22 JULY 2021

Australia is grappling with several Covid-19 outbreaks and three states (NSW, Victoria and SA) are in lockdown. Other jurisdictions are watching nervously, knowing around 89% of our population still remain to be fully vaccinated.

Since Covid-19 arrived on Australian shores early last year, there have been over 32,000 cases and sadly more than 900 deaths. Globally there have been more than 190 million cases and 4 million deaths officially reported[1] although the actual numbers are likely to be much higher.

While it is understandable to focus on cases and Covid-19 related deaths, it is becoming increasingly clear that many people end up with persistent pain and other distressing symptoms long after they recover from the acute phase of Covid. Known as long Covid, the US Center for Disease Control said this condition is: “a range of symptoms that can last weeks or months…[that] can happen to anyone who has had Covid-19.” The symptoms may affect a number of organ systems, occur in diverse patterns, and frequently get worse after physical or mental activity.

The UK National Health Service advises that common long Covid symptoms include:

• extreme tiredness (fatigue)
• shortness of breath
• chest pain or tightness
• pins and needles
• joint pain
• tinnitus, earaches
• problems with memory and concentration ("brain fog")
• difficulty sleeping (insomnia)
• heart palpitations
• dizziness
• depression and anxiety
• feeling sick, diarrhoea, stomach aches, loss of appetite
• a high temperature, cough, headaches, sore throat, changes to sense of smell or taste
• rashes.[2]

The high incidence of persistent pain after a Covid infection is of particular concern to Painaustralia because it means more Australians will live with chronic pain. In the US and UK 10 to 30% of Covid-19 patients develop long Covid, so if a similar patten occurs in Australia we expect the number of Australians living with pain to increase.

We spoke to several leading pain specialists around the world, and they told us they are seeing dozens of people who have recovered from Covid presenting with persistent spinal cord and nerve pain, severe headaches that require an MRI, muscle and joint pain and other less specific forms of pain. One of the complications of an acute Covid infection is stroke and many of these patients are reporting nerve, muscle and joint pain months after they recover from Covid.

While the mechanisms leading to long Covid are yet to be well understood, many medical experts consider there is a strong link to the way our immune systems respond to the viral infection.[3] Within this context, it is not surprising that people living with chronic pain are likely to be more at risk of long Covid.

It goes without saying that the best preventative action is vaccination and other measures to reduce the prevalence and spread of Covid-19. But that alone may not be enough.

The multi-faceted nature of long Covid symptoms suggests we will need to develop multi-disciplinary treatment and support pathways that build on the lessons learned in the treatment of other post-infection conditions. As the seriousness and potential extent of long Covid becomes better understood, the need to develop a national plan to appropriately address the issues arising from long Covid and to minimise its impact is also becoming clear.

For people living with ongoing and persistent pain, long Covid is a genuine concern. Painaustralia encourages everyone who experiences chronic pain to consult their health care expert and do everything they can to avoid contracting Covid-19. This includes obtaining a vaccination if that is possible and appropriate, and carefully considering actions that may lead to greater risk of contracting the disease.

It may seem that the Covid-19 pandemic has gone on for a long time already, but over time, we will obtain herd immunity and possibly even treatments that reduce the impact of the disease. Until we are better prepared and understand more about Covid-19, contracting long Covid is a further risk that people with chronic pain need to be especially careful about.