Coronavirus: COVID recovery and hospitalization adding to your physical pain? Here's what physiotherapists recommend to manage pain

The second wave of coronavirus has not only impacted people's physical health, but also taken a heavy toll on their mental well-being. While severe COVID patients continue to scavenge for hospital beds amidst the massive surge in the number of coronavirus cases, those who have managed to find a bed are also struggling to cope with the physical ailments caused due to their long hospitalisation period.
In such a scenario, it is not only important to evaluate when a person should seek hospitalisation, but people should also be aware of the measures they can take to ease their pain. That said, we spoke to some physiotherapists, who list down ways to tackle not just the physiological problems, but also psychological challenges caused due to extended hospital stays.
When should you seek hospitalisation/medical attention?
Dr. Shivangi Borkar, Head of the Department of Physiotherapy, P.D Hinduja Hospital & MRC, recommends that every individual with symptoms related to COVID-19 needs to check their temperature and oxygen saturation regularly. Apart from that, "Monitoring the levels, periodically and following up with the doctor plays a significant role," she says.
However, when it comes to hospitalising COVID patients, Dr. Rebecca Pinto of Dr. Rebecca Pinto Physiotherapy Clinic, Mumbai, suggests that admission should depend on a patient's general condition, comorbidities and lab reports. If the frequency of fever increases or the temperature remains above 102 degrees celsius, respiration rate is more than 30, there is shortness of breath or spo2 is less than 92, then patients should seek hospitalisation, as per Dr. Pinto.
Challenges faced by patients during their long hospital stays
Long, extended lengths of hospitalisation can often lead to immobility causing severe muscle pain and stiffness in various parts of the body.
According to Dr. Borkar, given that the patient is made to lie down on the bed for long hours, they tend to develop joint pains, stiffness, and the body gets de-conditioned. "In case the patient has any existing underlying problem like stroke or kidney disease or any other medical or surgical condition before COVID-19, the situation worsens because of lying down on the bed due to lack of mobility," she adds.
In addition, Dr. Pinto emphasizes the need for psychological care during long hospital stays. While physical challenges can be taken care of with good nursing care, physiotherapists and support staff, maintaining a good state of mind is also crucial during such times, she notes.
Prolonged hospitalisation can cause inactivity, leading to decrease in muscle strength
Dr Dharam Pandey, HOD and Consultant, Physiotherapy & Rehabilitation Sciences, Manipal Hospitals, Dwarka, New Delhi elaborates on how prolonged bed rest can lead to restricted mobility, lack of physical activity and cause 'deconditioning'.
According to Dr. Pandey, immobilisation can decrease muscle strength. Use of certain essential medications and prolonged mechanical ventilation may also result in critical illnesses associated with neuromyopathy. Apart from that, Dr. Pandey mentions how inactivity can cause the periarticular and cartilaginous joint structure to change (most rapidly in the legs), limiting motion and contributing to development of contractures.
How can you minimise body aches/pains and injuries during your hospitalisation?
While joint pain and body aches are very common during hospitalisation, Dr. Borkar recommends patients to move as much as they can in their own capacities. Frequent movements of the hands and legs and turning one's body from one side to another, can minimise joint stiffness and pain in the body.
In case of severe pain, Dr. Pinto advises patients to take analgesics given by doctors. A good support or nursing staff can be a good source of assistance to those who cannot move around on their own. Apart from that, frequent changes in postures is recommended in order to prevent bed sores.
Maximising lung capacity in COVID-19 patients
Additionally, Dr. Borkar discusses the consequences of laying in bed for long hours. She says, "Patients in bed for long hours will face a situation where the capacity of the lungs goes down. Sometimes patients have persistent coughs too. Chest physiotherapy plays a significant role in the recovery to improve lung capacity and stamina."
Apart from that, she sheds light on how patients also tend to get depressed, which is why it becomes crucial to psychologically boosting their moods to help them stay positive.
"Physical exercises, improving lung capacity, and psychological counseling play a significant role," she emphasizes.
Dr. Pinto also accents on the need to increase lung capacity and recommends 'proning' for good ventilation of lungs and drainage of secretions. Proning or prone positioning is the placement of patients on their stomach or on the sides. This is used in the treatment of patients dealing with acute respiratory distress syndrome and is currently a very sought after method to treat lung distress in COVID patients.
Therapeutic treatments patients can get post-hospitalisation
Being discharged from hospitals is surely a relief and means that a person is out of danger. However, the real battle starts post-hospitalisation during the recovery phase.
Dr. Pandey suggests, "Physical rehabilitation is very important after prolonged hospitalisation. It improves the quality of life of patients who have recovered from COVID-19 but continue to have generalised weakness, muscle pain, decreased muscle strength, fatigue and breathing problems."
He believes physiotherapy is the most effective intervention in treating post COVID hospitalisation, as it is non-invasive, non-pharmacological, yet very effective in improving the muscle strength, lung capacity, fatigue management, etc. "A typical post hospitalisation physiotherapy care plan consists of assessment of physical strength, breathing pattern and exercises tolerance level of the patient. Based on the assessment findings, an appropriate physiotherapeutic rehabilitation plan can be made," he adds.
In addition, patients need to continue breathing exercises, must take multivitamins, indulge in a good diet and gradually increase their exercises/walking/jogging, emphasizes Dr. Pinto.