Body aches, medically termed myalgia, are a common and often uncomfortable symptom associated with many viral infections. Generalized muscle pain can make it difficult to distinguish between a simple cold, the flu, or COVID-19. Understanding the specific role of body aches in a COVID-19 infection is important for recognizing and managing the disease. This article clarifies the connection between myalgia and COVID-19, exploring why these aches occur and how they compare to other common respiratory illnesses.
Body Aches as a Confirmed COVID-19 Symptom
Body aches are a recognized manifestation of COVID-19 infection, often presenting early in the disease course. Myalgia is one of the most frequently reported musculoskeletal symptoms, affecting up to 53% of patients during or after infection. The pain is generally described as a dull, aching sensation in the muscles that can limit mobility and energy.
These aches frequently involve larger muscle groups such as the back, shoulders, and legs. Some people report constant aching discomfort in the lower back or heavy, throbbing sensations in the legs, which can interfere with sleep and movement. Body aches and fatigue may even be the first symptoms to appear, preceding respiratory signs like cough or shortness of breath.
The severity of the myalgia can vary widely, ranging from mild soreness to extreme muscle pain. Most people experience the worst aches during the initial acute phase, typically lasting five to seven days. However, muscle and joint pain can persist for weeks or months after the initial infection has cleared. This lingering discomfort is a recognized component of post-COVID conditions.
The Immune Mechanism Behind Muscle Pain
The muscle pain experienced during a viral infection is generally a byproduct of the body’s immune response, not direct viral damage. When the SARS-CoV-2 virus enters the body, the immune system launches an inflammatory response involving the release of signaling proteins called cytokines.
These cytokines, such as interleukin-6 (IL-6), coordinate immune cells but also trigger systemic inflammation. This widespread inflammation irritates muscle fibers, joints, and tissues throughout the body. This irritation is the primary source of the stiffness, soreness, and generalized heavy feeling associated with myalgia.
The virus may also contribute to the pain through other mechanisms. SARS-CoV-2 utilizes the Angiotensin-Converting Enzyme 2 (ACE2) receptor to enter cells. Since ACE2 receptors are present in muscle tissue, the virus has the potential to cause some direct muscle injury.
Comparing COVID-19 Aches to Other Viral Illnesses
Body aches are common to many infections, making it challenging to differentiate COVID-19 from the flu or the common cold based on myalgia alone. The flu typically causes body aches that are often severe and appear suddenly along with fever and chills. In contrast, myalgia is less common and usually milder with the common cold, which is characterized by sneezing and a stuffy nose.
With COVID-19, body aches are frequent, similar to the flu, but the overall presentation differs. The onset of COVID-19 symptoms, including myalgia, is often more gradual, appearing a few days after exposure, while flu symptoms appear abruptly. The specific symptom of new loss of taste or smell is strongly associated with COVID-19, offering a distinguishing factor.
The severity of COVID-19 aches can sometimes be more intense than a seasonal cold due to the SARS-CoV-2 virus’s interaction with the immune system. However, symptoms overlap significantly. The presence or absence of body aches alone is insufficient to definitively diagnose any specific viral illness; professional testing remains the only reliable way to confirm a diagnosis.
Managing Myalgia and When to Seek Care
Body aches associated with COVID-19 can be managed effectively at home. Staying well-hydrated by drinking plenty of water and electrolyte solutions is important, as is getting adequate rest to support the immune system. Over-the-counter pain relievers such as acetaminophen or ibuprofen can help alleviate muscle discomfort, but consult a medical professional about the appropriate choice and dosage.
Applying heat, like taking a warm bath or using a heating pad, can temporarily relieve muscle stiffness and soreness. Gentle movement, such as light stretching or short walks, can also prevent muscles from becoming overly stiff. Strenuous activity should be avoided while ill. If the pain persists for more than a week, worsens significantly, or is accompanied by other concerning issues, seek medical advice.
Specific “red flags” signal the need for immediate medical attention, as they may indicate a more serious progression of the illness. These urgent symptoms include severe shortness of breath or difficulty breathing, persistent pain or pressure in the chest, new confusion, or an inability to wake or stay awake. The combination of myalgia with these severe signs warrants prompt evaluation.