Musculoskeletal and Neuropathic Pain in COVID-19: Diagnosis and Management Challenge

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 8634

Special Issue Editors


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Guest Editor
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Madrid, Spain
Interests: chronic pain; pain neuroscience education, manual therapy; central nervous system sensitization
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E-Mail Website
Guest Editor
Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation Department, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain
Interests: pain assessment; headache; temporomandibular disorders; neck pain; electromyography; measurement properties; musculoskeletal disorders; physiotherapy interventions
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The SARS-CoV-2 infection responsible for COVID-19 has spread rapidly across the world in the most unprecedented sanitary outbreak of recent history. Chronic pain is another sanitary crisis that has been present for several decades. Current data suggest a post-COVID pandemic, i.e., the presence of long COVID. Long COVID can be briefly defined as the presence of symptoms in individuals who have recovered from COVID-19. Pain is one of these symptoms and can be experienced by almost 50% of COVID-19 survivors during the first year after the infection. Proper classification of post-COVID pain is crucial for proper identification and management. The current literature shows that individuals with pain symptoms before the infection experienced an exacerbation of their symptoms. Additionally, several patients have also experienced the presence of new pain symptoms as a consequence of SARS-CoV-2 infection. Several gaps in the proper definition, identification, mechanisms, and treatment strategies for the management of post-COVID pain symptoms exist.

We are pleased to invite you to submit your article to this Special Issue titled “Musculoskeletal and Neuropathic Pain in COVID-19: Diagnosis and Management Challenge”. This Special Issue aims to define, classify, understand, and suggest treatments for post-COVID pain symptoms by focusing on potential aspects of pain as a sequela of COVID-19. We invite researchers/clinicians to submit original articles, cohort studies, case–control studies, systematic reviews, narrative reviews, or meta-analyses related to the proper identification or management of post-COVID pain symptoms to this Special Issue. Papers can be related, but not limited, to the following topics:

  • Epidemiology of pain symptoms during the COVID-19 acute phase;
  • Studies addressing treatment interventions of pain during the COVID-19 acute phase;
  • Epidemiology on post-COVID pain symptoms;
  • Characterization studies on pain associated with COVID-19;
  • Identification of risk factors associated with post-COVID pain symptoms;
  • Clinical trials evaluating treatment interventions for the management of post-COVID pain;
  • Evaluation of psychological status of patients with chronic pain in relation to COVID-19 outbreak;
  • Definition or consensus studies on post-COVID pain symptomatology;
  • Genetic and epigenetic studies associated with pain symptoms and COVID-19;
  • Validation of pain questionnaires in COVID-19 populations.

Prof. Dr. César Fernández De Las Peñas
Prof. Dr. Lidiane Lima Florencio
Guest Editors

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Keywords

  • COVID-19
  • long-COVID
  • pain
  • musculoskeletal
  • neuropathic
  • sensitization
  • mechanism

Published Papers (4 papers)

