When COVID-19 halted all non-essential health services, it begged the question — what types of care can’t be delayed? Treatment for chronic pain, for one. Not only is pain management essential care, it’s even more critical during stressful times.
The good news is the pandemic has inspired innovations, such as telehealth and minimally invasive treatments for long-lasting pain relief, to help suffering patients, says the American Society of Anesthesiologists (ASA).
“The anxiety and isolation caused by COVID-19 adds to chronic pain, which is further compounded by reduced access to strategies, such as physical therapy, exercise and even visits with the grandkids or other loved ones, that help people manage their discomfort,” said Dr. David Dickerson, pain medicine specialist and vice chair of ASA’s Committee on Pain Medicine. “As a result, they may be more likely to turn to medications or alcohol, increasing the risk of misuse and abuse. Physician anesthesiologists who specialize in pain medicine have gotten creative to ensure their patients have access to the safest and most effective care.”
Here are three ways pain management changed due to COVID-19.
1. Greater access to providers through telehealth
When the COVID-19 pandemic suspended in-person visits, physician anesthesiologist pain medicine specialists turned to secure video meetings or telephone calls to consult with patients. Led by the Centers for Medicare & Medicaid (CMS), health insurance companies revised their coverage to include telehealth to ensure this vital care. Using telehealth visits, pain medicine specialists see the patient face-to-face via video, ask and answer questions and formulate a plan. They can refer those struggling with stress from COVID-19 to psychologists who also can counsel them via telehealth.
Telehealth also removes some barriers to care during a pandemic. Patients don’t need to worry about getting to an appointment or sitting for long periods in crowded waiting rooms. Via telehealth, they wait in a virtual waiting room in their own home. Specialists can easily access patients’ electronic medical records while talking to them virtually. As a result, 95% of people seeing pain medicine specialists have continued to do so, many of them via telehealth, which likely will remain an option for the foreseeable future.
2. Pain medicine specialists expand role to meet patients’ needs
During the pandemic, many patients have put off seeing their primary care physicians, so pain medicine specialists have been helping fill that role. They’re getting patients to understand the importance of seeking necessary treatment, such as visiting the emergency room if they are experiencing signs of stroke or angina, a symptom of heart disease.
As in-person medical appointments resume, many pain medicine specialists have revised their office visit practices, requiring masks and staggering appointments, to keep patients safe. Although telehealth remains an option, having the patient come into the office is preferred in some instances. For example, pain medicine specialists can more readily treat those with addiction issues in person. During this national health emergency, the number of patients needing treatment for pancreatitis — painful inflammation of the pancreas often due to excessive alcohol use — has increased dramatically. Early evidence suggests drug overdoses, including those from opioids, may be increasing as well, according to a report at odmap.org.
3. Long-lasting, minimally invasive techniques reduce visits and hospitalizations
To reduce the frequency of visits while keeping patients out of the hospital, pain medicine specialists are focusing on office-based treatments that can ease pain for six months or more. For example, rather than giving patients a series of injections that require regular office visits, pain medicine specialists can perform procedures in one visit. Some of these treatments include a procedure called percutaneous image-guided lumbar decompression (PILD), which reduces pain by removing excess tissue in people with spinal stenosis (narrowing of the spinal canal that can compress nerves and cause pain in the back and legs); neurostimulation, in which a device implanted under the skin generates electrical impulses that disrupt pain signals; and radiofrequency ablation or neurolysis, which silences nerves that bring pain signals from inflamed joints or tissue.
“Treatment for debilitating pain is complex in any circumstance and even more so during this health crisis,” said Dickerson. “Physician anesthesiologists and other pain medicine specialists can ensure proper and effective approaches to care that improve quality of life during the pandemic and beyond.”