University of Liverpool researchers have been working to understand the impact of lockdown on people living with chronic pain.

It is estimated that up to 28 million people in the UK live with some form of chronic pain (pain lasting for more than 3 months), and up to 8 million suffer from pain that is disabling. Evidence shows that chronic pain is a significant personal, societal and economic problem. The wellbeing of people with chronic pain can be impacted by levels of social support, access to physical exercise and aspects of mental health.

As the COVID-19 pandemic unfolded in 2020, a team of scientists and clinicians from University and The Walton Centre designed an online study, supported by the Pain Relief Foundation, to track more than 400 people with chronic pain across the period of the first lockdown. They monitored pain levels and many aspects of psychological and physical wellbeing.

Their findings, published in the British Pain Journal, showed that people living with chronic pain were more adversely affected by lockdown conditions than pain-free individuals, reporting greater self-perceived increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise. They also reported that their pain felt more severe compared to before lockdown.

The researchers suggested that psychological constructs (pain catastrophizing) and physical activity levels – both of which are known to impact on chronic pain experience – could be potentially important targets for pain management interventions during the pandemic.

Lead researcher Dr Nick Fallon, a Lecturer in Psychology in the University’s Institute of Population Health, said: “Our research was the first to consider the impact of lockdown conditions in the UK on people living with chronic pain. Further research is urgently needed so that we can make evidence-based decisions about adapting clinical provision for such patients to tailor and target interventions and minimise suffering during the pandemic.”

“The data from our study supports the need for improved remote management of people living with chronic pain. Specifically, we can utilise these findings to consider the type of remote therapeutic approaches required, or even to target the mechanisms leading to adverse effects of lockdown in this vulnerable population,” he added.

Samantha Sunners, who suffers from chronic pain after a car accident in January 2019, took part in the study. Speaking about her own personal experience of lockdown, she said: “I have persistent nerve pain and neck pain that requires me to have injections into my neck and take pain killers. During lockdown my pain heightened, as all of my hospital treatment was cancelled, in particular a steroid injection that was delayed from March until October.

“I have caring responsibilities for my three young children and this took its toll along with home school and juggling work from home. My anxiety increased as I was concerned that all of my pain management and coping mechanisms had been withdrawn. I did eventually commence my treatment, but the months in between were incredibly challenging.”

The team has continued to monitor patients as they navigate the pandemic. Now, one year on from the first lockdown, data collection will cease and the researchers will try to understand how the experience of chronic pain patients fluctuated across this difficult year.

“We anticipate differences in pain and other symptoms, from Eat Out to Help Out, to the Christmas period, to the recent winter lockdown. It is hoped that this longitudinal perspective will give even more insight into the impact of the pandemic on the lives of people living with chronic pain. Hopefully, this knowledge can contribute to help us to protect our vulnerable populations and better prepare for future crises,” said Dr Fallon.

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Research reference:

Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain, British Journal of Pain, DOI: 10.1177/2049463720973703