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Research

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14 pages, 913 KiB  
Article
Association of Kinesiophobia with Catastrophism and Sensitization-Associated Symptoms in COVID-19 Survivors with Post-COVID Pain
by Manuel Herrero-Montes, César Fernández-de-las-Peñas, Diego Ferrer-Pargada, Sheila Izquierdo-Cuervo, Beatriz Abascal-Bolado, Juan Antonio Valera-Calero and Paula Paras-Bravo
Diagnostics 2023, 13(5), 847; https://doi.org/10.3390/diagnostics13050847 - 23 Feb 2023
Cited by 2 | Viewed by 1684
Abstract
Pain symptoms after the acute phase of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are present in almost 50% of COVID-19 survivors. The presence of kinesiophobia is a risk factor which may promote and perpetuate pain. This study aimed to investigate variables associated with [...] Read more.
Pain symptoms after the acute phase of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) are present in almost 50% of COVID-19 survivors. The presence of kinesiophobia is a risk factor which may promote and perpetuate pain. This study aimed to investigate variables associated with the presence of kinesiophobia in a sample of previously hospitalized COVID-19 survivors exhibiting post-COVID pain. An observational study was conducted in three urban hospitals in Spain, including one hundred and forty-six COVID-19 survivors with post-COVID pain. Demographic (age, weight, height), clinical (intensity and duration of pain), psychological (anxiety level, depressive level, sleep quality), cognitive (catastrophizing), sensitization-associated symptoms, and health-related quality of life variables were collected in 146 survivors with post-COVID pain, as well as whether they exhibited kinesiophobia. Stepwise multiple linear regression models were conducted to identify variables significantly associated with kinesiophobia. Patients were assessed a mean of 18.8 (SD 1.8) months after hospital discharge. Kinesiophobia levels were positively associated with anxiety levels (r: 0.356, p < 0.001), depression levels (r: 0.306, p < 0.001), sleep quality (r: 0.288, p < 0.001), catastrophism (r: 0.578, p < 0.001), and sensitization-associated symptoms (r: 0.450, p < 0.001). The stepwise regression analysis revealed that 38.1% of kinesiophobia variance was explained by catastrophism (r2 adj: 0.329, B = 0.416, t = 8.377, p < 0.001) and sensitization-associated symptoms (r2 adj: 0.381, B = 0.130, t = 3.585, p < 0.001). Kinesiophobia levels were associated with catastrophism and sensitization-associated symptoms in previously hospitalized COVID-19 survivors with post-COVID pain. Identification of patients at a higher risk of developing a higher level of kinesiophobia, associated with post-COVID pain symptoms, could lead to better therapeutic strategies. Full article
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11 pages, 1303 KiB  
Article
Understanding Sensitization, Cognitive and Neuropathic Associated Mechanisms behind Post-COVID Pain: A Network Analysis
by César Fernández-de-las-Peñas, Manuel Herrero-Montes, Ignacio Cancela-Cilleruelo, Jorge Rodríguez-Jiménez, Paula Parás-Bravo, Umut Varol, Pablo del-Valle-Loarte, Gema Flox-Benítez, Lars Arendt-Nielsen and Juan A. Valera-Calero
Diagnostics 2022, 12(7), 1538; https://doi.org/10.3390/diagnostics12071538 - 24 Jun 2022
Cited by 9 | Viewed by 1768
Abstract
This study aimed to describe a network including demographic, sensory-related, psychological/cognitive and other variables in individuals with post-COVID pain after hospitalization. Demographic (i.e., age, height, weight, months with symptoms), sensory-related (Central Sensitization Inventory -CSI-, Self-Report Leeds Assessment of Neuropathic Symptoms -S-LANSS-, PainDETECT), psychological/cognitive [...] Read more.
This study aimed to describe a network including demographic, sensory-related, psychological/cognitive and other variables in individuals with post-COVID pain after hospitalization. Demographic (i.e., age, height, weight, months with symptoms), sensory-related (Central Sensitization Inventory -CSI-, Self-Report Leeds Assessment of Neuropathic Symptoms -S-LANSS-, PainDETECT), psychological/cognitive (Hospital Anxiety and Depression Scale -HADS-A/HADS-D-, Pain Catastrophizing Scale -PCS-, Tampa Scale for Kinesiophobia -TSK-11-) and other (sleep quality and health-related quality of life -EQ/5D/5L) variables were collected in 146 COVID-19 survivors with post-COVID pain. A network analysis was conducted to quantify the adjusted correlations between the modelled variables, and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the system modelled as network). The network revealed associations between sensory-related and psychological/cognitive variables. PainDETECT was associated with S-LANSS (ρ: 0.388) and CSI (ρ: 0.207). Further, CSI was associated with HADS-A (ρ: 0.269), TSK-11 (ρ: 0.165) and female gender (ρ: 0.413). As expected, HADS-A was associated with HADS-D (ρ: 0.598) and TSK-11 with PCS (ρ: 0.405). The only negative association was between sleep quality and EQ-5D-5L (ρ: −0.162). Gender was the node showing the highest strength, closeness, and betweenness centralities. In addition, CSI was the node with the second highest closeness and betweenness centralities, whereas HADS-D was the node with the second highest strength centrality. This is the first study applying a network analysis for phenotyping post-COVID pain. Our findings support a model where sensitization-associated symptoms, neuropathic phenotype, and psychological aspects are connected, reflecting post-COVID pain as a nociplastic pain condition. In addition, post-COVID pain is gender dependent since female sex plays a relevant role. Clinical implications of current findings, e.g., developing treatments targeting these mechanisms, are discussed. Full article
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Review

