID should therefore be taken seriously and not dismissed as mere tension. To avoid the pain becoming chronic and to relieve the pain immediately, heat therapy with a heating belt is suitable. This improves blood circulation to the back muscle and relieves tension. Additional vibration massages promote relaxation and regeneration of the muscles and increase well-being by reducing stress. 

COVID and back pain – Omicron symptom as a warning sign?

With the Omicron variant the occurrence of back pain has become much more frequent. Back pain with COVID caused by the Omicron variant is now one of the 20 most frequently mentioned symptoms and is reported by about 20 percent of all those infected with the variant. People who suffer from this newly frequent symptom are often unsettled and afraid that severe back pain from COVID is the harbinger of a particularly severe course. However, the symptoms affecting the back often occur in the early stages of the disease. General muscle pain, which is common for infections and is referred to as myalgia in medical terminology, is mentioned by 36 percent of respondents and is often one of the first symptoms to appear. So far, there is no evidence that back pain from a COVID infection is related to a severe course of the disease.

Omicron back pain – Does the Omicron variant attack the musculoskeletal system?

The back pain from COVID could be because the Omicron variant is particularly widespread and thus certain symptoms occur with a greater frequency and are therefore mentioned more often. 
Another possibility, however, is that frequent omicron back pain is related to a change in the virus itself. The mutation's increased affinity for the ACE2 receptors, which are also present in skeletal muscle cells, could be a reason for this.

In any case, it has been known since the beginning of the pandemic that COVID-19 often causes a dysregulated immune response, which makes those affected more susceptible to pain. At this point, it becomes clear once again that COVID-19 differs from most respiratory infections in that it affects the whole body and can cause a variety of symptoms, some of them severe.

Long COVID Symptom – Back pain as an inflammatory reaction

Omicron back pain is also a secondary phenomenon, occurring in only about 20 percent of symptomatically infected persons and is not yet one of the leading symptoms, compared to cough and fever, for example, which more than 50 percent of people infected report as a symptom. In contrast, persistent back and muscle pain is the second most common symptom of Long COVID. Increased back pain after a COVID infection may indicate an ongoing inflammatory response within the body. It is thought that COVID-19 may cause pre-existing chronic inflammation to be exacerbated. This is also likely related to the dysregulated immune response that is often caused by the disease. The cytokines released in this process can stimulate the formation of a molecule called E2, which acts on the nerves and transmits pain signals to the brain. These cytokines are not only released during the acute phase of infection, but in the case of Long COVID and beyond. According to a study published in the International Journal of Infectious Diseases, 24.4% of those who had survived a COVID infection reported back pain in the lower back after a COVID infection. Of these, 93.5% reported that the back pain occurred after COVID and was therefore a new complaint. Back pain in the lower back after COVID is therefore a particularly common persistent symptom.

This back pain after COVID is apparently a long-term symptom:

According to the survey, 74.6% of those affected still reported suffering from at least one rheumatic or musculoskeletal symptom three months after the disease, and after six months, the figure was still 43.2% of respondents. 

What causes back pain after COVID vaccine?

Back pain after COVID vaccine is reported by about 10 percent of respondents as a vaccination reaction. For the Johnson & Johnson vaccine, back pain after COVID vaccine is listed as a reaction and side effect. Suffering from back pain after a COVID vaccine is therefore possible, but not a particularly common symptom. The reason for back pain after the COVID vaccine are the immune reactions described above, which also occur with a "natural" infection, but are provoked in a targeted but weakened manner with the vaccine.

What other connection is there between COVID and back pain?

Quarantine measures and increased stays at home, which are accompanied by reduced mobility, can also cause back pain. In addition, home office workplaces are often not designed ergonomically, so working conditions often fail to maintain back health. Whether at home in the home office, in the office or on the road, heat therapy with a heating belt with integrated vibration massage can provide relief and support the healing process and help relieve stress.

How can COVID back pain be prevented from becoming chronic?

Studies predict an imminent wave of back pain following the COVID pandemic, as well as an increase in other diseases of the skeletal system. These are caused by the consequences of Long COVID, but also pandemic-related changes in our working and living environment, which have often led to less physical activity. Accordingly, a preventive and physiotherapeutic approach is necessary here because pain medication can only suppress the symptoms for a time but is not suitable for eliminating the cause of the pain.

Effective measures that can prevent chronic back pain are: 

Connection between COVID and back pain, in brief