Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain

Abstract

Countries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions, including social and physical distancing measures, may disproportionately impact those living with chronic pain and require rapid adaptation to treatment and care strategies. Using an online methodology, we investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N = 431) relative to a healthy control group (N = 88). Data were collected during the most stringent period of lockdown in the United Kingdom (mid-April to early-May 2020). In accordance with the fear-avoidance model, we hypothesised lockdown-related increases in pain and psychological distress, which would be mediated by levels of pain catastrophising. Responses indicated that people with chronic pain perceived increased pain severity, compared to their estimation of typical pain levels prior to lockdown (p < .001). They were also more adversely affected by lockdown conditions compared to pain-free individuals, demonstrating greater self-perceived increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise (p ⩽ .001). Hierarchical regression analysis revealed that pain catastrophising was an important factor relating to the extent of self-perceived increases in pain severity during lockdown (β = .27, p < .001) and also mediated the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also related to perceptions of increased pain (β = .15, p < .001). Interestingly, levels of pain intensity (measured at two time points at pre and during lockdown) in a subgroup (N = 85) did not demonstrate a significant change. However, individuals in this subgroup still reported self-perceived pain increases during lockdown, which were also predicted by baseline levels of pain catastrophising. Overall, the findings indicate that people with chronic pain suffer adverse effects of lockdown including self-perceived increases in their pain. Remote pain management provision to target reduction of pain catastrophising and increase health behaviours including physical activity could be beneficial for this vulnerable population.

Impact of lockdown on musculoskeletal health due to COVID-19 outbreak in Bangladesh: A cross sectional survey study

“…In this study they investigated how lockdown impacted individuals with chronic pain in United Kingdom. The study results indicated that the perception of pain was increased during the lockdown periods [ 21 ]. In another study, the negative impact of lockdown on pain and physical function in patients with hip and knee osteoarthritis (OA) was observed.…”

“…Quarantine measures have a negative impact on human beings which increases anger and aggression, increases sedentary behaviors and leads to development of musculoskeletal pain [ 18 ]. Few recent studies investigate the impact of lockdown on physical and/or intellectual disability [ 19 ], low back pain [ 18 ], hip and knee osteoarthritis [ 20 ], and physical activity and psychological well-being in people with chronic pain [ 21 ]. But there is scarcity of literature regarding the various effects of the nationwide lockdown on the overall musculoskeletal health in Bangladesh.…”

“…So, in this current situation, due to lockdown most of the people are living a sedentary lifestyle [ 22 ], spending more time on their phone, watching television and excessive sleeping [ 23 ] leading to decreased physical activity which is associated with high risk of musculoskeletal pain [ 21 ]. Physical activity and well-being outcome were associated with each other, as significant difference were observed between physical activity level and well-being status [ 24 ].…”

Pain Management in Children During the COVID-19 Pandemic

“…For example, virtual or hybrid learning at school has facilitated continuity of education to some degree, but simultaneously, significantly increased children's daily screen time with less opportunity for physical activity, maintaining routines, and social engagement. Self-report data collected during COVID-19 with an adult sample of individuals with CP found that decreases in levels of physical exercise were associated with increased pain [49]. These associations will be important to examine in pediatrics.…”

The Impact of the COVID-19 Pandemic and Lockdown on Prevalence of and Risk Factors for Neck Pain Among College Students: a Cross-sectional Study

“…Lockdown is an effective way to prevent the transmission of the COVID-19 virus [10]. Yet it may also have negative effects on the musculoskeletal system [3].…”