The covid-19 pandemic has exacerbated conditions for people living with chronic pain around the world and its long-term consequences are likely to be substantial, according to a new paper from researchers at the University of Bath's Centre for Pain Research.
Their Topical Review, published recently in the journal PAIN, suggests that with many doctors specializing in pain being redeployed to focus on the immediate crisis, access to traditional services for patients suffering from acute conditions, such as nerve damage or arthritis, has been severely disrupted. Whilst this creates an immediate capacity challenge for healthcare professionals, it has also provided them an opportunity to move towards the greater use of 'telemedicine' with online consultation, say the researchers.
Chronic or persistent pain is characterized as pain that carries on for longer than 12 weeks despite medication or treatment. Whereas most people get back to normal following an injury or operation, sometimes pain carries on for longer, or comes on without any history of an injury or operation. Common examples include lower back pain, arthritis, fibromyalgia and persistent and frequent headaches. Globally the burden of chronic pain is as high as 1 in 4 of adults. Data from young people are similar.
For those suffering, to date, access to healthcare professionals who can advise on physical therapy, psychological support, or prescriptions for painkillers, has relied heavily on face-to-face consultations. With the recent shift towards online web conferencing platforms in conducting many of our daily interactions, the researchers see a possibility to enable vital access to services at a time of crisis.
The team from the University have been working with healthcare providers locally, nationally and internationally on how best to manage that process and to support patients.
There is clearly an opportunity to reform how consultations for patients with chronic pain are delivered through new online platforms and technologies. This has come to the fore as a result of covid-19, the immediate public health challenge we are facing and the abrupt shifts we have seen in people adopting new ways of working and interacting. Applying telemedicine to practice, which our team at Bath has assisted with, has enabled doctors to keep their doors open, in a virtual way, to patients who are desperately in need of help and support. It is having important impacts."
Professor Christopher Eccleston, Professor of Medical Psychology and Director of the Centre for Pain Research at the University of Bath
Yet, Professor Eccleston and team argue that the broader application of telemedicine is complex and now requires further research in particular about how it can be best coordinated, financially supported and integrated with traditional practice.
He adds: "Changing practice in such an unplanned way will have positive and negative consequences, many unforeseen. Systems can establish protocols that can enable them to oversee, monitor, and capture important patient and provider outcomes and perspectives. When we come to redesign services after the pandemic, we will need to share that experience and use it to learn what works, to modify what does not work, and to build new models of care for people living with chronic pain."
Eccleston, C., et al. (2020) Managing patients with chronic pain during the COVID-19 outbreak: considerations for the rapid introduction of remotely supported (eHealth) pain management services. Pain. doi.org/10.1097/j.pain.0000000000001885.