COVID-19 is an illness primarily known for its respiratory symptoms, but the infection caused by the SARS-CoV-2 virus affects multiple systems in the body. Patients have reported a broad spectrum of complaints, prompting questions about whether less common physical aches, such as lower back pain, can be a symptom of the viral illness itself.
Lower Back Pain as a Recognized COVID Symptom
Lower back pain is a documented occurrence in a subset of people infected with SARS-CoV-2, although it is not listed among the most common symptoms like fever or cough. This pain is often categorized under generalized myalgia, the technical term for muscle aches and body pains, which is a frequent symptom of many viral infections. Studies show that a significant percentage of COVID-19 patients report some form of body pain, with lower back pain specifically cited by many. For example, during the circulation of variants like Omicron, lower back pain was noted to be a more frequent complaint, sometimes described as intense muscle spasms.
Systemic Inflammation and Musculoskeletal Pain
The underlying reason for COVID-19-related back pain is the body’s powerful immune response to the viral invasion. When the SARS-CoV-2 virus enters the body, the immune system releases numerous pro-inflammatory molecules called cytokines to fight the infection. This widespread inflammatory reaction causes general malaise and muscle pain throughout the body, often concentrating in the lower back. The pain is typically generalized, reflecting the systemic nature of the illness, rather than being localized due to injury. Additionally, prolonged periods of rest or immobility due to fever and fatigue can cause muscles to stiffen and lead to back discomfort.
Differentiating Between Viral and Common Back Pain Causes
Distinguishing COVID-related back pain from common causes, such as muscle strain or poor posture, relies on recognizing accompanying symptoms and the nature of the pain. Mechanical back pain usually results from a specific physical event and is typically localized, worsening with movement and improving with rest. In contrast, back pain caused by a systemic viral infection is often accompanied by other symptoms, including fever, persistent fatigue, headache, or loss of taste or smell. The pain itself tends to be a diffuse, deep ache or cramping sensation, reflecting widespread muscle involvement. Virally-induced back pain, unlike mechanical pain, may not significantly improve with rest and can even be worse in the morning.
When Back Pain Signals a Need for Testing or Medical Care
While most back pain resolves on its own, certain accompanying signs warrant immediate medical attention, regardless of potential COVID-19 status. These “red flag” symptoms suggest a serious underlying condition, such as a spinal infection or neurological compromise. Red flags include new or sudden loss of bladder or bowel control, severe pain accompanied by a high fever, or weakness and numbness in the legs. Pain that wakes you up from sleep or severe pain that does not improve when lying down also prompts an urgent medical consultation. If the back pain is persistent or severe and is accompanied by systemic symptoms like fever or cough, getting tested for COVID-19 is advisable.