Management of the Neuropathic Pain due to COVID-19: A Case Report

Year 2022, Volume: 9 Issue: 3, 627 - 635, 31.12.2022

Emel Taşvuran Horata Hilal Yeşil

Abstract

Objectives: This study aimed to present the management of a case with neuropathic pain after COVID-19.
Materials and Methods: A 27-year-old man presented to the hospital with a high fever, headache, dyspnea, and fatigue. COVID-19 test of the patient was positive and he started to be followed up at home. After the 8th week, the patient had complaints of difficulty in wearing his clothes, sensitivity to temperature changes, and allodynia and was referred to physiotherapy and rehabilitation with the diagnosis of neuropathic pain. Neuropathic pain screening tools and the Visual Analog Scale were used in the evaluation. Painful areas were mapped with Semmens Weinstein 15 g monofilament. In management, 6 weeks (twice a day, approximately 1 hour) of physiotherapy (classic massage and TENS) was applied with pregabalin.
Results: Physiotherapy applications with Pregabalin decreased both pain severity and pain area.
Conclusion: Physiotherapy applications are useful in neuropathic pain due to COVID-19. Further studies are needed.

Keywords

COVID-19, Neuropathy, Pandemics, Physical Therapy Modalities

Supporting Institution

Destekleyen Kurum bulunmamaktadır.

Project Number

-

Thanks

-

COVID-19 Nedeniyle Oluşan Nöropatik Ağrının Yönetimi: Bir Vaka Sunumu

Abstract

Amaç: Bu çalışma, COVID-19 sonrası oluşan nöropatik ağrılı bir vakanın yönetimini sunmayı amaçlamıştır.
Gereç ve Yöntem: 27 yaşında erkek hasta yüksek ateş, baş ağrısı, nefes darlığı ve halsizlik ile hastaneye başvurdu. Hastanın COVID-19 testi pozitif çıktı ve evde takip edilmeye başlandı. 8. haftadan sonra hasta kıyafetlerini giymekte güçlük, ısı değişikliklerine duyarlılık ve allodini şikayetleri ile nöropatik ağrı tanısıyla fizyoterapi ve rehabilitasyona yönlendirildi. Değerlendirmede, nöropatik ağrı tarama araçları ve Görsel Analog Skalası kullanıldı. Ağrılı alanlar Semmens Weinstein 15 g monofilament ile haritalandı. Tedavide pregabalin ile 6 hafta (günde iki kez, yaklaşık 1 saat) fizyoterapi (klasik masaj ve TENS) uygulandı.
Bulgular: Pregabalinle birlikte fizyoterapi uygulamaları hem ağrı şiddetini hem de ağrı alanını azalttı.
Sonuç: COVID-19 nedeniyle oluşan nöropatik ağrıda fizyoterapi uygulamaları yararlıdır. Daha ileri çalışmalara ihtiyaç vardır.

Keywords

COVID-19, Nöropati, Pandemi, Fizik tedavi modaliteleri

Project Number

-

References

• Aksan, F., Nelson, E. A., & Swedish, K. A. (2020). A COVID-19 patient with intense burning pain. J Neurovirol, 26(5), 800-801. DOI: 10.1007/s13365-020-00887-4.
• Buckenmaier, C., Cambron, J., Werner, R., Buckenmaier, P., Deery, C., Schwartz, J., et al. (2016). Massage therapy for pain—call to action. Pain Medicine: The Official Journal of the American Academy of Pain Medicine, 17(7), 1211-1214. https://doi.org/10.1093/pm/pnw092.
• Dietz, F. R., & Compton, S. P. (2015). Outcomes of a simple treatment for complex regional pain syndrome type I in children. The Iowa orthopaedic journal, 35, 175-180.
• Ellul, M. A., Benjamin, L., Singh, B., Lant, S., Michael, B. D., Easton, A., . . . Solomon, T. (2020). Neurological associations of COVID-19. The Lancet Neurology, 19(9), 767-783. DOI: https://doi.org/10.1016/S1474-4422(20)30221-0.
• Ftiha, F., Shalom, M., & Jradeh, H. (2020). Neurological symptoms due to Coronavirus disease 2019. Neurology international, 12(1), 15-18. doi: 10.4081/ni.2020.8639.
• Gibson, W., Wand, B. M., & O'Connell, N. E. (2017). Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database of Systematic Reviews 9(9), CD011976. DOI: 10.1002/14651858.CD011976.pub2.
• Gupta, A., Madhavan, M. V., Sehgal, K., Nair, N., Mahajan, S., Sehrawat, T. S., et al. (2020). Extrapulmonary manifestations of COVID-19. Nature medicine, 26(7), 1017-1032. DOI: 10.1038/s41591-020-0968-3.
• Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., et al. (2020). Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol, 77(6), 683-690. https://doi.org/10.1001/jamaneurol.2020.1127.
• Murnion, B. P. (2018). Neuropathic pain: current definition and review of drug treatment. Australian prescriber, 41(3), 60–63. https://doi.org/10.18773/austprescr.2018.022.
• Piovesan, E. J., Di Stani, F., Kowacs, P. A., Mulinari, R. A., Radunz, V. H., Utiumi, M., et al. (2007). Massaging over the greater occipital nerve reduces the intensity of migraine attacks: evidence for inhibitory trigemino-cervical convergence mechanisms. Arquivos de neuro-psiquiatria, 65(3A), 599-604. DOI: 10.1590/s0004-282x2007000400010.
• Sarısoy, P., & Ovayolu, O. (2020). The Effect of Foot Massage on Peripheral Neuropathy-Related Pain and Sleep Quality in Patients With Non-Hodgkin's Lymphoma. Holistic Nursing Practice, 34(6), 345-355. DOI: 10.1097/HNP.0000000000000412.
• Sherry, D. D., Wallace, C. A., Kelley, C., Kidder, M., & Sapp, L. (1999). Short-and long-term outcomes of children with complex regional pain syndrome type I treated with exercise therapy. The Clinical journal of pain, 15(3), 218-223. doi: 10.1097/00002508-199909000-00009.
• Spicher, C. J., Fehlmann, P., Maihöfner, C., Sprumont, P., Letourneau, E., Dyer, J., et al. (2016). Management Algorithm of Spontaneous Neuropathic Pain and/or Touch-evoked Neuropathic Pain illustrated by prospective observations in clinical practice of 66 chronic Neuropathic Pain Patients. E-News Somatosens Rehab, 13(1), 4-32.
• Widyadharma, I. P. E., Sari, N. N. S. P., Pradnyaswari, K. E., Yuwana, K. T., Adikarya, I. P. G. D., Tertia, C., etal. (2020). Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: a literature review. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 56(1), 1-8. doi: 10.1186/s41983-020-00258-0.