Joint Pain After COVID-19 Vaccination: A Patient's Journey

Q: Joint Pain After COVID-19 Vaccination: A Patient's Journey

Hello： It is difficult to determine whether your knee pain is related to the COVID-19 vaccine. <br>You mentioned visiting a rheumatology clinic, where objective examinations revealed synovitis and mild degenerative arthritis. <br>However, the presence of synovitis and mild degene

After receiving the COVID-19 vaccine

Since receiving the COVID-19 vaccines, my reactions have varied with each dose.
Last year, after the first dose of AstraZeneca (AZ), I experienced swollen tonsils (commonly referred to in Taiwanese as "柱仔") and visited an ENT specialist.
I also had slight discomfort in my finger joints, which I consulted an immunologist about, and everything was normal.
After the second dose of AZ last year, I again had swollen tonsils and saw an ENT specialist.

This year, after the third dose of BNT on January 15, I developed a fever and cough, which improved after taking medication.
However, I continued to have issues with my foot joints (pain).
Initially, I thought I had sprained my foot, so I saw a doctor and underwent rehabilitation.
I didn’t pay much attention to it, and the pain subsided, but then it shifted to my knee joints.

After the fourth dose of Moderna on July 28, I started experiencing normal discomfort that I could find information about, but my knee pain worsened.
The next day, I saw a doctor and took medication, which improved my condition, including the knee pain.
However, a week later, I developed blisters on my lips, followed by swollen lymph nodes (referred to as "豆子" in Taiwanese).
Once I stopped the medication, my knee discomfort returned.

I began to wonder if this was related to the vaccine and consulted an infectious disease specialist, who found normal blood tests and X-rays.
The swollen lymph nodes resolved, and the knee pain improved with anti-inflammatory pain medication, but it returned when I stopped taking it.
The conclusion was that the vaccine might have triggered discomfort due to pre-existing conditions.

I then saw an orthopedic and rehabilitation specialist, who provided similar answers, and I was referred to a rheumatologist.
Blood tests were normal, but there was inflammation, and an ultrasound revealed synovitis and mild degenerative arthritis.
I was prescribed anti-inflammatory pain medication, but it was not very effective.

Some doctors suggested that my obesity (BMI around 30) and sedentary work might contribute to my knee pain, which would occur regardless of the vaccine, as I do not have hypertension, diabetes, or hyperlipidemia.
My knee pain has persisted for nearly three months, affecting my ability to stand, walk, sit, and squat.
I can only stand and walk now; sitting or squatting causes pain, leading to daily discomfort.
I take a painkiller daily.

I once asked a rheumatologist why my joints feel better after taking cold medication (which makes them more flexible), but once the cold resolves, the pain returns.
The doctor explained that it is normal because cold medications contain anti-inflammatory pain relievers, which alleviate joint pain.
Now, I take a simpler regimen for my cold (one cough suppressant three times a day, one expectorant three times a day, and one allergy medication daily), which also works well for my knee joints.

I would like to know if the joint pain after vaccination is a normal symptom, as I have never had knee injuries or pain before.
I am unsure if the discomfort from synovitis and degenerative arthritis is the same as my pain.
In conclusion, I am currently treating both my cold and joint pain with the same medications.
Is this normal?

su, 50~59 year old female. Ask Date: 2022/10/17

Dr. Lin Zhebin reply Family Medicine

Hello: It is difficult to determine whether your knee pain is related to the COVID-19 vaccine.
You mentioned visiting a rheumatology clinic, where objective examinations revealed synovitis and mild degenerative arthritis.
However, the presence of synovitis and mild degenerative arthritis does not necessarily mean that they will cause knee pain.
It is also possible that your body is reacting to the vaccine by producing antibodies, which may exacerbate the discomfort from synovitis and degenerative arthritis.
However, vaccine-related joint pain is typically a short-term side effect (within 7 days).

Additionally, cold medications theoretically should not have a therapeutic effect on knee pain.
However, it is possible that the central nervous system depressant effects of cough medicine may indirectly reduce pain, or that antihistamines may modulate the body's immune response, decreasing inflammation in the knee and alleviating pain.

Finally, I recommend that you engage in moderate exercise to increase muscle strength, perform appropriate stretching to maintain joint mobility, and make lifestyle adjustments to lose weight.
If taking cold medication currently alleviates your symptoms, you may continue using it for now.
Once your knee strength and mobility improve, and you lose weight, you can consider trying to discontinue the medication.

Reply Date: 2022/10/17

More Info

Understanding joint pain after COVID-19 vaccination is a complex issue that can involve various factors, including the immune response to the vaccine, pre-existing conditions, and individual health status. Based on your detailed account, it seems that you have experienced a range of symptoms following each vaccination, particularly with joint pain that has persisted and evolved over time.

1. Vaccine Response and Joint Pain: Vaccines, including those for COVID-19, can trigger an immune response that may lead to temporary inflammation in various parts of the body, including the joints. This is generally a normal reaction as the body builds immunity. However, in some individuals, this response can be more pronounced, leading to symptoms such as joint pain or stiffness. The fact that you have experienced joint pain after multiple vaccinations suggests that your body may be reacting to the vaccine in a way that exacerbates underlying conditions or sensitivities.

2. Underlying Conditions: You mentioned having a history of joint discomfort and being evaluated for conditions like synovitis and early degenerative joint disease. It is important to recognize that pre-existing conditions can be influenced by external factors, including vaccinations. The inflammation from the vaccine could potentially aggravate these conditions, leading to increased pain or discomfort. Your healthcare providers have noted that your joint pain may not be directly caused by the vaccine but could be a result of your overall health status, including factors like obesity and sedentary lifestyle.

3. Management of Symptoms: The use of anti-inflammatory medications, including over-the-counter pain relievers, can help manage symptoms. It is not uncommon for individuals to find relief from joint pain when taking medications that also address other symptoms, such as those found in cold or allergy medications. This is likely due to the anti-inflammatory properties of these medications, which can temporarily alleviate joint discomfort.

4. Monitoring and Follow-Up: Given that your joint pain has persisted for several months, it is crucial to continue monitoring your symptoms and maintain open communication with your healthcare providers. If your pain worsens or if you experience new symptoms, further evaluation may be necessary. This could include imaging studies or referrals to specialists, such as rheumatologists, who can provide more targeted assessments for autoimmune or inflammatory conditions.

5. Lifestyle Modifications: In addition to medication, consider lifestyle changes that may help alleviate joint pain. Regular low-impact exercise, weight management, and physical therapy can be beneficial in improving joint function and reducing discomfort. Engaging in activities that promote flexibility and strength can also be advantageous.

6. Psychological Impact: The psychological aspect of dealing with chronic pain and health concerns cannot be overlooked. Anxiety and stress can exacerbate physical symptoms, so it may be helpful to explore stress management techniques, such as mindfulness, meditation, or counseling.

In conclusion, while joint pain following COVID-19 vaccination can be concerning, it is essential to consider the broader context of your health. The interplay between the vaccine, your immune response, and any underlying conditions is complex. Continued monitoring, appropriate medical management, and lifestyle adjustments can help you navigate these challenges effectively. If you have further concerns or if your symptoms change, do not hesitate to seek medical advice for a thorough evaluation.

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