COVID-19 is a respiratory infection caused by a virus in the coronavirus family. It typically causes symptoms such as fatigue, fever, and cough. But there are many more symptoms of the virus, ranging from mild to severe. For some people, this can include back pain.

Back pain due to COVID-19 can appear (and disappear) in the early stages of the infection. It can also be a long-term symptom that persists long after the infection is gone.

What causes someone to develop back pain during COVID-19? 

This guide from HealthTap explains why COVID-19 may cause back pain and how to manage it. 

Is back pain a symptom of COVID-19?

Pain is one of the more common symptoms of a COVID-19 infection. According to a 2020 review, pain may appear early in the infection — even in the absence of other symptoms. Pain can show up as headaches, general muscle aches, and joint pain. 

According to the same review, as many as 40 percent of people infected with COVID-19 may develop general muscle aches.

One 2020 study found that back pain was one of the most common COVID-19 symptoms, seen in about 10 percent of the cases analyzed in the study. 

Back pain is not only a possible symptom of COVID-19 but a common one. 

Why does COVID-19 cause back pain?

The body’s immune response to COVID-19 and other viral infections likely causes back pain. 

COVID-19 can stimulate the body to release inflammatory molecules called cytokines. These molecules can trigger the formation of a chemical called prostaglandin E2, which affects the nerves and sends pain signals to the brain. 

It is also possible that a COVID-19 infection may lead to tissue damage in the muscles. The virus that causes the disease can pretend to be an enzyme called angiotensin, speeding up certain chemical reactions in the body3, possibly leading to muscle pain.  

How can you tell if COVID-19 is causing back pain?

Just because someone has back pain doesn’t necessarily mean they are or were infected with COVID-19. Back pain has many causes, including muscle strains, postural issues, and problems with structures of the back.

Many describe back pain caused by COVID-19 as a dull pain located deeper in the back — as opposed to a sharp pain like muscle pulls. This pain may be constant and less likely to be relieved by changing positions. 

A positive COVID-19 test is important to confirm an infection. PCR tests are the most accurate tests available. In order to know if COVID-19 is causing back pain, a healthcare provider must rule out other potential causes of back pain. 

Is back pain a symptom of long COVID-19?

Long COVID-19 refers to a condition where people develop symptoms that last weeks or months after the infection. Long COVID-19 can affect as many as 50 percent of those infected, with symptoms lasting (on average) 30 days. 

The most common long COVID symptoms include loss of taste and smell, shortness of breath, physical fatigue, and brain fog. Anxiety and depression are also seen in many “long haulers” of the virus. 

About 25 percent of long haulers had persistent pain, which includes back pain. If a healthcare provider rules out all other causes of back pain, long-term inflammation from the virus may be causing back pain. 

Can the pandemic cause back pain?

Since the beginning of the pandemic, much has changed, which could explain why some are experiencing back pain. 

Some pandemic-related causes of back pain include:

• Lack of physical activity

Due to stay-at-home orders, many people stopped hitting the gym, decreasing their physical activity. This may have led some people to develop weaker back muscles, which is a significant risk factor for back pain. Being less active may reduce circulation, which can increase inflammation in the body. 

• Poor posture

With many people working from home, screen time significantly increased during the pandemic. Sitting at a computer for long periods can promote poor posture, which may cause muscle tension and gradually lead to back pain. 

• Emotional stress

Stress was a common theme during the pandemic. Emotional stress can promote muscle tension, leading to back pain. 

• Unhealthy diet

Diets high in sugar may promote inflammation, exacerbating pre-existing back problems. 

One 2020 study found that rates of back pain increased by about 10 percent in adults after quarantine7. And those who experienced back pain before the pandemic had it worsen significantly. Those who fared worst also reported higher stress levels, long periods of being sedentary, and lack of physical activity. 

What are ways to get back pain relief? 

Whether it’s related to a COVID-19 infection or another cause, there are many options for managing back pain.

