Chronic Pain Patients Suffer Due to COVID-19 Delays

October 01, 2020, Kitchener, Ontario

Posted by: Robert Deutschmann, Personal Injury Lawyer

Chronic pain sufferers have been among the hardest hit from the COVID-19 pandemic. The restrictions on treatment and access have left many patients overwhelmed with chronic pain, and their treatments delayed.

“Impact of COVID-19 on chronic pain patients: a pain physician’s perspective”. Saba Javed,*,1 Joey Hung,1 and Billy K Huh2 Published online 2020 Aug 10, concludes that:

Just like most other medical specialties, the field of chronic pain is 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…Due to the on-going pandemic, other sources of stressors and pain have amplified ultimately worsening chronic pain…And with limited availability of multimodal therapeutic alternatives employed by pain physicians, these physicians are having to prescribe pain medications until the patient is able to get their treatment. Chronic pain physicians are having to walk the fine line of balancing the previously on-going opioid crisis and now this pandemic in managing the pain with the limited resources available. The key moving forward is trying to closely follow these patients, wean opioids and get them back on their pre-COVID-19 treatment plan as other multimodal therapeutic options open up.

In Canada we know that due to physical distancing rules, enhanced cleaning requirements and other restrictions many patients are stretching the time between their pain block injections by as much as double going from 4 week intervals to seven or 8. The pain for patients can become overwhelming, consuming their lives, causing intense fatigue and emotional distress. Even physical therapy treatments, aquatic therapy, and other treatment modalities are difficult to access or non-existent. This lack of non-narcotic treatment access can result in more opioids being prescribed to help patients with pain management.

The CBC reported on Mr. David Ellis and his journey through the pandemic.

For David Ellis, even the most seemingly innocuous sensations can be excruciating. The feeling of clothes touching his skin, or even his feet touching the ground can bring him severe pain.

The 34-year-old suffers from fibromyalgia and chronic fatigue syndrome. It took five years for Ellis to be properly diagnosed with what are often referred to as the "invisible illnesses" — and just a year and a half ago he found treatment that worked for him.

Ellis normally receives lidocaine infusions at St. Paul's Hospital every four weeks. The anesthetic is injected into the fat of his abdomen and numbs his nerves and relaxes his muscles, allowing him to do basic things like brush his teeth.
It helps block those pain signals … and it allows me more functionality. With it I'm able to get out of the house a bit more, do a bit of exercise, a little bit of walking," he said of the treatment, which provides a degree of relief for about three weeks.
But due to the pandemic and physical distancing rules at the hospital, he isn't able to get the treatment as frequently as before. He used to go in every four weeks — now it's every seven weeks.

"Without it for long periods of time I become overwhelmed by pain, bone-crushing fatigue that is indescribable and unimaginable by most people, there is nothing I can really do about it. There are no medications that help. I just have to lay in bed and rest and wait for the symptoms to lessen a little bit."
Pre-COVID, the Interventional and Complex Pain Clinic at St. Paul's Hospital had capacity for seven or eight subcutaneous lidocaine treatments per day. Now it can accommodate four or five.

In a statement, a spokesperson for the hospital said it "triages and schedules patients for treatment according to the urgency of their condition," adding that it's planning to increase access to services — "including new partnerships with physicians to offer virtual support and infusion therapy for patients in more settings."

Maria Hudspith, executive director of Pain B.C., a charitable organization that aims to enhance the lives of those living with chronic pain, says access to all kinds of pain management treatments have been disrupted since the start of the pandemic.
"It might be medication or interventions but it's also things like physiotherapy, going to the pool, going to the community centre for a gentle movement class … all of those kinds of treatments have been disrupted because of COVID and we've certainly seen significant numbers of people who live with pain, facing increasing distress and definitely increasing disability," she said.

Hudspith said they're working with provincial governments and health authorities to provide a provincial strategy for addressing chronic pain, adding that there are limited services available at the moment.
"We really only have a handful of publicly funded pain clinics in our province, a number of other ones that are privately funded and provide services under MSP, but when you think [that] chronic pain affects one in five people in the population, we do not have the degree of services we need to address this," she said.

As for Ellis, he worries treatments will be even more staggered as the fall approaches. In the meantime, he says there is nothing he can do but manage his activity level to ensure he doesn't overexert himself as he waits for his next appointment.a

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