An exploration into the self-reported experiences of musculoskeletal pain in females diagnosed with long Covid within the eThekwini Municipality

Abstract

BACKGROUND The COVID-19 pandemic caused a worldwide health crisis that prompted an increase in the output of research targeted at expanding the knowledge available about COVID-19, the symptoms experienced and its consequences. Post-acute sequelae of SARS-CoV-2 infection is described as the persistence of symptoms since the initial diagnosis of COVID-19 for more than four weeks and, in most cases, lasting for months at a time. It is also referred to as Long COVID. Musculoskeletal pain (MSP) in relation to this condition is associated with tenderness, discomfort and stiffness of the joints, bones or muscles. Amidst the various reports of symptoms experienced by those affected by Long COVID, MSP has been identified as the most prevalent and debilitating manifestation, common in patients diagnosed with Long COVID. Despite current literature detailing the prevalence of various symptoms associated with Long COVID, a gap in the literature remains in the understanding of the experiences of individuals affected by MSP. Research has identified that women are more likely to endure symptoms of Long COVID, especially MSP, as compared to males. Given that women share a disproportionate burden of Long COVID, it is imperative to get a better understanding of the unique difficulties and lived experiences of women suffering from MSP. A thorough exploration into the various factors that play a role in the onset, development, persistence, and consequences of this symptom is required to fully grasp the experiences women have had whilst enduring MSP. Various factors play a vital role in the influence of an individual’s experiences of MSP throughout their Long COVID journey; these include pre-existing musculoskeletal conditions, the severity of the illness itself, biological changes because of COVID-19, psychological stresses, social determinants of health and health seeking approaches. This qualitative investigation aimed to address this gap in the literature by conducting in depth interviews amongst women with Long COVID experiencing MSP. This approach was to capture the rich perspectives of the participants, detailing daily life experiences, and methods of coping and challenges associated with MSP as a result of Long COVID. The benefits of a deeper understanding of the MSP experiences in women with Long COVID include interventions and support services specifically designed to address the unique challenges and needs that women encounter, resulting in a better quality of life and overall well-being. AIM OF STUDY The aim of this study has been to explore the experiences of MSP as a clinical manifestation of long COVID in women. METHODOLOGY A qualitative, exploratory, descriptive approach was utilised in this study(McLeod 2017). The purpose of a qualitative approach is to obtain a greater understanding of the experiences and perspectives of individuals who provide rich data without the use of quantitative and statistical methods. The sampling strategy utilised in this study was purposive sampling with the snowball method to obtain data. In this study, MSP was explored through the first-hand experiences of women with Long COVID to further understand how this clinical manifestation has affected their quality of life. This study involved conducting individual in-person interviews with a sample size of 12 women with Long COVID, with the purpose of providing personal, engaging interactions to obtain rich, reliable data. The benefit of conducting personal interviews is that it gathers the personal perspectives of individuals and explores responses to questions, which adds reliability to the study. Data was collected until saturation was attained. Data saturation was reached after interviewing the eighth participant, but four additional participants were interviewed thereafter to confirm saturation was reached. RESULTS The data were analysed using Tesch’s method to identify themes and subthemes. This involved the transcription and review of the participant responses, coding the responses according to themes and further categorizing similar themes into subthemes. The main themes that were identified in this study were the common clinical presentation of MSP experience due to Long COVID, negative effects of MSP on the quality of life and the varied and limited choice of healthcare treatment options. The participants shared a commonality with regard to the clinical presentation MSP, as most of them experienced back pain, neck pain, shoulder pain and headaches. The participants reported that they led a poor quality of life due to the extent of MSP which negatively affected their ability to perform daily tasks and resulted in constant fatigue. A high prevalence of anxiety, depression and frustration was experienced by the participants as they were exhausted from trying to find an effective treatment to resolve their pain. Most participants were highly reliant on pain medication to find some type of relief. Others sought alternate methods of care in the form of chiropractic treatment and lifestyle changes. This helped them better manage their pain and improve their general well-being. CONCLUSION The results of this study revealed that MSP is a prevalent and debilitating symptom amongst women with Long COVID. It affects various major aspects of lives, such as physical functioning, socialisation and mental health. A multi-disciplinary approach is imperative to provide efficient and effective health care to patients. Therefore, it is imperative that not only chiropractors but all health care practitioners who come into contact with affected women are able to create well-rounded treatment plans for those patients and converse easily with them to find a solution to their pain.