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, April to May, 2020

Abstract

Objective Individuals with chronic pain are uniquely challenged by the COVID-19 pandemic, as increased stress may exacerbate chronic pain, and there are new barriers to receiving chronic pain treatment. In light of this, using a large online sample in the United States, we examined 1) the early impact of COVID-19 on pain severity, pain interference, and chronic pain management; and 2) variables associated with perceived changes in pain severity and pain interference. Design A cross-sectional study. Methods Online survey data for 1,453 adults with chronic pain were collected via Amazon’s Mechanical Turk platform. Results Although a large proportion of participants reported no perceived changes in their pain severity and pain interference since the outbreak, approximately 25–30% of individuals reported exacerbation in these domains. Individuals identifying as Black and of non-Hispanic origin, who experienced greater disruptions in their mood and sleep quality, were more likely to report worsened pain interference. The majority of participants reported engaging in self-management strategies as usual. However, most appointments for chronic pain treatment were either postponed or canceled, with no future session scheduled. Furthermore, a notable proportion of participants had concerns about or difficulty accessing prescription opioids due to COVID-19. Conclusions We may expect to see a long-term exacerbation of chronic pain and related interference in functioning and chronic pain management among individuals most impacted by the pandemic. These individuals may benefit from remotely delivered intervention to effectively mitigate COVID-19–related exacerbations in chronic pain and interruptions in face-to-face treatment.

Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study

“…In the area of chronic pain, several studies have highlighted racial inequities regarding pain assessment and access to analgesia, with racialized persons facing prejudices, stigma, and lack of recognizing of their pain [ 27 , 32 , 75 ]. According to a recent study, Black Americans with chronic pain were particularly at risk of experiencing higher pain levels and disruptions in mood and sleep during the COVID-19 first wave [ 45 ]. By highlighting the specific challenges of belonging to a racial minority with chronic pain during the pandemic, our results contribute to situate their deteriorated pain outcomes within social experiences and systemic barriers.…”

“…This suggests that women experienced specific difficulties in accessing their usual pain treatment. In an American study, no differences were found between women and men in terms of changes in pain severity and interference in daily life during the COVID-19 first wave [ 45 ]. However, the authors state that differential impacts will likely appear over time, given the existing literature documenting gendered disparities related to pain [ 45 ].…”

“…In an American study, no differences were found between women and men in terms of changes in pain severity and interference in daily life during the COVID-19 first wave [ 45 ]. However, the authors state that differential impacts will likely appear over time, given the existing literature documenting gendered disparities related to pain [ 45 ]. Indeed, inequities have been documented in the experience and treatment of chronic pain: women are more represented in underdiagnosed or medically controversial conditions such as fibromyalgia and they are more exposed to providers’ prejudices during health care interactions [ 29 , 64 ].…”

“…A survey among Canadian pain clinics underscored major disruptions of services offered in these facilities during the COVID-19 first wave [ 42 ]. A few recent quantitative studies in Spain and North America [ 43 – 46 ] have identified some negative impacts of the pandemic on pain and its management, such as pain deterioration due to increased stress and anxiety [ 43 – 45 ] and changes in pain treatments [ 43 , 46 ]. However, currently, no qualitative studies have examined the impacts of the pandemic from the perspectives of individuals living with chronic pain.…”

Kratom Use Within the Context of the Evolving Opioid Crisis and the COVID-19 Pandemic in the United States

“…Besides its direct impact on public health in the US, the COVID-19 pandemic also has had many subtle and less direct effects. For example, many people with non-COVID health issues have encountered difficulties in obtaining appropriate care for their non-COVID problems, as national health leaders called for hospitals to forgo routine visits as well as screening and elective procedures (Puntillo et al, 2020;Caton et al, 2021;Jacka et al, 2021;Kedia et al, 2021;Linas et al, 2021;Mun et al, 2021;Peckham et al, 2021). The lack of access to care has been especially acute for patients with chronic pain problems and/ or substance use disorders (Jacka et al, 2021;Kedia et al, 2021;Narayan and Balkrishnan, 2021).…”