If You’re in Pain – Here are Nine Things You Need to Know About COVID-19

Being in pain can be a struggle, and in these days of COVID-19 people with pain have the added burden of keeping the virus at bay. We all know that the virus is out there—so how can we prevent it from affecting us and our loved ones? And how do we manage our pain in this time?

Here Are My Top Tips for Pain Sufferers In the Time of COVID-19

1. Stay in touch with your physician and your clinical healthcare team. A lot of doctors offer telehealth now, which may be just as simple as talking to your doctor by phone or using a video call. Be sure to let them know any changes in your health status and changes in your pain level.

2. Take your medicine. If you have prescribed medications, stick with your drug regimen. Don’t use the pandemic as an excuse not to keep taking the drugs that are keeping you well. If you are worried about going to the pharmacy, call them or your doctor to see if you can arrange for home delivery. Many places will also home-deliver over-the-counter products.

3. Talk to your doctor about your medications. There has been a lot of talk that certain medicines, such as opioids, can suppress the immune system. There has also been talk that certain medications might increase your risk for getting COVID-19 or make it worse if you have it. The fact is that COVID-19 is a new disease and we have not learned all there is to learn about it. Many factors contribute to your health and your doctor may want to change a prescription or advise you about a specific drug, but this may be an individualized decision based on your health, your condition, and all of the other drugs you take. I can’t make an overall recommendation for all patients.

4. Boost your immune system. We have a lot more control over our health than we think! The best way to have the strongest immune system you can have is to stay healthy.¹ Get plenty of sleep, exercise, eat a healthy diet, and drink lots of water. Sounds pretty basic, but it really helps. If you need to lose weight, make that a goal. There are lots of good weight-loss programs available and you can ask your doctor for specific recommendations if you feel at a loss. There is no one single weight-loss program that’s right for everyone, so that’s why I would talk to your clinical team if you don’t know how to lose weight safely. Finally, take a good probiotic. Most of your so-called “immune system” lives in your gut. The various micro-organisms that live in our digestive system are the frontlines in the fight against pathogens. A daily probiotic gives them a big boost of powerful pathogen-fighting organisms.

5. Take Vitamin D. Vitamin D is amazing. I don’t have space in this article to write about all of the good things that Vitamin D can do. It has been shown to significantly decrease the rate of respiratory infections—which is important with COVID-19 and the regular flu going around.² Vitamin D is also associated with improved heart health, healthy blood sugar, and even healthy weight. You can get Vitamin D from three sources: natural sunlight, the food you eat, and supplements. Right now, many of us are not getting outside as much as we should, and—let’s face it—the “COVID-19 diet” has a lot of us eating processed foods, sweets, and unhealthful snacks. Taking a daily Vitamin D supplement is good general advice. I also recommend getting some natural sunlight when the weather and circumstances permit.

6. Consider over-the-counter products carefully. When COVID-19 first reached epidemic levels, there was speculation that certain pain relievers, in particular, ibuprofen, might be dangerous. The French public health officials even issued a warning, but that has since been rolled back. Part of the problem is that COVID-19 is not only a new disease, it is different from other viral infections we’ve ever dealt with. Many early warnings were issued out of an abundance of caution. Ask your physician about over-the-counter products if they are part of your daily routine. If you need an over-the-counter pain reliever from time to time, acetaminophen may be a good choice but be careful to stay within the recommended dose range. Topical pain relievers can be a good choice (if they work for you) because the drug does not get into your system but stays localized. Do not forget a great resource to whom you have easy access: your local pharmacist. You can ask the pharmacist for recommendations for over-the-counter drugs, drug-drug interactions, and supplements.

7. Risk factors and what to do about them. Risk factors for COVID-19 are starting to be known. The main risk factors considered these days are not so much the risk of getting COVID-19, but why some people have mild and others severe, even deadly, symptoms. Some risk factors are things we cannot do anything about. For instance, older people are more vulnerable to bad outcomes with COVID-19 than children and men seem to do worse with COVID-19 than women. From a statistical viewpoint, people with cancer, chronic kidney disease, obesity, type 2 diabetes, heart disease, chronic obstructive pulmonary disease (COPD) and sickle cell disease are at higher risk of having worse illness with COVID-19.^4,5 We don’t know for sure but it looks like people with asthma, type 1 diabetes, and neurological conditions such as dementia have worse outcomes. The best thing to do if you have these or any serious underlying health conditions is to stay as healthy as you can. Take your medications, follow your doctor’s instructions, and try to have your best lifestyle.

8. Pain as a risk factor. Pain is not a direct risk factor for getting COVID-19 or for having a more severe illness. However, pain is not helpful. Your pain may prevent you from exercising, doing ordinary household activities, and having a good quality of life. These things can set the stage for any sort of illness, including depression. It may not put you at risk for getting COVID-19 but it may make it harder for your body to fight it off. Pain puts your body under stress and that means it has to divert a lot of its energy to the pain, rather than promoting your overall health. We all know how distressing pain can be, and this may cause you to isolate yourself and not interact with others. Social interaction is already so limited with COVID-19, this can mean that pain patients are more or less living solitary lives. This is not good for your overall physical or mental health. For these reasons, people living with pain need to keep their pain under control as best they can. Keep doing the right things. Talk to your doctor if your pain gets worse or if new pains develop.

9. Don’t give in to fear. The best and brightest medical and scientific minds are fighting COVID-19. With modern research techniques, advanced tools, and instantaneous global communication, we are learning more about this disease faster than ever before. I am confident that major breakthroughs in treatment are likely. Meanwhile, there are lots of everyday strategies to protect yourself—things you already know how to do. Statistics show that even though COVID-19 is contagious, the rate of confirmed cases in the United States at the time of this writing is about 7 million, which means 2.3% of the population has diagnosed with COVID-19. Some people are not diagnosed because they never have symptoms or have such mild symptoms they do not know they have COVID-19. Of those who got diagnosed with COVID-19, the vast majority, over 95%, survive. If you factor in all of the COVID-19 cases that never got diagnosed, the survival rate is even better. Let’s be safe and take this disease seriously, but realize that the odds are in our favor.

References

1. Yousfi N, Bragazzi NL, Briki W, Zmijewski P, Chamari K. The COVID-19 pandemic: how to maintain a healthy immune system during the lockdown - a multidisciplinary approach with special focus on athletes. Biol Sport. 2020;37(3):211-216.
2. Dancer RC, Parekh D, Lax S, et al. Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS). Thorax. 2015;70(7):617-624.
3. Garland CF, Garland FC, Gorham ED, et al. The role of vitamin D in cancer prevention. American journal of public health. 2006;96(2):252-261.
4. Centers for Disease Control and Prevention. People with Certain Medical Conditions. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19) Web site. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. Published 2020. Accessed September 24, 2020.
5. Zhou Y, Chi J, Lv W, Wang Y. Obesity and diabetes as high-risk factors for severe coronavirus disease 2019 (Covid-19). Diabetes Metab Res Rev. 2020:e3377.