Impact of COVID-19 on Acute Pain Management

Benjamin W. Friedman, MD, MS: I want to segue into a topic that’s been on my mind lately: the role of COVID-19 with regard to acute pain. I’m sure you guys have been thinking about this too. Certainly, many patients have been affected as well. Have you guys seen any changes in the prevalence or the experience of acute pain during the past few years of the pandemic that we could specifically attribute to COVID-19?

Francesca Beaudoin, MD, MS, PhD: There are a few things going on here that we can unpack with COVID-19. We can’t have a health care discussion today without talking about the COVID-19–related impacts. I might break down those into direct impacts of COVID-19 itself, the infection and post-acute sequelae of COVID-19, then also health care access and resources and how that’s been impacted by the pandemic. That’s important. The third thing is the psychological distress that probably the majority of people in the United States and the world have experienced at some point during the pandemic, and how that impacts pain, coping with pain, and perceptions of pain.

The first point is that COVID-19 has pain manifestations itself, particularly when we’re talking about post-acute COVID-19 sequelae, or long COVID. Pain is a common presenting component, especially chest pain and neuropathic pain. That constellation of symptoms itself is increasing our prevalence of pain conditions. We’re still trying to understand what long COVID is, who gets it, and how we treat it, but pain is a piece of that.

In terms of pain management, COVID-19 also plays a part in resources; access to health care, which has been a challenge during the pandemic; and this psychological overlay that has been caused by the pandemic. Rates of anxiety, depression, suicidality have been going up during the pandemic, and there’s a lot of intersection with mental health symptoms and pain. We could probably do a whole session talking about only COVID-19 and pain, but I’ll leave it there.

Benjamin W. Friedman, MD, MS: Seeing the manifestations of this among our patients has been a very real experience for us working in the emergency department over the past few years.

Transcript Edited for Clarity