Shoulder pain has emerged as a topic of concern for many individuals during and after COVID-19 infection. As the understanding of this virus evolves, so does the recognition of its wide-ranging effects on the human body. This article aims to clarify the connection between COVID-19 and shoulder pain, exploring how the virus might directly influence muscle and nerve tissues, as well as other factors that can contribute to such discomfort.
Shoulder Pain as a COVID-19 Symptom
Shoulder pain is recognized as a symptom of COVID-19, often falling under the broader category of myalgia, which refers to muscle aches and pains. Myalgia is a commonly reported symptom in COVID-19 cases. Prevalence rates vary, with some studies reporting muscle pain in approximately 15-17% of individuals with COVID-19.
Myalgia can manifest in various areas, including the shoulders and legs, and can range from mild to debilitating. It often appears alongside other common COVID-19 symptoms like fever, cough, and fatigue. While the pain typically resolves after recovery from the acute illness, for some, it can persist for an average of two to three days or even longer.
Underlying Reasons for COVID-Related Shoulder Pain
The direct impact of COVID-19 on the body can lead to shoulder pain through several physiological mechanisms, including systemic inflammation and potential neurological involvement. The SARS-CoV-2 virus triggers an immune response that can result in widespread inflammation throughout the body. This systemic inflammatory response, sometimes referred to as a “cytokine storm” in severe cases, involves the release of inflammatory molecules from immune cells. These molecules can cause muscle aches and pain, including in the shoulder area.
The virus may also directly affect muscle tissue. Both cardiac and skeletal muscle tissues express ACE2, a receptor that SARS-CoV-2 uses to enter cells, suggesting these tissues are susceptible to direct viral infection. Autopsies have revealed evidence of muscle damage and inflammation. While the exact biological mechanisms are still being fully understood, some studies indicate a decrease in muscle mass shortly after infection.
Another factor is neurological involvement, which can contribute to shoulder pain. COVID-19 has been linked to peripheral neuropathies. These can manifest as nerve pain, tingling, or numbness, affecting the shoulder region. The causes of such nerve irritation or damage are not fully understood but may stem from inflammation and immune system dysregulation triggered by the infection.
Other Causes of Shoulder Pain During or After COVID
Beyond the direct effects of the virus, other factors can contribute to shoulder pain experienced during or after a COVID-19 infection. Post-vaccination soreness is a common and temporary cause of arm and shoulder pain, typically localized to the injection site. This soreness is a normal immune response to the vaccine and generally resolves within a few days.
Prolonged immobility or bed rest during severe illness can also lead to musculoskeletal pain, including in the shoulders. Extended inactivity can cause muscles to weaken and stiffen, resulting in discomfort. This is a general consequence of inactivity and not specific to COVID-19 itself.
Increased stress and anxiety associated with illness can cause muscle tension, particularly in the neck and shoulders. The psychological burden of illness can manifest physically as heightened muscle tightness and pain. This type of tension-related pain is a common bodily response to psychological distress.
Shoulder pain can also be a component of “Long COVID,” where symptoms persist for weeks, months, or even years after the initial infection. Muscle and joint pain are frequently reported in individuals with Long COVID. This chronic pain can be widespread or localized and is believed to be linked to ongoing inflammation and immune system dysregulation.
Managing and When to Seek Help for Shoulder Pain
Managing shoulder pain associated with COVID-19 often involves strategies similar to those for other types of musculoskeletal discomfort. Rest is frequently recommended to allow the affected muscles and tissues to recover. Over-the-counter pain relievers, such as NSAIDs like ibuprofen or acetaminophen, can help reduce pain and inflammation. Applying ice packs, followed by heat therapy, may also provide relief. Gentle stretching and movement, as tolerated, can help prevent stiffness and promote circulation.
It is important to seek medical attention if shoulder pain is severe, worsens progressively, or does not improve with home management strategies. Consult a healthcare provider promptly if you experience:
- Pain accompanied by significant weakness or numbness in the arm or hand, which could indicate nerve involvement.
- Persistent pain that interferes with daily activities.
- New or worsening fever.
- Difficulty breathing alongside shoulder pain.
These signs could suggest more serious underlying issues that require professional diagnosis and treatment.