How long does the pain caused by chikungunya last?

There is no vaccine or specific treatment to treat chikungunya. The disease is a mosquito-borne arbovirus Aedes aegypti. Theories point out that the virus has an affinity for tissues that have the fibroblast present, a cell that is in the joints, cartilage, that is, in the skeletal muscle. The theory may explain why one of the sequelae of the disease is the joint painwhich can last from 14 days to three months or, worse, become chronic.

The rheumatologist Claudia Marques, from the Brazilian Society of Rheumatology (SBR) and professor of the discipline of Rheumatology at the Federal University of Pernambuco (UFPE), explains how the virus can manifest itself in people, what other sequelae the disease can generate and, mainly, what care people can take to ease the pain of this arbovirus.

How does chikungunya act on the human body?

The chikungunya virus has an affinity for tissues that have a cell, which we call a fibroblast, which is a cell that is present in joint tissues, nerve tissue cells, skeletal muscle tissue, as well as joints and cartilage. When this virus attacks the immune system, an immune response occurs, which can be the joint inflammatory response, sometimes muscular, but is preferentially joint.

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Why does chikungunya leave sequels?

There is a thesis of the continuity of the presence of viral proteins, which remain in the joint tissues after 14 days of the disease. The pain and sequelae of the disease are not all the same. There is the inflammatory sequel, which is a sequel in which the patient develops a condition similar to arthritis and arthrosis, and it is treated in exactly the same way, but this is the minority of patients.

Most are non-inflammatory, a pain that we cannot identify. It is this non-inflammatory pain that is not very well understood why it happens. One hypothesis is that the virus causes central sensitization, which is a painful and exaggerated response, which is why the patient is in pain.

Patients with non-inflammatory conditions do not have sequelae from a structural point of view. They just feel pain, which can prevent the patient from doing everyday activities. But, however, he will not have a motor sequel, that is, a joint involvement, with a disease such as arthritis and osteoarthritis.

What are the main sequelae of chikungunya and who tends to have them?

The major sequel is muscle and skeletal pain. There are patients who have neurological, cardiac and pulmonary involvement, but this is more in the acute phase, which is that phase in which the patient inflames, in the first 14 days. These are the less common sequelae. The most common really is joint pain. Patients over 45 years of age are more likely to have joint sequelae.

How long does the joint pain caused by chikungunya last?

It’s variable. It can be a short period, which is in the acute phase, which lasts up to 14 days. There are patients who progress to the sub-acute phase, which lasts up to three months, and there are patients who go to the chronic phase. In this case, there are reports from patients that the pain can follow from five to ten years. Everything will depend on how the disease will manifest itself in the patient. If it is inflammatory, the time is longer. Non-inflammatory, the time is shorter, with the help of treatment, such as physical activity and physiotherapy.

What care should people who have sequelae have after the disease?

If the patient in the acute phase improves in the first 14 days, he does not need to look for a specialist. If he is very uncomfortable, that is, in a lot of pain, he should seek medical attention.

When he is in the chronic phase, it is appropriate for him to see a rheumatologist. The professional will undergo a treatment involving the practice of physical activities and physiotherapy, how he can deal with the pain, and will use medications that will relieve the patient’s painful condition. But, in general, everyone should do physical therapy and have a routine of physical activities.

Is there a period when people affected by the disease should rest?

Not. On the contrary, staying at rest is worse for aggravating the pains of the disease. Chikungunya likes people who stand still. So, the more still a person is, the more the pain subsides. People need to move. Therefore, if the person is unable to move, they should seek medical help to receive appropriate guidance and treatment for this sequel.

Where to look for care to treat chikungunya pain?

In Ceará, there are no health units dedicated only to the treatment of the disease. The orientation of the Secretary of Health of Ceará (Sesa) is that people affected by the sequelae seek the Basic Health Units (UBS) of the municipalities to receive care and guidance for the disease.

In case of emergency, the folder guides the patient to look for the municipal and state Emergency Care Units (UPAs). The Municipal Health Department of Fortaleza (SMS) reported that users who need care due to arboviruses should look for the Health Centers closest to their residence; the Capital currently has 116 units.

According to the folder, the same procedure is adopted for subsequent treatment of arboviruses. After consultation at the health center, the user is referred to a specialist in the Specialized Network.

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