In the journal JAMA Network Open, research on the long-term effects of contracting COVID-19 shows that at least 50% of COVID-19 survivors experience numerous physical and psychological health issues lasting six months or more after their initial recovery. According to The Washington Post, while the adverse health effects vary from person to person, more than half experienced a decline in general well-being and the onset of pain. “Cardiovascular issues — chest pain and palpitations – are common, as are stomach and gastrointestinal problems,” reports the Post.
While some doctors see these post-recovery symptoms as largely psychosomatic, what such a diagnosis conveniently sidesteps is the greater issue. There is a lack of understanding of what exactly is triggering the infirmities, making the approach to treatment a guessing game. The Post goes on to say that other disabilities lacking a clear treatment, such as chronic fatigue syndrome, are hopeful that current research into long COVID-19 may unlock some answers to their condition as well.
This got me to thinking about our concept and understanding of pain. What the Free Dictionary describes as “an unpleasant feeling that is conveyed to the brain by sensory neurons. Discomfort that that signals actual potential injury to the body.”
It is important to remember that pain is also subjective to the person experiencing it. It comes in many forms, and with thoughts of Veterans Day fresh in mind, comes the memory of those Americans whose service to our country has left them not only with many forms of lingering disabilities but loss of limbs. They know pain all too well. According to DAV, a nonprofit charity that provides support for veterans and their families, integrated data from the Departments of Veterans Affairs and Defense show that “after leaving military service, over 80% of amputees also have diagnoses in each of the following categories: mental disorders, diseases of the nervous system and sense organs, and diseases of the musculoskeletal system and connective tissue.”
They also suffer from “phantom pain,” which the National Center for Biotechnology Information clinically defines as “the perception of pain or discomfort in a limb that no longer exists.” It is something that veteran amputees have in common with those on the receiving end of what the Center estimates to be the 30,000 to 40,000 amputations performed each year In the United States
According to the website Neuroscientifically Challenged, phantom pain doesn’t just occur in limbs, it has also been recorded after the loss or removal of other parts of the body. In one study of 5000 American veterans, “78% of them reported experiencing phantom pain in their amputated limbs.” It is a condition that remains not well understood by medical professionals, even though they have had a long time to work on the problem.
As reported by the National Center for Biotechnology Information, “phantom limb sensation” was first described by French military surgeon Ambroise Pare in the sixteenth century. His writing on the subject is believed to be the first recorded description of this condition. Neuroscientifically Challenged says, the term phantom limb wouldn’t be used until the Civil War — more than three centuries later.
Today, there are several pharmacological treatments for phantom limb pain. High on the list is opioid drugs (and we all know by now how that approach has turned out).
Among the alternate treatments available is “mirror therapy.” This is a technique where a mirror is situated between the missing and intact limb, so it reflects the patient’s intact limb. ‘This creates the illusion (from the patient’s perspective) that they have two intact limbs,” says Neuroscientifically Challenged. “They can move their intact limb and observe the illusory limb moving in the same manner. It is thought that this imagery may help to reduce some of the discomfort caused by the lack of visual feedback from a missing limb that the brain has maintained an internal representation of. Although studies support the effectiveness of mirror therapy, the mechanisms underlying why the approach works are not fully understood.”
As stated by the Mayo Clinic, today “no medications specifically for phantom pain exist” and “no single drug works for everyone, and not everyone benefits from medications.”
Another form of pain, not to be confused with phantom pain, is “referred pain.” This “refers” to pain that you experience on one part of your body that is not the actual source of the problem. Healthline explains it this way: “When your body experiences a pain stimulus, your nervous system carries the signal to your brain. The brain then sends a signal to your body that you’re experiencing pain. Sometimes, because of how nerves are wired in your body, your brain will send a pain signal to a different part of your body than the area where the pain stems from … Researchers are still working to understand the exact mechanism and reason why your body has this type of reaction.”
One example of referred pain given by U.S. News — and a good reason we should not ignore such pain — is a sign of a heart attack can appear as a sensation of pain in the jaw. “That doesn’t mean there’s a problem with your jaw. It’s a problem with your heart that is ‘referring’ pain to the jawline.” Another example is pain in the upper back area right below and between your shoulder blades. It could be an indication that you have a stomach condition.
Say a U.S. News report, a relatively common example is when the first and only sign of a problem with the hip joint is the onset of knee pain. As with phantom pain and other health conditions, researchers are still working to understand the exact mechanism and reason why the human body has the reaction it does. As to adverse health effects of long COVID-19, medical science may have a clue or two as to why, but we have no answers.