I wrote a post called Chronic illness: Pandemic stress and we are well into pandemic stress at this point. I think it is time to acknowledge the impact it is having on people with chronic pain

“Unfortunately, the COVID-19 pandemic has disrupted treatments for people with pain because regular out-patient appointments with doctors and physical therapists have had to be cancelled or postponed. Also, many of the support systems that people usually use to help them cope with their pain (such as getting together with friends and family or church services) have had to be cancelled. This has led many people to report feeling isolated and lonely. Believe it or not, this can make a patient’s perception of their pain worsen.”

Sports Medicine Center
Chronic pain and the pandemic

Impact of the pandemic on chronic pain patients

On one side, patients tend to stay away from hospitals due to fear of infection, so that acute pain is largely untreated and can more easily progress to chronic pain, increasing the risk of disability and depressive status. On the other side, social isolation imposed during the pandemic can promote passive coping strategies, with further worsening of depressive mood and increasing suicidal ideation. Therefore, in this global health pandemic, risk factors for pain morbidity and mortality have been amplified.

Impact of COVID-19 pandemic on chronic pain management: Looking for the best way to deliver care

Resources

We are limited in the face to face resources we have available to us during the pandemic that assist us in our pain management. That can be anything from specialist appointments, pain clinics, to the care we get from alternative treatments such as massage therapy. I have not been to the pain clinic since this began and my pain has not been treated since. I have not been able to make an appointment with the pain psychologist there as well which would be highly beneficial during these times. It is too risky to go to the hospital for appointments for one thing and too risky for me to get someone to give me a lift and expose them as well.

Isolation

Isolation is becoming a normal thing these days. We have to limit social interactions and the worse numbers get in our area the more that diminishes until we cannot socialize at all. We tend to deal with isolation well, short term, because we have to. Pain levels can be severe at times and we can’t get out and about. But this is different. It is lasting for a long time and our normal social support system is not readily available. So the small amount of social contact we depended on for socialization or assistance is no longer there.

This can increase anxiety and depression. It can increase that sense of loneliness facing the pain we deal with. Increase the stress of dealing and coping with pain. And our mood can just really suffer.

Stress

We can’t underestimate the impact of stress due to the pandemic on our chronic pain

  • Stress affects pain, doesn’t cause it
  • Can be affected by external factors
  • Increases intensity of pain
  • Contributes to depression and anxiety
  • We are less likely to use our effective coping strategies

Understanding the stress-pain cycle

Therefore, when in high stress situations when we worry about ourselves, our finances, our loved ones… stress gets to a level we are not able to manage with our usual coping strategies and this impacts our pain adversely.

The slump

Add all this together and what can happen is a change in sleep cycle, a change in routines, a change in our usual pain management… and worsening in pain as a result. This slump can happen simply because we are overwhelmed by the stress with no outlet due to isolation and have no pain management outside of what we do at home.

This can lead to a slump in mood. Lack of sleep. Lack of motivation. Lack of self-care.

What can we do?

The COVID-19 pandemic has stressed healthcare systems worldwide, so that many pain services are no longer open for business. Chronic pain patient populations remain isolated with consequent social and psychological impact. Telehealth represents a good opportunity to avoid “missed care”, helping to triage a single case as urgent or emergent and to address pandemic related emotional disorders. This represents an opportunity for all pain physicians to better point out chronic pain patients’ needs and how to care for them.


Impact of COVID-19 pandemic on chronic pain management: Looking for the best way to deliver care

Telehealth

We have to utilize all the resources available to use within the new telehealth programs. I for one quite welcome doctor phone appointments which save me getting a lift to the doctors office all the time for something as simple as refills. And now I am thinking I am going to have to start to utilize more and more of these resources to help maintain my well-being during this time.

Reduce isolation

We have to use any method we can to reduce the levels of isolation we are experiencing. Technology assists a great deal with this. We have social media, text, phone calls, video chats… all helping us reach out to people we would normally see in person.

Routines

It is extremely beneficial for us to maintain our routines. To maintain our normal sleep cycle. To do the same sort of exercise level, or more, that we did before. That we engage in all the self-care and distraction/hobbies we usually do. To eat normally and on schedule. All these things help maintain stress levels and mood levels by keeping us motivated and productive. If you have had the Slump I mentioned it is a matter of slowly getting back into those routines which will help immensely in feeling more motivated and increase well-being.

