COVID-19 presents a wide array of symptoms, with many people reporting muscle pain and spasms in addition to common respiratory issues. Understanding these less typical manifestations is important for those navigating an infection or its lingering effects. This article explores the connection between COVID-19 and muscle spasms, examining why they occur and how they might be managed.
The Link Between COVID and Muscle Spasms
Muscle pain, medically termed myalgia, is a recognized symptom of COVID-19, appearing in both the acute phase of the illness and as part of long COVID. Studies indicate that muscle pain is a relatively common symptom; for instance, one review found it reported in 14.8% to 17% of individuals with COVID-19, and in one study of hospitalized patients, 68% experienced muscle pain. This achiness can manifest as anything from mild discomfort to severe, involuntary contractions that can be debilitating, affecting areas like the legs, neck, shoulders, and lower back.
Muscle and joint pain often appear early in the course of the infection, sometimes even before common respiratory symptoms like cough or a runny nose. While the pain often resolves within a few days or weeks for many, it can persist for months in some individuals, particularly those experiencing long COVID. Upwards of 10% of those with long COVID report ongoing muscle and joint aches. The presence of muscle pain in long COVID has also been linked to a longer time for the body to clear the SARS-CoV-2 viral RNA during the acute infection.
Understanding Why Muscle Spasms Occur with COVID
The muscle spasms and pain associated with COVID-19 are thought to stem from several physiological responses to the viral infection. One primary mechanism involves the body’s generalized inflammatory response. When the immune system detects the SARS-CoV-2 virus, it releases signaling proteins called cytokines, which can trigger widespread inflammation throughout the body, including in muscle tissues. This inflammatory process can lead to muscle and joint aches, with specific cytokines like interleukin-6 (IL-6), interleukin-1 (IL-1), and tumor necrosis factor-alpha (TNF-α) implicated in this reaction.
In some cases, the immune response can become overactive, leading to a “cytokine storm,” where an excessive release of pro-inflammatory cytokines causes widespread inflammation and potential organ damage, including muscles. While less common, the virus may also directly affect muscle tissue, a condition known as myositis, though direct viral invasion of muscle cells is still being investigated. Myositis can manifest with muscle weakness and tenderness, and in severe instances, can lead to rhabdomyolysis, a condition involving muscle breakdown.
Electrolyte imbalances can also contribute to muscle spasms. The COVID-19 infection can affect kidney and gastrointestinal tract function, leading to disturbances in essential minerals like potassium, sodium, and calcium. For example, low potassium (hypokalemia) or low calcium (hypocalcemia) can cause muscle weakness, cramps, and other neuromuscular irritability. Additionally, the physical stress of illness, reduced movement during recovery, or even a lack of oxygen getting to the muscles (ischemic myalgia) can play a role in the development or persistence of muscle pain and spasms.
Addressing COVID-Related Muscle Spasms
For individuals experiencing muscle spasms during or after a COVID-19 infection, several home-based strategies can help manage the discomfort. Staying well-hydrated by drinking plenty of fluids, especially those containing electrolytes, supports muscle function and overall recovery. Adequate rest allows the body to conserve energy and focus on fighting the infection and repairing tissues.
Over-the-counter pain relievers such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate muscle aches and reduce inflammation. Applying heat or cold packs to affected areas can also provide relief; heat helps relax tight muscles and improve blood flow, while cold can numb pain and reduce inflammation. Gentle stretching and massage can also help to ease muscle soreness and promote relaxation and mobility.
If muscle pain or spasms persist for several weeks after the initial infection, worsen, or significantly impact daily activities, consult a healthcare professional. They can assess the situation, rule out other causes, and recommend further steps, which might include physical therapy to strengthen and stretch muscles, or other targeted treatments.