5 keys for recovering from lingering joint pain after covid


Ben Ahrens, HHP

Published on

December 7, 2023

Updated on

April 4, 2024

Medically reviewed by

Dr. Robert Stevens

Chronic Pain

While most people recover quickly from viral infections such as COVID-19, some percentage of people report fingerling symptoms of post-viral fatigue – what’s come to be known as Long-haul COVID. And although Long-COVID may impact each individual in different ways, many people have experienced muscle pain, joint pain, and musculoskeletal issues.

This article will dive into post-covid joint pain, common symptoms, possible causes, and the known pathophysiology of so-called reactive arthritis or viral arthritis. We will also examine the brain’s role in chronic inflammatory conditions such as COVID-related joint pain, and how brain retraining with a neuroplasticity program may be a viable option for addressing joint pain and the inflammatory-based symptoms that may arise as part of post-COVID syndrome.

Why do some people experience joint pain after COVID?

Generally speaking, infections lead to an increase in bodily inflammation and elevated antibodies that can linger for some time post-infection. Inflammatory cytokines such as IL-1, IL6, and TNF Alpha are associated with numerous symptoms ranging from general malaise and flu-like symptoms to acute pain, headaches, and joint & muscle stiffness. The duration of such symptoms can vary due to a variety of precipitating factors. For instance, for someone experiencing lingering joint pain after COVID, factors that could influence this include:

  • Past health history – This includes past infections, antibodies, physical injuries, or traumatic life events
  • Present psychological & emotional stress – Stress can impact a person’s sleep and ability to get into a deep recovery state by inhibiting parasympathetic (rest & digest) functions
  • Genetic predispositions – Genes and epigenetics can play a role in how symptoms express in an individual post COVID-19
  • Environmental conditions – Cold damp weather and mold may increase joint pain and stiffness or slow its resolution post prolonged infection
  • Diet and lifestyle – A person’s diet and lifestyle also play a key role when it comes to healthcare and especially rheumatology.

During the pandemic, many people’s day-to-day lifestyle was turned upside down. Working spawned new dietary habits for many, and may have limited physical activity for a time as well. Furthermore, the constant flow of alarming information lead many to a state of self-reported overwhelm and chronic anxiety, which evidence shows may be deleterious to the immune system.

All of the above could lead to a form of viral arthritis. Fortunately, recent research shows that it is possible to rewire the brain and body’s stress response and downregulate inflammatory processes that contribute to reactive arthritis.

Other common symptoms of post-COVID syndrome

According to the Center for Disease Control and Prevention common symptoms experienced in post-covid conditions can include:

  • Difficulty breathing or shortness of breath
  • Tiredness or fatigue
  • Symptoms that get worse after physical or mental activities (also known as post-exertional malaise)
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
  • Cough
  • Chest or stomach pain
  • Headache
  • Fast-beating or pounding heart (also known as heart palpitations)
  • Joint or muscle pain
  • Pins-and-needles feeling
  • Diarrhea
  • Sleep problems
  • Fever
  • Dizziness on standing (lightheadedness)
  • Rash
  • Mood changes
  • Change in smell or taste
  • Changes in menstrual period cycles

Many of these symptoms, even the most common ones, have complex pathophysiology that is still not well understood. For this reason, it is unclear exactly why certain individuals tend to exhibit certain symptoms such as inflammatory arthritis, while others do not. Broadly speaking, three precipitating factors may include:

  • Past history & exposures
  • Genetic predispositions
  • Levels of stress at the time of infection

The link between viral infections and  reactive arthritis

According to the Clinical Medicine Journal, there is a broad range of viral infections that can lead to acute-onset and lingering arthritis. So what we are seeing now with lingering joint pain and reactive arthritis after COVID is not entirely new. Some of the other infections that have been previously known to produce similar effects are:

  • Parvovirus B19
  • Hepatitis B, C, E
  • HTLV
  • HIV
  • Alphaviruses
  • Chikungunya
  • Ross River virus
  • Flaviviruses
  • Other viruses

This just goes to show that there is likely nothing unique or specific to COVID-19 when it comes to lingering joint pain or viral arthritis. It seems more to be the case that the increased cytokine activity and resulting inflammation is the primary culprit, combined with the predisposing factors mentioned above.

