Minimal Impact of COVID-19 Pandemic on Chronic Noncancer Pain Symptoms

The impact of the COIVD-19 pandemic on mental health and chronic pain was likely negligible, according to results of a study published in Pain.

This 2-wave longitudinal cohort study was conducted between May and August 2019 and May and June 2020 in Australia. Participants were recruited via advertising on pain-related social media websites. Eligible individuals (N=236) had been diagnosed with chronic noncancer pain by a medical professional and reported symptoms for at least 3 months. Demographic and health service use information was obtained via the Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), Pain Self-Efficacy Questionnaire (PSEQ), Current Opioid Misuse Measure (COMM), and Depression Anxiety Stress Scale (DASS-21).

In the first wave, the mean age of participants was 51 years, 79% were women, and 54% were undergoing treatment with prescription opioid medications.  A current diagnosis of depression was self-reported by 34% of participants, an anxiety disorder was reported by 30% of participants, and posttraumatic stress disorder (PTSD) was reported by 13% of participants.

Participants reported experiencing chronic noncancer low back pain in the back, spine, or sacrum (70.2%); shoulders or upper limbs (53.2%); lower limbs (52.3%); neck (50.2%); abdomen, pelvis, or groin (30.6%); head or face (26.4%); and whole body (23.4%). Pain was reported to be associated with a noncancer medical condition (31.9%), a work-related injury (15.7%), or an injury sustained in another setting (14.0%).  A total of 17% of participants reported no obvious cause for the pain.

In wave 1, pain severity, pain interference, and symptoms of depression were reported as moderate, and symptoms of anxiety were reported as mild to moderate.

In the second wave of the study, COVID-19-related symptoms of depression and anxiety were relatively low. However, some study participants reported more opioid misuse (t, 2.733; P =.007). Fewer individuals visited their general practitioner (z, -5.67; P <.001) in the second wave of the study compared with the first wave.

Between the first and second study waves, participants reported decreased scores for pain interference (mean, 6.15 vs 5.65; P <.001), pain catastrophizing (mean, 21.23 vs 19.16; P <.001), opioid misuse (mean, 13.75 vs 11.18; P <.001), anxiety symptoms (mean, 9.69 vs 8.26; P =.003), pain severity (mean, 5.58 vs 5.26; P =.006), and depressive symptoms (mean, 14.50 vs 12.87; P =.006), and increased scores for pain self-efficacy (mean, 27.58 vs 30.67; P <.001), respectively.

Over time, pain severity improved by more than 10% among 30.09% of participants and worsened by more than 10% among 15.49% of participants, and pain interference improved by more than 10% among 33.63% of participants and worsened by more than 10% among 17.70% of participants.

This study may have been limited as the timing of the second wave coincided with easing of COVID-19 restrictions, and responses may reflect feelings of optimism and relief. In addition, as a result of strictly enforced lockdown and distancing measures, fewer cases of COVID-19 were experienced in Australia compared with other high-income countries.

This study did not detect widespread detriments to chronic pain symptoms or mental health during the COVID-19 pandemic among individuals with chronic noncancer pain. The authors comment, “It remains interesting to understand resiliency in people with [chronic noncancer pain] beyond their initial responses to the pandemic and the role of jurisdiction policies.”

This article originally appeared on Clinical Pain Advisor