Facing the Pandemic: Improving the Lives of Chronic Pain Patients

For more than half of 2020, we’ve all agonized over the drastic changes the pandemic brought. Stay-at-home orders. Social distancing measures. Lockdowns. Activities that we once relied on and enjoyed disappeared in an instant, and it’s no surprise that people are suffering. That is even more true for patients living with chronic pain.

Many patients have had to battle chronic pain alone throughout the pandemic, without consistent access to medication, treatment, and in-person therapy. On top of all the pandemic-related stress, incidences of pain have increased. Because chronic pain care involves ongoing treatments, any significant disruption in health care leads to new difficulties. That’s why pain management practices must continue providing access to care while minimizing the risk of COVID-19 exposure.

Treating Chronic Pain Patients During the Pandemic

With chronic pain affecting how their immune systems function, pain management patients may have a higher susceptibility to the virus. What’s worse, most chronic pain patients are elderly, with multiple comorbidities and significantly weaker immune systems. 

To help provide access to pain management services while reducing infection risk, industry experts have been hard at work building systems and guidelines. In the July issue of Pain Medicine, a panel of specialists compiled a comprehensive investigation and recommendations for best practices. The guide included both general and specialty-specific elements that pain management practitioners and institutions should adopt. Unfortunately, they are still just as applicable.

Consider Telehealth Whenever Possible

Across the country, practices that successfully responded to the pandemic have one thing in common: Telehealth. With fewer in-person visits, pain medicine specialists should turn to secure video calls to consult with patients. Using Telehealth to evaluate the patient and arrange the necessary treatment minimizes delay and prevents unnecessary visits that increase exposure risk.

Telehealth visits help pain specialists see the patient face-to-face over video. You can still understand how the patient feels, ask and answer questions, and even refer those struggling with stress to psychologists, who can also counsel them through video calls.

Monitor the Use of Opioids

Withholding or suspending treatment of chronic pain patients could lead to disability, anxiety, and depression. For patients who are receiving opioids as pain treatment, though, halting medication could even cause withdrawals. Carefully monitor patients and adjust opioid prescriptions only after careful evaluations of the ongoing treatment.

Ideally, these evaluations include an in-person history and physical exam, but given our present situation, that’s no longer always the best and safest practice. To ensure that patients receive proper opioid treatments while staying safe at home, it comes back to making the most of Telehealth. Staying connected and vigilant, despite the distance, will make all the difference.

Manage the Use of Steroids

Although there is no definitive evidence that anti-inflammatory drugs make patients more susceptible to the virus, they may mask COVID-19 symptoms such as fever and muscle pain. Patients receiving anti-inflammatory drugs as treatment need to report even mild occurrences of these symptoms.

Steroids may also alter a patient’s immune response, so pain care specialists should administer a decreased dose (or the lowest dose possible) and inform patients about the added risk of infection. 

When the Need for an In-Person Appointment Does Arise…

A screening for COVID-19 is a must. For both COVID-19 negative and positive patients, the American Society of Regional Anesthesia and Pain Medicine (ASRA) published procedural and conduct recommendations that help reduce the risk of in-person visits, protecting patients and health care providers. These include measures as simple as minimizing movement within the practice premises, following routine aseptic technique, handwashing, and simulation sessions for putting on and taking off PPE.

Pain Treatment Shouldn’t Have to Wait for the New Normal

As pain management practices open their doors and start accepting in-person appointments again, we can expect a high volume of patients coming in for treatment. Pain management practices are integral to the lives of patients more than ever. Some practices have gone above and beyond, using Telehealth and adapting in creative ways.

The past months have shown how vital tools like Telehealth can be. If you don’t yet offer remote care services, or you’re looking for a more reliable Telehealth solution, take a look at Meditab’s Televisit. It’s only one piece of Meditab’s larger Pain Management EHR solution, an EHR explicitly built for pain management clinics. September is Pain Awareness Month, and it is a chance for all of us to think about the extra steps we can take.