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17 pages, 1296 KiB  
Review
Musculoskeletal and Neuropathic Pain in COVID-19
by Christopher M. Lam, Miles Sanderson, Dan T. Vu, Dawood Sayed, Usman Latif, Andrea L. Chadwick, Peter Staats, Abigail York, Gabriella Smith, Vivek Velagapudi and Talal W. Khan
Diagnostics 2024, 14(3), 332; https://doi.org/10.3390/diagnostics14030332 - 04 Feb 2024
Viewed by 1269
Abstract
Chronic pain constitutes a significant disease burden globally and accounts for a substantial portion of healthcare spending. The COVID-19 pandemic contributed to an increase in this burden as patients presented with musculoskeletal or neuropathic pain after contracting COVID-19 or had their chronic pain [...] Read more.
Chronic pain constitutes a significant disease burden globally and accounts for a substantial portion of healthcare spending. The COVID-19 pandemic contributed to an increase in this burden as patients presented with musculoskeletal or neuropathic pain after contracting COVID-19 or had their chronic pain symptoms exacerbated by the virus. This extensive literature review analyzes the epidemiology of pain pre-pandemic, the costs associated with the COVID-19 pandemic, the impact of the virus on the body, mechanisms of pain, management of chronic pain post-pandemic, and potential treatment options available for people living with chronic pain who have had or are currently infected with COVID-19. Full article
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Other

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18 pages, 846 KiB  
Systematic Review
Post-Acute COVID-19 Joint Pain and New Onset of Rheumatic Musculoskeletal Diseases: A Systematic Review
by Jacopo Ciaffi, Elena Vanni, Luana Mancarella, Veronica Brusi, Lucia Lisi, Federica Pignatti, Susanna Naldi, Elisa Assirelli, Simona Neri, Massimo Reta, Cesare Faldini and Francesco Ursini
Diagnostics 2023, 13(11), 1850; https://doi.org/10.3390/diagnostics13111850 - 25 May 2023
Cited by 7 | Viewed by 2909
Abstract
As the number of reports of post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it is important to summarize the current available literature in order to shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review to provide [...] Read more.
As the number of reports of post-acute COVID-19 musculoskeletal manifestations is rapidly rising, it is important to summarize the current available literature in order to shed light on this new and not fully understood phenomenon. Therefore, we conducted a systematic review to provide an updated picture of post-acute COVID-19 musculoskeletal manifestations of potential rheumatological interest, with a particular focus on joint pain, new onset of rheumatic musculoskeletal diseases and presence of autoantibodies related to inflammatory arthritis such as rheumatoid factor and anti-citrullinated protein antibodies. We included 54 original papers in our systematic review. The prevalence of arthralgia was found to range from 2% to 65% within a time frame varying from 4 weeks to 12 months after acute SARS-CoV-2 infection. Inflammatory arthritis was also reported with various clinical phenotypes such as symmetrical polyarthritis with RA-like pattern similar to other prototypical viral arthritis, polymyalgia-like symptoms, or acute monoarthritis and oligoarthritis of large joints resembling reactive arthritis. Moreover, high figures of post-COVID-19 patients fulfilling the classification criteria for fibromyalgia were found, ranging from 31% to 40%. Finally, the available literature about prevalence of rheumatoid factor and anti-citrullinated protein antibodies was largely inconsistent. In conclusion, manifestations of rheumatological interest such as joint pain, new-onset inflammatory arthritis and fibromyalgia are frequently reported after COVID-19, highlighting the potential role of SARS-CoV-2 as a trigger for the development of autoimmune conditions and rheumatic musculoskeletal diseases. Full article
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