Chad Stephens is the President and Managing Partner of Noble Pain Management & Sports Medicine in Texas, USA. As a musculoskeletal expert, his unique training with fellowships in sports medicine and interventional pain leads him to seek out the most innovative and cutting-edge treatments to help his patients. He works as a consultant for multiple sports and spine companies and enjoys teaching and mentoring other doctors.
OPN: How has the cancellation of elective surgeries impacted the pain management landscape?
CS: COVID-19 has had far-reaching effects in all aspects of the healthcare system. A significant number of elective surgeries have been delayed or even cancelled. Furthermore, it remains unclear how hospital systems are going to deal with the backlog of elective surgeries once they do start happening again.
With pain management, and knee pain in particular, we have seen many patients that were scheduled for surgery only to have their surgeries indefinitely delayed. Unfortunately, their pain is not delayed. In some instances, they are in even more pain. Often, those indicated for surgery are at the end of their treatment journey – minimally invasive procedures have lost their efficacy and surgery is their terminal treatment. It can be disheartening, and many patients are feeling like they don’t have many options.
With my practice, I aim to help restore function, which in turn will increase mobility and decrease pain. When the treatments within my practice aren’t able to help this, I will send patients to an orthopedic surgeon.
OPN: What complications does COVID-19 present to pain patients?
CS: In addition to the cancellation of elective surgeries, COVID-19 has impacted how patients feel about entering hospitals. Many patients are hesitant to go into a hospital for fears of exposure to the virus. Even though elective surgeries have resumed, we have a number of patients who aren’t comfortable undergoing invasive procedures. These patients will still need effective procedures to help manage their pain.
Additionally, we have seen a lot of concerns regarding loss of health insurance. Because of the economic toll of COVID-19, patients are fearful they will not have insurance by the time their surgery will take place. These patients are hoping for something in the near term that can manage their pain while they still have coverage.
COVID-19 has also had lifestyle impacts for the pain patient that might not be immediately evident. Because of sheltering-in-place, many patients are finding themselves much more sedentary. This can be detrimental to patients, and movement is key to helping manage pain.
OPN: What options have pain patients turned to in the interim?
CS: The typical treatments for knee pain remain, but COVID has impacted a lot of these as well. Over the counter analgesics can be helpful for people early in their disease progression, but often times doesn’t provide adequate pain relief. Physical therapy can be effective, but patients are still expressing hesitation of returning to healthcare settings. Healthcare practices can offer the standard injections (steroid and hyaluronic acid), but these effects wear off after a few months.
Additionally, we’ve seen many patients resort to self-medication (e.g. alcohol and illicit drugs), which can lead to substance abuse problems. It’s important these patients come back into a healthcare setting to manage their pain.
OPN: What