March 15, 2021
Clinical Contributors to this Story
Sagar Parikh, M.D. contributes to topics such as Pain Management.
Talya Fleming, M.D. contributes to topics such as Physical Medicine and Rehabilitation.
Back pain is one of the most common conditions treated by rehabilitation specialists. But since the start of the COVID-19 pandemic, rehabilitation specialists say they have seen an increase in patients with back pain.
“We’re seeing a few different types of back pain,” says Talya Fleming, M.D., Medical Director of the Stroke Recovery Program & Aftercare Program at Hackensack Meridian JFK Johnson Rehabilitation Institute. “We’re seeing patients with old back pain that is now worse from sitting more, new back pain related to habits that have changed due to the pandemic and new back pain related to COVID-19 itself.”
Back Pain and COVID-19
Although physicians are still learning about the effects of COVID-19, back pain alone isn’t usually a symptom of COVID-19. However, if you have general muscle aches, headache, fever, chills, cough or shortness of breath along with back pain, it is possible that you could be dealing with a COVID-19 infection.
“People who have COVID-19 may experience muscle pain and body aches due to the body’s inflammatory response, which can be felt in the upper and lower back,” says Sagar Parikh, M.D., an interventional pain medicine specialist and Director of the Center for Sports and Spine Medicine at JFK Johnson. “Some people may even experience muscle soreness, aches, and pain after the COVID vaccine, which is normal and means that their immune system is doing its work.”
“Back pain related to COVID-19 itself often feels different than overexertion,” comments Dr. Fleming. “Pain from overexertion usually lasts a few days, but the pain from COVID-19 may last days or weeks.”
People who get COVID-19 may also spend a lot of time recovering in bed, which may lead to back pain due to deconditioned muscles and altered spinal biomechanics.
Back Pain Due to Pandemic-Related Changes
The conditions that cause back pain — including disc herniations, spinal arthritis and lumbar muscle strain — haven’t changed due to the pandemic. However, what has changed are people’s lifestyles and daily habits.
“One difference we have been noticing is an increase in the number of disc herniations,” shares Dr. Parikh. “Given that huge numbers of the population are working from home, we find that many of our patients develop muscular strain or disc herniations from using a laptop and sitting on a poorly supported couch, bed or dining chair for long hours — something that would not have happened before the pandemic.”
And Dr. Parikh said that even patients who have a make-shift home office often are not working under optimal ergonomic conditions, which can strain the lower back and neck.
Working from home has also resulted in changed routines that may contribute to lower levels of activity. People who used to walk with co-workers on their breaks or stop at the gym for a workout on the way home from the office may no longer be participating in these activities, and the lack of movement may lead to weakened, tight muscles that contribute to back pain.
Preventing and Treating Pandemic-Related Back Pain
Patients who develop back pain due to COVID-19 may find some relief by using over-the-counter pain medications or warm compresses as the infection runs its course. However, Dr. Fleming and Dr. Parikh said there are a few things that people can do to prevent and treat other types of pandemic-related back pain.
Dr. Fleming said she uses the acronym “B-A-C-K” to help her patients remember what they need to do to prevent and treat back pain:
Make movement a part of your day, whether you walk, bike, hike, stretch or dance.
Set an alarm and make movement a routine. Dr. Parikh suggests doing some type of activity every half-hour, such as stretching or walking around, even while working.
Research shows that anxiety and lack of sleep — which some people are experiencing during COVID-19 — can contribute to clenched muscles and pain in the body. Take steps to reduce stress through meditation or other calming activities.
Keep the environment ergonomically friendly by using a supportive chair with a lumbar pillow, avoiding hunching, elevating your computer screen and making other adjustments to reduce stress on the body.
But most of all, Dr. Fleming and Dr. Parikh stressed that a health care provider should always evaluate persistent or severe back pain.
“Most mild-to-moderate back pain caused by muscle strain gets better on its own in 1-2 weeks,” says Dr. Parikh. “If pain persists, or if you have a known injury, sudden severe pain or pain or numbness down your legs, you need to get checked out right away.”
Dr. Fleming and Dr. Parikh said other “red flag” symptoms that should prompt an urgent health care visit include weakness, numbness, tingling, loss of bowel or bladder control and unintended weight loss.
“Many patients are hesitant to go to a [healthcare facility] due to COVID-19 and may delay care for back pain,” explains Dr. Parikh. “Health care facilities were some of the earliest adopters of COVID-19 precautions, including masking, physical distancing, and enhanced cleaning. Also, it’s best and easiest to treat back pain within the first three months of onset to prevent it from becoming chronic.”
“People don’t have to choose between safety and receiving care for back pain; they can have both,” says Dr. Fleming.
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