Gonder Morgan E, Orr Walter N, Khan Talal W
Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS.
Pain Physician. 2022 Mar;25(2):E185-E191.
During the COVID-19 pandemic, social distancing has been employed to decrease the spread of COVID-19, especially within the geriatric population; however, the resulting loneliness and isolation carry their own detrimental effects. Loneliness resulting from the COVID-19 pandemic may also have negative implications on those with chronic musculoskeletal pain.
The aim of this review was to identify the role of loneliness specific to the recent COVID-19 pandemic as it relates to the prevalence and severity of chronic pain in the geriatric population and to provide an overview for clinicians.
Narrative review.
A literature search was conducted using combinations of relevant search terms. Databases included PubMed and relevant grey literature sources. Reference lists of selected articles were also searched for additional relevant literature.
Recent literature supports that social isolation and loneliness stemming from the COVID-19 pandemic have negative implications on chronic musculoskeletal pain. Loneliness has been well documented to have deleterious effects on physical and mental health, and it is increasingly linked to worsening debility and pain interference for those with chronic musculoskeletal pain. This has been found to be most prominent in the geriatric population, who are at the greatest risk for social decline and loneliness. Loneliness has also been found to have negative effects on cardiovascular disease, infectious disease, and mental health, as well as cognitive decline.
Potential selection bias due to the narrative review design. Some included studies required the use of online questionnaires, which may not be accessible for the geriatric population, those without technology literacy, or low socioeconomic status populations. Future studies should emphasize screening patients for access to technological devices and reliable internet while partnering with community programs focused on digital literacy and resource access.
A myriad of deleterious effects stemming from social isolation and loneliness have been documented, of which geriatric populations are especially susceptible. Both early identification of at-risk patients and safe interventions are essential to mitigate loneliness and stop the progression of debility. Further resources and research are necessary to illuminate how best to proceed, both in the setting of the ongoing pandemic and how interventions can be applied to alleviate suffering in those with limited ability to receive hospital or clinic-based care.
在新冠疫情期间，人们采用社交距离措施来减少新冠病毒的传播，尤其是在老年人群体中；然而，由此产生的孤独感和隔离状态也有其自身的有害影响。新冠疫情导致的孤独感对患有慢性肌肉骨骼疼痛的人可能也有负面影响。
本综述的目的是确定近期新冠疫情特有的孤独感在老年人群体慢性疼痛的患病率和严重程度方面所起的作用，并为临床医生提供概述。
叙述性综述。
使用相关检索词组合进行文献检索。数据库包括PubMed和相关灰色文献来源。还检索了所选文章的参考文献列表以获取更多相关文献。
近期文献支持新冠疫情导致的社会隔离和孤独感对慢性肌肉骨骼疼痛有负面影响。孤独感对身心健康的有害影响已有充分记录，并且它与慢性肌肉骨骼疼痛患者的身体衰弱和疼痛干扰加剧越来越相关。这在老年人群体中最为明显，他们面临社会衰退和孤独感的风险最大。孤独感还被发现对心血管疾病、传染病、心理健康以及认知衰退有负面影响。
由于叙述性综述设计存在潜在的选择偏倚。一些纳入的研究需要使用在线问卷，而老年人群体、没有技术素养的人群或社会经济地位较低的人群可能无法获取这些问卷。未来的研究应强调筛查患者是否能够使用技术设备和可靠的互联网，同时与专注于数字素养和资源获取的社区项目合作。
社会隔离和孤独感产生的众多有害影响已有记录，老年人群体尤其易受影响。早期识别高危患者和安全干预对于减轻孤独感和阻止身体衰弱的进展至关重要。需要更多资源和研究来阐明在当前疫情背景下如何最好地开展工作，以及如何应用干预措施来减轻那些接受医院或诊所护理能力有限的人的痛苦。
