Whilst we have not instigated any personal injury claims regarding individuals becoming infected with COVID-19 as a result of negligence or breach of statutory duty, the effects of the virus in both causing and exacerbating chronic pain is becoming more and more evident.
It’s become clear that the majority of people who develop symptoms of COVID-19 recover over the course of a few days to a few weeks. But a significant number do not. Those with persistent symptoms have been labelled as suffering from ‘long COVID’ and there seems to be no correlation between the seriousness of the original illness and the chance of experiencing longer-term problems.
On 1 April 2021, the Office for National Statistics (ONS) published the results of a study on the prevalence of symptoms at 12 weeks:
“Among a sample of over 20,000 study participants who tested positive for COVID-19 between 26 April 2020 and 6 March 2021, 13.7% continued to experience symptoms for at least 12 weeks.”
“Of study participants who tested positive for COVID-19, symptom prevalence at 12 weeks post-infection was higher for female participants (14.7%) than male participants (12.7%) and was highest among those aged 25 to 34 years (18.2%).”
There is currently no firm evidence on whether these figures differ between variants of COVID-19.
What are the symptoms of long COVID?
The NHS list the following common symptoms of long COVID, but it’s clear we are very far from a full understanding of the long-term effects of the condition:
- extreme tiredness (fatigue);
- shortness of breath;
- chest pain or tightness;
- problems with memory and concentration (“brain fog”);
- difficulty sleeping (insomnia);
- heart palpitations;
- pins and needles;
- joint pain;
- depression and anxiety;
- tinnitus, earaches;
- feeling sick, diarrhoea, stomach aches, loss of appetite;
- a high temperature, cough, headaches, sore throat, changes to sense of smell or taste;
Chronic pain and COVID-19
Multiple studies are now investigating COVID-19 as both a trigger for chronic pain and as an aggravating factor for those already suffering chronic pain. Indeed, as early in the pandemic as May 2020, the British Journal of Anaesthesia published an article, ‘Chronic pain after COVID-19: implications for rehabilitation’, in which the authors considered the role of COVID-19 as both a direct and indirect cause of pain, highlighting that “a consistent risk factor for chronic pain development is the occurrence of acute pain”. They reported that pain is often an early symptom of COVID-19 in the form of “myalgia, arthralgia, abdominal pain, headache, and chest pain”, among others. More indirectly, it can form part of what is referred to as post-intensive care syndrome (PICS) following ICU discharge for those with the most serious illness.
A team of researchers in France has suggested that some COVID patients develop neuropathic pain within weeks or months of infection and that patients with neuropathic pain who then develop COVID-19 sometimes present with a deterioration of their neurological symptoms and/or pain exacerbation.
More recently, talking to The Guardian, Professor Lars Arendt-Nielsen, director of the translational pain research centre at Aalborg University in Denmark, said “Musculoskeletal pain is an issue that we must start considering as a Long COVID problem.” Muscle and joint pain are commonly reported symptoms in long COVID patients. Although research remains at an early stage, a plausible theory being explored is that long COVID musculoskeletal pain is the result of a COVID-triggered overreaction in the body’s immune system, resulting in various forms of inflammatory arthritis and other auto-immune conditions.
Lockdown and chronic pain
It’s also clear that lockdown has had, and continues to have, a seriously detrimental effect on many chronic pain sufferers. The cancellation or delay of medical and therapy appointments, and the loss of face-to-face contact with clinicians, has severely disrupted long term pain management strategies.
Also, the psychological consequences of lockdown cannot be underestimated. Yet, there may be one positive to emerge from all of this. Many of our clients have commented that the effect of isolation and loneliness on mental health and wellbeing is now more widely understood and openly discussed. Previously, they felt it was often overlooked by society at large.