Beatrice* has struggled for three years with chronic pain from fibromyalgia and spinal stenosis. She was managing her pain and frustration with minimal limitations in daily functioning when COVID happened. Beatrice can no longer safely meet with her friends and family that were a support to her and provided necessary outlets for fun and companionship. Her chiropractor is not seeing clients in person, which has resulted in increased pain. Symptoms of depression and anxiety have also increased. Beatrice no longer feels motivated to exercise or walk her dog; mainly she just wants to stay in bed.
COVID has changed the way we live our lives. To contain the spread of the virus, we have had to socially distance from others. There have been limitations on the use of public transportation, public spaces, work, education, and recreational facilities. Furthermore, access to vital, but nonurgent, healthcare services (including pain management services) has been restricted. These changes have affected the way people connect with each other, manage their health and wellbeing, and fulfil their social roles.
The negative impact of social isolation is having a disproportionately negative effect on those struggling with chronic pain. Social distancing and subsequent loneliness can have a drastic impact on overall functioning. Experiencing increased fear of illness, when your body already feels out of your control, can exacerbate chronic discomfort and suffering. What can people do to mitigate the effects of social distancing and fear while awaiting the safe opening of society?
1. Reach out to others
No, you may not be able to get together safely with other people outside of your immediate household, but you can make an effort to connect with friends and family members. ZOOM/FaceTime/Skype meetings, phone calls, and texts may not be the same, but these connections can definitely remind you that you are not alone. Also, maintaining these relationships will be important for when you can get together again, so that we you’ll feel comfortable. There may be days when you don’t feel up for any type of interaction and that’s okay. However, fewer good days means it’s even more important to use the days that you feel up for talking with others to make sure to use that time to maintain connection with others.
2. Move your body
Exercise and movement may be very difficult when you’re in pain and that’s understandable. However, keeping your body moving, no matter how small the movements may be, is vital in maintaining a positive mood. We’ve all heard before about the benefits of exercise on our mind and body. It may seem counterintuitive for someone in pain to move your body, when all you may want to do is stay in bed. But it is imperative to move. You may have had physical therapy in the past – what were some of your exercises you did in treatment? Could you do fifteen minutes a day of your old routine? Could you walk around the block (not if it’s icy/slippery like it is outside my house right now) or walk around your kitchen? Could you do chair yoga (yes, it’s a thing!)? Do arm lifts while watching tv? When we are isolated, it’s important to think outside the box because gyms and many physical therapy centers are closed.
3. Practice relaxation techniques
If things become overwhelming and stress increases, it’s important to utilize effective coping strategies to maintain positive functioning. Progressive muscle relaxation is a powerful relaxation skill, which can help you learn to recognize how tension can be held in the body. I’ve had clients realize for the first time that they are perpetually tense and were able to feel what it’s like to relax. Deep breathing and mindfulness meditation have also been found to be effective in decreasing anxiety the suffering associated with chronic pain.
4. Confront negative/irrational thoughts
Do you find yourself making negative self-statements like, “If I were stronger, I’d be able to handle the pain,” or experiencing irrational thoughts about the future such as “things are never going to get better?” Increasing awareness of these types of thoughts is important because thoughts are powerful and what we think affects how we feel. Studies have shown that constant negative thoughts create more negative thoughts. But the oppositive is also true. if we change our thoughts and focus on the positive, we are then more likely to have positive thoughts. In addition, having thoughts that predict the future is a cognitive distortion called fortune-telling. We really have no idea what’s going to happen. Just because a steroid injection didn’t work to alleviate back pain, doesn’t meant the new treatment your doctor recommended won’t help. Furthermore, there’s a difference between experiencing chronic pain and suffering. Confronting your thoughts and making changes in how you think can decrease suffering. The pain may still be there, but your reaction to it can change.
*name changed to protect confidentiality