The US Centers for Disease Control and Prevention recently added six new COVID-19 symptoms to its official list. Now, in addition to the standard dry cough, shortness of breath, and fever, the CDC also lists chills, repeated shaking with chills, headache, sore throat, new loss of smell or taste, and muscle pain to the list of signs of a coronavirus infection.

To be clear, many of those symptoms aren’t brand-new discoveries: In March, ear, nose, and throat specialists in the United Kingdom warned that lost sense of smell and taste may be a symptom of COVID-19; and anecdotally, people have also reported chills, headache, and sore throat.

The newly-added symptom of muscle pain, however, may be a little more surprising than the rest. While body aches and pain can be the result of pretty much anything, it turns out coronavirus-related muscle pain is a bit different.

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How common is muscle pain with COVID-19?

The CDC doesn’t provide that information on its list of symptoms, but according to the World Health Organization, muscle pain (aka, myalgia) was a little less common than other well-known coronavirus symptoms.

A February WHO report, which analyzed 55,924 laboratory-confirmed cases of COVID-19 in China, found that 14.8% of patients reported myalgia or arthralgia (joint pain). That’s significantly less than the amount of patients who reported a fever (87.9%) and dry cough (67.7%), and still less common than other symptoms like fatigue (38.1%) and shortness of breath (18.6%). It is, however, slightly more common than sore throat (13.9%), headache (13.6%), and chills (11.4%).

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Why does COVID-19 cause muscle pain

Muscle pain—often caused by muscle inflammation (myositis)—isn’t an uncommon symptom for a viral infection. “In general, coronavirus, like other viruses, can cause inflammation of the muscle tissue,” Amir Barzin, DO, MS, incident commander for the Respiratory Diagnostic Center at UNC Medical Center in Chapel Hill, tells Health.

Dr. Barzin explains that muscle pain that results from a viral infection is caused by damage to the muscle fibers from the virus itself. The virus also triggers an inflammatory response within your body—through inflammatory cytokines that essentially signal the immune system to get to work—that can cause abnormal tissue breakdown.

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What does muscle pain from COVID-19 feel like?

According to Dr. Barzin, the muscle pain associated with COVID-19 usually feels like “tenderness to the touch of the muscle or pain with movements of the muscle.” While muscle pain from a workout can feel similar to muscle pain caused by a virus like SARS-CoV-2, virus pain tends to be more generalized, while exercise- or injury-related pain tends to be more localized in a specific muscle.

Sometimes even doctors have a hard time distinguishing virus-induced muscle pain from exercise-induced muscle pain. “It’s very hard to tell the difference,” Dr. Barzin admits, adding that doctors often have to play detective to get to the root of the issue—questioning whether the patient has worked out recently or if they have other infectious symptoms, like fever, chills, or coughing, which can help with a diagnosis.

Virus-related muscle pain and exercise-induced muscle pain are also different in how long they take to resolve. “Viral myopathies [muscle issues] tend to resolve in weeks to months after the infection clears,” says Dr. Barzin, while he notes that muscle soreness from exercise tends to resolve within 48-72 hours.

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How can you treat muscle pain from COVID-19?

According to Dr. Barzin, “muscle soreness from exercise can be relieved by icing, rolling, light stretching, massage, and light aerobic activity before starting your workout routine.”

But when it comes to muscle pain that may be a result of COVID-19 or another viral infection, treatment looks a little different. Charles Odonkor, MD, a Yale Medicine physiatrist and pain medicine specialist recommends bed rest, fluid hydration, and general symptom management with pain relievers like acetaminophen or NSAIDs (nonsteroidal anti-inflammatory drugs) like aspirin and ibuprofen. Dr. Odonkor notes, however, that if you don’t feel relief from the above recommendations, you should seek medical care. 

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it’s possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department