Back pain is a common concern for people experiencing illness with COVID-19. While the virus is primarily known for its respiratory effects, it belongs to a category of infections that frequently cause systemic symptoms, including generalized body aches and pain. These full-body symptoms, medically termed myalgia, are a common response to many viral illnesses, and COVID-19 is no exception. Reports from infected individuals confirm that back pain, particularly in the lower back, has been documented as a symptom of the disease.
Back Pain as a Recognized Symptom
Back pain is a documented symptom of COVID-19, often categorized under the broader umbrella of muscle aches and body pain experienced during infection. This symptom can manifest in the early stages of the disease, sometimes even preceding the more characteristic respiratory signs like cough or fever. Among those who report pain, back pain is one of the most frequently mentioned locations. For instance, back pain was reported by roughly one in five people infected with the Omicron variant. This symptom is not isolated to the acute phase; it can also persist for weeks or months, becoming a feature of long COVID.
Understanding the Biological Causes
The primary physiological reason for COVID-related back pain is the body’s generalized immune response to the SARS-CoV-2 virus. When the immune system detects the virus, it releases pro-inflammatory molecules known as cytokines into the bloodstream. This systemic inflammatory state causes widespread muscle and joint pain, which can easily localize in the back. The virus itself can potentially affect muscle tissue, though the overarching inflammatory response is considered the main driver of the pain. This generalized pain is distinct from pain caused by a structural injury or overuse.
Beyond the systemic immune response, back pain can also arise from secondary effects of the illness. Severe, persistent coughing associated with the infection can strain the muscles and joints of the upper back and rib cage. Furthermore, extended periods of immobility and bed rest during the recovery phase can cause muscle weakness and cramping, leading to back discomfort.
Distinguishing COVID-Related Back Pain
Differentiating COVID-related back pain from common mechanical back pain relies on recognizing the specific characteristics of each. Viral back pain is often described as a deep, non-localized ache that affects both sides of the body, consistent with a systemic condition. This type of pain is generally not relieved by changing positions and is typically accompanied by other signs of infection, such as fever, fatigue, or headache.
In contrast, mechanical back pain, which results from issues with the spine or surrounding soft tissues, is usually localized to a specific spot. This pain is often sharp or stabbing, can be unilateral, and is frequently triggered by specific movements or activities like bending or lifting. Mechanical pain often finds some relief through rest or a specific change in body position. Understanding the context of the pain provides a useful initial clue.
When to Consult a Healthcare Provider
For typical COVID-related aches, management usually involves resting, maintaining hydration, and using over-the-counter pain relievers like acetaminophen or ibuprofen, following medical guidance. However, certain symptoms accompanying back pain, regardless of a potential COVID diagnosis, require immediate medical attention. These are known as “red flags” that can signal a more serious underlying issue.
Immediate consultation is necessary if the back pain is accompanied by a sudden loss of bowel or bladder control. Other urgent signs include new or progressive weakness, numbness, or tingling in the legs or arms, especially if difficulty walking is present. Severe, unrelenting pain that is not relieved by rest or worsens significantly at night should also be evaluated promptly. If back pain occurs alongside a high fever, chills, or unexplained weight loss, this may suggest an infection or other serious condition that requires a thorough medical assessment.