Chronic Pain Management During Public Health Crises

Chronic pain affects up to one in five individuals worldwide and represents a major cause of disability and economic burden. Public health crises such as pandemics magnify these challenges by interrupting multimodal care, compounding psychosocial stressors and limiting access to pharmacological and rehabilitative services. Lockdowns and social distancing measures have been associated with heightened anxiety, social isolation and disrupted routines, each contributing to increased pain intensity and interference with daily activities. Adaptive strategies, including rapid deployment of telehealth, digital self-management tools and community support networks, have emerged to mitigate treatment gaps. Understanding the interplay between biological, psychological and social determinants of pain during crises is essential to inform equitable and resilient care models.

Research from Nature Portfolio

Network-level analyses have illuminated how biopsychosocial factors interact to influence pain outcomes during lockdowns. One large cross-sectional study used network mapping to reveal that pain duration, symptom evolution and anxiety exerted the strongest bidirectional effects on pain-related outcomes among patients receiving manual therapies, highlighting targets for psychosocial intervention. Subgroup analyses further demonstrated differential network structures between acute and chronic pain cohorts, suggesting tailored strategies for each group. Another investigation compared patient-reported symptoms before and after pandemic onset in a tertiary pain clinic population. Although overall pain ratings remained stable, measures of pain catastrophizing peaked at disease surges, while functional domains such as activity interference and sleep showed improvement, indicating patient resilience but underscoring the need for ongoing psychological support when cases rise.

Chronic Pain Management During Public Health Crises publication trend

The graph below shows the total number of articles in chronic pain management during public health crises across all publications each year (not limited to Nature Index journals).

Technical terms

Biopsychosocial model: An approach recognising the interaction of biological, psychological and social factors in health and disease.

Pain interference: The extent to which pain hampers engagement in daily activities, mood and social participation.

Telehealth: Remote delivery of health services via telecommunications technology.

Pain catastrophizing: An exaggerated negative cognitive–affective response to anticipated or actual pain.

Neuroinflammation: Activation of the central nervous system’s immune response, often involving microglia and cytokine release.

References

1. Neuroimmune activation and increased brain aging in chronic pain patients after the COVID-19 pandemic onset. Brain Behavior and Immunity (2023).
2. A network analysis on biopsychosocial factors and pain-related outcomes assessed during a COVID-19 lockdown. Scientific Reports (2023).
3. Examining changes in pain interference via pandemic-induced isolation among patients receiving medication for opioid use disorder: a secondary data analysis. BMC Public Health (2024).
4. Impact of the COVID-19 pandemic on the pharmacological, physical, and psychological treatments of pain: findings from the Chronic Pain & COVID-19 Pan-Canadian Study. PAIN Reports (2021).
5. The impact of COVID-19 on patients with chronic pain seeking care at a tertiary pain clinic. Scientific Reports (2022).