COVID-19: Impact on Pain and Opioid Use

The Effects of the COVID19 Pandemic on the Pain Experience

Amanda Nelli MD, Padma Gulur MD


Social networks and support are a key factor in supporting mental health. Both physical and virtual (not in-person) connection works to build a support system. During the COVID-19 pandemic, common interactions which are relied upon for support have become virtual or even nonexistent. With the national restrictions limiting gatherings, stay-at-home orders, and social distancing in place, the support needed for mental health may be lacking. This can result in increased or worsening psychological disorders – such as depression or anxiety, more cases of domestic abuse – both spousal and child abuse, among other effects. But what effect are these mandates having on pain?

The pain experience is deeply connected with the psychological health of the individual. The lack of positive interactions with family and friends results in worsening mental health, which can lead to worsening pain. However, it is not only the physical distancing orders, resulting in decreased social support, which may adversely affect patients with chronic pain.

Another cause of increased pain during the COVID pandemic may be related to a patient’s access to care by their pain physician. Healthcare facilities are taking precautions to ensure the safety of their patients. This results in decreased volume of patients in the clinic, which may delay the care, and ultimately prescriptions, for patients who may present on maintenance treatment.

Additionally, patients often use exercise to alleviate or better control their pain. During this time of shutdown, regular and effective exercise may be difficult to maintain. This may, in part, be due to closure of workout or physical therapy facilities which limits access to equipment and personnel at these locations. While it is a noble effort to persist in this pursuit, pushing through exercises may result in injury without proper supervision by professionals. However, an alternative of no exercise may result in worsening of the pain syndrome, tightness or decreased mobility. A subsequent sequela from changes an exercise routine can be weight gain. This often turns into a cycle where decreased movement leads to increased weight, which, in turn, results in a further decrease in movement. As this cycle continues, not only is the overall health of the patient compromised, psychological and pain conditions are amplified resulting in harsh effects felt by the patient.

During this time of uncertainty, maintaining both physical health and mental health is crucial. Engaging in positive social interactions, including virtual connections, works to decrease stress and anxiety, improves depressive symptoms and may ultimately improve pain. Staying active, without pushing beyond the limits, and maintaining a healthy diet can also aid in pain control. Although many diets exist for weight loss or fat loss, a diet rich in anti-inflammatory foods is beneficial for patients suffering from chronic pain.

Lastly, if worsening pain and/or mental health is experienced, a patient should feel confident in reaching out to their healthcare provider.


Common causes for increased pain during the COVID 19 Pandemic

1. Worsening mental health

2. Delays in seeing providers or delays in essential pain medications

3. Lack of exercise or lack of supervision during exercise

4. Weight gain


Ways to cope with pain during this pandemic

1. Call a friend or family member

2. Engage in regular social activities, including virtual events (i.e. game nights on zoom)

3. Spend time outside when possible

4. Try to eat a balanced diet, with fruits and vegetables daily

5. Reach out for help early



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