The world of medicine must constantly learn what it does not know. This requires a level of humility and a measure of hunger. With the advent of COVID, we have all faced the unknown of a novel infection which required us to admit that we had much to learn about viruses and their diseases. The suffering COVID produced created a hunger for a deeper understanding. As such new knowledge filtered out from the research world, those of us in clinical setting, directly caring for patients must both keep learning from the research and keep our eyes open for the obvious patterns of disease we see in our patients.
When it comes to COVID 19, the newest viral epidemic which we all have come to hate, besides the initial disease with fever and breathing issues, we have come face to face with multiple post-acute, lingering or even permanent symptoms. Both researchers and clinicians have acknowledged various patterns left over in a large percentage COVID patients which deserve all our attention. In caring for numerous patients with biotoxin illnesses like mold toxicity, Lyme disease, and Bartonella, our clinic has recognized similar multi-system, multi-symptom patterns after COVID infection.
These researchers from the Washington School of Medicine recognized that many post-COVID patients appeared to experience neuropathic type pain for weeks to months after the initial infection. Neuropathic pain simply indicates that the person feels a painful sensation due to damage to the nerve rather than the tissue or body part that the nerve connects to. Rather than pain from a bruise or broken bone, the person feels pain from damage to the nerve to the skin or bone. Our clinic has seen this pattern in a few patients as well. To evaluate if their suspicions were correct, they applied a combination of a COVID test with a follow up survey to compare the occurrence of neuropathic pain between COVID positive and COVID negative patients. The COVID positive group numbered around 500 while the COVID negative comparison group numbered around 1000.
One might ask why we need to spend time and money on such research instead of just responding to the clinical observations that some patients appear to develop neuropathic pain after COVID. To answer this challenge, we must consider the shortcomings of simple observation in terms of large populations experiencing a symptom or disease. Any single medical provider will only see a limited number of the new disease or new pattern, insufficient to fully assess if their suspicions are accurate. With a limited number of examples for that single provider, the ability test therapies will be limited such that determining the best therapy will be practically impossible in most cases. With a small number of cases, nuances and risk factors will be hard to ascertain leaving the clinician doing a lot of guess work. Furthermore, the general consensus of individual providers may be swayed by public opinion or media pressure to go off in less-than-optimal directions.
Therefore, for these and other reasons, systematically comparing such groups as this study does helps us to grow in our confidence that COVID 19 infection does leave a significant percentage of its sufferers with some neuropathic pain symptoms for weeks to months after its occurrence. In this study, 28.9% of COVID positive patients experienced some type of neuropathic pain versus 12.9% of the COVID negative patients. Furthermore, such neuropathic pain persisted up to 90 days post infection in 6.1% of the COVID patients versus only 1.9% of the negative individuals. This statistically significant difference persisted after considering the contribution of prior pain diagnoses in each group.
If you are a medical provider today, this study means that you must keep your ears open to your patients and listen for such patterns. Only when you stay watchful can you properly identify patients who might benefit from intervention to lessen such patterns of pain. Moreover, regardless of this study, we as medical providers must keep our antennae ready to catch any developing signal in groups of patients entering our clinic doors. Instead of ignoring the patterns of patients complaining of new or unusual symptoms, maybe blaming the unexplained issues on fear or anxiety, we should take our patients complaints seriously and look for root causes. We will find keys to helping our patients overcome such initially unexplained symptoms by staying humble and hungry for answers.
If you are an individual with such symptoms who cannot get answers from the providers you are seeing, you will want to continue looking for a medical provider who is humble and hungry. Their willingness to keep looking for answers to what seems initially puzzling may lead to answers for you and others with a healthier, more abundant life.
Odozor, Chioma U.a; Kannampallil, Thomasa,b; Ben Abdallah, Arbia; Roles, Kristena; Burk, Carriea; Warner, Benjamin C.b; Alaverdyan, Harutyuna; Clifford, David B.c; Piccirillo, Jay F.d; Haroutounian, Simona,e Post-acute sensory neurological sequelae in patients with SARS-CoV-2 infection: the COVID-PN observational cohort study, PAIN: March 24, 2022 – Volume – Issue – 10.1097/j.pain.0000000000002639 doi: 10.1097/j.pain.0000000000002639
Thanks to Science Daily:
Washington University School of Medicine. “COVID-19 infection linked to higher risk of neuropathy: Symptoms persisted for months after a positive test for COVID-19.” ScienceDaily. ScienceDaily, 25 March 2022. <www.sciencedaily.com/releases/2022/03/220325122658.htm>.
Sanctuary Functional Medicine, under the direction of Dr Eric Potter, IFMCP MD, provides functional medicine services to Nashville, Middle Tennessee and beyond. We frequently treat patients from Kentucky, Alabama, Mississippi, Georgia, Ohio, Indiana, and more... offering the hope of healthier more abundant lives to those with chronic illness.