MUSCULOSKELETAL PAIN POST- COVID-19 IN PATIENTS UNDERGOING PHYSICAL THERAPY IN SAUDI ARABIA: A CROSS-SECTIONAL STUDY

O. Alnamlah¹, M. Almarwani¹

¹Collage of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia

Background: Physiotherapy delivery has been challenged by the COVID-19 (coronavirus disease 2019) pandemic. In addition to pandemic-associated treatment interference, many recovered COVID-19 (RC) patients developed new or worsening musculoskeletal pain as a sequela of COVID-19, which has been shown to affect musculoskeletal system. Fatigue was the most frequently reported musculoskeletal symptom, followed by myalgia, arthralgia, and back pain. Low physical activity (PA) levels during the quarantine play a role in the prevalence of musculoskeletal pain such as low back pain and neck pain. These findings highlight the importance and effectiveness of physiotherapy during the COVID-19 crisis. It is essential to determine the effects of COVID-19 on the musculoskeletal system and provide multidisciplinary interventions, including physical rehabilitation.

Purpose: There is a lack of information in the literature regarding musculoskeletal pain and physiotherapy needs of post-covid-19 patients attending rehabilitation clinics in Saudi Arabia. The purpose of this study is to compare the musculoskeletal pain pre and post COVID-19 inpatients undergoing physical therapy in Saudi Arabia.

Methods: English/Arabic cross-sectional survey was developed and made available online and in print for completion by RC patients attending rehabilitation clinics. The survey collected sociodemographic, clinical and activity data. Pain severity was rated on a 10-point numerical rating scale (NRS). Likert-scale (5-point scale) included multiple-choice questions inquiring about pain location, pain frequency, pain relief strategies, physiotherapy sessions and physical activity levels after recovering from COVID-19. The data were analyzed with paired sample t test with a significance level was set at ≤ 0.05. Means are reported with standard deviations (SDs).

Results: Of 85 RC participants, 30 had musculoskeletal pain prior to getting COVID-19, while 55 acquired it after; the most commonly affected sites were the lower back and shoulder. Mean pain levels reported increased from 4.48 ± 2.54 pre-illness to 6.92 ± 8.06 after COVID-19 (mean difference, 1.61 ± 2.61; t = 5.68; p < .0001). Mean pain scores did not associate significantly with demographic or clinical factors. Patient responses skewed toward increased pain as well as toward decreased activity levels after being infected with COVID-19 versus pre-illness levels (all p < .0001).

Conclusions: RC patients report increased pain intensity and frequency, together with reduced activity levels, relative to pre-COVID-19 levels, without effects of sociodemographic or clinical characteristics. In the future research, we expect to conduct further research like this to detect if there are other factors related to an increase the pain after infected with COVID-19.

Implications: This study may offer important clinical information on COVID-19 that would help physiotherapists to be more attention to RC patients suffering from persistent musculoskeletal symptoms providing the required physiotherapy treatment and improving their activity levels.

Funding acknowledgements: This research received no external funding.

Keywords:
COVID-19, musculoskeletal symptoms, pain
physical activity, Saudi Arabia

Topics:
COVID-19

Did this work require ethics approval? Yes

Institution: Institution Review Board of King Saud University

Committee: Institution Review Board of King Saud University

Ethics number: (E-21-6506)