Dr. Jordan Sudberg on Long COVID and Chronic Pain: Understanding the Overlap and Paths to Relief

When the COVID-19 pandemic began, the world focused on preventing transmission and saving lives during the acute phase of the virus. But as time passed, a new concern emerged: Long COVID—a complex, often debilitating condition affecting millions globally. While symptoms vary widely, chronic pain has become one of the most persistent and challenging consequences of this post-viral syndrome.

Pain management specialist Dr. Jordan Sudberg has been at the forefront of helping patients manage these lingering symptoms. “We’re now seeing a clear overlap between Long COVID and chronic pain,” says Dr. Sudberg. “What was once an acute illness for many has become a long-term pain condition that needs specialized care.”

In this article, we explore the connection between Long COVID and chronic pain, the underlying mechanisms, and how experts like Dr. Sudberg are addressing this evolving health challenge.

What Is Long COVID?

Also known as post-acute sequelae of SARS-CoV-2 infection (PASC), Long COVID refers to a constellation of symptoms that persist for weeks or months after the initial COVID-19 infection has resolved. These symptoms can affect virtually every system in the body and often include:

• Fatigue
  
• Brain fog
  
• Shortness of breath
  
• Heart palpitations
  
• Muscle and joint pain
  
• Headaches
  
• Sleep disturbances
  

For some, these symptoms resemble autoimmune conditions or chronic fatigue syndrome (ME/CFS). For others, pain—especially musculoskeletal pain—becomes the most debilitating feature.

Chronic Pain and Long COVID: What’s the Link?

Dr. Jordan Sudberg explains that chronic pain is not uncommon after viral illnesses, but COVID-19 has introduced a new level of complexity.

“COVID-19 is a systemic virus. It doesn’t just affect the lungs—it has the ability to impact the nervous system, blood vessels, muscles, and connective tissues,” says Dr. Sudberg. “That’s why so many Long COVID patients experience chronic pain in diverse forms.”

Some of the most common pain-related symptoms include:

• Myalgia (muscle pain)
  
• Arthralgia (joint pain)
  
• Neuropathic pain (burning, tingling, or shooting pain often tied to nerve damage)
  
• Headaches and migraines
  
• Widespread body pain resembling fibromyalgia
  

Why Does Long COVID Cause Pain?

Though research is still developing, Dr. Sudberg outlines several key theories that may explain the link:

1. Nervous System Dysfunction

COVID-19 has been shown to affect the central and peripheral nervous systems. This can result in dysregulation of pain signals, similar to what is seen in conditions like fibromyalgia.

“Pain is essentially a signal. When the nervous system becomes hypersensitive due to viral damage or inflammation, it can send pain signals even in the absence of actual tissue damage,” Dr. Sudberg explains.

2. Immune Response and Inflammation

Persistent inflammation following infection can trigger pain in muscles, joints, and nerves. Cytokine storms—a hallmark of severe COVID cases—may also leave long-term inflammatory imprints on the body.

3. Mitochondrial Dysfunction

Fatigue and muscle pain may stem from impaired mitochondrial function—meaning cells are unable to produce energy efficiently. This leads to muscle weakness and soreness, particularly after exertion.

4. Deconditioning

Prolonged bed rest or reduced activity during and after acute illness can lead to muscle wasting and joint stiffness, which compounds chronic pain.

Diagnosis: A Challenge for Patients and Providers

Diagnosing chronic pain related to Long COVID isn’t always straightforward. There’s no single test, and symptoms often overlap with other conditions like:

• Chronic fatigue syndrome
  
• Fibromyalgia
  
• Autoimmune diseases
  
• Post-viral syndromes
  

Dr. Sudberg emphasizes the importance of listening to patients. “Many Long COVID patients feel dismissed or misunderstood. As pain specialists, it’s our responsibility to validate their experience, conduct a thorough evaluation, and create a personalized care plan.”

Treatment: How Dr. Jordan Sudberg Approaches Pain in Long COVID

Because of the multi-system nature of Long COVID, treatment requires an interdisciplinary approach that addresses both the physical and neurological aspects of pain.

1. Physical Rehabilitation and Graded Exercise Therapy

Gentle, progressive physical therapy is often key to restoring mobility and strength. However, Dr. Sudberg warns against overexertion, especially in patients experiencing post-exertional malaise (PEM).

“We tailor movement programs very carefully,” he says. “The goal is to build resilience without triggering crashes.”

2. Neuromodulation and Nerve Blocks

For patients with neuropathic pain, Dr. Sudberg may use targeted nerve blocks, spinal cord stimulation, or non-invasive neuromodulation techniques to disrupt pain signaling pathways.

“These interventions can offer relief when oral medications fall short,” he notes.

3. Medication Management

Depending on the type of pain, a combination of medications may be used:

• NSAIDs for inflammation
  
• Anticonvulsants (like gabapentin) for nerve pain
  
• Low-dose antidepressants for pain sensitization and mood stabilization
  
• Muscle relaxants for stiffness
  

Importantly, Dr. Sudberg stresses that opioid use is rarely the best option for Long COVID pain due to the chronic and multifaceted nature of symptoms.

4. Mind-Body Therapies

CBT (Cognitive Behavioral Therapy), mindfulness, and breathing techniques can help reduce the emotional burden of pain and improve coping skills.

“Pain lives in the body, but it’s processed by the brain,” says Dr. Sudberg. “Teaching patients how to manage their stress response can make a profound difference.”

Hope on the Horizon: Research and Recovery

New research on Long COVID is happening at an unprecedented pace, offering hope for improved understanding and treatments. Multidisciplinary Long COVID clinics are also becoming more common, bringing together pulmonologists, neurologists, pain specialists, and psychologists.

Dr. Sudberg remains optimistic. “We’re learning more every month. The key is early intervention, compassionate care, and a personalized treatment plan that addresses the unique needs of each patient.”

Final Thoughts from Dr. Jordan Sudberg

“The pandemic has taught us that recovery doesn’t always end when the virus is gone,” Dr. Jordan Sudberg reflects. “For many people, the real battle begins after the acute illness, especially when pain becomes a constant companion.”

Long COVID and chronic pain may present new challenges, but with informed, integrated care, recovery is possible. Patients don’t have to suffer in silence—support, science, and solutions are out there.