Even after a year into the pandemic, many communities are still operating under strict health and safety protocols to control the spread of COVID-19. Social distancing and stay-at-home guidelines are some of the most important measures to limit transmission of the disease, however, these measures may have negative consequences for people living with chronic pain.
To better understand just how the pandemic has impacted chronic pain management, here are the problems facing chronic pain patients amidst COVID-19, according to a recent review.
1. Lack of treatment
With many hospitals stretched out thin due to COVID-19 patients, many chronic pain patients have experienced prolonged delays in treatment. It’s either hospitals are too crowded to accommodate them, or patients themselves are apprehensive about seeking treatment in fear of catching the virus. Either way, delaying or stopping treatment for chronic pain will bear negative consequences, including the worsening of patient condition or overuse of non-opioid or opioid analgesics.
The review mentioned above contains recommendations for both inpatient and outpatient pain patients. Outpatient pain clinics are recommended to triage all patients into different levels of care according to their pain level, which should be measured through the Numeric Pain Rating scale or the Brief Pain Index. For inpatient facilities, on the other hand, it is recommended to have only one provider working in a certain area at a given time to limit patient-to-provider and provider-to-provider exposure. Patients who do not need urgent care should be given the option to consult with a provider through telemedicine to eliminate the risk of exposure entirely.
2. Overuse of pain medication
The overuse of pain medication is not a new issue in chronic pain management, but the isolation, lack of treatment options, and increased mental health concerns resulting from the pandemic can urge chronic pain patients to take more medication than necessary.
Opioids are considered controlled substances because they can be highly addicting when misused. In the short-term, opioid misuse can lead to drowsiness, slowed respiration, constipation, nausea, and loss of consciousness. Continued abuse of opioids can cause a physical dependence on the drug, leading to withdrawal periods when intake is halted, as well as symptoms like vomiting, diarrhea, insomnia, pain, and cold flashes.
Immunosuppression is another pressing effect of opioid overuse. In the middle of a pandemic, a weakened immune system can make chronic pain patients even more susceptible to the virus, as well as other diseases and infections.
3. Reduced physical activity
Many chronic pain patients rely on physical therapy sessions and regular exercise programs to minimize their pain. However, due to widespread stay-at-home guidelines, patients are finding it difficult to engage in regular physical activity, which makes their pain worse and ultimately impacts their quality of life.
Fortunately, telemedicine makes it possible for patients to consult with their physical therapists. While sessions may be limited to video conferencing, it is definitely a better option than going without physical therapy whatsoever. Many physical therapy clinics are also continuing operations, albeit at limited capacity, with health and safety standards in place to protect both staff and patients.
4. Exacerbation of mental health problems
Mental health is a concern for everyone during the pandemic, not just chronic pain patients. However, people living with chronic pain are more susceptible to mental health problems due to the consistent physical and emotional stress that they experience daily. Chronic stress due to pain is known to change the levels of neurochemicals and stress hormones in the brain and nervous system, which can ultimately affect one’s behavior, mood, and way of thinking. And with the added stress of the pandemic and its effects, chronic pain patients may experience the development or exacerbation of mental health problems, primarily depression and anxiety.
For this reason, mental health support for chronic pain patients is more critical now more than ever. With many patients also experiencing isolation amidst the pandemic, mental health services must be made more available and accessible to prevent patients from spiraling further downward and instead receive the care that they need.
5. Financial burden
Millions of people have lost their jobs because of COVID-19, and for patients with chronic pain, this could directly translate to a lack of access to proper nutrition, medication, healthcare, and shelter. Needless to say, these consequences can lead to further deterioration of health, both physical and mental, as well as an inevitable decrease in quality of life.
These complications in pain management during COVID-19 have forced healthcare facilities to adapt in order to provide care to chronic pain patients. Some of these adaptations include the use of telemedicine, alternative pain therapies, and increased monitoring of opioid use among pain patients.