Of course, I myself, am experiencing a downturn in my vertigo which means less mobility- leading to a lot more pain. So routines can be thrown out the window for various reasons.

Seek help

Talk to people when you are feeling rough and down. Get things out. Seek additional help and resources in your area that are online such as mental health resources. Never be afraid to reach out.

Write it out

I love journalling. Even visual journalling if you are more artistic and visual. It helps you get your thoughts and emotions out. It helps you think about them and work through them. Sometimes that can really help us reduce some of the emotional toll we are having in these extremely stressful times.

Mind your mood

I have depression, which is treated with medication, but you add in winter and a crapton of stress and sometimes I get some serious mood slumps I have to really manage and keep an eye on. I know this and I do things like meditation, art, writing, listening to music or a really good self-care day to help manage it. You know what boosts your mood and you know when it is slumping. Just be very mindful of it and do the best you can to help maintain it like you do your pain management strategies from home. See: 11 ways to boost your mood for ideas

Some Canadian government sites and resources: Resources for Canadians living with pain during COVID-19

Other resources to check out

See more posts:

Pandemic life vs. Disability life for me
Pandemic: Disabled voices not heard
Chronic stress and the body

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13 thoughts on “Chronic pain and the pandemic

  1. Hi Nikki

    I also take antidepressants but I’m still depressed. I’m even on mood stabilizers but it doesn’t matter what I take I still cry from the pain and everything else I’ve lost because of it. How long did it take you to get your pain under control? I feel so down some days I think to myself I don’t want this life anymore. But my parents keep me alive and give me strength

    Liked by 1 person

    1. Antidepressants make me depressed so I am on Abilify. Anyway my pain is not well managed at the moment. But the depression is. I suppose what made a major difference in how I think about the pain is a) not working with it and b) the psychologist as the pain clinic i saw for about a year or so.

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  2. I’ve just read about Abilify and I’m surprised that I wasn’t offered it. It’s used for treatment resistant depression. I’m going to ask my psychiatrist next time I have an appointment with him. Thank you for sharing.

    Liked by 1 person

    1. My problem was I literally can’t take any antidepressant without making my depression quite a bit more severe. So it was my best option… and it is extremely effective for me. I am quite astonished it worked so well since most meds for depression do not work That well. But I am glad it does. Anyway, yes, usually it is used for resistant depression and actually it would be a good idea to ask about it for sure since your response to meds hasn’t been effective. And depression Plus pain is brutal to cope with… you just never get anywhere fighting both.

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  3. Another great article, Nikki. I’m not in Canada, but obviously I follow the news closely because my family and friends are there. It’s so different compared to Taiwan. I can’t imagine what winter is going to be like for everyone this year. It sounds like it’s going to be a very hard winter. (My parents are still pushing me to come home, but every friend I have in Canada that is chronically ill has said don’t do it. Even before the pandemic hit.)

    Thanks so much for the update and sending you well wishes. I hope you’ve found some relief over the past few days.

    Liked by 1 person

    1. Yeah I wouldn’t. Between flu season and COVID getting worse not the time to come home. I am already isolated but no one else in the house is. I am just because I am too sick to get out and about.

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  4. Great points. Isolation has been the hardest as everyone around me lives their normal lives, and I still have to stay home and be careful. The good news is we’re the opposite of most places, we get good weather in winter so I can go outside!

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  5. Fibromyalgia 30 yrs; T12 syndrome 18 years, neuropathy 16 years, DDD 18 years, depression 0 years, 99% housebound 18 years. Lockdown has meant nothing different apart from not being able to see a doctor face to face. When I suddenly lost my hearing completely the consultant texted to say he would phone me!!!!!!!! Hey, I CAN’T HEAR! But I did get urgent tests for cancer very quickly (clear) and saw the GP face to face once although my follow up appointment with the consultant has been cancelled. No, not depressed. It is what it is. Frustrated, annoyed yes.but; I can use the internet and now my hearing’s back i can phone my son even if I haven’t seen him all year – even when he had Covid.. I’m alive

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