Can COVID-19 Cause Joint Pain, Affect Bone Health and Density Once You Recover?

This article is a part of a series by The Better India to share verified information about COVID-19 care. While several posts on various aspects of fighting COVID-19 are being circulated on social media and messaging services like WhatsApp, we urge you not to trust unverified content. To separate fact from fiction, we will be sharing the videos and content with doctors and experts and bring you their responses with scientific research-backed information.

We must have all laughed at the relatable ‘ankle twisting’ meme that shows how one’s joint unfortunately spasms and twists on smooth surfaces for no reason.

But the reality may be a little more serious than we think.

With very little to no physical activity, our bone health is taking a beating. In some cases, those who have recovered from COVID-19 are complaining of joint pains, which they did not have before contracting the virus.

Dr Ameet Pispati, Director of Orthopaedics, Jaslok Hospital, Mumbai, speaks to The Better India about the link between bone health and COVID-19.

What is the impact of COVID-19 on one’s bone health?

Dr Pispati: Bone problems increased during the pandemic because of multiple reasons:

a) The lockdown forced people to stay indoors, thus curtailing their activity. This led to bone pains, stiff joints and osteoporosis (weak bones).

b) Lack of exercise and mobility led to weight gain and thus knee or joint pains.

c) Vitamin D deficiency occurred due to staying indoors and lack of sunlight exposure. Also, people could not always consume nutritional food due to supply chain disruptions.

d) People were not able to take regular injectable drug treatments and missed doses for osteoporosis due to availability issues.

e) Patients were not able to follow up with their orthopaedic surgeons regularly.

Does prolonged exposure to steroids have an impact on bone health?

Dr Pispati: Yes, prolonged exposure to steroids leads to osteoporosis and could lead to Avascular Necrosis [Also called Osteonecrosis, it can lead to tiny breaks in the bone and the bone’s eventual collapse].

Steroid induced osteoporosis needs prolonged treatment. Steroids can damage the fat cells in the bone, leading to blockage of blood supply to the bone, called Avascular Necrosis. This is particularly common in the hip joint and leads to pain and difficulty in walking, often eventually requiring a total hip replacement surgery.

What can we do to regain strength in our bones?

Dr Pispati: Irrespective of COVID-19, we need to work on strengthening our bones and ensuring that our bones are healthy. This requires us to make certain lifestyle changes and includes taking up walking as an exercise. You should commence walking while maintaining physical distance.

Get as much exposure to sunlight as possible. If after consultation with your doctor, you are advised to take Vitamin D supplements, this must be taken without fail. Consuming foods rich in Calcium and Vitamin D, which includes eggs, protein, almonds, soya, dark green leafy vegetables, will also help in maintaining good bone health.

It is imperative that you avoid the consumption of alcohol and tobacco. Get your tests done, especially the Osteoporosis test, which can be diagnosed with a DEXA scan and then treated. Early detection and treatment is always better.

Are there any specific exercises we can do to strengthen our bones?

Dr Pispati: Weight-bearing exercises are recommended. Weight lifting with light weights can also help strengthen bones. Besides this, brisk walking is very helpful. Trekking, hiking, jogging are also useful. If one is physically fit, they can do hop, skip and jump exercises to strengthen bones.

After recovering from COVID-19, how long should one wait to start lifting weights and start strength training?

Dr Pispati: This depends on the individual, as each person can be affected very differently by COVID-19. Asymptomatic patients with no lung involvement and who never had a drop in their SpO2 or a temperature rise, could start with mild weight lifting and strength training as early as six weeks after testing negative for COVID-19. Those who needed oxygen or whose lungs were affected will need an individual assessment before they can start strength training or even exercising.

Is there a relationship between low Vitamin D levels and COVID-19?

Dr Pispati: Studies have shown that upto 80 per cent of COVID-19 patients can be Vitamin D deficient.

Patients with sufficient Vitamin D levels have a lower risk of developing serious COVID-19 infections.

The connection between Vitamin D and COVID-19 is not as straightforward as one would think but it would be prudent for us to maintain sufficient levels of Vitamin D in our blood, regardless.

(Edited by Yoshita Rao)

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