How to treat chronic pain during the COVID-19 pandemic

The coronavirus (COVID-19) pandemic has presented unique challenges for everyone but it has also been a particularly challenging time for people living with and experiencing chronic persistent pain. Lockdown, social distancing and isolation measures have meant that people may not have been able to access the full range of advice and treatment for their existing or new pain conditions.

One of our pain management specialists Professor Neeraj Saxena shares his expert advice on managing such conditions during the crisis. Here he reiterates the advice given by the British Pain Society with guidance in this area.

What is the advice regarding common treatment options for those with chronic pain at the moment?

Whether you are living with pre-existing pain or if you have developed coronavirus-related symptoms that have left you in pain, the following is recommended:
 

Ibuprofen

There have been questions about the use of ibuprofen-like medicines with concerns that they may increase the likelihood of contracting the virus or worsen the symptoms. While there is no clear evidence to support this, it is advised that people who have confirmed COVID-19 infection or believe they have COVID-19 infection should take paracetamol in preference to ibuprofen.

However, if people have been prescribed ibuprofen or another NSAID and are taking them regularly then they should not stop without taking advice from a healthcare professional.
 

Steroid injections

Corticosteroids are commonly used in pain-injection procedures. These have the potential to reduce immune function. While the impact of this in people with COVID-19 infections is unknown, currently most pain specialists are deferring such procedures, if possible. 

When steroid injections are undertaken, detailed risk-benefit discussions are required to balance the benefit against the potential (but not clearly known) harm. Certainly, the consensus is that corticosteroids should not be administered if a person has COVID-19 infection or if there is a possibility, they may have COVID-19 even if there are no symptoms at the time.
 

COVID-19 related pain

COVID-19 infection itself can cause an exacerbation of pain-related symptoms especially in the presence of persistent dry cough. In such cases, it is essential to seek advice via the NHS111 Coronavirus Service before seeking specialist advice for pain management from your GP or local pain clinic.
 

Virtual consultations (such as e-Consultation)

Until social distancing measures are in place and the NHS restructures its capacity, it is likely that face-to-face consultations will be replaced by virtual consultations either through video or telephone.

Professor Saxena is available for video call via Top Doctor’s’ e-Consultation tool today. Simply click the blue button on his profile here and he will organise a suitable time and date to have a virtual consultation with you.