COVID-19, caused by the SARS-CoV-2 virus, primarily affects the respiratory system, but its impact extends far beyond the lungs, manifesting in diverse symptoms throughout the body. Individuals infected can experience symptoms varying from mild to severe, including fever, cough, and widespread body aches. This broad clinical presentation means the virus can influence various bodily systems, sometimes leading to less commonly discussed issues such as hip pain.
Exploring the Connection
A recognized association exists between COVID-19 infection and the onset of joint pain, specifically including the hip. Musculoskeletal complaints, such as joint pain (arthralgia) and muscle aches (myalgia), have been observed in a notable percentage of individuals with COVID-19. Studies indicate that approximately 15% of patients report experiencing joint pain during the acute phase of the illness.
General observations and emerging research consistently point to this link, underscoring that hip discomfort can be a direct or indirect consequence of the infection. Specific case reports have detailed instances of acute, severe hip pain developing shortly after an individual tests positive for COVID-19. This suggests the relationship is more than coincidental, prompting further investigation.
Understanding the Mechanisms
The development of hip pain in the context of COVID-19 is attributed to several biological pathways. One significant factor is the body’s systemic inflammatory response to the virus. COVID-19 can trigger the release of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), which can affect various tissues, including bones and joints. This widespread inflammation can lead to increased permeability of blood vessels, resulting in fluid accumulation and pressure within the bone, thereby reducing blood flow.
Beyond systemic inflammation, the virus can directly contribute to joint issues. Viral infections are known to cause arthralgia (joint pain) and even arthritis, where the immune system overreacts and attacks healthy joint tissues, a condition known as reactive arthritis. This reactive arthritis can manifest as acute hip arthritis, with some cases reported to occur within weeks of the initial COVID-19 infection. Muscle or body aches are also common symptoms of COVID-19, and these myalgias can contribute to discomfort that may radiate to the hip region.
A more severe, albeit less common, mechanism involves vascular issues that can lead to avascular necrosis (AVN), also known as osteonecrosis. COVID-19 can induce a state of hypercoagulability, meaning an increased tendency for blood clot formation. These clots can obstruct blood flow to the bones, particularly the femoral head in the hip joint, causing bone tissue to die. There has been a rise in COVID-19-induced AVN cases, affecting individuals in younger age groups (20-40 years old) with symptoms sometimes developing within three months of infection.
Additionally, treatments for severe COVID-19 can play a role. Corticosteroids, frequently administered to manage the inflammatory response in severe cases, are a known risk factor for AVN. These medications can impair blood flow to bones by affecting fat cell metabolism, potentially leading to vessel blockage. The uncontrolled use of steroids during the pandemic has been associated with a surge in AVN cases. Furthermore, general physical stress on the body and reduced mobility during severe illness or recovery can also contribute to musculoskeletal pain and stiffness in the hip.
Hip Pain and Long COVID
Hip pain can also be a persistent or chronic symptom, falling under “Long COVID” or Post-Acute Sequelae of SARS-CoV-2 infection (PASC). These symptoms linger for weeks or months after acute infection. Musculoskeletal disorders, including joint pain, are common and enduring issues in Long COVID patients.
Persistent joint pain (arthralgia) in Long COVID patients varies from 2% to 65% within four to twelve months post-infection. This discomfort stems from continued inflammation and elevated antibody levels after viral clearance. Unlike the acute phase, Long COVID pain reflects ongoing dysregulation within the body’s systems. This persistent hip pain often occurs alongside other Long COVID symptoms like fatigue, cognitive difficulties, and muscle aches.
Seeking Medical Guidance
Individuals with hip pain, especially after a COVID-19 infection, should consult a healthcare professional for evaluation. Medical attention is important for accurate diagnosis and an appropriate management plan. This is true if pain is severe, impacts daily activities, or persists for over two weeks.
Seek immediate medical attention if hip pain is accompanied by severe symptoms like inability to bear weight, a deformed joint, sudden swelling, or fever and chills. A professional can assess the cause, ruling out other conditions. Early diagnosis and intervention, especially for avascular necrosis, can help manage the condition and prevent further hip joint damage.