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

Int J Equity Health. 2021 Jun 23;20(1):147. doi: 10.1186/s12939-021-01496-1.

Abstract

Background: Chronic 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.

Methods: This 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.

Results: Our 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.

Conclusions: 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. 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.

Keywords: COVID-19; Canada; Chronic pain; Illness experience; Qualitative research; Social inequities.

MeSH terms

  • Activities of Daily Living
  • Adult
  • COVID-19 / epidemiology
  • COVID-19 / psychology*
  • Canada
  • Chronic Pain / epidemiology
  • Chronic Pain / psychology*
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Qualitative Research
  • Quality of Life / psychology*
  • Social Support*
  • Stress, Psychological / psychology
  • Young Adult