Why, Post Omicron, Do My Joints Feel Like Gravel? I Investigate.

The Omicron saga is ongoing, however the latest data shows that it might finally be receding.  This variant was harsher here than in other countries, and truly, the reasons for that are easy to ascertain.  Other countries don’t have Fox News.  Other countries don’t have half of their population diagnosable as certifiable.  And of course these other countries tend not to have a political party willing to sacrifice population for an election.

For me, it has been an ebb and flow, then an absolute wall.  I have been rendered nearly stationary at times, and walking is a chore.  I still do it, but it has been hard.  I crunch.  Now I am sure those of a certain age knows the sound of crunching joints, but lately I have sounded like a bag of potato chips.  But this is not a post to update my condition or complain.  The point of this is to get to the bottom of why my attempts to move around make me sound like Rice Krispies.

As this has been a strange circumstance, in that even while not exercising I lost some weight, and I have been fatigued, I nonetheless decided it was necessary to research the joint pain, not just for myself, but for anyone in pain and scared or confused.  Here is what the U.K. says:

Many people will have had some aches and pains before getting ill with COVID. Being unwell may have made these problems come back or get worse. This is because joints and muscles are better when we regularly move. When unwell with COVID people are less active than usual. This can cause aches and pains, stiffness and muscle weakness. Muscle weakness can lead to difficulties with activities such as standing, climbing stairs, gripping objects with your hands or lifting your arms above your head.  Some of the treatments that were needed during your COVID illness may have put extra stresses and strains on some of your joints and muscles. These may have caused new or increased joint and muscle problems.

Let us just say that does not satisfactorily explain it to me.  Sciencedaily.com has ideas.

Let’s try this:

“We’ve realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management,” said corresponding author Dr. Swati Deshmukh.

“Many patients with COVID-related musculoskeletal disorders recover, but for some individuals, their symptoms become serious, are deeply concerning to the patient or impact their quality of life, which leads them to seek medical attention and imaging,” said Deshmukh, an assistant professor of musculoskeletal radiology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine musculoskeletal radiologist. “That imaging allows us to see if COVID-related muscle and joint pain, for example, are not just body aches similar to what we see from the flu — but something more insidious.”

That sounds suspiciously like Covid takes on an auto-immune component.

“We might see edema and inflammatory changes of the tissues (fluid, swelling), hematomas (collections of blood) or devitalized tissue (gangrene),” Deshmukh said. “In some patients, the nerves are injured (bright, enlarged) and in others, the problem is impaired blood flow (clots).”

Covid can injure tissues and nerves?  Apparently so.  We know that the virus attacks organs, and in the cases where smell and taste are affected, that suggests a neurological component.  But if this is so, does it go away, or get better?  Or are my joints permanently damaged?  The initial data says that within 60-90 days it should resolve.  But for many, including my mother, this is not the case.

Does this explain why?

Inflammatory molecules break the muscle fiber protein and decrease muscle protein synthesis leading to decreased muscle strength and also weaken bones, Dr Uma Kumar, Head of Department of Rheumatology at AIIMS, said on the eve of the World Arthritis Day.  Inflammatory molecules damage cartilage leading to worsening of osteoarthritis.

The virus eats cartilage?

Dr Ajay Shukla, Head of Department, Orthopaedics at RML hospital also said that there is an increase in the number of patients who have recovered from COVID-19 coming to RML hospital with Arthralgia (pain in musculoskeletal system).

Well we are not sure..

“Also, though there was a debate earlier on whether certain forms of arthritis like rheumatoid arthritis were triggered by Covid, but a consensus is that till date there is no definitive evidence to prove that the infection triggered it,” he said.

Here is a case study that gives me hope.  After having Covid, about ten days later the young healthy male began to develop the same issues as me.
Ten days later, patient returned with swelling, severe pain and tenderness in his right knee which was more marked in the morning (Figure 1). There was no history of urinary complaints, visual disturbances or loose stool. At the same time he had elevated levels of C-reactive protein and serum Ferritin. Plain radiograph (X-Ray) of the joint was unremarkable (Figure 2). However, the MRI of the affected joint revealed mild effusion especially in patella-femoral compartment which extended to the supra-patellar region (Figure 3).
There was also associated pre-patellar soft tissue swelling with subcutaneous edema and blurring of myofascial planes. Because of typical findings and clinical presentation patient was diagnosed with Reactive arthritis secondary to COVID-19 infection. Patient was treated with Non-steroidal anti-inflammatory drugs and intra articular steroid was injected. His symptoms of arthritis resolved completely within next 10 days.

Ok finally I have a term for it.  “Reactive Arthritis.”  And apparently, proper treatment did result in improvement.  Of course given my myriad of health conditions I can’t just ask for certain treatments without examining contraindications, but it does give me hope.  But having a term for it is helpful.  So let’s get into what reactive arthritis is.

This according to the Mayo Clinic is how it is best described:

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body — most often the intestines, genitals or urinary tract.

This condition usually targets the knees, ankles and feet. Inflammation also can affect the eyes, skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis was sometimes called Reiter’s syndrome.  Reactive arthritis isn’t common. For most people, signs and symptoms come and go, eventually disappearing within 12 months.

The signs and symptoms of reactive arthritis generally start 1 to 4 weeks after exposure to a triggering infection.

Well hey that describes me.  And as it turns out, millions of other people.  Perhaps yourself.  What we know is that in the near future, a comprehensive program is going to have to be established to help survivors with long Covid financially and emotionally, and it is going to have to be done quickly.

And when the inevitable complaints about spending come, I don’t want our party to hesitate in slapping down the arguments.  All over the country more died, fell ill, and suffered broadly than necessary because Republican politicians prioritized political gain over the health of their constituents.  They forced open an economy that was not ready to re-open, then complained when there was a labor shortage, largely because of, and we need to remember this, dead service workers don’t come back to life and put the smock back on.

In fact initially as seen here, restaurant line workers suffered the highest death rates, along with those in cramped factories, of anyone.

So the need for support was greatly exacerbated by an unwillingness to exercise patience and follow the science.  So I do not want to hear a word, not a one, about how much it costs.  To millions of people around the globe, if they survived, Covid has cost them nearly everything.

As for me I am puttering along, sleeping here and there, and taking what I believe to be safe over the counter medicines.  And hopefully over time these symptoms of this so called “mild” variant self-resolve.

For now I do what I can, and work as much as possible, and try not to focus on the pain, like so many others are doing.

It did not have to be this way.

Except for the fact, some wanted it this way.


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