Sore throat and a runny or stuffy nose may be common signs of COVID-19, but it’s important to remember that the coronavirus can cause a wide range of symptoms, some of them still mystifying.

Among those lesser-known symptoms: muscle aches and pains, known in the medical field as myalgia. The ZOE COVID Study, culled from data of more than four million people in the United Kingdom, lists muscle aches and pains as among the top 10 COVID-19 symptoms.

The type and degree of muscle pain associated with COVID-19 can vary greatly from person to person, says Aaron E. Glatt, MD, chief of infectious diseases at Mount Sinai South Nassau in Oceanside, New York. It can range from “‘It’s a little tender in some spots’ to ‘I’m bedridden because it hurts to move,’” he says.

No one is exactly sure how many people experience muscle aches when they get the virus, but the number is undoubtedly high. In one study of people sick enough to be hospitalized for COVID-19, 68 percent said they experienced muscle pain, according to a study by Turkish researchers published August 2021 in the European Journal of Physical and Rehabilitation Medicine.

In some people who recover from those first weeks of coronavirus infection, body aches linger. This symptom is among the dozen-plus identified by the Centers for Disease Control and Prevention (CDC) as being part of a post-COVID condition (PCC), more commonly known as long COVID.

While experts still don’t know exactly how many people have long COVID (defined by the CDC as symptoms lasting for three months or longer after the initial illness), current CDC estimates stand at roughly 14 percent.

“A good number of the patients we see experience muscle pain,” says Jennifer Hankenson, MD, a physical medicine and rehabilitation specialist at Yale Medicine and assistant professor at Yale School of Medicine who works with long COVID patients. People may have pain in their neck, low back, shoulder, and other places, “which they didn’t have before they got COVID,” she says.

What Are COVID-19 Muscle Aches?

Muscle pain refers to a range of sensations people experience in one or more muscles of the body. As the Cleveland Clinic observes, the pain can range from deep, steady aches to intermittent sharp stinging. Some people have pain all over their body, while in others the pain is limited to specific areas.

In some cases, people at risk for muscle pain due to other conditions or medications may find they develop aches when they catch COVID-19.

People who take statin medicines to lower their cholesterol, for example, often experience muscle pain as a side effect. In an interesting study, Polish researchers examined statin takers who had not had muscle pain before contracting COVID-19 and found that a higher percentage than non–statin users developed aches once they got sick, as reported in Biomedicine & Pharmacotherapy in April 2022.

Another related symptom, muscle weakness, can also appear in people who contract COVID-19. Many of those in the Turkish research exhibited low grip strength along with the pain, indicating weakness. Among the women studied, those with the most severe infections reported the weakest strength.

Why Does COVID-19 Cause Muscle Aches?

“We don’t exactly understand why any viral illness, including COVID, leads to muscle pain,” Dr. Glatt says.

Possible factors, which may work in tandem, include the physical stress that illness puts on the body; an imbalance of electrolytes like potassium and sodium, which are important for muscle health, caused by virus’s effects on the kidneys; and even the breakdown of muscle that results from lying in bed and not moving.

Another likely factor is inflammation, which can make any affected body part hurt. Since COVID-19 is known to invoke an inflammatory response throughout the body, it makes sense that the muscles aren’t spared, Glatt says.

Lingering inflammation is likely a key factor behind long COVID’s muscle symptoms, Dr. Hankenson says. Many of her patients were in excellent shape prior to contracting COVID-19, but subsequently reported ongoing low-grade aches with periodic flares. Flares often come after performing any activity, which can range from strength training to barely moving, she says. “For some, just getting out of bed and moving around for the day” triggers pain.

Could My Muscle Aches Be Due to Something Else Besides COVID-19?

Aside from contracting COVID-19, a long list of illnesses and injuries can incite muscle pain.

According to the Cleveland Clinic, this includes injuries, certain medications such as ACE inhibitors for blood pressure, and chemotherapy and radiation treatments for cancer.

Infectious diseases other than COVID-19 can also involve muscle pain, including malaria, Lyme disease, Rocky Mountain spotted fever, as can autoimmune conditions such as lupus, multiple sclerosis, and inflammatory myopathies.

And of course, whole-body aches are a common symptom of the flu. As the CDC notes, muscle pain is a symptom of both COVID-19 and flu, along with sore throat, headache, and other issues. This is why it can be difficult to determine which type of viral infection you have without taking a test.

What’s the Best Way to Treat COVID-19 Muscle Aches?

When muscle aches first appear during a bout of COVID-19, patients can seek relief at home with over-the-counter pain relievers such as acetaminophen or ibuprofen, Glatt says.

It’s also worth trying non-drug approaches. “Each person’s pain is different so what helps them is unique, too,” Glatt says. For example, some people feel better taking a hot shower, while others find relief from cold packs. Some want to lie flat while others feel more comfortable when sitting in a recliner.

Once a person recovers from COVID-19, muscle pain usually disappears. But as the United Kingdom’s National Health Service notes, muscle aches can linger for a little while due to the deconditioning brought on by days of rest.

People who develop ongoing muscle aches as part of long COVID should get a referral for physical therapy (PT) or occupational therapy (OT) to strengthen and stretch the muscles, Hankenson recommends. Taking drugstore pain-relieving medicines or bumping up to prescription-strength drugs, including naproxen or meloxicam, can also help, as may acupuncture and massage.

One difference between muscle pain caused by injury or a different illness and those that develop as part of long COVID is that with the former, “there may be restrictions in range of motion or limitations on how quickly the person should be getting back to previous activities,” Hankenson says. But this is not the case with long COVID — although some people find they must pace their movements to avoid fatigue or shortness of breath.

When Should I See a Doctor for My COVID-19 Muscle Aches?

Anyone who contracts COVID-19 should check in with their healthcare provider and keep them abreast of any problems that develop, Glatt says. A person should seek medical help for muscle pain if it continues several weeks after recovery from the virus, Hankenson says.

Treatments prescribed in that case should help the muscles rebuild their strength — a move that hopefully ends the pain.