If rest, applying heat, and over-the-counter painkillers don’t help, these are some options to consider for back pain relief. 

1. Physical therapy

Targeted exercise is one of the first treatments someone should try to address back pain. It is not only incredibly effective but also free of significant side effects. 

In physical therapy, a healthcare provider will develop exercises for a patient’s particular condition.

Physical therapy for back pain may include:

• Stretching exercises.

• Strength-training exercises.

• Correcting posture. 

• Core development. 

• Application of heat or cold.

• Electrical stimulation.

2. Anti-inflammatory diet 

Diets high in refined carbs, trans fats, and other processed ingredients may worsen someone’s back pain. Eating more fresh produce, healthy protein and fat, and complex carbohydrates may help manage back pain. 

As an added benefit, a healthy diet may also promote weight loss, which can help to take pressure off the spine and promote back pain relief. 

3. Lifestyle changes 

Some lifestyle habits may be contributing to back pain. Hunching over a desk, maintaining poor posture, and being sedentary may worsen back pain. It’s important to identify these factors and change them.

Quitting smoking, not engaging in strenuous activities, and avoiding sudden movements may lessen pain. 

4. Mind-body practices

Stress is a common factor amongst those with back pain, especially related to COVID-19.​​ Mind-body practices offer a solution with many options. 

Those with back pain can use meditation, yoga, tai chi, and other mind-body practices for stress relief. 

5. Injection treatments 

Nerve-blocking injections can significantly reduce back pain. These are especially helpful when the underlying cause of the pain is unknown. This treatment usually lasts for only a few months and isn’t a long-term solution. 

6. Pharmacologic treatments 

People can use various medications to treat back pain. Over-the-counter (OTC) painkillers, such as ibuprofen, are generally used first because they do not require a doctor’s prescription. OTC painkillers also have fewer side effects than prescription painkillers.

Other types of medication for back pain include muscle relaxants, antidepressants, and opioids. Many of these medications can have side effects, so these are often the last resort.

Opioid medications especially require caution. They are associated with dependence, and they may only mask the symptoms. 

7. Alternative treatments 

Despite being called “alternative,” these treatments are often used as the first line of treatment. Treatments include massage, acupuncture, laser therapy, biofeedback therapy, and electrical nerve stimulation. These treatments are non-invasive and come with minimal side effects. 

When is surgery a good idea for back pain?

Surgery may be an option if conventional treatments don’t help relieve back pain. It can also be something to consider for those who experience prolonged disability due to back pain. 

In general, doctors may recommend surgery for those who experience the following symptoms related to back pain. 

• Balance problems. 

• Bowel or bladder issues (e.g., incontinence).

• Weakness in the arms or legs.

• Overactive reflexes. 

Surgery can also be an option for back pain if there is a known cause that imaging (e.g. MRI or X-ray) can confirm. Some of these causes may include disk problems and bone overgrowth. 

Disks cushion the spine, helping to support it. If the disk ruptures, it can lead to back pain. 

Bone overgrowth is associated with osteoarthritis. It can result in bone spurs, which can press on the nerves and lead to pain. 

Before agreeing to surgery, it’s important to consult with different surgeons. These specialists may have different opinions about which type of surgery to choose. Some spinal surgeons may not feel surgery is necessary and may recommend alternative treatments. 

Managing back pain with HealthTap 

There are various potential causes of back pain. 

Back pain is common for people who get infected with COVID-19. Often, pain develops early in the disease as part of the body’s immune system response. It is often accompanied by other symptoms, although back pain can be the only symptom of COVID-19. 

Back pain can also be a symptom that develops after the infection, which is known as long COVID. This symptom may last weeks or months. Back pain can also develop due to lifestyle changes, such as lack of exercise. 

If you are dealing with back pain, HealthTap can connect you with a primary care providertoday to create the right treatment plan. Schedule your virtual appointment today.