Common symptoms of COVID joint pain

Common symptoms of COVID related joint pain may include:

  • Joint stiffness
  • Joint swelling
  • Muscle pains
  • Soft tissue sensitivity or redness
  • Migrating pains & sensitivities
  • Joint pain that may worsen in the morning and evening horse but loosen up and improve when with certain exercises or controlled movements.

One of the challenges when it comes to improving joint pain is that by its very nature, it becomes uncomfortable to move the affected joints. However, it is oftentimes deliberate motion that is exactly what is needed to mobilize the area and increase circulation to speed up recovery. For this reason, it is important to maintain some level of non-draining physical activity. Yoga, breathwork, tai chi, and chi gong are all good options.

The brain’s role in post-COVID inflammation

What does science say?

One recent breakthrough in just the last decade has been understanding neuroplasticity, the brain’s ability to adapt and change. Neuroplasticity is what makes it possible for us to learn new skills like riding a bike, but it also can also enable our bodies and even immune systems to learn to perform certain actions that may be warranted in some circumstances (e.g. acute infection) but not in others (e.g. months after the infection has passed).

This recent article in Scientific American articulates how the brain has a special kind of “memory” for past infections and begins to explain how immune system activity may have certainly learned a component that produces what researchers call an inflammatory reflex response.

The hopeful part is that in the same way that the brain can learn to produce certain immune responses, there is research to support that it can also be retrained through self-directed means to learn new responses that inhibit the inflammatory activity which is thought to be at the heart of many of the symptoms the people experience.

5 keys for recovering from lingering joint pain after covid

While the following keys pertain to recovering from the persistent joint pain aspect that some may be experiencing as a symptom of Long-COVID, these tips would apply to anyone on the road to COVID recovery or recovery from any sort of post-viral fatigue.

1 – Rest

It’s important when recovering from any condition to get plenty of rest and allow your body to engage in its natural self-healing processes. This includes limiting intense physical activity, but also work-related tasks that may be creating ongoing stress or causing sleep disturbances.

One way to ensure that you’re getting the rest you need is to create an evening ritual in which you take a break from screens and consume new information. During the pandemic, many of us found ourselves turning to the news constantly and finding it difficult to “turn off our racing minds.”

It’s so important when recovering to ensure that your mind is resting as well as your body. And this all starts with creating the optimal conditions by removing the activities that prevent us from settling in.

2 – Movement

Light physical activity and mobilization can be beneficial. Of course, you’ll have to gauge your energy expenditure, and a cold rule of thumb is to avoid glycolytic types of activities such as high-intensity training or HIT while on the mend. Slow stretching and walks in nature are great.

3 – Stress Reduction

Cortisol and adrenaline are known as stress hormones for the ability to increase heart rate and keep our nervous systems in a sympathetic state. This is an important function to have in the acute setting because it sharpens our focus and gives us a short-term burst of energy needed to solve problems or get to safety. The problem is that if we are under chronic stress, these same hormones and chemicals can actually wear us down, overly taxing the adrenal glands and leading to excess inflammation and symptoms.

Disengaging from stressful thoughts and activities is paramount for recovery and re-origin has a program that actually teaches you how to do this.

4 – Mood Elevation

It may seem trite but there is scientific evidence to support that elevating your mood actually increases the release of specific feel-good neurotransmitters such as dopamine, oxytocin, serotonin, and endorphins. Moreover, this boost in positive neurochemistry actually counteracts the effects of the stress response through a phenomenon known as reciprocal inhibition.  

In short, the more time you spend in an elevated state, the less time you are spending in an adrenalized state. Over time this can have a massive positive impact on your physiology and even help to rewire your brain to default to a more parasympathetic state which is optimal for healing and recovery.

5 – Brain Retraining

It is now becoming more widely known and accepted that it is scientifically possible to rewire the stress response through the use of a self-directed neuroplasticity program like the one re-origin offers. In this recent article in the Washington Post, the key takeaway is that even chronic pain is treatable when patients focus on the brain. Within the article, this study is referenced in which 66% of patients eliminated their chronic pain using neuroplasticity training while 98% saw a reduction in pain.


If you’ve been struggling with muscle or joint pain after COVID-19, or other common post-COVID symptoms mentioned herein, there may be a reason to be hopeful when you turn your attention toward retaining the brain. If you’ve found this article insightful, then check out our section on neuroplasticity and see if our brain retraining program is the right fit for you.




Ben Ahrens, HHP