Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study

Lise Dassieu,James M Thompson,Maria Hudspith,M Gabrielle Pagé,Anaïs Lacasse,Maude Laflamme,Manon Choinière,Audrée Janelle-Montcalm,Gregg Moor,Kathryn Sutton,Vickie Perron

doi:10.1186/s12939-021-01496-1

Abstract

BackgroundChronic pain affects about 20 % of the Canadian population and can lead to physical, psychological and social vulnerabilities. However, this condition remains poorly recognized and undertreated. During 2020, as the COVID-19 pandemic disrupted daily living and health care systems, the situation of people with chronic pain has drawn little public attention.MethodsThis qualitative study was part of a pan-Canadian mixed-methods project and aimed to understand the experiences and challenges of people living with chronic pain during the COVID-19 pandemic in Canada. Between May and August 2020, we conducted in-depth semi-structured interviews with 22 individuals living with chronic pain across the country. We used reflexive thematic analysis to interpret data.ResultsOur findings underscored four dimensions of the chronic pain experience during the pandemic: (1) Reinforced vulnerability due to uncertainties regarding pain and its management; (2) Social network as a determinant of pain and psychological condition; (3) Increasing systemic inequities intermingling with the chronic pain experience; (4) More viable living conditions due to confinement measures. Though several participants reported improvements in their quality of life and reduced social pressure in the context of stay-at-home orders, participants from socio-economically deprived groups and minorities reported more challenges in accessing pain relief, health care services, and psychosocial support.ConclusionsThe COVID-19 pandemic has revealed and intensified pre-existing disparities and challenges among people living with chronic pain in terms of material resources, psychosocial condition, social support, and access to care. In post-pandemic times, it will be essential to address flaws in health and welfare policies to foster equity and social inclusiveness of people with chronic pain.

Highlights

Chronic pain affects about 20 % of the Canadian population and can lead to physical, psychological and social vulnerabilities
The COVID-19 pandemic has revealed and intensified pre-existing disparities and challenges among people living with chronic pain in terms of material resources, psychosocial condition, social support, and access to care
As in many other countries, unprepared health care systems have been under pressure due to the sudden influx of patients presenting with COVID-19 and dealing with complications arising from this disease [5, 6]

Summary

Introduction

Chronic pain affects about 20 % of the Canadian population and can lead to physical, psychological and social vulnerabilities This condition remains poorly recognized and undertreated. Groups with lower socio-economic status, immigrants, and racialized persons were especially exposed to the virus as a result of precarious housing conditions and/or work in essential services [10,11,12]. They faced additional economic burdens such as job loss or evictions [3, 10,11,12,13,14,15]. Many people that did not previously belong to socioeconomically disadvantaged groups fell into poverty as a result of the unintended economic consequences of the pandemic [3]

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Results

Discussion

Conclusion