Can Covid-19 Cause or Make My Knee and hip pain worse?
Every week I am asked by patients if their long-term knee and hip pain can be caused by the COVID-19 virus. In the past it has been thought that this type of virus has never had those capabilities; but because of recent research I would have to change that answer to “Mabey”.
Arthritis is joint pain with tissue destruction. The symptoms of Arthralgia (Joint) and Myalgia (Muscle) describe temporary “aches” without destruction. Viruses are categorized according to their shape and COVID-19 is a member of a group called Corona Virus. Historically the symptoms of all corona viruses have been pain, but not arthritis. Importantly, it is known that COVID-19 symptoms cause inflammation of alveolar lung tissue; and similarly, rheumatoid arthritis (RA) symptoms come from inflammation of the knee’s synovial lining.
Septic arthritis typically comes from infections with two different types of bacteria. Several viruses such as hepatitis C, as well as other “Alpha viruses” (Chikungunya, Ross River, Barmah Forest, O’nyong-nyong and Mayaro viruses) can cause arthritis. Also, parvovirus, rubella and hepatitis B may can cause a “self-limited” arthritis where the symptoms resolve with time.
A recent study done in Korea and authored in Arthritis Research Therapies (Aug 2019) compared the numbers of new cases of rheumatoid arthritis in patients that had previously tested positive for COVID-19 to the new cases of rheumatoid arthritis in patients that had not been previously diagnosed with COVID 19. Out of several thousand patients reviewed, the authors found a small but significant correlation with new RA in the post COVID-19 group number as compared to those that that had not been recently diagnosed with the virus in the past.
What does this study mean?
This study was the first to show in a very small patient group an association between these two diseases. However, before any conclusions are made it should be repeated and the mechanism for the disease established.
What can you do for your joint pain while quarantined?
The first treatment principle for arthritis is to manage the inflammation. This is usually done with Aspirin or NSAID’S like Aleve or Motrin. Other prescription drugs that are more powerful and have higher risk profiles are used when ones with lesser risks become ineffective. In certain situations, steroids such as prednisone may be taken orally or through joint injections to minimize and manage the inflammation.
Activity modification like avoiding low chairs, and the use of an ambulatory aid’s like a cane, crutch, or walker are effective. If correctly used, a cane can remove around 50% of the pressure on the painful Joint. The next treatment principle is exercise. Long-term benefits have been shown with activities as simple as walking the stairs in your house. And if you cannot stand long enough to exercise, seated activities may give lasting aid to muscle mass, and bone health.
Then, when you can safely see you doctor, they can help sort through these symptoms and together you can create a care plan for your future health and wellbeing.