Covid. Covid-19. Corona. “The ‘Rona”. Delta. Omicron. As we enter our third year of living with this virus it is no wonder that we have given it so many different names. Not only has it shaped our world but it continues to affect every aspect of our lives from our health to our society, and our economy.
According to John Hopkins University, the COVID-19 pandemic has sickened more than 315 million people , globally, and claimed the lives of more than 5.5 million people. The United States has the world’s largest number of cases — over 62 million — and more than 843,000 deaths. As a nation, and as a global village, we have all had to endure economic uncertainty, lockdowns, job losses, the loss of loved ones, and so much more.
With this in mind it comes as no surprise that emerging research is showing just how greatly the Covid-19 pandemic has affected both our physical and our mental health.
Working From Home
Prior to the pandemic, while many employees had expressed interest in working from home, only one in five people did actually work from home all, or most, of the time. Long commutes and terrible traffic jams were wearing people down and many felt that they could do the same type of work from the comfort of their own home. When the pandemic happened and many countries went into “lockdown” conditions, employees were forced to work from home, with 71% of workers still doing their job from home all or most of the time.
Current research around the effects of sedentary behavior and physical activity have shown that the more sedentary we are, the likelier we are to experience musculo-skeletal pain. Many individuals began working from home during the pandemic, leading to increased time sitting at desks, coffee tables, and breakfast bars. Parents were forced to juggle home-schooling their children with maintaining a rigorous work schedule leaving them with very little time left in their day to simply take a walk or exercise.
Now that so many people were working from home (many without the proper ergonomic furniture) it was not surprising that doctors saw an increase in muscular strains and disk herniations. People often spent the majority of their day hunching over laptops, or sitting on floors, couches, or even beds. Even those who were fortunate enough to have access to a home office or study often lacked properly designed and supportive chairs and desks. Working in these conditions for hours on end, with few exercise breaks in between, wreaked havoc on people’s backs and necks.
Sedentary Behavior
One of the measures that many countries implemented to slow down the spread of Covid-19 was lockdowns. Lockdowns consisted of a variety of measures that governments implemented including stay-at-home orders, quarantines, curfews, and other societal restrictions. Australia implemented one of the strictest lockdowns in the world, banning anyone from entering or exiting the country altogether. By April of 2020, almost half of the world’s population was under some type of “lockdown” to try and stop the spread of the virus.
As people were forced to stay home, gyms closed, children were no longer able to play in communal playgrounds and many were too scared to even leave their homes. This decrease in physical activity means that the conditions were perfect for increases in low back pain cases. While some individuals were fortunate enough to have the time and financial means to invest in home-based exercise programs like Peloton, not everyone was lucky enough to have access to those types of resources.
A study by Amini et al. found that 78% of participants in a study of the Iranian population did not meet the physical activity guidelines recommended by healthcare professionals. Similarly, in Brazil, almost 80% of adults said that their levels of physical activity decreased during the pandemic.
Sedentary behavior puts people at increased risk for low back pain. A study published in Nature found that those who engaged in ‘medium level physical activity have a 10% lower risk of low back pain compared to those engaged in low level physical activity’. When it comes to a lack of physical activity, the less we do, the more likely we are to experience some form of musculo-skeletal pain.
Isolation/ Stress
Strict lockdown measures and social distancing requirements have likewise, had significant negative effects on the mental health of many individuals. Schools and churches closed. Seniors in nursing homes were unable to visit with loved ones for extended periods of time. Many seniors who lived in their own homes were cut off from family and found themselves completely isolated.
The effects of social isolation range from insomnia to depression and reduced immune system functioning. The loneliness brought on by the implementation of strict social distancing measures resulted in many people feeling increasingly anxious and depressed. These mental health issues are intricately connected with our physical health.
Increasingly, recent studies have looked at the effects of chronic stress on low back pain. Chronic stress has already been shown to have negative effects on many aspects of physical and mental health so it is unsurprising that these effects have carried over into musculo-skeletal conditions like low back pain.
One study, conducted in North Korea, looked at over 20,000 participants and found that chronic low back pain was associated with increasing stress levels within the general Korean population. The study found that ‘severe stress was associated with a 2.8-fold increase in risk of chronic low back pain compared to the general population’. The results of this study were similar to other studies that had shown the link between psychological stress and pain.
With so many of our healthcare workers, teachers, emergency care workers and nursing home workers being at the front of caring for us during the pandemic, those working in these occupations have experienced unprecedented levels of stress. Potential new strains of Covid-19, such as the Omicron variant, cause us to wonder if these workers will continue to feel immense pressure as resources remain scarce.
Inflammation
Those who have had the misfortune of being infected with the Covid-19 virus may have experienced symptoms such as muscle pain and body aches. These symptoms that are commonly associated with the virus are due to the body’s inflammatory response to the infection.
Common clinical symptoms of Covid-19 include musculo-skeletal symptoms like myalgias (muscle pains and aches that can involve the tendons and ligaments of the muscles), arthralgias (joint pain) and myopathies (muscle weakness). While several studies have been done on the inflammatory response and its impact on the respiratory system, more studies are needed to see the effects on other organ systems such as the musculo-skeletal system. Inflammation has, however, been definitively linked to diseases of the bones and joints as well as to damage of the skeletal muscles.
As research around Covid-19 has grown, new treatments are being explored to see which ones are effective in treating the disease and reducing the symptoms associated with it. Current treatment options include medications such as corticosteroids, hydroxychloroquine, chloroquine, and certain antiviral medications. Unfortunately, while these medications may be effective in helping people recover faster from a Covid-19 infection, some of them come with serious side effects such as arthralgias and toxic myopathies (muscle weakness and pain associated with the specific medication).
Nutrition
What we eat has been shown to have significant impacts on low back pain. Diets rich in antioxidants have been shown to reduce pain and inflammation, while diets that contain large amounts of processed foods, sugars, and few vegetables have been shown to have a negative impact on low back pain.
When it comes to preventing and managing low back pain, the global pandemic has made it increasingly difficult for people to access nutritious anti-inflammatory foods.
According to research by the World Economic Forum, the pandemic had the following impact on people’s access to food:
Many Americans had altered access to food along with reduced financial resources.
Many Americans who were experiencing financial difficulties consumed less food and tried to make use of government programs such as SNAP.
Many Americans were forced to make use of food banks to keep their families fed.
For those that did have the financial means to continue buying food, many items were in short supply due to supply chain issues - an issue that prevails, even today. Workers being out sick means fewer people to prepare, package, and ship foods. Grocery store shelves continue to be bare in many places and shortages range from potatoes to frozen fruits and vegetables.
During lockdown many of us turned to food for comfort and out of boredom. There was such an dramatic increase in bread baking that yeast became a high-ticket item and sour-dough starters saturated social media.
Research has shown an increased associated between obesity and lower back pain, and while the pandemic certainly was not the start of the obesity epidemic in the US, it certainly did not help.
Conclusions
As we continue to navigate our way through an ever-changing pandemic, we are learning more and more about the many ways that this historical event has impacted our lives. When we understand how our bodies and our minds have been influenced we can learn from our experiences, discover what we need to do to combat any negative effects, and take the steps necessary to find our way back to health.
No matter whether you have actually had Covid-19 or if you are one of the last players standing in what has felt like a two year-plus game of dodgeball, there are things we can do to stay healthy and prevent problems like low back pain. Engaging in regular exercise, feeding our bodies nutritious and healthy foods, and practicing mindfulness and meditation techniques can make a big difference to our health and to low back pain in particular. If you want to learn more about any of these therapies then check out our other articles on how to prevent low back pain. Stay healthy, friends!