Background & Aims

The Corona virus infectious disease (COVID-19) pandemic is one of the most important world-wide healthcare challenges to have emerged in the recent past. Just like most other medical specialties, the field of chronic pain was one of the hardest hit from the COVID-19 pandemic leaving many patients over burdened with their chronic pain and their on-going treatment delayed. We aimed at studying the effects of COVID-19 pandemic on the management of chronic pain patients.

Methods

This prospective observational study was conducted on 150 patients of age > 18 years, of either sex presenting to pain management centre with chronic pain conditions > 3 months. Responses were recorded against a designed questionnaire including demographic profile, pain profile parameters, coping strategies, association of chronic pain with comorbidities, effects on daily activities, sleep, working capacity and mental/emotional health, COVID-19 profile of the patients with chronic pain. At the end of study the data was compiled and analysed. Continuous parametric variables were expressed as means and standard deviation, while continuous non- parametric variables were expressed as median and interquartile range. Categorical variables were expressed as percentages. Comparison of median NRS score was done using Friedman’s two-way analysis of variance by ranks. Comparison of categorical variables was done using Chi square test. p-value<.05 was considered significant.

Results

Majority of the patients were females, with the mean age of 50 ±13 years, belonging to the middle socio-economic status with most common sites of pain being low back pain, knee pain and neck pain. In our study, 20% patients had multiple sites of pain as well. There was significant increase in intensity and frequency of pain, also affecting the sleep, working capacity and mental health of the individuals. More than two third of the patients could not get their interventional pain procedure done on time that played a negative role in management and contributed to increase in pain. Fear of contracting infection, intermittent closure of OPD and assumption of non- availability of pain physician, advised against visiting hospital by family members and travel restrictions decreased follow-up in the OPD. The pain management strategies adopted by the patients were taking over the counter medications, continuing past treatment on their own, and teleconsultation.

Conclusions

There is an urgent need to develop various training programs for healthcare providers and patients to have better utilization of resources in order to provide uninterrupted and safe treatment services for chronic pain patients during a pandemic.

References

1. Arora N, Kumar A, Kumar A, Sharma RS. Chronic pain management during a pandemic: evidence-based review. Turk J Anaesth Reanim 2022;50:159-66.
2. El-Tallawy SN, Nalamasu R, Pergolizzi JV, Gharibo C. Pain management during the COVID-19 pandemic. Pain Therap 2020;25:1-4.
3. Clauw DJ, Häuser W, Cohen SP, Fitzcharles MA. Considering the potential for an
increase in chronic pain after the COVID-19 pandemic. Pain 2020;161:1694-7.
4. Alonso-Matielo H, da Silva Oliveira VR, de Oliveira VT, Dale CS. Pain in COVID era. Front Physiol 2021;12:6241-54
5. Alizadeh R, Aghsaeifard Z. Does COVID-19 activates previous chronic pain? A case series. Annals Med Surg 2021;61:169–71.
6. Nieto R, Pardo R, Sora B, Feliu-Soler A, Luciano JV. Impact of COVID-19 lockdown measures on spanish people with chronic pain: an online study survey. J Clin Med 2020;9:3558-72.
7. Serrano?Ibáñez ER, Esteve R, Ramírez?Maestre C, Ruiz?Párraga GT, López?Martínez AE. Chronic pain in the time of COVID?19: stress aftermath and central sensitization. Br J Health Psychol 2020;26:544–52.
8. Hruschak V, Flowers KM, Azizoddin DR, Jamison RN, Edwards RR, Schreiber KL. Cross-sectional study of psychosocial and pain-related variables among patients with chronic pain during a time of social distancing imposed by the coronavirus disease 2019 pandemic. Pain 2020;162:619-29.
9. Fallon N, Brown C, Twiddy H, Brian E, Frank B, Nurmikko T et al. Adverse effects of COVID-19 related lockdown on pain, physical activity and psychological wellbeing in people with chronic pain. Br J Pain 2020;4:1-12.
10. Lacasse A, Pagé MG, Dassieu L, Sourial N, Janelle-Montcalm A, Dorais M et al. Impact of the COVID-19 pandemic on the pharmacological, physical and psychological treatments of pain: findings from the chronic pain & COVID-19. Pain Reports 2021;6:75-82.
11. Lassen CL, Siam L, Degenhart A, Klier TW, Bundscherer A, Lindenberg N. Short-term impact of the COVID-19 pandemic on patients with a chronic pain disorder. Medicine 2021;100:1-10.
12. Mun CJ, Campbell CM, McGill LS, Aaron RV. The early impact of COVID-19 on chronic pain: a cross-sectional investigation of a large online sample of individuals with chronic pain in the United States. Pain Med 2021;22:470–80.
13. Elran-Barak R, Mozeikov M. One month into the reinforcement of social distancing due to the COVID-19 outbreak: subjective health, health behaviours, and loneliness among people with chronic medical conditions. Intl J Environ Res Public Health 2020;17:5403-18.

Presenting Author

Naveen Malhotra

Poster Authors

Naveen Malhotra

MD, DNBE, FIAPM

Pt. BDS PGIMS, Rohtak, Haryana, India

Lead Author

Charan N

MD

Pt. BD Sharma PGIMS Rohtak, Haryana, India

Lead Author

Deepika Budhwar

MD

Pt. BD Sharma PGIMS Rohtak, Haryana, India

Lead Author

Amit Kumar

MD

Pt. BD Sharma PGIMS Rohtak, Haryana, India

Lead Author

Neha Sinha

MD

Pt. BD Sharma PGIMS Rohtak, Haryana, India

Lead Author

Vaishali Phoghat

MD

Pt. BD Sharma PGIMS Rohtak, Haryana, India

Lead Author

Topics

  • Access to Care