Center For Complementary and Integrative Medicine, Division of Rheumatology, Allergy & Immunology, Tufts Medicine/Tufts Medical Center, Boston, MA, 02111, USA.
Curr Rheumatol Rep. 2023 Jul;25(7):128-143. doi: 10.1007/s11926-023-01103-y. Epub 2023 May 3.
The COVID-19 pandemic has affected the management of chronic musculoskeletal pain; however, the extent of its impact has not been established. We conducted a comprehensive review of the pandemic's impact on clinical outcomes and healthcare accessibility for osteoarthritis (OA), rheumatoid arthritis (RA), fibromyalgia (FM), lower back pain (LBP), and other musculoskeletal disorders and chronic pain syndromes to better inform clinical decision-making.
We examined 30 studies (n = 18,810) from 36 countries investigating the impact of the COVID-19 pandemic on chronic musculoskeletal pain outcomes. The available evidence suggests that the pandemic significantly impacted pain levels, mental health, quality of life and healthcare accessibility in patients with chronic musculoskeletal pain. Of 30 studies, 25 (83%) reported symptom worsening, and 20 (67%) reported reduced healthcare accessibility. Patients were unable to access necessary care services during the pandemic, including orthopedic surgeries, medications, and complementary therapies, leading to worsened pain, psychological health, and quality of life. Across conditions, vulnerable patients reported high pain catastrophizing, psychological stress, and low physical activity related to social isolation. Notably, positive coping strategies, regular physical activity, and social support were associated with positive health outcomes. Most patients with chronic musculoskeletal pain had greatly affected pain severity, physical function, and quality of life during the COVID-19 pandemic. Moreover, the pandemic significantly impacted treatment accessibility, preventing necessary therapies. These findings support further prioritization of chronic musculoskeletal pain patient care.
COVID-19 大流行影响了慢性肌肉骨骼疼痛的管理;然而,其影响程度尚未确定。我们对大流行对骨关节炎(OA)、类风湿关节炎(RA)、纤维肌痛(FM)、下腰痛(LBP)和其他肌肉骨骼疾病和慢性疼痛综合征的临床结果和医疗保健可及性的影响进行了全面综述,以便更好地为临床决策提供信息。
我们研究了 36 个国家的 30 项研究(n=18810),调查了 COVID-19 大流行对慢性肌肉骨骼疼痛结果的影响。现有证据表明,大流行显著影响了慢性肌肉骨骼疼痛患者的疼痛水平、心理健康、生活质量和医疗保健可及性。在 30 项研究中,有 25 项(83%)报告症状恶化,20 项(67%)报告医疗保健可及性降低。患者在大流行期间无法获得必要的护理服务,包括骨科手术、药物和补充疗法,导致疼痛加剧、心理健康和生活质量下降。在各种疾病中,弱势患者报告疼痛灾难化、心理压力和社交隔离导致的低身体活动较高。值得注意的是,积极的应对策略、定期的身体活动和社会支持与良好的健康结果相关。大多数慢性肌肉骨骼疼痛患者在 COVID-19 大流行期间的疼痛严重程度、身体功能和生活质量受到了极大影响。此外,大流行显著影响了治疗的可及性,阻止了必要的治疗。这些发现支持进一步优先考虑慢性肌肉骨骼疼痛患者的护理。