Joint Pain After COVID

Many people who have gotten COVID are still suffering from lingering symptoms – referred to as “long-COVID”. According to the CDC, “post-COVID conditions are found more often in people who had severe COVID-19 illness, but anyone who has been infected with the virus that causes COVID-19 can experience post-COVID conditions, even people who had mild illness or no symptoms from COVID-19”.
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Can COVID Cause Joint Pain?

Of these symptoms, joint pain is one that many people develop during COVID and are unfortunately still experiencing long after. In fact, according to data collected from 54 different studies, arthralgia (joint pain) and myalgia (muscle pain) were the most common of the musculoskeletal symptoms in COVID-19 patients.
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What Causes Joint Pain After COVID?

There is no clear cut answer as to why some people experience lingering joint pain, but it is thought to be mainly from a rise in inflammatory markers i.e. IL-6 and TNF-alpha and/or and upregulation of the immune response. One might assume that people with already elevated inflammatory markers or a problem with their immune system would be at higher risk for developing post-COVID joint pain, but as of the time of this writing, there simply isn’t enough research to definitively say.

Naturopathic Strategies For Joint Pain After COVID

Our Approach To Post-COVID Joint Pain

  • Cortisol normalization
  • Immune optimization
  • Maintenance of ideal body weight
  • Strengthen muscles and balance
  • Anti-inflammatory diet
  • Anti-inflammatory herbs and nutraceuticals
  • Exercise
  • Joint protection
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Our Approach To Post COVID Joint Pain

The Gut-joint Axis

Gut related antigens from pathogens, bacteria, and proteins in food can contribute to tissue inflammation and joint dysfunction. Bacteria in the gut can produce a toxin called lipopolysaccharide (LPS) that can produce inflammatory cytokines in the joints, which can exacerbate post-COVID joint pain and dysfunction. Additionally, the vast majority of the immune system resides in the gut. The immune system is thought to be dysfunctional in long-COVID symptoms such as joint pain. For these reasons, healing and optimizing gut function is of prime importance.

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Anti-inflammatory Diet

Inflammation is thought to play a major role in long-COVID symptoms such as joint pain through inflammatory cytokines i.e. interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha).
The diet is a major contributor to levels of inflammation in the body. Many foods contribute to higher inflammation such as meat, dairy products, and added sugars. Joints are particularly susceptible to inflammation and adhering to an anti-inflammatory diet is one of the best things you can do to improve post-COVID joint pain.

Adrenal Health

The adrenal glands are responsible for producing cortisol, our body’s stress hormone. In times of chronic stress, higher levels of cortisol circulate throughout the body which can dampen the effectiveness of our immune system while also thinning the gut lining (making leaky gut and inflammation more likely).

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Hormone Balancing

Estrogen has an anti-inflammatory effect on the body, so when levels decline, this can exacerbate post-COVID joint pain
Testosterone has been shown to promote ideal weight, disc, and tendon health while also decreasing levels of inflammation i.e. TNF-alpha, IL-1B, IL-6, and CRP.

IV Therapy

IV therapy is an excellent way to support the body and give it the nutrients it needs. The nutrients given intravenously are absorbed 100% while nutrients taken orally have significantly less absorption. IV therapy is especially helpful in those with leaky gut or other gastrointestinal absorption issues, which is extremely common. There are IV formulations specifically to support the immune system and decrease inflammation. For more about IV therapy (insert link to IV therapy here)

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PRP

Platelet rich plasma (PRP) is an excellent option for post-COVID joint pain. PRP is a simple and effective process, using your own body’s healing factors to stimulate the joint healing process. PRP is known to improve mobility, decrease pain, and decrease levels of inflammation in the joints.

Testing For Post COVID Joint Pain

While testing is not mandatory, we find that it can be extremely helpful in uncovering both the root causes and exacerbating factors to your post-COVID joint pain.

  • Inflammatory markers
    • i.e. hs-CRP, ESR, homocysteine, interleukins, inflammatory cytokines
    • Inflammation is thought to be a major player in post-COVID joint pain
  • Vitamin D
    • Optimal vitamin D levels are critical to immune function. Dysregulated immune function is thought to be another prime factor in post-COVID joint pain.
  • Comprehensive stool test analysis
    • This test measures the health and function of the gastrointestinal system. Approximately 90% of our immune system resides in the gut, and oftentimes the root of inflammation is the gut.
  • Salivary Adrenal Test
    • Chronic stress increases levels of cortisol which are known to deplete the immune system. By measuring your adrenal function over a 24 hour time period, we can better understand the connection between your stress levels and your immune function.
  • CBC (complete blood count)
    • This test looks at the health of your red and white blood cells. Your white blood cells are a major determinant of the health of your immune system. This test helps to determine your immune status.
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Conventional Approach To Joint Pain After COVID

While the conventional approach may be necessary and helpful for some, many people want relief from more natural approaches and want to avoid some of the not so pleasant side effects of commonly prescribed medications. Some of the most common conventional treatments for post-COVID joint pain are as follows:

  • Glucocorticoids i.e. prednisone
  • NSAIDs (non-steroidal anti-inflammatory drugs) i.e. advil, naproxen, aspirin
  • DMARDs (disease modifying antirheumatic drugs) i.e. methotrexate, sulfasalazine,
  • Hydroxychloroquine
  • Physical therapy
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